Abstract
Mantle cell lymphoma (MCL) patients can be treated with intensive induction therapy, followed by high dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) for consolidation and subsequent anti-CD20 maintenance. For patients relapsing after bruton tyrosine kinase (BTK) inhibitors, CAR T-cell therapy became available in late 2020 fueling the interest in outcomes of relapsing MCL patients. We retrospectively analyzed the outcome of MCL patients receiving HDCT/ASCT at our center between 2000 and 2021, thus, before availability of CAR-T cells. We identified 97 MCL patients undergoing HDCT/ASCT in this period with a median follow-up of 52months. 43 (44%) patients ultimately relapsed, and 29 (30%) have died. The median progression-free survival (PFS) for the entire cohort was 48months and overall survival (OS) was 202months. Relapsing patients had a median PFS of only 28months and median OS of 105months. The OS of relapsing patients receiving BTK inhibitors was 148 versus 78months in patients who never received BTK inhibitors (p=0.1175). Even after HDCT/ASCT, a substantial proportion of MCL patients will relapse and ultimately die of the disease, emphasizing the need for new therapeutic options including CAR T-cell treatment for this lymphoma subtype.
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