Early Isolated Central Nervous System Relapse of Mantle Cell Lymphoma Successfully Treated with Ibrutinib and Chimeric Antigen Receptor T-Cell Therapy – A Case Report

Abstract

Mantle cell lymphoma (MCL) is a relatively rare and clinically distinct subtype of non-Hodgkin lymphoma. Involvement of the central nervous system is an uncommon manifestation at both diagnosis and recurrence. Central nervous system (CNS) relapse more frequently occurs in the context of aggressive disease behavior and portends a poor prognosis. However, advances in therapeutic strategies for MCL have opened the possibility of achieving durable remission, even in this high-risk presentation. We report a case of a patient who developed an early, isolated CNS relapse following autologous stem cell transplantation. The patient was successfully treated with a sequential treatment protocol combining chemoimmunotherapy, ibrutinib and chimeric antigen receptor T-cell therapy.