Bruton Tyrosine Kinase Inhibitors for the Treatment of Relapsed Mantle Cell Lymphoma Involving CNS: Two Case Reports and Literature Review

Mantle cell lymphoma (MCL) accounts for 3–10 % of all non-Hodgkin lymphoma variants and is characterized by its aggressive course with frequent relapses and extranodal lesions. Due to more effective systemic chemotherapy and, as a consequence of this, increased life expectancy, relapse rate in MCL involving CNS, according to the literature, has increased to 4–20 %. Despite widespread introduction of targeted drugs into clinical practice, the prognosis in patients with CNS lesions remains extremely poor. This paper concentrates on the feasibility of Bruton tyrosine kinase (BTK) inhibitors for the treatment of relapsed MCL involving CNS. The most commonly recommended drug is ibrutinib, as it penetrates the blood-brain barrier and possesses high antitumor activity. Our own experience with ibrutinib in the treatment of MCL neurorelapses is illustrated in two case reports. In parallel, a comprehensive analysis focuses on the relevant literature data. Besides, this study used the data from 67 MCL patients treated at hematology hospitals of various medical institutions in Saint Petersburg and the Leningrad Region from 2006 to 2023. The reports on two clinical cases were made in compliance with the international CARE guidelines for case reports, 2017.