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Lee D, Goyal A, Wang WL, Ananth S, Lau E, Binkley MS, Bharadwaj S, Dahiya S. Lisocabtagene maraleucel for treatment of relapsed and refractory primary mediastinal large B-cell lymphoma in an adolescent patient. EJHAEM 2024; 5:153-156. [PMID: 38406546 PMCID: PMC10887261 DOI: 10.1002/jha2.859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/18/2024] [Accepted: 01/24/2024] [Indexed: 02/27/2024]
Abstract
The safety and efficacy of CAR T-cell therapy are unknown in pediatric and adolescent patients with relapsed or refractory primary mediastinal large B-cell lymphoma (R/R PMBCL) which is associated with dismal prognosis. Here, we present a case report of a 16-year-old patient with R/R PMBCL treated with lisocabtagene maraleucel including correlative studies. Patient achieved complete response at 6 months without cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. She only experienced mild cytopenias, requiring filgrastim once. This report highlights the safety and efficacy of lisocabtagene maraleucel in this population, warranting prospective studies to improve clinical outcomes.
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Affiliation(s)
- Dasom Lee
- Division of HematologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Anmol Goyal
- Division of Blood and Marrow Transplantation and Cellular TherapyStanford University School of MedicineStanfordCaliforniaUSA
| | - William L Wang
- Division of HematologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Snegha Ananth
- Division of Blood and Marrow Transplantation and Cellular TherapyStanford University School of MedicineStanfordCaliforniaUSA
| | - Eric Lau
- Department of Hematology and OncologyPalo Alto Foundation Medical GroupPalo AltoCaliforniaUSA
| | - Michael S Binkley
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Sushma Bharadwaj
- Division of Blood and Marrow Transplantation and Cellular TherapyStanford University School of MedicineStanfordCaliforniaUSA
| | - Saurabh Dahiya
- Division of Blood and Marrow Transplantation and Cellular TherapyStanford University School of MedicineStanfordCaliforniaUSA
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Barth M, Xavier AC, Armenian S, Audino AN, Blazin L, Bloom D, Chung J, Davies K, Ding H, Ford JB, Galardy PJ, Hanna R, Hayashi R, Lee-Miller C, Machnitz AJ, Maloney KW, Marks L, Martin PL, McCall D, Pacheco M, Reilly AF, Roshal M, Song S, Weinstein J, Zarnegar-Lumley S, McMillian N, Schonfeld R, Sundar H. Pediatric Aggressive Mature B-Cell Lymphomas, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022; 20:1267-1275. [PMID: 36351334 DOI: 10.6004/jnccn.2022.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Pediatric Aggressive Mature B-Cell Lymphomas include recommendations for the diagnosis and management of pediatric patients with primary mediastinal large B-cell lymphoma (PMBL) and sporadic variants of Burkitt lymphoma and diffuse large B-cell lymphoma. PMBL is now considered as a distinct entity arising from mature thymic B-cells accounting for 2% of mature B-cell lymphomas in children and adolescents. This discussion section includes the recommendations outlined in the NCCN Guidelines for the diagnosis and management of pediatric patients with PMBL.
