Dr. Karmali on Challenges in MCL

Reem Karmali, MD, MS, assistant professor of medicine, Northwestern University Feinberg School of Medicine, discusses challenges in the field of mantle cell lymphoma (MCL).

Chemoimmunotherapy induces high response rates in MCL; however, there is no standardized frontline approach. Treatments are variable and they depend on several different patient factors, says Karmali. When a symptomatic patient presents with a relatively aggressive disease, treatments can range from rituximab (Rituxan) monotherapy to chemoimmunotherapy with or without autologous stem cell transplant (ASCT).

However, it is unclear whether patients should be consolidated with an ASCT and whether rituximab maintenance is appropriate, depending on the type of induction therapy the patient is started on. Importantly, the US Cooperative Group study is looking to address this question of whether an ASCT is needed across the board in MCL.

Apart from picking the right therapy for patients, one of the biggest challenges is the fact that relapse is quite common, and when patients relapse, their outcomes are poor, concludes Karmali.