Mantle Cell Lymphoma: Relapsed/Refractory (2023)

Mantle Cell Lymphoma: Relapsed/Refractory (1) What is Lymphoma?

Although MCL usually responds well to initial treatment, patients do tend to relapse or become refractory.

The term “relapsed” refers to disease that reappears or grows again after a period of remission.

The term “refractory” is used to describe when the lymphoma does not respond to treatment (meaning that the cancer cells continue to grow) or when the response to treatment does not last very long.

For patients who relapse or become refractory, secondary therapies may be successful in providing another remission.

Like other forms of non-Hodgkin lymphomas (NHL), there is no consensus on the best treatment for relapsed or refractory MCL; however, there are an increasing number of treatment options available for these patients. The type of treatment recommended for any individual patient depends on several factors, including the timing of the relapse, the patient’s age, extent of disease, overall health, and prior therapies received.

The following agents have been approved by the FDA for treatment of relapsed or refractory MCL:

  • Acalabrutinib (Calquence)
  • Bortezomib (Velcade) with or without rituximab
  • Brexucabtagene Autoleucel (Tecartus)
  • Lenalidomide (Revlimid) with or without rituximab
  • Zanubrutinib (Brukinsa)

Although not approved in combination, bortezomib and lenalidomide may be used with rituximab (Rituxan). Additional agents and regimens that are commonly used for the treatment of relapsed/refractory MCL include:

  • Bendamustine (Treanda) +/- rituximab
  • Combination chemotherapy +/- rituximab

Stem cell transplant (SCT) can be effective in patients with relapsed or refractory MCL. There are two types of SCTs: allogeneic (in which patients receive stem cells from another person) and autologous (in which patients receive their own stem cells). Autologous SCT is generally considered after initial therapy rather than in relapse, but may be an option for medically fit patients who have shown a good response to treatment of their relapsed MCL. In the case of younger, medically fit patients, intensive chemotherapy followed by allogeneic stem cell transplantation is a higher risk, but potentially a curative option.

To learn more about relapsed/refractory MCL, download theMantle Cell Lymphoma Relapsed/Refractory Fact Sheet.

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Mantle Cell Lymphoma: Relapsed/Refractory (4)


What is the survival rate for relapsed mantle cell lymphoma? ›

The MANTLE-FIRST study, which involved a total of 606 younger patients with relapsed and refractory MCL, reported an OS of 36 months after the first relapse. We analysed survival rates after the first and second relapse events. The median OS was 18 months after the first relapse and 7 months after the second.

What happens if mantle cell lymphoma doesn't respond to treatment? ›

The term “refractory” is used to describe when the lymphoma does not respond to treatment (meaning that the cancer cells continue to grow) or when the response to treatment does not last very long. For patients who relapse or become refractory, secondary therapies may be successful in providing another remission.

Does mantle cell lymphoma always relapse? ›

There are treatments that put this condition into remission for months. But mantle cell lymphoma always comes back (relapses). You may go through several cycles of remissions and relapses, and you'll need new or different treatment when your symptoms come back.

What is the prognosis for refractory lymphoma? ›

Overall survival is approximately 80% to 90%. A subset of these patients has refractory disease or experience disease relapse. Conventional salvage therapies and autologous stem-cell transplantation is usually considered the standard of care for these patients.

What is the longest survival for mantle cell lymphoma? ›

Median overall survival after autoSCT and previous TBI was 11.4 years (142 months). In total, 11 out of 19 patients treated with autoSCT lived longer than 6.8 years (82–202 months). After alloSCT and previous TBI, the median overall survival was 3.25 years (14–59 months).

Can relapsed lymphoma be cured? ›

Many people with non-Hodgkin lymphoma (NHL) are cured. But your doctor cannot know straight away whether your lymphoma will come back or not. If your NHL comes back after treatment, your doctor might still be able to cure it.

What are promising treatments for mantle cell lymphoma? ›

Rituximab plus bendamustine and cytarabine continues to show clinical efficacy and favorable outcomes in a population of elderly patients with mantle cell lymphoma.

Has anyone been cured of mantle lymphoma? ›

Often, mantle cell lymphoma has spread to other parts of the body by the time you get a diagnosis. Although in most cases, it can't be cured.

What is the life expectancy of Stage 4 mantle cell lymphoma? ›

Most people with mantle cell lymphoma respond to treatment initially, but the cancer will later progress after chemotherapy. The average life expectancy of patients with mantle cell lymphoma is about 6 to 7 years, while the 10-year survival rate is 5 to 10 percent.

What is the most successful treatment of mantle cell lymphoma? ›

Chemotherapy, often followed by stem cell transplant, remains the cornerstone of front-line treatment for patients with mantle cell lymphoma.

How effective is car T therapy for mantle cell lymphoma? ›

For relapsed/refractory mantle cell lymphoma (MCL), a single infusion of brexucabtagene autoleucel (brex-cel, KTE-X19), an anti-CD19 CAR T-cell therapy, was associated with an overall response rate of 93% and complete response (CR) rate of 67%.

What are the first signs of lymphoma relapse? ›

Signs of a lymphoma relapse include:
  • Swollen lymph nodes in your neck, under your arms, or in your groin.
  • Fever.
  • Night sweats.
  • Tiredness.
  • Weight loss without trying.
Dec 14, 2022

Can refractory lymphoma be cured? ›

For patients who relapse or become refractory, secondary therapies are often successful in providing another remission and may even cure the disease. A number of treatment options are available for patients with relapsed or refractory HL.

What is the difference between refractory and relapse lymphoma? ›

Refractory non-Hodgkin lymphoma (NHL) is NHL that has not responded to initial treatment. Refractory disease may be disease that is getting worse or staying the same. Relapsed non-Hodgkin lymphoma (NHL) is NHL that responded to treatment but then returns.

How many times can lymphoma relapse? ›

Some people with Hodgkin lymphoma or high-grade non-Hodgkin lymphoma relapse more than once. If this happens, options for further treatment might include: chemotherapy with a different combination of drugs (regimen) to those you had before.

What is the success rate of CAR T-cell therapy for mantle cell lymphoma? ›

Kite's Tecartus® CAR T-cell Therapy Demonstrates 78% Complete Response Rate and 90% Overall Response Rate in Largest Real-World Evidence Analysis for Relapsed/Refractory Mantle Cell Lymphoma.

What is the survival rate of stage 4 mantle cell lymphoma? ›

Mantle cell lymphoma is generally not able to be cured with standard treatments and the prognosis is usually poor. About 50 to 70% of patients respond to some regimens initially, but the cancer tends to progress after chemotherapy. The average life expectancy of patients with mantle cell lymphoma is about 6 to 7 years.

Is Stage 4 mantle cell lymphoma terminal? ›

And, stage IV indicates bone marrow is affected. Patients are often diagnosed at stage IV, since mantle cell lymphoma symptoms can easily be confused with other less serious conditions, but Wang says there is hope: “Even patients with stage IV mantle cell lymphoma can live for many years to come.”


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