Up to 60% of patients with aggressive B-cell lymphoma who receive chimeric antigen
receptor (CAR) T-cell therapy experience treatment failure and subsequently have a poor
prognosis. Allogeneic hematopoietic stem cell transplantation (alloHSCT) remains a
potentially curative approach for patients in this situation. Induction of a deep response
prior to alloHSCT is crucial for long-term outcomes, but the optimal bridging strategy
following relapse after CAR T-cell therapy has not yet been established. Polatuzumab
vedotin, an antibody drug conjugate targeting CD79b, is a novel treatment option for use in
combination with rituximab and bendamustine (Pola-BR) in relapsed or refractory disease.
Patients: We report two heavily pretreated patients with primary refractory diffuse large Bcell
lymphoma (DLBCL) and primary mediastinal B-cell lymphoma (PMBCL) respectively
who relapsed after therapy with CAR T-cells with both nodal and extranodal
manifestations of the disease. After application of three courses of Pola-BR both
patients achieved a complete metabolic remission. Both patients underwent alloHSCT
from a human leukocyte antigen (HLA)-mismatched donor following conditioning with
busulfan and fludarabine and are disease free 362 days and 195 days after alloHSCT
respectively. We conclude that Pola-BR can be an effective bridging therapy before
alloHSCT of patients relapsing after CAR T-cell therapy. Further studies will be necessary
to define the depth and durability of remission of this salvage regimen before alloHSCT.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84399 |
| Date | 30 March 2023 |
| Creators | Gerhardt, Kristin, Jentzsch, Madlen, Georgi, Thomas, Sretenovi´c, Aleksandra, Cross, Michael, Bach, Enrica, Monecke, Astrid, Leiblein, Sabine, Hoffmann, Sandra, Todorovi´c, Milena, Bila, Jelena, Sabri, Osama, Schwind, Sebastian, Franke, Georg-Nikolaus, Platzbecker, Uwe, Vucˇ ini´c, Vladan |
| Publisher | Frontiers Research Foundation |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2234-943X, 737645 |
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