39 NCCN Guidelines for Patients ® : Mantle Cell Lymphoma, 2017 4 Treatment guide Stage I and limited stage II Primer on first-line drug regimens Combinations of drugs are almost always used to treat mantle cell lymphomas. These combination regimens can be complex. Below, the first-line regimens that are listed in Part 4 are briefly described. Ask your treatment team for more information. Bendamustine + rituximab , or BR, is given for up to 6 cycles. Each cycle is 28 days long. CALGB 59909 is a series of treatments, which includes: Two or three cycles of R-M-CHOP (rituximab, methotrexate, cyclophosphamide, doxorubicin, vincristine, prednisone); One cycle of etoposide, cytarabine, and rituximab; One cycle of high-dose carmustine, etoposide, and cyclophosphamide followed by autologous stem cell transplant; Rituximab maintenance weekly for two weeks. Cladribine + rituximab is given for up to 6 cycles. Each cycle is 28 days long. Lenalidomide + rituximab is given for 12 cycles. Each cycle is 28 days long. Modified R-Hyper-CVAD is given for up to 6 cycles. Each cycle is 28 days long. This regimen is given only to people older than 65 years. No methotrexate or cytarabine is received. Rituximab maintenance is received weekly for 4 weeks then repeated every 6 months for two years. NORDIC is a 6-cycle regimen. Each cycle is 21 days long. Cycle 1 consists of maxi-CHOP (dose-intensified cyclophosphamide, vincristine, doxorubicin, prednisone) and cycles 3 and 5 consist of maxi-CHOP with rituximab. Cycles 2, 4, and 6 consist of rituximab and high-dose cytarabine. RCHOP is given for up to 6 cycles. Each cycle is 28 days long. RCHOP consists of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone. RDHAP is a 4-cycle regimen. Each cycle is 21 days long. RDHAP consists of rituximab, dexamethasone, cisplatin, and cytarabine. RCHOP/RDHAP is a 6-cycle regimen. Each cycle is 21 days long. Cycles 1 and 2 consist of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone). Cycle 3 consists of RCHOP. Cycles 4–6 consist of RDHAP. RCHOP/RICE is a 6- or 7-cycle regimen. Each cycle is 21 days long. The first 4 cycles consist of RCHOP. You may then receive two or three cycles of RICE (rituximab, ifosfamide, carboplatin, etoposide). R-Hyper-CVAD is an 8-cycle regimen. Each cycle is 21 days long. Cycles 1, 3, 5, and 7 consist of rituximab, cyclophosphamide, vincristine, doxorubicin, and dexamethasone. Cycles 2, 4, 6, and 8 consist of rituximab, high-dose methotrexate, and cytarabine.

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