Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma that is largely a disease of older adults with a median age at diagnosis of 67 years. MCL is considered incurable with current therapies and has historically been associated with a poor prognosis. A subset of patients will present with features of more indolent disease and can be safely observed for a period of time after diagnosis, but the majority will require treatment at some point in the disease course. Younger patients who are eligible to undergo intensive induction chemotherapy followed by consolidation with an autologous stem cell transplant can experience prolonged survival times with a median overall survival of 13 years; however, there are limited data to support this treatment approach in older adults and these patients often have medical comorbidities that preclude such intensive therapy. Fortunately, an increased understanding of the disease biology has led to the development of novel therapies in recent years that are well-tolerated and have led to improved outcomes in this patient population. In this article, we will review the current treatment landscape for older adults with MCL, with a focus on the safety and efficacy of chemotherapy regimens and novel agents such as lenalidomide, bortezomib, and the Bruton's tyrosine kinase inhibitors that have been formally studied in this population.

中文翻译：

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地幔细胞淋巴瘤的老年人管理。

套细胞淋巴瘤（MCL）是一种B细胞非霍奇金淋巴瘤，主要是老年人的疾病，诊断中位年龄为67岁。MCL被认为是目前治疗方法无法治愈的，历史上一直与不良预后有关。一小部分患者表现出疾病更加顽固，在诊断后可以安全地观察一段时间，但是大多数患者将需要在疾病过程中的某个时间点进行治疗。有资格接受强化诱导化疗然后合并自体干细胞移植的年轻患者可以延长生存时间，中位总生存期为13年；然而，在老年人中，支持这种治疗方法的数据有限，这些患者通常患有合并症，无法进行这种强化治疗。幸运的是，对疾病生物学的深入了解导致近年来新疗法的发展，该疗法具有良好的耐受性，并导致该患者群体的预后得到改善。在本文中，我们将回顾目前针对MCL老年人的治疗前景，重点是化疗方案和新药（如来那度胺，硼替佐米和Bruton酪氨酸激酶抑制剂）的安全性和有效性，这些药物已在本研究中进行了正式研究。人口。近年来，对疾病生物学的深入了解导致人们开发了耐受性良好的新型疗法，并改善了该患者群体的治疗效果。在本文中，我们将回顾目前针对MCL老年人的治疗前景，重点是化疗方案和新药（如来那度胺，硼替佐米和Bruton酪氨酸激酶抑制剂）的安全性和有效性，这些药物已在本研究中进行了正式研究。人口。近年来，对疾病生物学的深入了解导致了新疗法的发展，该疗法具有良好的耐受性，并改善了该患者的治疗效果。在本文中，我们将回顾目前针对MCL老年人的治疗前景，重点是化疗方案和新药（如来那度胺，硼替佐米和Bruton酪氨酸激酶抑制剂）的安全性和有效性，这些药物已在本研究中进行了正式研究。人口。