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The Challenge of Treating Elderly Patients with Mantle Cell Lymphoma

Chapter

Abstract

Treatment of elderly patients with mantle cell lymphoma is considered a major challenge, due to the peculiar chemorefractory features and continuous relapse pattern of this neoplasm. With a median age of 65 years at presentation, more than half of the patients with newly diagnosed mantle cell lymphoma fall into the category ‘elderly’. The most effective treatment for this type of lymphoma consists of high dose cytarabine followed by upfront autologous stem cell transplantation, but such a therapeutic option is not feasible for the higher age category, due to limiting toxicity. Nevertheless, patients obtaining a complete molecular response, independent of age, can enjoy longstanding event-free survival and even improved overall survival. Thus, it is important to obtain a complete response also in the elderly patients: these considerations justify more intensive approaches.

However, it is fundamental to classify these patients in geriatric categories, objectively identifying those able to receive a chemotherapy aiming at long term control of the disease and patients appropriate only for a palliative therapy, primarily mitigating lymphoma symptoms. Therefore, treatment of elderly patient with mantle cell lymphoma should be individualized, and benefits and possible side effects should be carefully balanced.

Keywords

Mantle cell lymphoma Elderly Tailored treatment Therapeutic algorithm New drugs Clinical trials Prognostic factors Diagnostic procedures 

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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Division of Hematology, Department of Molecular Biotechnologies and Health SciencesUniversity of TorinoTorinoItaly
  2. 2.Department of Medicine IIIUniversity Hospital Großhadern/LMU MünchenMunichGermany

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