Department of Hematology, Hospital Clínico Universitario, Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente 58, 37007, Salamanca, Spain.
Ann Hematol. 2013 Sep;92(9):1151-79. doi: 10.1007/s00277-013-1783-4. Epub 2013 May 29.
Mantle cell lymphoma (MCL) is considered a distinct type of B-cell lymphoma genetically characterized by the t(11;14) translocation and cyclin D1 overexpression. There is also a small subset of tumors negative for cyclin D1 expression that are morphologically and immunophenotypically indistinguishable from conventional MCL. Although in the last decades, the median overall survival of patients with MCL has improved significantly, it is still considered as one of the poorest prognoses diseases among B-cell lymphomas. Election of treatment for patients with MCL is complex due to the scarcity of solid evidence. Current available data shows that conventional chemotherapy does not yield satisfactory results as in other types of B-cell lymphomas. However, the role of other approaches such as autologous or allogenic stem cell transplantation, immunotherapy, the administration of consolidation or maintenance schedules, or the use of targeted therapies still lack clear indications. In view of this situation, the Spanish Group of Lymphomas/Autologous Bone Marrow Transplantation has conducted a series of reviews on different aspects of MCL, namely its diagnosis, prognosis, first-line and salvage treatment (both in young and elderly patients), new targeted therapies, and detection of minimal residual disease. On the basis of the available evidence, a series of recommendations have been issued with the intention of providing guidance to clinicians on the diagnosis, treatment, and monitoring of patients with MCL.
套细胞淋巴瘤(MCL)被认为是一种独特的 B 细胞淋巴瘤,其遗传学特征为 t(11;14)易位和 cyclin D1 过表达。还有一小部分肿瘤 cyclin D1 表达阴性,其形态学和免疫表型与常规 MCL 无法区分。尽管在过去几十年中,MCL 患者的总体中位生存期有了显著改善,但它仍然被认为是 B 细胞淋巴瘤中预后最差的疾病之一。由于缺乏确凿的证据,MCL 患者的治疗选择非常复杂。目前的可用数据表明,常规化疗在其他类型的 B 细胞淋巴瘤中并不能取得令人满意的效果。然而,其他方法的作用,如自体或同种异体干细胞移植、免疫疗法、巩固或维持治疗方案的应用,或靶向治疗的应用,仍缺乏明确的适应证。鉴于这种情况,西班牙淋巴瘤组/自体骨髓移植已经对 MCL 的不同方面进行了一系列综述,包括其诊断、预后、一线和挽救治疗(包括年轻和老年患者)、新的靶向治疗以及微小残留病的检测。基于现有证据,已经提出了一系列建议,旨在为临床医生提供关于 MCL 患者的诊断、治疗和监测的指导。