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Best Pract Res Clin Haematol. 2018 Sep;31(3):270-278. doi: 10.1016/j.beha.2018.07.005. Epub 2018 Jul 7.

Evolving treatment strategies in mantle cell lymphoma.

Author information

1
Division of Oncology, Washington University Medical School, 660 South Euclid Avenue, Campus Box 8056, St Louis, MO, 63110, USA. Electronic address: ncedwin@wustl.edu.
2
Division of Medical Oncology, Department of Medicine, Washington University in St Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8056, St Louis, MO, 63110, USA. Electronic address: bkahl@wustl.edu.

Abstract

Mantle cell lymphoma is an incurable, moderately aggressive B cell lymphoma. While a small proportion of patients with indolent disease can be managed expectantly, most patients require treatment. The therapeutic approach is driven by physician recommendation, patient choice, age, fitness and comorbidities. Young, fit patients often receive combination chemoimmunotherapy, including high dose cytarabine, with autologous stem cell transplant. Recent data has indicated benefit from maintenance rituximab following autologous stem cell transplant. Ongoing trials are investigating combinations of chemotherapy and targeted agents as well as the role of minimal residual disease guided therapy. Older, less fit patients often receive bendamustine and rituximab or anthracycline based regimens. Maintenance rituximab is typically administered in older MCL patients after anthracycline based chemotherapy although its use after bendamustine based therapy is not supported by current data. Current trials focus on refining this regimen with the addition of targeted agents. In the relapsed and refractory setting, novel agents have demonstrated activity although durability of responses remains unsatisfactory.

KEYWORDS:

Clinical trials; Mantle cell lymphoma; Novel therapeutics

PMID:
30213396
DOI:
10.1016/j.beha.2018.07.005

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