The challenge of treating elderly patients with mantle cell lymphoma

Treatment of elderly patients with mantle cell lymphoma is considered a major challenge, due to the peculiar chemorefractory features and continuous relapse pattern of this neoplasm. With a median age of 65 years at presentation, more than half of the patients with newly diagnosed mantle cell lymphoma fall into the category ‘elderly’. The most effective treatment for this type of lymphoma consists of high dose cytarabine followed by upfront autologous stem cell transplantation, but such a therapeutic option is not feasible for the higher age category, due to limiting toxicity. Nevertheless, patients obtaining a complete molecular response, independent of age, can enjoy longstanding event-free survival and even improved overall survival. Thus, it is important to obtain a complete response also in the elderly patients: these considerations justify more intensive approaches.