Which aggressive induction therapy regimens for mantle cell lymphoma (MCL) are recommended by NCCN?

Updated: Mar 15, 2019
  • Author: Muhammad Rashid Abbasi, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

For induction therapy, the NCCN lists the following aggressive regimens [8] :

  • CALGB regimen (Treatment 1, 2, 2.5: rituximab + methotrexate with augmented CHOP [cyclophosphamide, doxorubicin, vincristine, prednisone]; Treatment 3: etoposide, cytarabine, rituximab; Treatment 4: carmustine, etoposide, cyclophosphamide/autologous stem cell rescue; Treatment 5: rituximab maintenance) (Treatment 2.5 is given if the pre-Treatment 3 bone marrow biopsy contains >15% MCL.)
  • HyperCVAD (cyclophosphamide, vincristine, doxorubicin, and 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 RCHOP/RDHAP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone)/(rituximab, dexamethasone, cisplatin, cytarabine)
  • RDHAP 
  • Sequential RCHOP/RICE (rituximab, ifosfamide, carboplatin, etoposide)

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