Relapsed and refractory (R/R)
mantle cell lymphoma (MCL) remains an incurable
lymphoma with a poor prognosis. Recently, there are a few studies demonstrating the efficacy of anti-CD19
chimeric antigen receptor T (CAR-T) cell therapy in MCL, including ZUMA-2 study in which CD28-based CAR-T cells were used. However, long-term efficacy and safety associated with 4-1BB-based CAR-T
therapy in MCL are not defined well. Here, we report three male patients with R/R classical MCL, who received CD19-directed 4-1BB CAR-T
therapy and achieved complete remission, showed mild symptoms of
cytokine-release syndrome (CRS) and had no neurological toxicity. During a follow-up of 24-35 months, all three patients remained
in complete remission. Persistent B-cell depletion was observed in two patients. Recovery of CD19+ polyclonal B cells was detected in one patient at 6 months after CAR-T cell infusion. Recovery of serum
immunoglobulin, including
IgG,
IgA and
IgM, was not observed in two patients at the last follow-up. Only one patient developed
herpes zoster, and the other two patients had no serious
infection. This is the first report about the efficacy, long-term remission and safety of CD19-directed 4-1BB CAR-T
therapy in R/R MCL.