What are the induction therapy regimens for the treatment of B-cell mantle cell lymphoma (MCL)?

Updated: Feb 23, 2021
  • Author: Mohammad Muhsin Chisti, MD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

For induction therapy, aggressive regimens include the following:

  • HyperCVAD (cyclophosphamide, vincristine, doxorubicin [Adriamycin], dexamethasone, alternating with high-dose methotrexate and cytarabine) + rituximab
  • NORDIC regimen (dose-intensified induction immunochemotherapy with rituximab + cyclophosphamide, vincristine, doxorubicin, prednisone [maxi-CHOP]) alternating with rituximab + high-dose cytarabine)
  • Alternating R-CHOP/RDHAP (rituximab, cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [Oncovin], prednisone)/(rituximab, dexamethasone, high-dose cytarabine [Ara-C], cisplatin [Platinol])
  • RDHAP (rituximab, dexamethasone, cytrabine, platinum)
  • Other recommended regimens include Bendamustine + rituximab

Less aggressive regimens include the following:

  • Bendamustine + rituximab
  • VR-CAP (bortezomib [Velcade], rituximab, cyclophosphamide, doxorubicin [Adriamycin], and prednisone)
  • R-CHOP
  • Lenalidomide + rituximab
  • Modified rituximab-HyperCVAD in patients older than 65 y
  • RBAC500 (Rituximab, bendamustine, cytarabine) 
  • Maintenance therapy: Rituximab maintenance every 8 weeks until progression or intolerance (category 1 following RCHOP; 2-5 y following modified Rituximab-HyperCVAD).

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