Mantle cell lymphoma.

Mantle cell lymphoma (MCL) is an aggressive non-Hodgkin's lymphoma that is incurable with current chemotherapeutic approaches. Despite response rates of 50% to 70% to many regimens, all patients have disease progression after chemotherapy, and median survival is approximately 3 years. There is no clear standard of care for MCL, which increases the importance of enrolling patients in clinical trials. Off protocol, chemotherapy with chlorambucil or combination regimens can be used in patients who are not candidates for high-dose therapy. Autologous stem cell transplant as initial therapy has high response rates and prolongs time to progression but has not been shown to improve survival. For young patients with matched donors, allogeneic transplant appears promising in the limited numbers of patients treated to date. Other agents, including rituximab, fludarabine, and cladribine, have demonstrated activity but do not appear to offer survival advantages over combination chemotherapy.