Released: April 09, 2025
Expiration: October 08, 2025
Acalabrutinib [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2025.
Acalabrutinib [product information]. Cambridge, United Kingdom: AstraZeneca AB; 2025.
Aukema SM, Hoster E, Rosenwald A, et al. Expression of TP53 is associated with the outcome of MCL independent of MIPI and Ki-67 in trials of the European MCL Network. Blood. 2018;131:417-420.
Beà S, Valdés-Mas R, Navarro A, et al. Landscape of somatic mutations and clonal evolution in mantle cell lymphoma. Proc Natl Acad Sci U S A. 2013;110:18250-18255.
Ben Barouch S, Kuruvilla J, Tsang RW, et al. Radiotherapy in mantle cell lymphoma: a literature review. Hematol Oncol 2020;38:223-228.
Bond DA, Martin P, Maddocks KJ. Relapsed mantle cell lymphoma: current management, recent progress, and future directions. J Clin Med. 2021;10:1207.
Bortezomib [prescribing information]. Cambridge, MA: Millennium Pharmaceuticals, Inc; 2024.
Bortezomib Accord [product information]. Barcelona, Spain: Accord Healthcare S.L.U.; 2024.
Brexucabtagene autoleucel [prescribing information]. Frederick, MD: Kite, A Gilead Company; 2020.
Brexucabtagene autoleucel [product information]. Hoofddorp, Netherlands: Kite Pharma EU B.V.; 2019.
Brown JR, Eichhorst B, Hillmen P, et al. Zanubrutinib or ibrutinib in relapsed or refractory chronic lymphocytic leukemia. N Engl J Med. 2023;388:319-332.
Byrd JC, Hillmen P, Ghia P, et al. Acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia: results of the first randomized phase III trial. J Clin Oncol. 2021;39:3441-3452.
Cohen JB, Shah NN, Alencar AJ, et al. MCL-133 Pirtobrutinib, a highly selective, non-covalent (reversible) BTK inhibitor in previously treated mantle cell lymphoma: updated results from the phase 1/2 BRUIN study. Clin Lymphoma Myeloma Leuk. 2022;22:S394-S395.
Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373-383.
Dabaja BS, Zelenetz AD, Ng AK, et al. Early-stage mantle cell lymphoma: a retrospective analysis from the International Lymphoma Radiation Oncology Group (ILROG). Ann Oncol. 2017;28:2185-2190.
Delfau-Larue MH, Klapper W, Berger F, et al. High-dose cytarabine does not overcome the adverse prognostic value of CDKN2A and TP53 deletions in mantle cell lymphoma. Blood. 2015;126:604-611.
Dreyling M, Doorduijn J, Giné E, et al. Ibrutinib combined with immunochemotherapy with or without autologous stem-cell transplantation versus immunochemotherapy and autologous stem-cell transplantation in previously untreated patients with mantle cell lymphoma (TRIANGLE): a three-arm, randomised, open-label, phase 3 superiority trial of the European Mantle Cell Lymphoma Network. Lancet. 2024;403:2293-2306.
Dreyling M, Klapper W, Rule S. Blastoid and pleomorphic mantle cell lymphoma: still a diagnostic and therapeutic challenge! Blood. 2018;132:2722-2729.
Eskelund CW, Dahl C, Hansen JW, et al. TP53 mutations identify younger mantle cell lymphoma patients who do not benefit from intensive chemoimmunotherapy. Blood. 2017;130:1903-1910.
Eskelund CW, Dimopoulos K, Kolstad A, et al. Detailed long-term follow-up of patients who relapsed after the Nordic mantle cell lymphoma trials: MCL2 and MCL3. Hemasphere. 2020;5:e510.
Ferrero S, Rossi D, Rinaldi A, et al. KMT2D mutations and TP53 disruptions are poor prognostic biomarkers in mantle cell lymphoma receiving high-dose therapy: a FIL study. Haematologica. 2020;105:1604-1612.
Gerson JN, Handorf E, Villa D, et al. Outcomes of patients with blastoid and pleomorphic variant mantle cell lymphoma. Blood Adv. 2023;7:7393–7401.
Glimelius I, Smedby KE, Eloranta S, et al. Comorbidities and sex differences in causes of death among mantle cell lymphoma patients - a nationwide population-based cohort study. Br J Haematol. 2020;189:106-116.
Greenwell IB, Staton AD, Lee MJ, et al. Complex karyotype in patients with mantle cell lymphoma predicts inferior survival and poor response to intensive induction therapy. Cancer. 2018;124:2306-2315.
