Mantle Cell Lymphoma: Relapsed/Refractory
Although MCL usually responds well to initial treatment, patients do tend to A disease that reappears or grows again after a period of remission. or become A cancer that is resistant to treatment..
The term “relapsed” refers to disease that reappears or grows again after a period of The absence of disease. Remission does not necessarily indicate that a person is cured. Patients may have complete or partial remission..
The term “refractory” is used to describe when the lymphoma does not respond to treatment (meaning that the Abnormal cell growth that cannot be controlled by the body's natural defenses. Cancerous cells can grow and eventually form tumors. cells continue to grow) or when the response to treatment does not last very long.
For patients who relapse or become refractory, secondary therapies may be successful in providing another remission.
Like other forms of non-Hodgkin lymphomas (NHL), there is no consensus on the best treatment for relapsed or refractory MCL; however, there are an increasing number of treatment options available for these patients. The type of treatment recommended for any individual patient depends on several factors, including the timing of the relapse, the patient’s age, extent of disease, overall health, and prior therapies received.
Three agents have been approved by the FDA for treatment of relapsed or refractory MCL:
- Acalabrutinib (Calquence)
- Bortezomib (Velcade) with or without rituximab
- Ibrutinib (Imbruvica)
- Lenalidomide (Revlimid) with or without rituximab
Although not approved in combination, bortezomib and lenalidomide may be used with rituximab (Rituxan). Additional agents and regimens that are commonly used for the treatment of relapsed/refractory MCL include:
- Bendamustine (Treanda) +/- rituximab
- Several drugs given together to increase response rate of certain tumors. +/- rituximab
Stem cell transplant (SCT) can be effective in patients with relapsed or refractory MCL. There are two types of SCTs: A procedure in which a patient receives bone marrow or stem cells donated by another person. (in which patients receive stem cells from another person) and A type of bone marrow or stem cell transplantation in which a patient receives his or her own cells. (in which patients receive their own stem cells). Autologous SCT is generally considered after initial therapy rather than in relapse, but may be an option for medically fit patients who have shown a good response to treatment of their relapsed MCL. In the case of younger, medically fit patients, intensive Treatment with drugs to stop the growth of rapidly dividing cancer cells, including lymphoma cells. followed by allogeneic stem cell transplantation is a higher risk, but potentially a curative option.
To learn more about relapsed/refractory MCL, download the Mantle Cell Lymphoma Relapsed/Refractory Fact Sheet.