A number of treatment options are currently available for mantle cell lymphoma (MCL), explains John C. Byrd, MD, and Myron Czuczman, MD. There is controversy regarding the frontline administration of rituximab, cyclophosphamide, doxorubicin, and prednisone plus vincristine (R-CHOP) in the frontline setting. Richard Furman, MD, describes a trial that added bortezomib to R-CHOP and produced impressive results, suggesting that long-term remissions can be achieved without using the more toxic regimens.

Minimal residual disease (MRD) could be utilized as a prognostic factor in MCL, suggests Shuo Ma, MD, PhD. The German group analyzed the effect of MRD in terms of prognosis for patients with MCL <65 years who were treated with immuno-chemotherapy followed by autologous stem cell transplantation for patients, and patients with MCL >65 years who were treated with rituximab or interferon maintenance. Based on these analyses, MRD-negativity appears to be the single most important prognostic factor, even more than Mantle Cell Lymphoma International Prognostic Index (MIPI) scores.