Treatment of Primary Ovarian Lymphoma in Mantle Cell Lymphoma — Age ≤65, Fit
This protocol covers first-line management of primary ovarian lymphoma in the specific context of mantle cell lymphoma in a fit patient aged 65 years or younger.
Clinical Scenario
Fit patients ≤65 years (up to 70 years at physician’s discretion) with mantle cell lymphoma are candidates for established first-line options, with a covalent BTK inhibitor-containing regimen preferred.
Mantle cell lymphoma
Age ≤65 · Fit
First-line
Treatment Approach — Partial Overview
Management involves a covalent BTK inhibitor-containing induction regimen followed by a multi-year maintenance phase, with residual disease assessment guiding whether consolidation is required — the full sequencing and response-adapted algorithm are in the complete protocol.
Primary Goal
Achievement of undetectable minimal residual disease following induction therapy.
References
DOI: 10.1016/j.annonc.2025.07.014
- Fit patients ≤65 years (up to 70 years at physician’s discretion) should receive one of the following first-line options, with a covalent BTKi (cBTKi) within the regimen preferred:
- R-CHOP—ibrutinib, alternating with either R—dexamethasone—HD-cytarabine—cisplatin (R-DHAP) or R—dexamethasone—HD-cytarabine—oxaliplatin (R-DHAOx) induction therapy [I, A], followed by 2 years of ibrutinib and 3 years of R maintenance therapy [I, A] (first-line ibrutinib is EMA approved, not FDA approved).
- R plus HD-cytarabine-based induction therapy [R-DHAP [I, A], R-CHOP/R-DHAP [I, A], R plus maximum strength CHOP (R-maxi-CHOP)/R-HD-cytarabine [III, A] or R-DHAOx [III, A]] and ASCT consolidation therapy [I, A] followed by 3 years of R maintenance therapy [I, A].
- ASCT should be omitted if MRD assessment demonstrates undetectable MRD (10−6) [I, A].
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