Rituximab for Mantle Cell Lymphoma (updated May 2011)

· London Medicines Information Service

Mantle cell lymphoma (MCL) is a rare, aggressive, distinct subtype of B-cell non-Hodgkin’s lymphoma (NHL), usually occurring in older adults. In most patients the tumour has an aggressive behaviour, and the majority present with advanced-stage disease.

MCL usually responds to chemotherapy, only to relapse frequently, with a much shorter duration of response, time to progression, and overall survival compared to follicular NHL. The treatment approach for newly diagnosed patients generally depends on whether they are transplant-eligible. Only a small minority of patients achieve sustained remission after first-line therapy, and sequential therapies must normally be used.

For years the standard treatment for patients with MCL has been polychemotherapy, mainly with CHOP but also with hyper-CVAD, fludarabine-containing regimens and other combinations. Rituximab, an antibody directed against the CD20 antigen which is universally expressed by MCL cells, has been studied both in combination with existing chemotherapeutic regimens and as monotherapy in the treatment of MCL. This review presents a summary of the main data published to date for rituximab in the treatment of MCL.