Emin Kaya, Omer Faruk Bahcecioglu, Mehmet Ali Erkurt, Hilal Er Ulubaba, Irfan Kuku, Soykan Bicim, Ahmet Sarici, Ilhami Berber

Experience of ibrutinib in a patient with recurrent mantle cell lymphoma with orbital involvement

Mantle cell lymphoma is a subtype of B cell non-Hodgkin's lymphoma with different clinical and molecular features. Extranodal involvement is common in MCL. Bone marrow, liver, spleen, waldeyer ring and gastrointestinal involvement are most common. Lymphomatosis polyposis can be seen in some patients. Central nervous system involvement is rare. Here, we aimed to present a blastoid variant MCL patient who developed orbital recurrence after four lines of systemic therapy and responded to ibrutinib (560 mg/day) monotherapy. The mass disappeared completely in the bilateral orbital MRI taken after the 5th month of the ibrutinib treatment.

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1. Cheah CY, Seymour JF, Wang ML. Mantle cell lymphoma. J Clin Oncol. 2016 34:1256–69.
2. Argatoff LH, Connors JM, Klasa RJ, et al. Mantle cell lymphoma: A clinicopathologic study of 80 cases. Blood 1997;89:2067.
3. Dreyling, M., Geisler C., Hermine O., et al., Newly diagnosed and relapsed mantle cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014 25 Suppl 3:iii83-92.
4. Vose JM. Mantle cell lymphoma: 2017 update on diagnosis, riskstratification, and clinical management. Am J Hematol. 2017 92:806–13.
5. Jares P, Colomer D, Campo E. Genetic and molecular pathogenesis of mantle cell lymphoma: perspectives for new targeted therapeutics. Nat Rev Cancer. 2007 7:750–62.
6. Barista I, Romaguera JE, Cabanillas F. Mantle-cell lymphoma. Lancet Oncol. 2001 2:141–8.
7. Mozos A, Royo C, Hartmann E, et al. SOX11 expression is highly specific for mantle cell lymphoma and identifies the cyclin D1-negative subtype. Haematologica. 2009 94:1555-62.
8. Bertoni F, Zucca E, Cotter FE. Molecular basis of mantle cell lymphoma. Br J Haematol. 2004;124:30.
9. Panayiotidis P, Kotsi P. Genetics of small lymphocyte disorders. Semin Hematol. 1999;36:171.
10. Armitage, J. O., Weisenburger, D. D. New approach to classifying non- Hodgkin's lymphomas: Clinical features of the major histologic subtypes. Non-Hodgkin's Lymphoma Classification Project. J Clin Oncol. 1998 16, 2780-95.
11. Ferrer A, Salaverria I, Bosch F, et al. Leukemic involvement is a common feature in mantle cell lymphoma. Cancer. 2007;109:2473.
12. Bernard M, Gressin R, Lefrère F, et al. Blastic variant of mantle cell lymphoma: A rare but highly aggressive subtype. Leukemia. 2001 15:1785– 91.
13. Rašić DM, Knežević M Terzić T, et al. Bilateral ocular panadnexal mass as initial presentation of systemic blastoid variant of mantle-cell lymphoma. Surv Ophthalmol. 2017 62:83-8.
14. Looi, A., Gascoyne, R. D., Chhanabhai, M., et al. Mantle cell lymphoma in the ocular adnexal region. Ophthalmology, 2005 112,114-9.
15. Knudsen MKH, Rasmssen PK, Coupland SE, et al. Clinicopathological features of ocular adnexal mantle-cell lymphoma in an international multicenter cohort. JAMA Ophthalmol. 2017;135:1367–74.
16. Geisler CH, Kolstad A, Laurell A, et al. Long-term progression-free survival of mantle cell lymphoma after intensive front-line immunochemotherapy with in vivo-purged stem cell rescue: a nonrandomized phase 2 multicenter study by the Nordic Lymphoma Group. Blood. 2008;112:2687–93.
17. Hermine O, Hoster E, Walewski J, et al. Addition of high-dose cytarabine to immunochemotherapy before autologous stem-cell transplantation in patients aged 65 years or younger with mantle cell lymphoma (MCL Younger): a randomised, open-label, phase 3 trial of the European Mantle Cell Lymphoma Network. Lancet. 2016;388:565.
18. Dreyling, M., Campo, E., Hermine, O., et al. Newly diagnosed and relapsed mantle cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2017 1;28(suppl_4):iv62- iv71.
19. Rule S, Jurczak W, Jerkeman M, et al. Ibrutinib versus temsirolimus: 3-year follow-up of patients with previously treated mantle cell lymphoma from the phase 3, international, randomized, open-label RAY study. Leukemia 2018; 32:1799.
20. Bernard S, Goldwirt L, Amorim S, et al. Activity of ibrutinib in mantle cell lymphoma patients with central nervous system relapse. Blood 2015; 126:1695.
21. Nishiyama‐Fujita, Y., Nakazato, T., Ito, C., et al. Rare case of ocular adnexal relapse with mantle cell lymphoma treated with ibrutinib monotherapy. Internal medicine journal, 2019 49,1187-89.
22. Corradini P, Dodero A, Farina L, et al. Allogeneic stem cell transplantation following reduced-intensity conditioning can induce durable clinical and molecular remissions in relapsed lymphomas: pre-transplant disease status and histotype heavily influence outcome. Leukemia. 2007;21:2316.
23. Fenske TS, Zhang MJ, Carreras J, et al. Autologous or reducedintensity conditioning allogeneic hematopoietic cell transplantation for chemotherapy-sensitive mantle-cell lymphoma: analysis of transplantation timing and modality. J Clin Oncol. 2014;32:273.