Dr. Rule Addresses Questions on the Watch-and-Wait Approach in MCL

Simon Rule, MD, PhD, professor of hematology, Plymouth University Medical School, United Kingdom, addresses questions on the watch-and-wait approach in mantle cell lymphoma (MCL).

Some young, asymptomatic patients with MCL may be able to avoid frontline therapy. This watch-and-wait approach is done to avoid unnecessary frontline treatment that may lead to toxicities. Rule says that patients who are asymptomatic should be considered for the watch-and-wait approach, and if the disease becomes aggressive, treatment can then be initiated. The question is, after a patient has progressed on the watch-and-wait approach, are they treated differently than those with aggressive disease that are treated at diagnosis?

Rule says that he treats all frontline patients the same, no matter the delay in treatment. Outcomes of patients who were treated upfront with standard therapy versus those who were watched then treated are being evaluated to inform whether treatment needs to be adjusted. One of the challenges is truly defining the group of patients who should be watched, Rule said.