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Different Therapeutic Options Required for Subtypes in Mantle Cell Lymphoma

Ezzat Elhassadi, MD
Published Online:4:45 PM, Tue June 25, 2019

Ezzat Elhassadi, MD, a consultant hematologist at the University Hospital Waterford in Ireland, discusses the therapeutic approach for different subtypes of mantle cell lymphoma (MCL). MCL is a spectrum of diseases that should be treated differently, he says.

One subset of patients includes those with indolent disease; physicians should be aware of this subtype as patients with indolent disease typically do not require treatment. However, they can acquire a secondary genetic aberration where they will behave differently and require therapeutic intervention. Elhassadi says, there is also strong evidence that the blastoid variant in MCL will not behave like the classical variant of MCL, and a subset of patients who present with a very high Ki-67 level behave differently than those with low Ki-67, he adds.

In Elhassadi’s study, he demonstrated that the higher the Mantle Cell Lymphoma International Prognostic Index (MIPI) score, the worse of an outcome a patient will have. The main take home message from these data is that subgroups of patients with the blastoid variant, high Ki-67, and P53 disruption need to be treated differently rather than using the standard of care.
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