Treatment Options in Relapsed/Refractory Mantle Cell Lymphoma: Different Factors to Consider

In a video posted on OncLive, Dr. Anita Kumar, a medical oncologist, discusses different considerations that must come into play when choosing a treatment for people living with relapsed/refractory mantle cell lymphoma (MCL). The condition and characteristics of the patient, such as overall fitness, age, and comorbidities, must all be accounted for during treatment decisions. Another factor that some doctors overlook is input on treatment from the patients themselves.

About Mantle Cell Lymphoma (MCL)

Mantle cell lymphoma is a rare type of non-Hodgkin’s lymphoma. There are only about 15,000 patients in the US. This blood cancer affects B-cells, a type of white blood cell. The risk factors for mantle cell lymphoma are not particularly well known; however, acquired genetic mutations in the affected cells are what eventually causes them to become malignant. Most patients are diagnosed in their 60s. In many cases, the disease is not diagnosed until it has reached an advanced stage. Symptoms include fever, night sweats, enlarged spleen and lymph nodes, and weight loss. Treatment options include immunotherapy, chemotherapy, and targeted therapies. Mantle cell lymphoma often relapses after treatment with chemotherapy. Prognosis is difficult to predict; the five year survival rate is 50 percent, but this figure improves to 70 percent with limited-stage disease. To learn more about mantle cell lymphoma, click here.

Therapy Considerations

In some cases, a patient may prefer to opt for a therapeutic approach that has less side effects and better tolerability. Such an approach can help maintain a better quality of life. However, in other cases, a patient may want the most aggressive approach possible using the full extent of available therapies. Input from the patient should also be used to determine if they should be treated in an academic environment or a community environment. 

Some more advanced approaches, such as stem cell transplant (both autologous and allogeneic) as well as CAR T-cell therapy may also be an option for some patients; in the case of transplant, the availability of a donor could become another hurdle.

The treatment of cancer, particularly once it is relapsed/refractory, is often a complex process, and only when accounting for all of the characteristics of the case (including the desires of the patient) can the most effective path forward be found.

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