Exploring Subsets of Patients With Mantle Cell Lymphoma

Sonali M. Smith, MD, of the University of Chicago Medicine, discusses the current understanding of mantle cell lymphoma (MCL) and how this understanding has evolved over recent years to understand different subsets of the disease that may require different frontline treatment for patients.

The standard of care in the frontline setting of MCL generally depends on the amount of a disease the patient presents with, the patient’s age, and their overall fitness. However, we have come a long way in our understanding of MCL, says Smith. It was first described and thought to be an aggressive disease in all patients. However, some patients present with more indolent MCL with an indolent disease course.

Smith says subsets of MCL include nodal, small volume or those with a low tumor mutational burden, or leukemic. Leukemic presents similar to chronic lymphocytic leukemia.

Overall, it is important to pull these patients aside in the frontline, Smith says. These patients can often be safely observed for a while without receiving initial frontline therapy, which physicians refer to as the “watch and wait” approach.