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Current Treatment Strategies in MCL

Published Online: Mar 14,2018
MANTLE CELL LYMPHOMA is a challenging disease that generally responds to initial treatment but inevitably relapses, making it incurable with standard chemotherapy.1,2 The clinical presentation of MCL varies widely. Some patients have an indolent disease course with longer survival, and others can have a very aggressive course with shorter survival, similar to acute leukemias.3

There is no curative therapy for MCL, with the rare exception of patients who achieve long-term disease-free survival following allogeneic stem cell transplantation (allo-SCT).4

Addressing the challenges in the treatment of patients with MCL, Wyndham Wilson, MD, commented, “Even if the initial treatment works, the disease comes back in virtually all patients. How long it will take to relapse and how long a second response may last depends largely on the patient’s response to the initial course of treatment and the biology of their disease, which can vary greatly from patient to patient.”5

Treatment Considerations in MCL

Several considerations should be addressed in treatment selection for MCL, including patient- and disease-related factors, expected therapy-related toxicities, and the overall goals of therapy.6 Effective management of MCL requires awareness of current therapeutic approaches for a wide range of patient populations, clinical trials supporting the use of therapy in the frontline or relapsed/refractory (R/R) settings, newer therapeutic options and strategies, and emerging therapies to improve patient outcomes in MCL.7 Although consensus guidelines for the treatment of patients with MCL are available,8,9 there is significant variation among regimens used in clinical practice, with no single accepted and approved standard of care in either the front-line or R/R settings.

Treatment Guidelines in MCL

NCCN guidelines on B-cell lymphomas provide separate treatment strategies for patients with MCL.8 The guidelines include recommendations for induction therapy (with aggressive or less-aggressive treatments), first-line consolidation, second-line therapy, and second-line consolidation (Table 1).8


The European Society for Medical Oncology Guidelines provide treatment recommendations for patients with newly diagnosed and R/R MCL (Table 2).9


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Current Treatment Strategies in MCL
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