Halldórsdóttir AM, Lundin A, Murray F, et al. Impact of TP53 mutation and 17p deletion in mantle cell lymphoma. Leukemia. 2011;25:1904-1908.
Hartmann EM, Campo E, Wright G, et al. Pathway discovery in mantle cell lymphoma by integrated analysis of high-resolution gene expression and copy number profiling. Blood. 2010;116:953-961.
Hillmen P, Eichhorst B, Brown JR, et al. zanubrutinib versus ibrutinib in relapsed/refractory chronic lymphocytic leukemia and small lymphocytic lymphoma: interim analysis of a randomized phase III trial. J Clin Oncol. 2023;41:1035-1045.
Hoster E, Dreyling M, Klapper W, et al. A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood. 2008;111:558-565.
Hoster E, Klapper W, Hermine O, et al. Confirmation of the mantle-cell lymphoma International Prognostic Index in randomized trials of the European Mantle-Cell Lymphoma Network. J Clin Oncol. 2014;32:1338-1346.
Hoster E, Rosenwald A, Berger F, et al. Prognostic value of Ki-67 index, cytology, and growth pattern in mantle-cell lymphoma: results from randomized trials of the European Mantle Cell Lymphoma Network. J Clin Oncol. 2016;34:1386-1394.
Ibrutinib [prescribing information]. Sunnyvale, CA: Pharmacyclics LLC; 2024.
Ibrutinib [product information]. Beerse, Belgium: Janssen-Cilag International NV; 2022.
Jain, P, Wang, M. Mantle cell lymphoma: 2019 update on the diagnosis, pathogenesis, prognostication, and management. Am J Hematol. 2019;94:710-725.
Jain P, Tang G, Yin C, et al. Complex karyotype is a significant predictor for worst outcomes in patients with mantle cell lymphoma (MCL) treated with BTK inhibitors - comprehensive analysis of 396 patients. Blood. 2020a;136:32-33.
Jain P, Wang M. Blastoid mantle cell lymphoma. Hematol Oncol Clin North Am. 2020b;34:941-956.
Jerkeman M, Eskelund CW, Hutchings M, et al. Ibrutinib, lenalidomide, and rituximab in relapsed or refractory mantle cell lymphoma (PHILEMON): a multicentre, open-label, single-arm, phase 2 trial. Lancet Haematol. 2018;5:e109-e116.
Jerkeman M, Wader KF, Glimelius I, et al. Acalabrutinib and rituximab in elderly patients with newly diagnosed mantle cell lymphoma including a matched population-based external comparator- the Nordic Lymphoma Group NLG-MCL8 (ALTAMIRA) phase II trial. Blood. 2024;144:747.
Kumar A, Eyre TA, Lewis KL, et al. New directions for mantle cell lymphoma in 2022. Am Soc Clin Oncol Educ Book. 2022;42:1-15.
Kumar A, Soumerai J, Abramson JS, et al. Zanubrutinib, obinutuzumab, and venetoclax for first-line treatment of mantle cell lymphoma with a TP53 mutation. Blood. 2025;145:497-507.
Lee C, Martin P. Watch and wait in mantle cell lymphoma. Hematol Oncol Clin North Am. 2020;34:837-847.
Le Gouill S, Morschhauser F, Chiron D, et al. Ibrutinib, obinutuzumab, and venetoclax in relapsed and untreated patients with mantle cell lymphoma: a phase 1/2 trial. Blood. 2021;137:877-887.
Lenalidomide [prescribing information]. Summit, NJ: Celgene Corporation; 2023.
Lenalidomide [product information]. Uxbridge, United Kingdom: Celgene Europe Limited; 2024.
Lewis DJ, Jerkeman M, Sorrell L, et al. Ibrutinib-rituximab is superior to rituximab-chemotherapy in previously untreated older mantle cell lymphoma patients: Results from the International Randomised Controlled Trial, ENRICH. Blood. 2024;144:235.
Lisocabtagene maraleucel [prescribing information]. Seattle, WA: Juno Therapeutics, Inc.; 2024.
Martin P, Chadburn A, Christos P, et al. Outcome of deferred initial therapy in mantle-cell lymphoma. J Clin Oncol. 2009;27:1209-1213.
McGowan JV, Chung R, Maulik A, et al. Anthracycline chemotherapy and cardiotoxicity. Cardiovasc Drugs Ther. 2017;31:63-75.
McKay P, Leach M, Jackson B, et al. Guideline for the management of mantle cell lymphoma. Br J Haematol. 2018;182:46-62.