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Affiliation(s)
| | - Ana C Xavier
- 2Children's of Alabama/O'Neal Comprehensive Cancer Center at UAB
| | | | - Anthony N Audino
- 4The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Lindsay Blazin
- 5Indiana University Melvin and Bren Simon Comprehensive Cancer Center
| | | | | | - Kimberly Davies
- 8Dana-Farber/Boston Children's Cancer and Blood Disorders Center
| | - Hilda Ding
- 9UCSD Rady Children's Hospital/UC San Diego Moores Cancer Center
| | | | | | - Rabi Hanna
- 12Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Robert Hayashi
- 13Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Kelly W Maloney
- 16Children's Hospital of Colorado/University of Colorado Cancer Center
| | | | | | - David McCall
- 19The University of Texas MD Anderson Cancer Center
| | | | - Anne F Reilly
- 21Abramson Cancer Center at the University of Pennsylvania
| | | | | | - Joanna Weinstein
- 24Robert H. Lurie Comprehensive Cancer Center of Northwestern University
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Management of Aggressive Non-Hodgkin Lymphomas in the Pediatric, Adolescent, and Young Adult Population: An Adult vs. Pediatric Perspective. Cancers (Basel) 2022; 14:cancers14122912. [PMID: 35740580 PMCID: PMC9221186 DOI: 10.3390/cancers14122912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary This review details the diagnosis and treatment of primary non-Hodgkin lymphoma (NHL) in the pediatric and adolescent population. We also describe treatment modalities such as hematopoietic stem cell transplantation for relapsed or refractory NHL in patients that fail or do not respond to the initial therapy. We then detail the current advancements in treatment for patients that fail initial therapy such as CAR T-cell therapy, the use of immunotherapy that target surface makers on malignant cells and highlight areas where further research is needed. The purpose of our review is to inform the pediatric oncology community in regard to the various types of NHLs and emphasize areas where the science is evolving in the treatment of primary, relapsed or refractory disease. Abstract Non-Hodgkin lymphoma (NHL) is a broad entity which comprises a number of different types of lymphomatous malignancies. In the pediatric and adolescent population, the type and prognosis of NHL varies by age and gender. In comparison to adults, pediatric and adolescent patients generally have better outcomes following treatment for primary NHL. However, relapsed/refractory (R/R) disease is associated with poorer outcomes in many types of NHL such as diffuse large B cell lymphoma and Burkitt lymphoma. Newer therapies have been approved in the use of primary NHL in the pediatric and adolescent population such as Rituximab and other therapies such as chimeric antigen receptor T-cell (CAR T-cell) therapy are under investigation for the treatment of R/R NHL. In this review, we feature the characteristics, diagnosis, and treatments of the most common NHLs in the pediatric and adolescent population and also highlight the differences that exist between pediatric and adult disease. We then detail the areas of treatment advances such as immunotherapy with CAR T-cells, brentuximab vedotin, and blinatumomab as well as cell cycle inhibitors and describe areas where further research is needed. The aim of this review is to juxtapose established research regarding pediatric and adolescent NHL with recent advancements as well as highlight treatment gaps where more investigation is needed.
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Smith J, Kumar A, Stanton NA, Katsanis E. Concurrent application of blinatumomab and haploidentical donor leukocyte infusions for refractory primary mediastinal large B-cell lymphoma. Ther Adv Hematol 2021; 12:2040620721994348. [PMID: 33747421 PMCID: PMC7905714 DOI: 10.1177/2040620721994348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/14/2021] [Indexed: 11/15/2022] Open
Abstract
Primary mediastinal large B-cell lymphoma (PMBCL) is a rare hematologic malignancy with distinct clinical and immunopathological features. We report a case of a young male with disease refractory to multiple lines of therapy, including chimeric antigen receptor-T cells, who achieved his first complete remission after haploidentical bone marrow transplantation (haplo-BMT), following donor leukocyte infusions (DLIs) given concurrently with blinatumomab. While DLI has been used after T-replete haplo-BMT with post-transplant cyclophosphamide, there are no reports on its use for PMBCL. Similarly, blinatumomab is active against B-cell lymphomas, but literature is lacking in patients with PMBCL. Our experience illustrates that blinatumomab can be used concurrently with DLI in a haploidentical setting to achieve disease response in PMBCL. Despite our encouraging experience with this case, we would not recommend this approach outside of a clinical trial as blinatumomab may exacerbate the graft versus host disease risks of DLI, especially in a haploidentical setting. Evaluating this treatment combination in high-risk patients in the setting of a clinical trial may be meaningful.
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Affiliation(s)
- Jasmine Smith
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
- Banner University Medical Center, Tucson, AZ, USA
| | - Abhijeet Kumar
- Department of Medicine, University of Arizona, Tucson, AZ, USA
- The University of Arizona Cancer Center, Tucson, AZ, USA
- Banner University Medical Center, Tucson, AZ, USA
| | | | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona, 1501 N. Campbell Ave., PO Box 245073, Tucson, AZ 85724-5073, USA
- Department of Immunobiology, University of Arizona, Tucson, AZ, USA
- Department of Medicine, University of Arizona, Tucson, AZ, USA
- Department of Pathology, University of Arizona, Tucson, AZ, USA
- The University of Arizona Cancer Center, Tucson, AZ, USA
- Banner University Medical Center, Tucson, AZ, USA
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