Vol 15 (2024): Continuous Publishing
Case report
Published online: 2024-10-03
CAR-T cell therapy in evolving therapeutic landscape of relapsed or refractory primary mediastinal B-cell lymphoma (PMBCL): challenges and aspirations — two case reports
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DOI: 10.5603/hicp.98832
Hematol Clin Pract 2024;15(1).
Abstract
Chimeric antigen receptor T-cell (CAR-T) therapy is a promising option in patients with r/r PMBCL as a radical approach or a part of combined modality treatment. However, failure after CAR-T poses challenges to clinicians. The report presents two cases of patients with r/r PMBCL who received CAR-T therapy following several lines of chemotherapy. The first patient remains in complete metabolic remission 20 months after CAR-T infusion. The second case depicts the use of CAR-T in a combined treatment with bridging therapy to allogeneic haematopoietic stem cell transplantation (allo-HSCT). Combining radiotherapy with pembrolizumab remains a promising salvage therapy in patients who progressed or relapsed after CAR-T. Allo-HSCT is considered a viable consolidation strategy for young and fit patients with r/r disease who respond to bridging therapy. The ideal combination of CAR-T with novel agents and allo-HSCT is still developing and needs to be explored in prospective randomized trials.
Keywords: R/R PMBCLCAR-Taxi-celallo-HSCTsalvage therapy in R/R PMBCL
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