"Immunologic Dream Team": BiTEs peri-allotransplant to redirect donor lymphocytes towards GVL

Bispecific T cell engagers (BiTEs) provide high rates of responses in patients with relapsed and refractory B cell lymphomas and multiple myeloma otherwise resistant to other therapies, but unfortunately the duration of response to these treatments is limited in time. Allogeneic stem cell transplantation is a potentially curative approach for those disorders, although its indication is limited to patients who achieve remission. While no established strategies to improve the "graft versus tumor effect" are available, relapses still account for the majority of the post-transplant failures. Herein, we report the first case in literature of a successful treatment with glofitamab, a CD20X2/CD3 BiTE, in a post-transplant relapse of mantle cell lymphoma with central nervous disease involvement. We propose the combination of BiTEs and allogeneic transplant as an integrated and sequential immunological approach to be tested in clinical trials.