Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review.

Autor: Alnassfan T; Department of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UK.; Authors Tahera Alnassfan and Megan J. Cox-Pridmore contributed equally to the review., Cox-Pridmore MJ; Department of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UK.; Authors Tahera Alnassfan and Megan J. Cox-Pridmore contributed equally to the review., Taktak A; Medical Physics and Clinical Engineering Royal Liverpool University Hospital Liverpool UK., Till KJ; Department of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UK.
Jazyk: angličtina
Zdroj: EJHaem [EJHaem] 2021 Nov 09; Vol. 3 (1), pp. 276-290. Date of Electronic Publication: 2021 Nov 09 (Print Publication: 2022).
DOI: 10.1002/jha2.311
Abstrakt: Mantle cell lymphoma (MCL) is a rare B-cell non-Hodgkin lymphoma (NHL) that is aggressive and incurable with existing therapies, presenting a significant unmet clinical need. MCL occurs mainly in elderly patients with comorbidities; thus, intense treatment options including allogeneic stem cell transplantation (Allo-SCT) are not feasible. New treatment options are emerging for this elderly/unfit treatment group, we therefore conducted a systematic review to determine whether they offered an advance on the existing recommended treatment, R-CHOP. The search strategies to identify MCL therapies were designed to capture the most relevant studies from 2013 to 2020. Following preferred reporting items for systematic reviews and meta-analyses and population,interventions, observations and study design analysis, R-CHOP, ibrutinib and bendamustine plus rituximab (BR) were taken forward for critical and statistical analysis. All three therapies were effective in increasing the overall survival (OS) and progression-free survival of elderly/unfit patients with MCL. However, none resulted in a significant increase in OS compared to R-CHOP. In addition, R-CHOP had a better toxicity profile when compared to both ibrutinib and BR. We therefore conclude that treatment of elderly/unfit patients with MCL is still a significant unmet clinical need; and suggest that outside of the clinical trial setting, R-CHOP should remain the recommended front-line treatment for this patient group.
Competing Interests: The authors report no conflicts of interest.
(© 2021 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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