Mantle cell lymphoma medical therapy: Difference between revisions
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:* Drug Regimen: Hyper-(CVAD) Course A:[[Cyclophosphamide]] {{and}} [[Vincristine]] {{and}} [[Doxorubicin]] {{and}} [[Dexamethasone]] ; Course B : [[Methotrexate]] {{and}} [[Cytarabine]] | :* Drug Regimen: Hyper-(CVAD) Course A:[[Cyclophosphamide]] {{and}} [[Vincristine]] {{and}} [[Doxorubicin]] {{and}} [[Dexamethasone]] ; Course B : [[Methotrexate]] {{and}} [[Cytarabine]] | ||
===Immunotherapy=== | ===Immunotherapy=== | ||
[[ | *[[Rituximab]] is monoclonal antibody that is effective against mantle cell lymhpma. It may be used in combination with other chemotherapeutic regimens to prolong response duration. Rituximab tags the cancer cells for destruction by the body. | ||
*Oariations on monoclonal antibodies combined with radioactive molecules include [[Radioimmunotherapy]] (RIT), such as Zevalin and [[Bexxar]]. | |||
===Targeted Therapy=== | ===Targeted Therapy=== | ||
Targeted agents include the proteasome inhibitor [[Velcade]] and mTor (mammalian target of rapamycin) inhibitors such as [[Torisel|temsirolimus]]. | Targeted agents include the proteasome inhibitor [[Velcade]] and mTor (mammalian target of rapamycin) inhibitors such as [[Torisel|temsirolimus]]. | ||
Revision as of 16:30, 4 September 2015
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Mantle cell lymphoma Microchapters |
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Treatment |
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Mantle cell lymphoma medical therapy On the Web |
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American Roentgen Ray Society Images of Mantle cell lymphoma medical therapy |
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Risk calculators and risk factors for Mantle cell lymphoma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Overview
The predominant therapy for mantle cell lymphoma is chemotherapy. Adjunctive immune based therapy, radioimmunotherapy, and new biologic agents may be required.
Medical Therapy
There are no proven standards of treatment for mantle cell lymphoma, and not even consensus among specialists on how to treat it optimally. Many regimens are available and often get good response rates, but patients almost always get disease progression after chemotherapy. Each relapse is typically more difficult to treat, and relapse is generally faster. Fortunately, regimens are available that will treat relapse, and new approaches are under test. Because of the aforementioned factors, many MCL patients enroll in clinical trials to get the latest treatments.
- There are four classes of treatments currently in general use:
- Chemotherapy
- Immune based therapy
- Radioimmunotherapy
- New biologic agents
- The phases of treatment are generally:
- Frontline
- Following diagnosis
- Consolidation
- After frontline response (to prolong remissions)
- Relapse (Relapse is usually experienced multiple times.)
Chemotherapy
Chemotherapy is widely used as frontline treatment, and often is not repeated in relapse due to side effects. Alternate chemotherapy is sometimes used at first relapse.[1]
- Frontline treatment
- Drug Regimen: CHOP (IV) (Cyclophosphamide AND Doxorubicin AND Vincristine AND Prednisone) PLUS Rituximab
- Drug Regimen: Fludarabine
- Drug Regimen: Fludarabine ± (Cyclophosphamide AND Mitoxantrone AND Rituximab)
- Elderly (over 65) patients, baseline beta-2 microglobulin blood test was normal
- Drug Regimen: Hyper-(CVAD) Course A:Cyclophosphamide AND Vincristine AND Doxorubicin AND Dexamethasone ; Course B : Methotrexate AND Cytarabine
Immunotherapy
- Rituximab is monoclonal antibody that is effective against mantle cell lymhpma. It may be used in combination with other chemotherapeutic regimens to prolong response duration. Rituximab tags the cancer cells for destruction by the body.
- Oariations on monoclonal antibodies combined with radioactive molecules include Radioimmunotherapy (RIT), such as Zevalin and Bexxar.
Targeted Therapy
Targeted agents include the proteasome inhibitor Velcade and mTor (mammalian target of rapamycin) inhibitors such as temsirolimus.