Hematopoietic SCT for mantle cell lymphoma: is it the standard of care?

The role of hematopoietic SCT (HSCT) in mantle cell lymphoma (MCL) remains controversial. Most studies that support the utility of this approach were small phase II single-institution studies with highly selected patient populations. Furthermore, recent evidence suggesting initial observation as opposed to immediate therapy in MCL, coupled with the availability of newer therapeutic agents, complicates the role of HSCT and argues for conducting large phase III studies. In this review, we discuss the limitation of current evidence and the lack of large definitive studies. We then analyze the data on HSCT in relapsed MCL and as a frontline approach propose applying the new prognostic index, MIPI (MCL International Prognostic Index), in the decision making.