Mantle cell lymphoma (MCL) is a rare lymphoma derived from mature B cells with the presence of translocation t(11;14) resulting in cyclin D1 overexpression, with a variety of clinical symptoms and a variable course. Despite better understanding regarding its pathogenesis, and the use of aggressive immunochemotherapy with autologous bone marrow transplantation, this disease is still considered incurable, with median overall survival of five years. Patients with refractory and relapsed disease have a poor prognosis and the traditional cytotoxic therapy is insufficiently effective in this group of patients. New therapies such as Bruton’s tyrosine kinase inhibitors (BTKi), B-cell lymphoma-2 (BCL-2) inhibitors, and immunomodulatory drugs have produced high response rates, but the duration of response is limited, and patients can have another relapse diagnosed.

Recently adopted immunotherapy with chimeric antigen receptor (CAR) T-cells directed against the CD19 receptor on lymphoma cells seems to be promising in the population of refractory and relapsed MCL patients. In July 2020, the United States Food and Drug Administration approved brexucaptagene autoleucel CAR-T product for patients with MCL after two lines of therapy and treatment with Bruton kinase inhibitors. In this review, we briefly discuss the treatment options in patients with refractory and relapsed MCL, focusing on BTKi treatment as the targeted therapy required before CAR-T treatment. We summarize our knowledge of CAR-T cell therapy for MCL in clinical trials and real-world clinical practice, and consider the place of CAR-T in future MCL therapy.