Early-stage mantle cell lymphoma: a retrospective analysis from the International Lymphoma Radiation Oncology Group (ILROG)

Dabaja, Bouthaina S.; Zelenetz, Andrew D.; Ng, Andrea K.; Tsang, Richard W.; Qi, Shunan; Allen, Pamela K.; Hodgson, David C.; Ricardi, Umberto; Hoppe, Richard T.; Advani, Ranjana H.; Mauch, Peter; Constine, Louis S.; Specht, Lena; Li, Y.; Terezakis, Stephanie A.; Wirth, Andrew; Reinartz, Gabriele; Eich, Hans Theodor; Aleman, Berthe M.P.; Barr, Paul M.; Yahalom, Joachim

doi:10.1093/annonc/mdx334

Cited by 27 publications

(27 citation statements)

References 15 publications

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“…Stage I/II limited, non-bulky disease MCL is usually diagnosed at an advanced stage, and stage I/ II MCL is rare [31,32] and some of these patients (up to 50%) have gastrointestinal involvement [32], which may be detected on gastroscopy and colonoscopy [31]. For patients with stage I/II limited, non-bulky disease, ESMO guidelines recommend a short course of conventional chemotherapy induction followed by consolidated radiotherapy [11].…”

Section: First-line Treatment Indolent MCLmentioning

confidence: 99%

Treatment of mantle cell lymphoma in Asia: a consensus paper from the Asian Lymphoma Study Group

et al. 2020

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Background: Mantle cell lymphoma (MCL) is a B cell malignancy that can be aggressive and with a poor prognosis; the clinical course is heterogeneous. The epidemiology of MCL in Asia is not well documented but appears to comprise 2-6% of all lymphoma cases based on available data, with variation observed between countries. Although international guidelines are available for the treatment of MCL, there is a lack of published data or guidance on the clinical characteristics and management of MCL in patient populations from Asia. This paper aims to review the available treatment and, where clinical gaps exist, provide expert consensus from the Asian Lymphoma Study Group (ALSG) on appropriate MCL management in Asia. Body: Management strategies for MCL are patient-and disease stage-specific and aim to achieve balance between efficacy outcomes and toxicity. For asymptomatic patients with clearly indolent disease, observation may be an appropriate strategy. For stage I/II disease, following international guidelines is appropriate, which include either a short course of conventional chemotherapy followed by consolidated radiotherapy, less aggressive chemotherapy regimens, or a combination of these approaches. For advanced disease, the approach is based on the age and fitness of the patient. For young, fit patients, the current practice for induction therapy differs across Asia, with cytarabine having an important role in this setting. Hematopoietic stem cell transplantation (HSCT) may be justified in selected patients because of the high relapse risk. In elderly patients, specific chemoimmunotherapy regimens available in each country/region are a treatment option. For maintenance therapy after first-line treatment, the choice of approach should be individualized, with cost being an important consideration within Asia. For relapsed/ refractory disease, ibrutinib should be considered as well as other follow-on compounds, if available. Conclusion: Asian patient-specific data for the treatment of MCL are lacking, and the availability of treatment options differs between country/region within Asia. Therefore, there is no clear one-size-fits-all approach and further investigation on the most appropriate sequence of treatment that should be considered for this heterogeneous disease.

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Section: First-line Treatment Indolent MCLmentioning

confidence: 99%

Treatment of mantle cell lymphoma in Asia: a consensus paper from the Asian Lymphoma Study Group

et al. 2020

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“…MCL presenting with truly limited stage disease is rare (<5% of all patients) and has more favourable outcomes . The largest study included 179 patients (75% head and neck) who received either chemotherapy, chemo‐radiation or radiation alone . The 10‐year overall survival (OS) rates were similar at 69, 62 and 74% respectively and 10‐year freedom from progression rates were also similar at 46, 43 and 31%.…”

Section: Mantle Cell Lymphomamentioning

confidence: 99%

Front‐line management of indolent non‐Hodgkin lymphoma in Australia. Part 2: mantle cell lymphoma and marginal zone lymphoma

Cheah

Opat

Trotman

et al. 2019

Internal Medicine Journal

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Mantle cell lymphoma (MCL) and the marginal zone lymphoma (MZL) subtypes (nodal MZL, extra-nodal MZL of mucosa-associated lymphoid tissue (MALT lymphoma) and splenic MZL) are uncommon lymphoma subtypes, accounting for less than 5-10% of all non-Hodgkin lymphoma. The evidence base for therapy is therefore limited and enrolment into clinical trials is preferred. Outcomes for patients with MCL have been steadily improving mainly due to the adoption of more intense strategies in younger patients, the use of rituximab maintenance and the recent introduction of bendamustine in older patients. MZL is a more heterogeneous group of cancer with both nodal, extra-nodal and splenic subtypes. Extranodal MZL may be associated with autoimmune or infectious aetiologies, and can respond to eradication of the causative pathogen. Proton pump inhibitor plus dual antibiotics in Helicobacter pylori positive gastric MALT lymphoma is curative in many patients. Watchful waiting is appropriate in most patients with asymptomatic advanced stage disease, which tends to behave in a particularly indolent manner. Other options for symptomatic disease include splenectomy, chemoimmunotherapy with rituximab and, more recently, targeted therapies.

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“…Targeted strategies include the proteasome inhibitors, immune modulatory drugs (IMiDs), mammalian target of rapamycin (mTOR) inhibitors and especially inhibitors of the B-cell receptor pathway (Dreyling, 2015). Given the excellent OS rates regardless of initial therapy in patients with early-stage MCL, de-intensified therapy to limit treatment-related toxicity is a reasonable approach (Dabaja, 2017).…”

Section: Treatmentmentioning

confidence: 99%

Mantle cell lymphoma

Chen¹

2018

Atlas of Genetics and Cytogenetics in Oncology and Haematology

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Early-stage mantle cell lymphoma: a retrospective analysis from the International Lymphoma Radiation Oncology Group (ILROG)

Abstract: Given the excellent OS rates regardless of initial therapy in patients with early-stage MCL, de-intensified therapy to limit treatment-related toxicity is a reasonable approach.

Cited by 27 publications

References 15 publications

Treatment of mantle cell lymphoma in Asia: a consensus paper from the Asian Lymphoma Study Group

Treatment of mantle cell lymphoma in Asia: a consensus paper from the Asian Lymphoma Study Group

Front‐line management of indolent non‐Hodgkin lymphoma in Australia. Part 2: mantle cell lymphoma and marginal zone lymphoma

Mantle cell lymphoma

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