Frontline therapy and the role of high-dose consolidation in mantle cell lymphoma

Simon Rule, MD of Plymouth University, Plymouth, UK discusses frontline therapy and the role of high-dose consolidation in mantle cell lymphoma (MCL), held at the 2016 American Society of Hematology (ASH) Annual Meeting, in San Diego, CA. According to Prof. Rule, the session on this topic brought the audience up to speed to on what is considered the standard of care for MCL today. For younger patients, evidence supports the use of high-dose therapy as consolidation of remission induction using high-dose cytarabine before transplant. In older patients, the choice between CHOP-based and bendamustine-based therapies is not clear as one is not conclusively better than the other. Further, there are several studies ongoing with novel therapies that are going to affect the treatment paradigm. For example, he believes that ibrutinib is going to come into frontline in elderly patients first, potentially in combination with bendamustine and rituximab, or rituximab alone. In younger patients, we know that high-dose cytarabine therapy and transplant give durable long-term remissions and he warns not to try something new when we know the established therapy works well.
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