The role of high-dose therapy and autologous hematopoietic stem cell transplantation for mantle cell lymphoma

Management of histologically indolent non-Hodgkin's lymphomas

Histologically indolent lymphomas which represent 40-50% of all non-Hodgkin's lymphomas encompass small lymphocytic lymphomas, follicular lymphomas and other entities more recently described such as mantle cell and marginal zone lymphomas. Their management has benefited from new drugs such as interferon alpha the purine analogues and new treatment modalities especially autologous stem cell transplantation.

Mantle-cell lymphoma: classification and therapeutic implications

Mantle-cell lymphomas have been recognized in the new Revised European-American Lymphoma Classification as a peripheral B-cell neoplasm that has a distinct morphologic, immunologic, and genetic phenotype. Mantle-cell lymphomas have been subtyped into four categories, termed 'mantle zone', 'nodular', 'diffuse', or 'blastoid'. The incidence of the 'mantle-zone' pattern remains controversial. The fact that patients with the nodular, diffuse, or blastoid subtypes of mantle-cell lymphoma have a high proliferative rate resulting from overexpression of the cyclin D1 and a very short median survival demonstrates conclusively that these patients should be categorized as having an aggressive lymphoma. Most authorities believe that the 'mantle zone' variant pursues a more benign clinical course than the other subtypes. Trials of the new purine analogs are of great interest in these mantle-zone lymphoma patients.