New strategies in the treatment of mantle cell lymphoma.
Mantle cell lymphoma (MCL) is a rare type of non-Hodgkin lymphoma that traditionally has been thought to possess the poor-risk features of both indolent lymphoma, with its incurability, and aggressive lymphoma, with its ability to proliferate rapidly. Although there is considerable debate as to whether MCL can be cured, a number of retrospective studies are beginning to suggest an improvement in overall survival over the past decade, likely coinciding with the introduction of rituximab, more intensive chemotherapy, and the increasing use of autologous stem cell transplant (ASCT) in first remission. At present, intensive induction chemotherapy regimens consistently produce a response rate of >90%, sometimes even 100% in the first-line setting, and consolidation with ASCT in first remission can improve the complete response rate to 90%. The emergence of a more sophisticated understanding of the underlying pathogenesis, coupled with a host of new agents and targets, has again created new opportunities to improve the care of our patients with MCL. Here, we discuss many of these developments and how they may potentially affect the natural history of this disease.
Center for Lymphoid Malignancies, Department of Medicine, Columbia University Medical Center, New York, New York 10022, USA.
Changchun
C
Deng
Sangmin
S
Lee
Owen A
OA
O'Connor
D000077329:Agammaglobulinaemia Tyrosine Kinase; D018906:Antineoplastic Agents, Alkylating / Q000494:pharmacology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use; D000069461:Bendamustine Hydrochloride; D002986:Clinical Trials as Topic; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins / Q000037:antagonists & inhibitors / Q000378:metabolism; D020522:Lymphoma, Mantle-Cell / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D058990:Molecular Targeted Therapy; D009588:Nitrogen Mustard Compounds / Q000494:pharmacology; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors / Q000378:metabolism; D033581:Stem Cell Transplantation; D000072377:Syk Kinase; D059016:Tumor Microenvironment
D018906:Antineoplastic Agents, Alkylating; D047908:Intracellular Signaling Peptides and Proteins; D009588:Nitrogen Mustard Compounds; D047428:Protein Kinase Inhibitors; D000069461:Bendamustine Hydrochloride; D011505:Protein-Tyrosine Kinases; D000077329:Agammaglobulinaemia Tyrosine Kinase; C000606896:SYK protein, human; D000072377:Syk Kinase