[Successful CAR-T cell therapy in a refractory mcl patient with rapidly progressive disease: a case report.]

Abstract

Mantle cell lymphoma is a rare and aggressive hematologic malignancy characterized by frequent relapses and poor prognosis. Recently, the approval of CAR-T cell therapy has transformed the treatment landscape for relapsed/refractory patients. We report the case of a 52-year-old patient with mantle cell lymphoma who experienced multiple disease relapses. Specifically, the patient showed a rapid and severe progression after treatment with BTK inhibitors in the second line of therapy and was subsequently evaluated for a CAR-T cell therapy program. This case highlights the importance of a multidisciplinary approach, with efficient collaboration optimizing timelines for treatment eligibility, leukapheresis planning, bridge therapy, and CAR-T cell infusion (brexu-cel). The CAR-T treatment was well tolerated, although it was associated with a rare cardiovascular complication, sinus bradycardia, and subsequently, a deep vein thrombosis. Thanks to close collaboration with cardiology specialists, these complications were resolved without sequelae. Post CAR-T cell therapy, the patient achieved complete remission, sustained at 15 months of follow-up.