套细胞淋巴瘤 (MCL) 是一种 B 细胞非霍奇金淋巴瘤，其临床病程具有异质性。患者通常可以接受序贯治疗，但这些治疗通常会缩短疾病控制的时间，从而引发了关于最佳治疗顺序的问题。嵌合抗原受体 T 细胞疗法和双特异性抗体等新型药物在复发性 MCL 中显示出希望，但通常保留用于后续治疗线，这可能无法为在治疗过程中早期死亡的侵袭性疾病表型患者提供服务。为了评估淋巴瘤相关死亡限制序贯治疗的患者流失问题，我们对 10 年来在澳大利亚和英国中心接受治疗的 389 名患者进行了多中心回顾性队列分析。每次治疗后 MCL 死亡人数均有所增加，一线、二线和三线治疗后分别有 7%、23% 和 26% 的患者死于未受控制的 MCL。诊断时年龄较大且诱导治疗后早期复发的患者在二线治疗后面临特别的死亡风险。淋巴瘤相关死亡对序贯治疗的这种限制为早期治疗线中新疗法的试验提供了支持，特别是在高危患者群体中。© 2023 作者。英国血液学杂志由英国血液学会和约翰·威利出版

Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma characterised by a heterogeneous clinical course. Patients can often receive sequential treatments, yet these typically yield diminishing periods of disease control, raising questions about optimal therapy sequencing. Novel agents, such as chimeric antigen receptor T-cell therapies and bispecific antibodies, show promise in relapsed MCL, but are often reserved for later treatment lines, which may underserve patients with aggressive disease phenotypes who die early in the treatment journey. To assess the problem of patient attrition from lymphoma-related death limiting sequential treatment, we performed a multicentre retrospective cohort analysis of 389 patients treated at Australian and UK centres over a 10-year period. Deaths from MCL increased after each treatment line, with 7%, 23% and 26% of patients dying from uncontrolled MCL after first, second and third lines respectively. Patients with older age at diagnosis and early relapse after induction therapy were at particular risk of death after second-line treatment. This limitation of sequential treatment by lymphoma-related death provides support for the trial of novel therapies in earlier treatment lines, particularly in high-risk patient populations.© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.