Therapies for mantle cell lymphoma: current challenges and a brighter future.

Mantle cell lymphoma (MCL), which accounts for about 6% of non-Hodgkin lymphoma (NHL), is characterized by the chromosomal translocation t(11;14)(q13;q32), resulting in de-regulated expression of cyclin D1. Managing MCL is challenging, because it is incurable with conventional chemotherapy as with indolent NHL, but has a more aggressive natural history. Therapeutic advances have been made in the past decade with the incorporation of targeted therapies into the frontline setting, use of aggressive combination regimens followed by consolidation with high dose therapy and autologous stem cell rescue for a younger population, use of less aggressive combinations in the elderly, and translation of pre-clinical findings to the clinical trial realm with novel agents that hold significant promise in the treatment of this disease. The authors review current standard approaches in the treatment of MCL, and novel findings in the pathogenesis of this disease that may guide the way for further development of modern therapeutic approaches.