In a nutshell
This review aimed to compare the safety and effectiveness of first-line treatments for mantle cell lymphoma. The authors concluded that newer treatments improve outcomes for younger transplant eligible patients and elderly transplant-ineligible patients.
Some background
Mantle cell lymphoma (MCL) is a rare form of non-Hodgkin’s lymphoma (NHL). It is an aggressive type of NHL, with poor outcomes. Treatments for MCL have evolved during recent years. However, the optimal treatment regimens for patients with MCL are still unknown.
Methods & findings
This review analyzed data from 9 randomized control trials (RCTs) and 20 non-randomized interventional studies on the safety and effectiveness of first-line therapies for MCL.
In elderly patients that were not fit for stem cell transplant (SCT), response to chemotherapy regimens varied from 65% to 100%. The best responses were seen with BR (bendamustine and rituximab) and cytarabine (Cytosar-U). The overall survival (OS) in these patients ranged from 40 months to 69.6 months. Patients had an OS of 69.6 months when they received rituximab (Rituxan) maintenance therapy (treatment meant to delay or prevent disease relapse).
In younger transplant-eligible patients, the overall response ranged between 64-100%. The best response (100%) was reported in patients receiving ibrutinib (Imbruvica) and rituximab. OS ranged from 81.6 months to 152.4 months.
The most common side effect reported in most trials was low white blood cell counts (neutropenia). The rates for this side effect ranged from 24% with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) to 85% with VR-CAP (bortezomib, rituximab, cyclophosphamide, epirubicin, and prednisone).
The bottom line
This review concluded that newer treatments improved the outcomes for patients with MCL. The authors suggested that future chemotherapy-free regimens may be promising.
Published By :
Critical reviews in oncology/hematology
Date :
Dec 28, 2020
