Lisocabtagene Maraleucel for Richter's Transformation—A Case Series

EJHaem Pub Date : 2025-03-10 DOI:10.1002/jha2.70011
Courtney J. Smith, Anmol Goyal, Brian R. Smith, Dasom Lee, Alexandria Jensen, Jonathan Alexander, Melody Smith, Matthew Frank, Saurabh Dahiya, David Miklos, Sushma Bharadwaj
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Abstract

Introduction

Richter's transformation (RT) from chronic lymphocytic leukemia (CLL) to lymphoma carries poor prognosis. This case series examines the efficacy of lisocabtagene maraleucel (liso-cel) in six RT patients, highlighting the impact of concurrent ibrutinib therapy.

Methods

Six patients were with RT who received liso-cel from were included in this single institution case series. Clinical data related to efficacy, safety, CAR-T expansion kinetics, and measurable residual disease were collected.

Results

The best overall response was 83.3%. The four patients who received ibrutinib concurrent with liso-cel therapy continue to show MRD-negative complete response till date. None experienced severe (grade 3+) cytokine release syndrome while 1 had severe (grade 3+) immune-effector cell-associated neurotoxicity syndrome (ICANS). All patients were noted to have in vivo CAR expansion.

Conclusion

This series of real cases suggests liso-cel with concurrent ibrutinib may be a promising treatment for RT, warranting further exploration.

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