Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review
Abstract 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...
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| Format: | Article |
| Language: | English |
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Wiley
2022-02-01
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| Series: | eJHaem |
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| Online Access: | https://doi.org/10.1002/jha2.311 |
| _version_ | 1797740056523309056 |
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| author | Tahera Alnassfan Megan J. Cox‐Pridmore Azzam Taktak Kathleen J Till |
| author_facet | Tahera Alnassfan Megan J. Cox‐Pridmore Azzam Taktak Kathleen J Till |
| author_sort | Tahera Alnassfan |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-12T14:06:42Z |
| format | Article |
| id | doaj.art-736ac27ab8634c8e933f4ef74c162ef7 |
| institution | Directory Open Access Journal |
| issn | 2688-6146 |
| language | English |
| last_indexed | 2024-03-12T14:06:42Z |
| publishDate | 2022-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | eJHaem |
| spelling | doaj.art-736ac27ab8634c8e933f4ef74c162ef72023-08-21T14:05:39ZengWileyeJHaem2688-61462022-02-013127629010.1002/jha2.311Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic reviewTahera Alnassfan0Megan J. Cox‐Pridmore1Azzam Taktak2Kathleen J Till3Department of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UKDepartment of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UKMedical Physics and Clinical Engineering Royal Liverpool University Hospital Liverpool UKDepartment of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UKAbstract 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.https://doi.org/10.1002/jha2.311elderlyibrutinibMCLR‐CHOPtreatment |
| spellingShingle | Tahera Alnassfan Megan J. Cox‐Pridmore Azzam Taktak Kathleen J Till Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review eJHaem elderly ibrutinib MCL R‐CHOP treatment |
| title | Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review |
| title_full | Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review |
| title_fullStr | Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review |
| title_full_unstemmed | Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review |
| title_short | Mantle cell lymphoma treatment options for elderly/unfit patients: A systematic review |
| title_sort | mantle cell lymphoma treatment options for elderly unfit patients a systematic review |
| topic | elderly ibrutinib MCL R‐CHOP treatment |
| url | https://doi.org/10.1002/jha2.311 |
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