Andre Goy, MD, MS, discusses treatment approaches for older patients with mantle cell lymphoma.
Andre Goy, MD, MS, chief, Division of Lymphoma, chairman and director, John Theurer Cancer Center, discusses treatment approaches for older patients with mantle cell lymphoma (MCL).
Many older patients with MCL are asymptomatic, says Goy. Moreover, some patients have a low bulk of disease. Next-generation sequencing (NGS) is typically done upon diagnosis. However, patients can generally be monitored for approximately 1 year before starting treatment, says Goy.
Upon progression, patients should undergo repeat biopsy to look for clonal evolution. For patients with greater disease bulk who are symptomatic or who may become symptomatic quickly, achieving an early, complete response is critical, says Goy. Typically, induction chemotherapy with either hyper-CVAD (hyperfractionated cyclophosphamide, vincristine, doxorubicin [Adriamycin], and dexamethasone with methotrexate and cytarabine) or rituximab (Rituxan) in combination with bendamustine and cytarabine (R-BAC) is given, followed by maintenance therapy based on MRD-negativity status.