National Comprehensive Cancer Network. Clinical practice guidelines in oncology: B-cell lymphomas. V2.2025. nccn.org. Accessed March 21, 2025.
Nguyen L, Papenhausen P, Shao H. The role of c-MYC in B-cell lymphomas: diagnostic and molecular aspects. Genes (Basel). 2017;8:116.
Pirtobrutinib [prescribing information]. Indianapolis, IN: Eli Lilly and Company; 2023.
Pirtobrutinib [product information]. Utrecht, Netherlands: Eli Lilly Nederland B.V.; 2021.
Rodrigues JM, Hassan M, Freiburghaus C, et al. p53 is associated with high‐risk and pinpoints TP53 missense mutations in mantle cell lymphoma. p53 is associated with high‐risk and pinpoints TP53 missense mutations in mantle cell lymphoma. Br J Haematol. 2020;191:796-805.
Rule S, Dreyling M, Goy A, et al. Ibrutinib for the treatment of relapsed/refractory mantle cell lymphoma: extended 3.5-year follow up from a pooled analysis. Haematologica. 2019;104:e211-e214.
Shuangshuang F, Wang M, Lairson DR, et al. Trends and variations in mantle cell lymphoma incidence from 1995 to 2013: a comparative study between Texas and National SEER areas. Oncotarget. 2017;8:112516-112529.
Scheubeck G, Jiang L , Hermine O, et al. Clinical outcome of Mantle Cell Lymphoma patients with high-risk disease (high-risk MIPI-c or high p53 expression). Leukemia. 2023;37:1887-1894.
Shah NN, Wang M, Roeker LE, et al. Pirtobrutinib monotherapy in Bruton tyrosine kinase inhibitor-intolerant patients with B-cell malignancies: results of the phase I/II BRUIN trial. Haematologica. 2025;110:92-102.
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Tam CS, Anderson MA, Pott C, et al. Ibrutinib plus venetoclax for the treatment of mantle-cell lymphoma. N Engl J Med. 2018;378:1211-1223.
Tiemann M, Schrader C, Klapper W, et al. Histopathology, cell proliferation indices and clinical outcome in 304 patients with mantle cell lymphoma (MCL): a clinicopathological study from the European MCL Network. Br J Haematol. 2005;131:29-38.
Visco C, Tisi MC, Evangelista A, et al. Time to progression of mantle cell lymphoma after high-dose cytarabine-based regimens defines patients risk for death. Br J Haematol. 2019;185:940-944.
Wang M, Jurczak W, Trneny M et al. Ibrutinib plus venetoclax in relapsed or refractory mantle cell lymphoma (SYMPATICO): a multicentre, randomised, double-blind, placebo-controlled, phase 3 study. Lancet Oncol. 2025;26:200-213.
Wang ML, Jurczak W, Jerkeman M, et al. Ibrutinib plus bendamustine and rituximab in untreated mantle-cell lymphoma. N Engl J Med. 2022;386:2482-2494.
Wang M, Mayer J, Belada D, et al. Acalabrutinib (A) plus bendamustine (B) and rituximab (R) in untreated mantle cell lymphoma: results from the phase 3, double-blind, placebo (P)-controlled ECHO trial. Presented at: European Hematology Association 2024 Hybrid Congress; June 13-16, 2024. Abstract LB3439.
Weaver JA, Peng Y, Ji Y, et al. A Medicare database analysis of practice patterns in patients with mantle cell lymphoma. J Geriatr Oncol. 2021;12:894-901.
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Zanubrutinib [prescribing information]. San Mateo, CA: BeiGene USA, Inc; 2025.
Access to and use of this Interactive Decision Support Tool titled, “Interactive Decision Support Tool: EU-Focused MCL Expert Treatment Guidance” is provided subject to the following terms and conditions. PLEASE READ THESE TERMS CAREFULLY.
This Interactive Decision Support Tool is designed to educate healthcare professionals on making optimal management choices for monitoring or treating individuals with mantle cell lymphoma. The information provided is based on guideline recommendations and expert guidance of Maria Gomes da Silva, MD, PhD; Georg Hess, MD; Mats Jerkeman, MD, PhD; Ana Marin-Niebla, MD, PhD; and Carlo Visco, MD.
The material published by Clinical Care Options reflects the views of the reviewers or authors of the CCO material, not those of Clinical Care Options, LLC, the accredited provider, or the companies providing educational grants. The materials may discuss uses and dosages for therapeutic products that have not been approved by the EMA. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or using any therapies described in these materials.
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