VIDEO: Treatment considerations for mantle cell lymphoma patients

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

The majority of patients with mantle cell lymphoma do require immediate treatment. There's a subset of mantle cell lymphoma that is termed leukemic non-nodal, which is often mistaken for CLL. And those patients can safely be monitored if they're asymptomatic, and don't have cytopenias or bulky adenopathy or splenomegaly. So watchful waiting is an appropriate and reasonable strategy in those incidentally-noted patients who have leukemic non-nodal mantle cell. But for the 90% of mantle cell patients who do need to be treated immediately, we really look at them as young, and fit, and candidates for intensive therapy versus kinda older, and perhaps frailer, and not fit for intensive therapy. For patients with, who are young and fit, offering chemotherapy regimens with some variation of what's called a Nordic approach, which uses typically bendamustine, sometimes R-CHOP-like chemotherapy, alternating or sequentially with regimens of high-dose cytarabine is relatively standard practice in the US. Followed by consolidation with an autologous stem cell transplant. Again, for patients, let's say, under 70 who are fit. After a transplant, there is a role for maintenance therapy with rituximab. This intervention over three years has been demonstrated to improve overall survival compared to no maintenance therapy. So that's really standard of care after a transplant. For patients who are not fit enough or young enough to go through intensive chemotherapy and autologous stem cell transplant, rather than incorporating a high-dose cytarabine and a transplant, usually we would recommend bendamustine rituximab for six cycles, followed by maintenance rituximab. And that approach is very effective and safe for most patients.