Tbakhi Bushra, Reagan Patrick M
Department of Hematology/Oncology, Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA.
Department of Hematology/Oncology, Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA.
Ther Adv Hematol. 2022 Feb 26;13:20406207221080738. doi: 10.1177/20406207221080738. eCollection 2022.
Mantle cell lymphoma (MCL) is a rare B-cell malignancy that remains challenging to treat with high rates of relapse. Frontline strategies range from intensive chemotherapy followed by consolidation with autologous stem cell transplant (ASCT), to less-intensive therapies including combination regimens. The treatment landscape for relapsed patients includes Bruton tyrosine kinase (BTK) inhibitors among other targeted treatments. Novel agents such as the selective BCL2 inhibitor venetoclax showed high response rates when used as monotherapy for refractory relapsed MCL. The rituximab, bendamustine, and cytarabine (R-BAC) regimen, while response rates were high, were not durable. Chimeric antigen receptor (CAR) T-cell products targeting CD19 have been efficacious in relapsed and refractory MCL patients. Brexucabtagene autoleucel (brexu-cel, formerly KTE-X19) was approved by US Food and Drug Administration (FDA) in July, 2020, for treatment of refractory and relapsed MCL. This article provides an overview for the available management strategies for relapsed MCL and examines the role of CAR T-cell in the current and future treatment of MCL.
套细胞淋巴瘤（MCL）是一种罕见的B细胞恶性肿瘤，治疗仍然具有挑战性，复发率很高。一线治疗策略包括强化化疗后进行自体干细胞移植（ASCT）巩固治疗，以及强度较低的疗法，包括联合方案。复发患者的治疗手段包括布鲁顿酪氨酸激酶（BTK）抑制剂等其他靶向治疗。新型药物如选择性BCL2抑制剂维奈克拉在用于难治性复发MCL的单药治疗时显示出高缓解率。利妥昔单抗、苯达莫司汀和阿糖胞苷（R-BAC）方案虽然缓解率高，但疗效不持久。靶向CD19的嵌合抗原受体（CAR）T细胞产品已在复发和难治性MCL患者中显示出疗效。布雷西尤单抗（brexu-cel，原名KTE-X19）于2020年7月获得美国食品药品监督管理局（FDA）批准，用于治疗难治性和复发性MCL。本文概述了复发MCL的可用管理策略，并探讨了CAR T细胞在MCL当前和未来治疗中的作用。
