Abstract
The treatment landscape for mantle cell lymphoma (MCL) is rapidly evolving toward the incorporation of novel and biologically targeted pharmaceuticals with improved disease activity and gentler toxicity profiles compared with conventional chemotherapeutics. Upfront intensive treatment of MCL includes autologous stem cell transplantation (SCT) consolidation aimed at deepening and lengthening disease remission, but subsequent relapse occurs. Maintenance therapy after autologous SCT in patients with MCL in remission features lower-intensity treatments given over extended periods to improve disease outcomes. Targeted drugs are a natural fit for this space, and are the focus of considerable clinical investigation. This review summarizes recent advances in the field and their potential impact on treatment practices for MCL.
Highlights
Mantle cell lymphoma (MCL) is an uncommon and heterogeneous subtype of B-cell non-Hodgkin lymphoma (B-NHL)
This review examines the role of targeted therapies to improve outcomes after autologous stem cell transplantation (SCT) for MCL
In a cohort of 157 patients with MCL treated with high-dose chemo- and/or radiation-therapy (HDT) and autologous SCT consolidation at the Fred Hutchinson Cancer Research Center in Seattle, 50 were given post-transplant maintenance rituximab (MR), and follow-up data was available for a median of 5 years [30]
Summary
Mantle cell lymphoma (MCL) is an uncommon and heterogeneous subtype of B-cell non-Hodgkin lymphoma (B-NHL). Fit patients that achieve remission with chemoimmunotherapy, consolidation therapy is recommended This consists of myeloablative high-dose chemo- and/or radiation-therapy (HDT) requiring rescue of the bone marrow stem cell compartment with autologous stem cell transplantation (SCT). Maintenance therapy is well-established in other oncological settings, including patients with MCL who receive upfront rituximabCHOP (R-CHOP) without autologous SCT consolidation [5]. A growing number of novel biologically-targeted therapies are profoundly altering the landscape of MCL treatment options in both first-line and relapsed settings [6,7]. These agents act through a variety of mechanisms, and possess unique and often limited toxicity profiles; as such, they make attractive candidates for post-autologous SCT maintenance therapy. This review examines the role of targeted therapies to improve outcomes after autologous SCT for MCL
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