ESMO Guideline for Mantle Cell Lymphoma

An Expert Interview With Martin Dreyling, MD, PhD

Martin H. Dreyling, MD, PhD; Linda Brookes, MSc

Disclosures

September 25, 2014

In This Article

First International Guideline on MCL

Editor's Note: A new clinical practice guideline on mantle cell lymphoma (MCL) has recently been issued by the European Society for Medical Oncology (ESMO).[1] This guideline replaces the section dedicated to MCL in the Consensus Conferences Guideline on Malignant Lymphoma published by ESMO in 2013.[2] The new guideline is the first international guideline produced solely for MCL, with input from leading experts in all major European countries.

Lead author Martin H. Dreyling, MD, PhD, professor of medicine and head of the Lymphoma Program at the Department of Medicine III, University Hospital - Grosshadern, Munich, Germany, spoke about the new guideline with Linda Brookes for Medscape. Prof Dreyling, who is a member of the ESMO Faculty, is also coauthor of ESMO's other recent guidelines on hematologic malignancies. In addition, he is chair of the European MCL Network and the scientific working group of the European Hematology Association (EHA).

Medscape: What will be different about the new MCL guideline compared with the previous guideline that ESMO issued last year?

Prof Dreyling: The new guideline is not only an update, but also is a completely new guideline solely for MCL. It represents a consensus on the most critical points from expert reviewers of all the major study groups in Europe and is set out in a format that indicates the strength of its recommendations based on the level of evidence. To the best of my knowledge, this is the first international guideline on MCL. We are very happy to have finally achieved this goal.

Medscape: The National Comprehensive Cancer Network (NCCN) recently updated its guideline on MCL.[3] Will the new ESMO guideline reflect differences in European clinical practice compared with the United States?

Prof Dreyling: Absolutely. Just to make a long story short, the NCCN lists the different options, but it takes a rather broad view, which has advantages and disadvantages; this format allows healthcare authorities to check the guidelines to see whether a patient is being treated in a way that is not listed. In such a case there might be a problem of reimbursement.

In the ESMO guideline we are a little more restrictive [than the NCCN guideline] because we really wanted to guide our colleagues; we only included recommendations that are strongly evidence-based. On the other hand, because we know that the guideline is used not only in discussion with patients but also by regulatory authorities and health systems, we wanted to be more rigorous in our evaluation of therapeutic options.

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