NCCN Guidelines for Patients® | Mantle Cell Lymphoma

44 NCCN Guidelines for Patients ® : Mantle Cell Lymphoma, 2017 Second-line treatment Guide 9 lists options for second-line treatment. These options are used if first-treatment didn’t work. They are also used if the lymphoma reappears on tests. The best treatment approach is unknown. More research is needed. One option is to join a clinical trial of new drugs or a stem cell transplant. A second option is radiation therapy if you have not received it before. The third option is a drug regimen listed in Guide 9. Sometimes, a regimen for diffuse large B-cell lymphoma is tried. If the lymphoma is fully treated, your doctor may suggest a blood stem cell transplant. An allogeneic transplant is an option. You must be fairly healthy to have this treatment. Guide 9. Second-line treatment What are the options? • Clinical trial • Radiation therapy • Drug treatment ◦◦ Bendamustine ± rituximab ◦◦ Bendamustine, bortezomib, and rituximab ◦◦ Bortezomib ± rituximab ◦◦ Cladribine + rituximab ◦◦ Ibrutinib ◦◦ Ibrutinib, lenalidomide, and rituximab ◦◦ Lenalidomide ± rituximab ◦◦ Venetoclax 4 Treatment guide Extensive stage II and stages III‒IV