Primary mediastinal large B-cell lymphoma (PMBCL) is a fairly rare variant of large B-cell lymphomas (LBCL) and accounts for about 10% of them. Despite the relatively satisfactory results of induction immunochemotherapy for PMBCL, in 10—30% of cases refractoriness or relapse of the disease occurs. Reliable prognostic models for identifying patients at risk of failure of initial treatment in PMBCL have not yet been fully developed. Salvage therapy for refractory/relapsed (r/r) PMBCL is similar to that used for r/r diffuse large B-cell lymphoma and, provided the tumor is chemosensitive, involves high-dose consolidation with autologous hematopoietic stem cell transplantation. However, relapses of PMBCL often turn out to be chemo-refractory and the effective reserves of traditional salvage therapy are exhausted. With the understanding of the molecular genetic features of PMBCL, new therapeutic targets are being actively studied. In recent years, more and more evidence has accumulated, reliably demonstrating the high and long-term effectiveness of new therapeutic options, such as immune checkpoint inhibitors and CAR-T cell therapies, which are already beginning to be integrated into earlier stages of treatment. However, the rarity of PMBCL limits the possibility of conducting randomized prospective trials to study new treatment strategies, the results of which can guide therapy in the case of r/r disease. Therefore, r/r PMBCL still represents an unresolved clinical problem.
Вернюк et al. (Tue,) studied this question.