Hematopoietic cell transplantation for mantle cell lymphoma

Hematopoietic cell transplantation (HCT) represents a valuable therapeutic option for younger patients with mantle cell lymphoma (MCL). Despite the rarity of this disease, significant research efforts have been undertaken to improve the outcomes, and autologous HCT is currently considered an established treatment for younger patients who respond to induction therapy. The past 20 years have seen further progress by incorporating rituximab and high-dose cytarabine into induction therapy and adopting rituximab as posttransplant maintenance therapy. Allogeneic HCT is generally reserved for relapsed/refractory patients because of concerns about high toxicities; however, a fraction of relapsed/refractory patients can be salvaged at the expense of high non-relapse mortality. Although significant advances have been attained over the past decades, MCL treatment still has room for improvement. A risk-adapted approach based on measurable residual disease and genetic information will promote therapeutic optimization and individualization. Moreover, the recent development of molecularly targeted drugs is expected to alter the therapeutic landscape, and the incorporation of novel drugs into the current treatment scheme is another key issue. These ongoing and future advances will change the role of HCT in MCL treatment and contribute to further improvements in outcomes.