Zaja Francesco, Federico Massimo, Vitolo Umberto, Zinzani Pier Luigi
Clinica Ematologica, Centro Trapianti e Terapie Cellulari "Carlo Melzi", DISM, Azienda Ospedaliero Universitaria S. M. Misericordia , Udine , Italy.
Leuk Lymphoma. 2014 May;55(5):988-98. doi: 10.3109/10428194.2013.825903. Epub 2013 Aug 31.
Abstract Despite recent advances in therapeutic strategies, a large proportion of patients with mantle cell lymphoma (MCL) experience progression after first-line treatment. Several attempts have been made to assess the role of different therapies for the treatment of patients with relapsed/refractory mantle cell lymphoma; however, a consensus on the optimal therapeutic strategy for each individual patient has not been reached. Overall, clinical evidence from phase II studies shows that high-dose cytarabine containing regimens, stem cell transplant and different biological agents all have promising activity with acceptable safety profiles. Therefore, these therapies can represent suitable treatment options for patients with relapsed/refractory MCL. Among different biological agents, at present only temsirolimus has been tested in a phase III study. This review considers available evidence on the management of relapsed/refractory MCL as discussed during a consensus meeting on the current treatment strategies for MCL.
摘要 尽管治疗策略最近有所进展,但很大一部分套细胞淋巴瘤(MCL)患者在一线治疗后仍会出现病情进展。已经进行了多项尝试来评估不同疗法在复发/难治性套细胞淋巴瘤患者治疗中的作用;然而,尚未就针对每个患者的最佳治疗策略达成共识。总体而言,II期研究的临床证据表明,含大剂量阿糖胞苷的方案、干细胞移植和不同的生物制剂都具有可观的活性且安全性可接受。因此,这些疗法可作为复发/难治性MCL患者的合适治疗选择。在不同的生物制剂中,目前只有替西罗莫司在III期研究中进行了测试。本综述考虑了在关于MCL当前治疗策略的共识会议上讨论的关于复发/难治性MCL管理的现有证据。