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Current Oncology
Volume 27
Issue 6
10.3747/co.27.7053
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

First-Line Therapy, Autologous Stem-Cell Transplantation, and Post-Transplantation Maintenance in the Management of Newly Diagnosed Mantle Cell Lymphoma

by
S. Bhella
1,
Norma P. Varela
2,*,
A. Aw
3,
C. Bredeson
4,
M. Cheung
5,
M. Crump
1,
G. Fraser
6,
S. Sajkowski
7 and
T. Kouroukis
6
1
Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada
2
Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), and Department of Oncology, McMaster University, Henderson Site, 711 Concession Street, Hamilton, ON L8S 4L8, Canada
3
Division of Hematology, The Ottawa Hospital, Ottawa, ON, Canada
4
Malignant Hematology and Stem Cell Transplantation, The Ottawa Hospital, Ottawa, ON, Canada
5
Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
6
Division of Malignant Hematology, Juravinski Cancer Centre, and Department of Oncology, McMaster University, Hamilton, ON, Canada
7
Patient Representative, Brampton, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2020, 27(6), 632-644; https://doi.org/10.3747/co.27.7053
Submission received: 2 September 2020 / Revised: 6 October 2020 / Accepted: 9 November 2020 / Published: 1 December 2020

Abstract

Background: In Ontario, no clearly defined standard of care for the management of mantle cell lymphoma (mcl) has been developed, and substantial variability from centre to centre is evident. This guidance document was prompted by the need to harmonize practice in Ontario with respect to first-line, conditioning, and post-transplantation maintenance therapy for patients newly diagnosed with transplantation-eligible mcl. Methods: The medline and embase databases were systematically searched from January 2013 to January 2020 for evidence, and the best available evidence was used to draft recommendations relevant to first-line therapy, autologous stem-cell transplantation, and post-transplantation maintenance in the management of transplantation-eligible newly diagnosed mcl. Final approval of this guidance document was obtained from the Stem Cell Transplant Advisory Committee. Recommendations: These recommendations apply to all cases of transplantation-eligible newly diagnosed mcl: (1) Alternating cycles of r-chop (rituximab plus cyclophosphamide–doxorubicin–vincristine–prednisolone) and r-dhap [rituximab plus dexamethasone–high-dose cytarabine–cisplatin] is the recommended first-line treatment for symptomatic patients newly diagnosed with mcl before autologous stem-cell transplantation (asct). (2) Rituximab plus hyperfractionated cyclophosphamide–vincristine–doxorubicin–dexamethasone (r–hypercvad), alternating with methotrexate and cytarabine, is not recommended for the treatment of patients with newly diagnosed mcl. (3) beam (carmustine–etoposide–cytarabine–melphalan), beac (carmustine–etoposide–cytarabine–cyclophosphamide), and total-body irradiation–based regimens are reasonable conditioning options for patients with mcl who have responded to first-line therapy and who are undergoing asct. (4) Maintenance therapy with rituximab is recommended for patients with newly diagnosed mcl who have undergone asct.
Keywords: mantle cell lymphoma; first-line therapy; autologous stem-cell transplantation; maintenance therapy mantle cell lymphoma; first-line therapy; autologous stem-cell transplantation; maintenance therapy

Share and Cite

MDPI and ACS Style

Bhella, S.; Varela, N.P.; Aw, A.; Bredeson, C.; Cheung, M.; Crump, M.; Fraser, G.; Sajkowski, S.; Kouroukis, T. First-Line Therapy, Autologous Stem-Cell Transplantation, and Post-Transplantation Maintenance in the Management of Newly Diagnosed Mantle Cell Lymphoma. Curr. Oncol. 2020, 27, 632-644. https://doi.org/10.3747/co.27.7053

AMA Style

Bhella S, Varela NP, Aw A, Bredeson C, Cheung M, Crump M, Fraser G, Sajkowski S, Kouroukis T. First-Line Therapy, Autologous Stem-Cell Transplantation, and Post-Transplantation Maintenance in the Management of Newly Diagnosed Mantle Cell Lymphoma. Current Oncology. 2020; 27(6):632-644. https://doi.org/10.3747/co.27.7053

Chicago/Turabian Style

Bhella, S., Norma P. Varela, A. Aw, C. Bredeson, M. Cheung, M. Crump, G. Fraser, S. Sajkowski, and T. Kouroukis. 2020. "First-Line Therapy, Autologous Stem-Cell Transplantation, and Post-Transplantation Maintenance in the Management of Newly Diagnosed Mantle Cell Lymphoma" Current Oncology 27, no. 6: 632-644. https://doi.org/10.3747/co.27.7053

APA Style

Bhella, S., Varela, N. P., Aw, A., Bredeson, C., Cheung, M., Crump, M., Fraser, G., Sajkowski, S., & Kouroukis, T. (2020). First-Line Therapy, Autologous Stem-Cell Transplantation, and Post-Transplantation Maintenance in the Management of Newly Diagnosed Mantle Cell Lymphoma. Current Oncology, 27(6), 632-644. https://doi.org/10.3747/co.27.7053

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