Does maintenance therapy have a role in mantle cell lymphoma treatment?

Introduction: Mantle cell lymphoma (MCL) is a rare but often aggressive B-cell non-Hodgkin lymphoma (NHL). Initial therapy can achieve high response rates but invariably patients relapse and die from their disease. Incorporating a maintenance phase into the treatment strategy may prolong remission duration and ultimately prolong survival.Areas covered: The current literature incorporating a maintenance phase into treatment strategies for newly diagnosed and pre-treated MCL patients has been summarized. A literature search was performed using search terms mantle cell lymphoma', indolent NHL', maintenance', interferon', rituximab', lenalidomide', bortezomib' and ibrutinib'. Relevant conference proceedings and on-going clinical trial databases were also searched.Expert commentary: There have been few significant trials evaluating the use of maintenance therapy in the context of MCL. Of those performed only rituximab has a significant body of evidence to support it's use and it's benefit is confined to use after certain specific therapies. Of the newer drugs ibrutinib is the most active of the single agents being used in this condition and it is given as continuous therapy to patients who respond to it. How it will be used precisely in a maintenance approach needs to be better defined and is the subject of on-going clinical trials.