Summary And Future Directions

MCL is an aggressive lymphoma that generally presents in advanced stages and has a median survival of about 3 years. Despite response to chemotherapy, the disease typically recurs within 1 year of therapy. Improved induction therapy using intensive regimens appear to increase the time to progression. Rituximab and radiolabeled anti-CD20 monoclonal antibodies have shown encouraging results when added to chemotherapy and stem cell transplantation. Rituximab also appears to improve clinical and molecular responses in patients when used for posttransplant consolidation and in vivo purging. Nonmyeloablative transplant is being evaluated as another promising treatment option which will be useful in the older patient population. As the field evolves, defining a MCL molecular signature, which identifies alterations in gene sets which are associated with molecular, phenotypic and clinical distinctions in this disease, will impact treatment decisions.30 90 By using molecular profiling, we may be able to identify subsets of patients with indolent or aggressive MCL or subsets of genes that predict treatment responses.30'91-93

As the optimal approach to the management of patients with MCL is still evolving, it is critical that these patients are enrolled in clinical trials to identify better treatment options.

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