Mantle cell lymphoma (MCL) is a B cell malignancy that can be aggressive and with a poor prognosis; the clinical course is heterogeneous. The epidemiology of MCL in Asia is not well documented but appears to comprise 2–6% of all lymphoma cases based on available data, with variation observed between countries. Although international guidelines are available for the treatment of MCL, there is a lack of published data or guidance on the clinical characteristics and management of MCL in patient populations from Asia. This paper aims to review the available treatment and, where clinical gaps exist, provide expert consensus from the Asian Lymphoma Study Group (ALSG) on appropriate MCL management in Asia. Management strategies for MCL are patient- and disease stage-specific and aim to achieve balance between efficacy outcomes and toxicity. For asymptomatic patients with clearly indolent disease, observation may be an appropriate strategy. For stage I/II disease, following international guidelines is appropriate, which include either a short course of conventional chemotherapy followed by consolidated radiotherapy, less aggressive chemotherapy regimens, or a combination of these approaches. For advanced disease, the approach is based on the age and fitness of the patient. For young, fit patients, the current practice for induction therapy differs across Asia, with cytarabine having an important role in this setting. Hematopoietic stem cell transplantation (HSCT) may be justified in selected patients because of the high relapse risk. In elderly patients, specific chemoimmunotherapy regimens available in each country/region are a treatment option. For maintenance therapy after first-line treatment, the choice of approach should be individualized, with cost being an important consideration within Asia. For relapsed/refractory disease, ibrutinib should be considered as well as other follow-on compounds, if available. Asian patient-specific data for the treatment of MCL are lacking, and the availability of treatment options differs between country/region within Asia. Therefore, there is no clear one-size-fits-all approach and further investigation on the most appropriate sequence of treatment that should be considered for this heterogeneous disease.

中文翻译：

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亚洲的套细胞淋巴瘤的治疗：亚洲淋巴瘤研究小组的共识性论文。

套细胞淋巴瘤（MCL）是一种B细胞恶性肿瘤，可能具有侵袭性且预后不良。临床过程是异质的。在亚洲，MCL的流行病学资料尚不充分，但根据现有数据，似乎占所有淋巴瘤病例的2–6％，各国之间存在差异。尽管有国际指南可用于MCL的治疗，但对于来自亚洲的患者人群，MCL的临床特征和治疗尚缺乏公开的数据或指南。本文旨在综述可用的治疗方法，并在存在临床空白的地方，就亚洲适当的MCL管理提供亚洲淋巴瘤研究小组（ALSG）的专家共识。MCL的管理策略是针对患者和疾病的特定阶段，旨在在疗效结果和毒性之间取得平衡。对于无症状的明显无症状的患者，观察可能是适当的策略。对于I / II期疾病，应遵循国际准则，包括短期疗程的常规化学疗法和联合放疗，不太积极的化学疗法或这些方法的组合。对于晚期疾病，该方法基于患者的年龄和健康状况。对于年轻的健康患者，目前的诱导疗法在亚洲各地有所不同，阿糖胞苷在这种情况下起着重要的作用。在某些患者中，造血干细胞移植（HSCT）可能是合理的，因为其复发风险很高。在老年患者中，每个国家/地区可用的特定化学免疫疗法是一种治疗选择。对于一线治疗后的维持治疗，治疗方法的选择应因人而异，而成本是亚洲内部的重要考虑因素。对于复发/难治性疾病，应考虑使用依鲁替尼以及其他后续用药（如果有）。缺乏用于MCL治疗的亚洲患者特定数据，并且亚洲国家/地区之间治疗选择的可用性也有所不同。因此，对于这种异质性疾病，尚无明确的万能方法和对最适当治疗顺序的进一步研究。缺乏用于MCL治疗的亚洲患者特定数据，并且亚洲国家/地区之间治疗方案的可用性也有所不同。因此，对于这种异质性疾病，尚无明确的万能方法和对最适当治疗顺序的进一步研究。缺乏用于MCL治疗的亚洲患者特定数据，并且亚洲国家/地区之间治疗方案的可用性也有所不同。因此，对于这种异质性疾病，尚无明确的万能方法和对最适当治疗顺序的进一步研究。