Management of Mantle Cell Lymphoma in the Elderly: Current and Potential Strategies
Autor: | Marie-Dominique Venon, Olivier Hermine, Richard Delarue, Marguerite Vignon |
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Rok vydání: | 2013 |
Předmět: |
Bendamustine
Oncology Vincristine medicine.medical_specialty Lymphoma Mantle-Cell Disease-Free Survival International Prognostic Index immune system diseases hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Pharmacology (medical) Molecular Targeted Therapy Aged Lenalidomide Aged 80 and over Bortezomib business.industry medicine.disease Lymphoma Practice Guidelines as Topic Immunology Mantle cell lymphoma Rituximab Geriatrics and Gerontology business Stem Cell Transplantation medicine.drug |
Zdroj: | Drugs & Aging. 30:979-986 |
ISSN: | 1179-1969 1170-229X |
Popis: | Mantle cell lymphoma is a distinct subtype of B-cell non-Hodgkin lymphoma, accounting for 3-10 % of all non-Hodgkin lymphoma cases. The median age at diagnosis is nearly 70 years. The prognosis of patients is based on the Mantle Cell Lymphoma International Prognostic Index, which is calculated on the basis of four independent prognostic factors (age, performance status, serum lactate dehydrogenase and leukocyte count). Treatment of elderly patients with de novo untreated mantle cell lymphoma is based on rituximab combined with chemotherapy. The most commonly used regimen is the classical CHOP21 (cyclophosphamide, doxorubicin, vincristine and prednisone) regimen. Bendamustine is also an option, especially for patients with cardiac comorbidities. In elderly patients who are relatively young and fit, an approach based on treatment usually used for younger patients, with cytarabine-based induction followed by autologous stem cell transplantation, should be discussed. Treatment of relapsing patients is based on the use of newer effective drugs, including bortezomib, lenalidomide and thalidomide, and mammalian target of rapamycin (mTOR) inhibitors, such as temsirolimus. These drugs are often combined with rituximab and can be prescribed in combination with chemotherapy. Promising new drugs are Bruton tyrosine kinase inhibitors and other inhibitors of the phosphoinositide 3-kinase (PI3K)-mTOR-protein kinase B (AKT) pathway. Despite these new advances, mantle cell lymphoma remains an incurable disease, and further basic and clinical research is warranted. |
Databáze: | OpenAIRE |
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