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Lookup NU author(s): Dr Tom Creasey
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.Bridging therapy (BT) prior to brexucabtagene autoleucel (brexu-cel) in mantle cell lymphoma (MCL) is supported by limited evidence. Here, we report BT modality and outcome in 176 patients at 15 centres in the United Kingdom. BT was delivered to 90% (158/176), the majority receiving standard chemotherapy +/− radiotherapy (53%) (SD chemo +/− RT) or targeted therapy (TT) alone (23%). Clinicians favoured SD chemo +/− RT in those with Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 1, blastoid disease, bulk >5 cm and elevated lactate dehydrogenase. Overall response rate (ORR) was 46%. Higher ORR was observed with SD chemo +/− RT (58%), particularly R-BAC (64%). Progressive disease despite BT was associated with a lower ORR to brexu-cel (77% vs. 91%, p = 0.03) and a higher risk of ≥grade 3 ICANS (OR 3.43, 95% CI 1.44–8.10, p = 0.01). SD chemo +/− RT was associated with a higher incidence of ≥grade 3 neutropenia (Month 1), ≥grade 3 thrombocytopenia (Month 1, Month 3) and early non-relapse mortality (<90 days, 13% vs. 0%) compared to TT alone. Neither BT modality nor response impacted progression-free or overall survival post-infusion. Review of haematopoietic reserve prior to the selection of BT regimen, rigorous management of delayed cytopenia post-infusion and more effective and tolerable BT should be prioritised.
Author(s): O'Reilly MA, Wilson W, Maybury B, Kuhnl A, Roddie C, Uttenthal B, Johnson R, Alajangi R, Creasey T, Abdulgawad A, Arias CG, Iyengar S, Ferguson G, Panopoulou K, Delaney A, Pryce A, Rubio L, Jones C, Lambert J, Gupta S, Mathew A, Kasivisvanathan S, Awofisayo O, Hanmantgad S, Collins GP, Besley C, Seymour F, Sanderson R, Chaganti S
Publication type: Article
Publication status: Published
Journal: British Journal of Haematology
Year: 2026
Pages: epub ahead of print
Online publication date: 08/03/2026
Acceptance date: 08/01/2026
Date deposited: 23/03/2026
ISSN (print): 0007-1048
ISSN (electronic): 1365-2141
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/bjh.70357
DOI: 10.1111/bjh.70357
Data Access Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions
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