Front-line therapy in elderly patients with mantle cell lymphoma

A number of recent therapeutic advances have improved outcomes for mantle cell lymphoma (MCL), both in the front-line and relapsed/refractory settings. With a median age of 65 at diagnosis, many patients are considered ineligible for autologous stem cell transplantation and at risk for increased toxicity from the intensified front-line therapies which are effective in younger patients. In recent years, the field has gained an understanding of the clinical and biologic heterogeneity that in turn may inform front-line therapy and provide options that balance treatment intensity with the special risks faced by older or medically unfit MCL patients. Noting that several key studies are currently underway which could alter this clinical landscape, this review will discuss the current state and evolving standards of care for elderly patients with previously-untreated MCL.