Autologous transplantation and management of younger patients with mantle cell lymphoma
- 作者：Christian H. Geisler ; MD ; DMSc ; Christian.geisler@rh.regionh.dk (Professor ; Consultant)
- 关键词：mantle cell lymphoma ; autologous stem cell transplantation ; CHOP chemotherapy ; cytarabine ; rituximab
- 刊名：Best Practice Research Clinical Haematology
- 出版年：2012
- 期刊代码：36_15216926
- 类别：med
- 出版时间：June, 2012
- 卷：25
- 期：2
- 页码：211-220
- 文件大小：258 K
摘要
Mantle cell lymphoma is traditionally conceived as one of the NHL subtypes with the worst prognosis and incurable. In responders to frontline induction with CHOP-like chemotherapy autologous stem cell transplantation (ASCT) is proven superior to interferon maintenance, but does not lead to long-term disease control. The efficacy of CHOP as induction therapy before ASCT in MCL is questioned and there is now evidence that as pretreatment before ASCT, AraC聽+聽rituximab leads to deeper remission and prolongs progression-free survival compared to rituximab聽+聽CHOP. The treatment goal of complete clinical and molecular remission in younger patients with MCL, is now within reach, based on an integrated approach of intensive AraC containing immunochemotherapy with or without subsequent ASCT, and post-treatment maintenance with rituximab or lenalidomide are now being investigated. Such an integrated approach might lead to a shift of paradigm of MCL from an incurable to a curable lymphoma.