Mantle cell lymphoma - optimal therapy choice based on clinical trial results

Abstract

Mantle cell lymphoma (MCL) develops resistance and becomes refractory to therapy, which makes it´s clinical course different from so called "indolent lymphomas", were prognosis is relatively good, despite multiple relapses. Consolidation approach offered to patients in complete or very good partial regression after the Ist line therapy gives the best chance to cure the disease. Although the response rate is increased and event free survival is prolonged after Rituximab containing regimens, it is not enough to cure MCL. High dose therapy with stem cell support (ASCT) is the standard I-st line approach feasible for most younger patients (< 60 years). MCL is the disease of the elderly where intensive treatment modalities are limited by patients´ general status and co-morbidities. Radiotherapy is an effective consolidation method in a rare cases diagnosed in I/II clinical stage. For those in advanced clinical stage, radioimmunotherapy could be an alternative consolidation method, allowing for a "total tumor" radiotherapy without the necessity of the transplant procedure.