Role of allogeneic stem cell transplantation in mantle cell lymphoma

Eur J Haematol. 2015 Apr;94(4):290-7. doi: 10.1111/ejh.12442. Epub 2014 Oct 18.

Abstract

Despite a wide spectrum of treatment options, mantle cell lymphoma (MCL) remains a challenging hematologic malignancy to manage. Advances in front-line therapy, including the monoclonal antibody rituximab and increasing use of cytarabine, have improved remission rates. Autologous hematopoietic cell transplantation (HCT) can effectively consolidate remission of MCL, leading to encouraging survival beyond 5 yr. However, nearly all patients with MCL will relapse and require salvage therapy. Novel agents such as ibrutinib, bortezomib, and lenalidomide have dramatically expanded the options for treating relapsed MCL. In this review, we summarize the clinical evidence supporting the use of allogeneic donor HCT in MCL and make recommendations on indications for its use. Data suggest that allogeneic donor HCT is the only curative therapy for patients with poor prognosis or aggressive MCL. Patient selection, timing, and optimal use remain a matter of scientific debate and given the rapidly changing therapeutic landscape of MCL, the outcomes of allogeneic HCT should be interpreted in the context of novel therapeutics.

Keywords: allogeneic donor; hematopoetic cell transplantation; mantle cell lymphoma; review.

Publication types

  • Review

MeSH terms

  • Combined Modality Therapy
  • Disease Management
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Lymphoma, Mantle-Cell / mortality
  • Lymphoma, Mantle-Cell / pathology
  • Lymphoma, Mantle-Cell / therapy*
  • Recurrence
  • Remission Induction
  • Retreatment
  • Transplantation Conditioning
  • Transplantation, Autologous
  • Treatment Outcome