title: Frontline therapy and role of high-dose consolidation in mantle cell lymphoma.
abstract: Mantle cell lymphoma (MCL) is a rare and aggressive form of non-Hodgkin lymphoma. It is predominantly a disease of older individuals, with a median age at presentation of ∼70 years. For the majority of patients, the management revolves around immuno-chemotherapy often followed by maintenance rituximab, and at relapse, a range of options are available. For the younger patient, it is possible to be more intensive with therapy, consolidate responses with high-dose procedures, and in a few there might be the prospect of a cure. The incorporation of high-dose cytarabine into the treatment algorithm has had a major impact on outcomes, with approximately half of the patients alive at 10 years whether an autologous stem cell transplant is adopted or not. Allogeneic transplantation produces some very durable responses in the relapsed setting and has a potential role up front in the highest-risk patients. However, with the advent of Bruton tyrosine kinase inhibitor and other highly effective nontraditional chemotherapeutic approaches, there is the potential for the management of this disease to change fundamentally over the next few years.
authors.affiliation: Department of Haematology, Derriford Hospital, Plymouth and Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Rule
mesh_terms: D000077329:Agammaglobulinaemia Tyrosine Kinase; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D064591:Allografts; D060830:Consolidation Chemotherapy / Q000379:methods; D003561:Cytarabine / Q000627:therapeutic use; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000628:therapy*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D033581:Stem Cell Transplantation
chemical_list: D047428:Protein Kinase Inhibitors; D003561:Cytarabine; D011505:Protein-Tyrosine Kinases; D000077329:Agammaglobulinaemia Tyrosine Kinase