Dr. Leslie on the Current Frontline Treatment Landscape in MCL

Lori A. Leslie, MD, lymphoma attending, John Theurer Cancer Center, discusses the current frontline treatment landscape in mantle cell lymphoma (MCL). 

Treatment selection for patients with MCL is based on age, fitness, and specific ​disease characteristics, says Leslie. Notably, a high Ki67 proliferation index of over 30% or a TP53 ​alteration, could indicate more aggressive course of disease.

Notably, a watch-and-wait approach is generally reserved for patients with indolent disease, Leslie adds. 

​Fit patients may receive a​n autologous stem cell transplant​ (ASCT) or dose-intensive chemotherapy​, says Leslie. Sometimes, patients receiving hyperfractionated cyclophosphamide, vincristine, doxorubicin hydrochloride, and dexamethasone may not require a consolidative transplant. 

Other high-dose regimens such as dihydroxyacetone phosphate or the Nordic regimen are typically followed by ASCT, says Leslie. After transplant or high​-dose chemotherapy, maintenance rituximab (Rituxan) is considered as it has been associated with overall survival benefit.​