Guideline for the management of mantle cell lymphoma

McKay, Pam; Leach, Mike; Jackson, Bob; Robinson, Stephen; Rule, Simon

doi:10.1111/bjh.15283

Cited by 39 publications

(66 citation statements)

References 144 publications

(191 reference statements)

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“…Allogeneic transplantation for MCL is currently considered as a treatment option for younger patients with relapsed disease and no preclusive comorbidities (Dreyling et al, 2014;Robinson et al, 2015;McKay et al, 2018). There have been multiple published series of patients with MCL undergoing an allogeneic transplant in this setting with a range of treatment outcomes (Le Gouill et al, 2012;Robinson et al, 2015;Vaughn et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…In these patients, long-term toxicity is significantly lower, and subsequent salvage in relapsing patients and RIC alloSCT may offer the optimal overall management strategy. As such, all of the major guidelines retain the allogeneic approach as one of the options in the relapse setting (Dreyling et al, 2014;Robinson et al, 2015;McKay et al, 2018). One question that arises is whether cohorts of higher risk patients could be identified that might benefit more from earlier alloSCT.…”

Section: Discussionmentioning

confidence: 99%

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Allogeneic stem cell transplantation as part of front line therapy for Mantle cell lymphoma

Rule

Cook

Russell³

et al. 2018

Br J Haematol

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Summary Mantle cell lymphoma (MCL) is an aggressive form of non‐Hodgkin lymphoma that remains incurable for the majority of patients. Allogeneic stem cell transplantation (alloSCT) produces long‐term disease‐free remissions for around 30–40% patients, however it is reserved for the treatment of relapsed disease. This study examined the use of front line transplantation for young patients in an attempt to improve outcomes. Twenty‐five patients received an alloSCT using BEAM [BCNU (carmustine), etoposide, cytarabine, melphalan)‐Campath conditioning following permissive induction therapy from both related and unrelated donors. This was a multi‐centre prospective trial. Twenty‐four of 25 patients engrafted with no non‐relapse mortality events by day 100. With a median follow‐up of 60·5 months, there have been six deaths (3 from MCL). The progression‐free survival (PFS) and overall survival were 68% and 80% at 2 years and 56% and 76% at 5 years. PFS was very similar for both sibling and unrelated transplants and there was no difference in PFS between patients with respect to remission status prior to transplantation. Nine (38%) patients experienced acute graft‐versus‐host disease (GVHD) and 14 (58%) experienced chronic GVHD, of which 8 were extensive. Front line alloSCT is feasible but should only be considered for patients at high risk of early progression following conventional therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Allogeneic stem cell transplantation as part of front line therapy for Mantle cell lymphoma

Rule

Cook

Russell³

et al. 2018

Br J Haematol

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“…peripheral blood lymphocytosis, and with little or no nodal disease, and thereby presenting with indolent features [3][4][5][6][7]. Patients with MCL may present with generalized lymphadenopathy; however, extra-nodal involvement is common in the peripheral blood, bone marrow, and gastrointestinal tract [8].…”

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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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“…In regard to the blastoid variant of MCL, the optimal approach to treatment has not been determined [20, 27]. As the blastoid variant of MCL is aggressive, more intensive therapy should be considered.…”

Section: Discussionmentioning

confidence: 99%

“…Blastoid histology is associated with a greater risk of involvement of the CNS [29, 30] and cerebrospinal fluid analysis and neuroimaging may be considered in patients with blastoid histology [1]. For patients with blastoid morphology, the use of empirical CNS-penetrating chemotherapy has been suggested to be possibly beneficial, although there is no clear consensus regarding CNS prophylaxis [27]. …”

Section: Discussionmentioning

confidence: 99%

Blastic Transformation of a Mantle Cell Lymphoma Presenting as an Enlarging Unilateral Orbital Mass

et al. 2018

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Mantle cell lymphoma (MCL) is an uncommon form of non-Hodgkin lymphoma predominantly affecting male individuals of advanced age. Approximately 1–9% of cases of lymphoma affecting the orbital and ocular adnexal regions are attributed to MCL. We describe the case of a 65-year-old man with a 24-year history of MCL with initial remission followed by multiple relapses who presented with acute-onset binocular diplopia and proptosis of the left eye. Subsequent imaging demonstrated a new left superior orbital mass. Biopsy of the mass revealed two clonally related, yet distinct cellular components demonstrating the classical mantle cell morphology and large cells that appeared to have transformed to the blastoid variant of MCL. Transformation of classical MCL to the blastoid variant of MCL is rare, with few reports in the literature. The blastoid variant of MCL tends to be aggressive and associated with a poor prognosis. The case we describe represents perhaps the first report of MCL transformation observed in the orbit.

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Guideline for the management of mantle cell lymphoma

Cited by 39 publications

References 144 publications

Allogeneic stem cell transplantation as part of front line therapy for Mantle cell lymphoma

Allogeneic stem cell transplantation as part of front line therapy for Mantle cell lymphoma

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

Blastic Transformation of a Mantle Cell Lymphoma Presenting as an Enlarging Unilateral Orbital Mass

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