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Review
. 2022 Feb 3;139(5):666-677.
doi: 10.1182/blood.2021013326.

Therapeutic options for relapsed/refractory mantle cell lymphoma

Toby A Eyre  1 , Chan Y Cheah  2   3 , Michael L Wang  4
Affiliations
Review

Therapeutic options for relapsed/refractory mantle cell lymphoma

Toby A Eyre et al. Blood. .

Abstract

Mantle cell lymphoma (MCL) is an uncommon subtype of non-Hodgkin lymphoma in which immunochemotherapy, with or without high-dose therapy, and autologous stem cell transplantation remain standard frontline therapies. Despite their clear efficacy, patients inevitably relapse and require subsequent therapy. In this review, we discuss the key therapeutic approaches in the management of relapsed MCL, covering in depth the data supporting the use of covalent Bruton tyrosine kinase (BTK) inhibitors at first or subsequent relapse. We describe the outcomes of patients progressing through BTK inhibitors and discuss the mechanisms of covalent BTKi resistance and treatment options after covalent treatment with BTKi. Options in this setting may depend on treatment availability, patient's and physician's preference, and the patient's age and comorbidity status. We discuss the rapid recent development of anti-CD19 chimeric antigen receptor T-cell therapy, as well as the utility of allogenic stem cell transplantation and novel therapies, such as noncovalent, reversible BTK inhibitors; ROR1 antibody drug conjugates; and bispecific antibodies.

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Figures

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Graphical abstract
Figure 1
Figure 1
Treatment algorithm for patients with R/R MCL.
See this image and copyright information in PMC

References

    1. Geisler CH, Kolstad A, Laurell A, et al. Nordic Lymphoma Group Long-term progression-free survival of mantle cell lymphoma after intensive front-line immunochemotherapy with in vivo-purged stem cell rescue: a nonrandomized phase 2 multicenter study by the Nordic Lymphoma Group. Blood. 2008;112(7):2687–2693. - PMC - PubMed
    1. Le Gouill S, Thieblemont C, Oberic L, et al. LYSA Group Rituximab after autologous stem-cell transplantation in mantle-cell lymphoma. N Engl J Med. 2017;377(13):1250–1260. - PubMed
    1. Kluin-Nelemans HC, Hoster E, Hermine O, et al. Treatment of older patients with mantle-cell lymphoma. N Engl J Med. 2012;367(6):520–531. - PubMed
    1. Kluin-Nelemans HC, Hoster E, Hermine O, et al. Treatment of older patients with mantle cell lymphoma (MCL): long-term follow-up of the randomized European MCL Elderly Trial. J Clin Oncol. 2020;38(3):248–256. - PubMed
    1. Rummel MJ, Niederle N, Maschmeyer G, et al. Study group indolent Lymphomas (StiL) Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase 3 non-inferiority trial. Lancet. 2013;381(9873):1203–1210. - PubMed

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