How we treat mantle cell lymphoma with cellular therapy in 2025: the European and American perspectives.

Mehdi Hamadani, Nilanjan Ghosh, Peter Dreger, Timothy S Fenske, Olivier Hermine, Sascha Dietrich, Sairah Ahmed, Ali Bazarbachi

Journal: Bone marrow transplantation 2025;60(6):759-768

PMID: 40229536

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Abstract

Cellular therapies have been cornerstones of the treatment of mantle cell lymphoma (MCL) for decades and have helped to improve the outcome of this formerly very unfavourable B-cell lymphoma considerably. Current established roles of cellular therapies include autologous hematopoietic cell transplantation (HCT) as part of first-line therapy, chimeric antigen receptor-engineered T-cells (CART) for relapsed/refractory MCL, and allogeneic HCT for settings in which CARTs have failed or are unavailable. Therapeutic innovations have recently entered the MCL treatment landscape and are moving upstream in treatment algorithms, challenging the existing management principles. The purpose of this paper is to give some guidance regarding how to best use cellular therapies in this increasingly complex environment. Due to differences in CART labels, available non-cellular treatment options, and philosophy between the American and the European health systems, we found it reasonable to contrast the American and European perspectives on defined standard scenarios, which are often overlapping but show discrepancies in some important aspects.

Address: Department Medicine V, University of Heidelberg, Heidelberg, Germany. [email protected].; Department of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA.; Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.; University Hospital Düsseldorf, Department of Hematology, Oncology and Clinical Immunology, Düsseldorf, Germany.; Sarah Cannon Transplant and Cellular Therapy Program, Methodist Hospital, San Antonio, TX, USA.; Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA.; Department of Adult Hematology, Necker Hospital, Université de Paris-Cité, Assistance Publique des Hôpitaux de Paris, Imagine Institute, INSERM U1183, Paris, France.; Division of Hematology & Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.

DOI: 10.1038/s41409-025-02599-x

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MeSH Terms: Lymphoma, Mantle-Cell, Humans, United States, Europe, Hematopoietic Stem Cell Transplantation, Cell- and Tissue-Based Therapy