NCCN Guidelines for Patients® | Mantle Cell Lymphoma

43 NCCN Guidelines for Patients ® : Mantle Cell Lymphoma, 2017 Guide 7. First-line treatment Without blood stem cell transplant Immunochemotherapy Results Treatment • Bendamustine + rituximab • VR-CAP • Cladribine + rituximab • RCHOP • Lenalidomide + rituximab • Modified R-Hyper-CVAD No signs of cancer • Clinical trial • Consider rituximab maintenance Cancer looks smaller • Consider second-line treatment Cancer looks the same or larger • Read Guide 9 With blood stem cell transplant Immunochemotherapy Results Treatment • CALGB 59909 • R-Hyper-CVAD • NORDIC • RCHOP/RDHAP • RDHAP • RCHOP/RICE No signs of cancer • Clinical trial • Autologous stem cell transplant with rituximab maintenance Cancer looks smaller • Consider second-line treatment Cancer looks the same or larger • Read Guide 9 Follow-up care Guide 8 lists follow-up care for when there are no signs of cancer after treatment. This care may include a medical history, physical exam, imaging, and blood tests. A test schedule is listed in the Guide. However, these tests may be done whenever there are signs or symptoms of lymphoma. A biopsy is often needed to confirm there’s cancer. If the cancer returns (relapses), read Guide 9 for options. Guide 8. Follow-up care Type of care How often is this care needed? Medical history, physical exam, blood counts, lactate dehydrogenase, metabolic panel, imaging • Every 3–6 months for 5 years ◦◦ If normal, then repeat every year or when needed 4 Treatment guide Extensive stage II and stages III‒IV

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