Kelas : 3EB24
NPM: 29214956
Review Article 6
Mantle cell lymphoma – Current standards of care and future directions
Highlights
• High-dose cytarabine is a standard of care for
induction in patients eligible for intensive therapy.
• Bendamustine-rituximab is a standard of care for
patients not eligible for intensive therapy.
• Ibrutinib is a standard of care for previously
treated mantle cell lymphoma.
• Future trials should build upon existing standards
of care. Phase III trials are required to evaluate potential new standards of
care.
Abstract
Over the past decade we have seen significant changes
in the biological characterization and strategies for treatment of mantle cell
lymphoma (MCL). MCL is heterogeneous a disease, and so are the people that have
it; although guidelines are appropriate, therapeutic approaches must be
individualized based on a variety of factors. In this review, we summarize data
on the range of therapeutic options, from observation in patients with slowly
progressive low-tumor-burden MCL, to bendamustine-based regimens in typical
MCL, to high-dose cytarabine-based regimens in young, fit patients. The management
of previously treated MCL is evolving with the availability of new agents and
more changes are expected. Several recent and ongoing clinical trials have the
potential to provide new options for patients and are discussed as future
directions. Additionally, prognostic tools, measurement of minimal residual
disease, and assessment of toxicity are already common research tools and may
soon impact therapeutic strategies as a standard of care. Indeed, there has
never been a time that management of MCL was as complicated while the promise
for real improvements in outcomes is so great.
Keywords
- Mantle cell lymphoma;
- Treatment;
- Chemotherapy;
- Transplant;
- Maintenance;
- Prognosis
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