Adaptive bridging radiation therapy for relapsed/refractory B-cell lymphoma patient undergoing CAR T-cell therapy: Case report

• Published in: Clinical and translational radiation oncology 2024-09, Vol.48, p.100832, Article 100832
• Main Authors: Ababneh, Hazim S., Connor Johnson, P., Pursley, Jennifer, Patel, Chirayu G.
• Format: Article
• Language: English
• Subjects: ABRT; aggressive B-cell lymphoma; CAR T-cell therapy
• ISSN: 2405-6308; 2405-6308
• DOI: 10.1016/j.ctro.2024.100832

•Radiation therapy (RT) is used as a bridging strategy before CD19-targeted CAR T-cell therapy in aggressive B-cell lymphoma.•Consensus on the optimal bridging RT dose and fractionation is still lacking.•We present a case of a patient with aggressive B-cell lymphoma receiving bridging adaptive RT on a CT-linac before CAR T-cell therapy.•At month 6 post-CAR T infusion, the patient shows no disease recurrence or unexpected toxicities from the combined treatment. Radiation therapy (RT) is utilized as a bridging strategy for patients with aggressive B-cell lymphoma prior to CD19-targeted chimeric antigen receptor (CAR T)-cell therapy. RT has been shown to provide local control without exacerbating the toxicities associated with subsequent CAR T-cell infusion. However, a consensus on the optimal radiation dose and fractionation for bridging purposes has yet to be established. We present a case of a patient with relapsed aggressive B-cell lymphoma who underwent bridging adaptive RT on a CT-linac prior to receiving CAR T-cell therapy. At month 6 post-CAR T infusion, the patient demonstrates no signs of disease recurrence or relapse, nor any unexpected toxicities attributable to the combined treatment. This underscores the feasibility and success of this innovative approach in treating lymphoma patients undergoing CAR T-cell therapy.