Peter Martin, MD

Peter Martin, MD, assistant professor of medicine, Division of Hematology/Oncology, Weil Cornell Medicine, discusses the differences between subgroups of mantle cell lymphoma (MCL). MCL is a heterogenous disease, and in the World Health Organization classification of lymphoid neoplasms, MCL has a leukemia non-nodal presentation, says Martin.

MCL cells that evolve from a cell that passes through the germinal center tend to be

-mutant, and behave more indolently, Martin says. These patients may also go on to develop a

mutation and blastoid transformation. The MCL cells that have not passed through the germinal center, on the other hand, represent more classic MCL subtypes. These patients tend to be

unmutated, and these patients have a worse prognosis, Martin says, compared with the non-nodal patients. However, about 20% of these patients can be observed for a significant period of time.

Other groups of patients with MCL that tend to do worse include the blastoid morphology that comes with a more proliferative state and those with

mutations or high p53 protein expression. Martin says that oftentimes, Ki-67, blastoid morphology, and p53 go hand-in-hand, but this is not universally true. These patients should be treated differently; patients with p53 mutations who are not blastoid, for example, can be managed with chemotherapy-free approaches. Patients with blastoid morphology and p53 mutations, however, should be offered allogenic stem cell transplant early on or be considered for a clinical trial with CAR T cells, Martin concludes.

Videos

Peter Martin, MD, discusses the differences between subgroups of mantle cell lymphoma. MCL is a heterogenous disease, and in the World Health Organization classification of lymphoid neoplasms, MCL has a leukemia non-nodal presentation, says Martin.

Exploring Approaches to Treating Different Subgroups of Mantle Cell Lymphoma

Peter Martin, MD, assistant professor of medicine in the Division of Hematology/Oncology at Weill Cornell Medical College, Weill Cornell Medicine/NewYork-Presbyterian Hospital, discusses a phase I, open-label, multicenter trial of oral azacitidine (CC-486) plus R-CHOP in patients with high-risk, previously untreated diffuse large B-cell lymphoma, grade 3B follicular lymphoma, or transformed lymphoma.

Overall, 33 patients with DLBCL were enrolled in the dose-escalation phase of the trial. They were treated with 100 mg, 150 mg, 200 mg, or 300 mg of oral azacitidine, with the majority of the patients treated with 200 mg and 300 mg. The patients received 7 days of oral azacitidine prior to the first cycle of R-CHOP and 14 days of oral azacitidine prior to cycles 2 through 6. All patients received granulocyte-colony stimulating factor (G-CSF) on day 2 of each cycle of R-CHOP.

Peter Martin, MD,&nbsp;assistant professor of medicine in the Division of Hematology/Oncology at Weill Cornell Medical College, Weill Cornell Medicine/NewYork-Presbyterian Hospital, discusses a phase I, open-label, multicenter trial of oral azacitidine (CC-486) plus R-CHOP in patients with high-risk, previously untreated diffuse large B-cell lymphoma, grade 3B follicular lymphoma, or transformed lymphoma.

Azacitidine Plus R-CHOP in High-Risk DLBCL

Peter Martin, MD, assistant professor of Medicine, Division of Hematology/Oncology, Weill Cornell Medical College, discusses the evolving paradigm of treatment for mantle cell lymphoma. Martin says the evolution of the paradigm currently includes Bruton's tyrosine kinase inhibitor, phosphoinositide 3-kinase inhibitor, immunomodulatory treatments, and immunotherapies.

Peter Martin, MD, discusses the evolving paradigm of treatment for mantle cell lymphoma. Martin says the evolution of the paradigm currently includes Bruton's tyrosine kinase inhibitor, phosphoinositide 3-kinase inhibitor, immunomodulatory treatments, and immunotherapies.

Peter Martin, MD | Authors

Articles

Exploring Approaches to Treating Different Subgroups of Mantle Cell Lymphoma

Azacitidine Plus R-CHOP in High-Risk DLBCL

Dr. Peter Martin on Alternatives to Aggressive Therapy in Mantle Cell Lymphoma