There is potential for the use of chemotherapy-free regimens in mantle cell lymphoma (MCL), such as lenalidomide combined with rituximab, which is an active regimen in MCL that has been evaluated in the relapsed setting, comments Brad S. Kahl, MD. Ongoing studies are assessing its role in the frontline setting. Additionally, maintenance rituximab is a commonly used strategy for older patients with MCL, adds Kahl.

Not all individuals with MCL who are eligible for stem cell transplantation need to undergo a transplant, says Kahl. About 20% to 25% of patients have an indolent version of the disease and can enjoy a high-quality, durable remission with non-intensive chemotherapy approaches. Kahl recounts treating individuals 8 to 10 years ago with a frontline regimen that did not include stem cell transplantation who are still in their first remission. While stem cell transplants in MCL have been shown to improve progression-free survival, there is no proven impact on overall survival, notes Kahl.