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Mantle Cell Lymphoma: Which Patients Should We Transplant?

  • B-cell NHL, T-cell NHL, and Hodgkin Lymphoma (J Amengual, Section Editor)
  • Published:
Current Hematologic Malignancy Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Mantle cell lymphoma is a CD5+ non-Hodgkin lymphoma associated with suboptimal outcome. Young, fit patients are generally offered intensive induction followed by autologous hematopoietic cell transplantation (AHCT) in first remission. Some patients may not benefit from this strategy.

Recent Findings

Recent studies have investigated the role of AHCT in the modern era. First, an analysis of the National Cancer Database demonstrated improved progression-free survival (PFS) for consolidative AHCT. Second, a multi-center study associated consolidative AHCT with improved PFS even after propensity-weighted analysis. Improved overall survival (OS) for certain subgroups was suggested. Third, patients with p53 mutations derive little benefit from AHCT. Finally, retrospective series suggest certain high-risk patients may be considered for allogenic HCT.

Summary

AHCT consolidation in first remission is associated with improved PFS even after adjustment for disease severity. An overall survival benefit has not been definitively shown. Patients with p53 mutations should be treated with novel agents.

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  1. Hospital of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA

    James N. Gerson & Stefan K. Barta

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James N. Gerson reports that he is on the Advisory board for Seattle Genetics.

Stefan K. Barta reports personal fees from Janssen, grants from Takeda, grants from Merck, grants from Celgene, grants from Bayer, grants and personal fees from Seattle Genetics, personal fees from Curis, and personal fees from Mundipharma.

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Gerson, J.N., Barta, S.K. Mantle Cell Lymphoma: Which Patients Should We Transplant?. Curr Hematol Malig Rep 14, 239–246 (2019). https://doi.org/10.1007/s11899-019-00520-0

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