Mantle cell lymphoma (MCL) is a relatively rare B-cell lymphoma subtype, with a higher incidence among males and a median age of 70 years at diagnosis. MCL is characterized by clinically diverse behavior, from indolent disease to extremely aggressive, related to the presence of biological risk factors such as proliferation rate and TP53 mutations. Most often, patients present with disseminated disease, necessitating systemic treatment. Immunochemotherapy has historically been the mainstay of treatment, but recent data indicate that addition of novel agents, especially covalent Bruton tyrosine kinase inhibitors (cBTKi), may substantially improve outcome in younger and older patients, although a curative approach remains to be shown. In elderly patients, the standard of care is still immuno-chemotherapy such as rituximab-bendamustine, although this may be challenged by non-chemotherapeutic options, such as rituximab plus cBTKi. For patients with relapsed or refractory disease, treatment options are developing rapidly, including CAR-T cell therapy, novel BTK targeting agents, BCL2 inhibitors, and T-cell engagers. In this clinical practice guideline, we present current evidence-based recommendations for diagnosis, staging, treatment, and follow-up of MCL.

1st Dept Of Internal Medicine Hematology University General Hospital Prague and 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Hematology Erasmus MC Cancer Institute University Medical Center Rotterdam The Netherlands

Department of Hematology Portuguese Institute of Oncology Lisbon Portugal

Department of Hematology Sir Charles Gairdner Hospital Perth Western Australia Australia

Department of Lymphoid Malignancies European Reference Network EuroBloodNet Warsaw Poland

Department of Lymphoid Malignancies Maria Sklodowska Curie National Research Institute of Oncology Warsaw

Department of Medical Oncology and Hematology Cantonal Hospital St Gallen St Gallen Switzerland

Department of Medicine 3 LMU University Hospital Munich

Department of Oncology Skåne University Hospital Lund Sweden

Department of Pathology Hospital Clínic de Barcelona Institute of Biomedical Research August Pi i Sunyer University of Barcelona CIBERONC Barcelona Spain

Department of Translational Medicine Division of Hematology University of Eastern Piedmont Alessandria Italy

Haematology and Cancer Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom

Hematology Department Assuta Medical Center Tel Aviv Israel

Hematology Department Hospital Clínic of Barcelona Institute of Biomedical Research August Pi i Sunyer CIBERONC Barcelona Spain

Inspire2Live Loosdrecht The Netherlands

Institut de Cancérologie Gustave Roussy Villejuif France

Lund University Lund Sweden

SCDU Ematologia Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo Alessandria Italy

University Hospital Centre Zagreb and Medical School University of Zagreb Zagreb Croatia

Zobrazit více v PubMed

National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Accessed 15 Feb, 2025. https://seer.cancer.gov/seertools/hemelymph/51f6cf57e3e27c3994bd5357/

Smedby KE, Hjalgrim H. Epidemiology and etiology of mantle cell lymphoma and other non‐Hodgkin lymphoma subtypes. Sem Cancer Biol. 2011;21(5):293‐298. 10.1016/j.semcancer.2011.09.010 PubMed DOI

Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS. Lymphoma incidence patterns by WHO subtype in the United States, 1992‐2001. Blood. 2006;107(1):265‐276. 10.1182/blood-2005-06-2508 PubMed DOI PMC

Sant M, Allemani C, Tereanu C, et al. Incidence of hematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood. 2010;116(19):3724‐3734. 10.1182/blood-2010-05-282632 PubMed DOI

Jerkeman M, Ekberg S, Glimelius I, et al. Nationwide assessment of patient trajectories in mantle cell lymphoma: The Swedish MCLcomplete Project. HemaSphere. 2023;7(8):e928. 10.1097/hs9.0000000000000928 PubMed DOI PMC

Abrahamsson A, Albertsson‐Lindblad A, Brown PN, et al. Real‐world data on primary treatment for mantle cell lymphoma: a Nordic Lymphoma Group observational study. Blood. 2014;124(8):1288‐1295. 10.1182/blood-2014-03-559930 PubMed DOI

Alzahrani M, Gerrie AS, Sehn LH, et al. Therapeutic advances and gradual improvement in overall survival in mantle cell lymphoma over four decades. Br J Haematol. Published online July 2, 2025. 10.1111/bjh.20239 PubMed DOI

Harmanen M, Hujo M, Sund R, et al. Survival of patients with mantle cell lymphoma in the rituximab era: retrospective binational analysis between 2000 and 2020. Br J Haematol. 2023;201(1):64‐74. 10.1111/bjh.18597 PubMed DOI

WHO Classification of Tumours. Haematolymphoid Tumours. 11, 5th ed. IARC; 2024.

Campo E, Jaffe ES, Cook JR, et al. The International Consensus Classification of Mature Lymphoid Neoplasms: a report from the Clinical Advisory Committee. Blood. 2022;140(11):1229‐1253. 10.1182/blood.2022015851 PubMed DOI PMC

Swerdlow SH. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC; 2017.

Martín‐Garcia D, Navarro A, Valdés‐Mas R, et al. PubMed DOI PMC

Royo C, Navarro A, Clot G, et al. Non‐nodal type of mantle cell lymphoma is a specific biological and clinical subgroup of the disease. Leukemia. 2012;26(8):1895‐1898. 10.1038/leu.2012.72 PubMed DOI PMC

Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375‐2390. 10.1182/blood-2016-01-643569 PubMed DOI PMC

Hoster E, Rosenwald A, Berger F, et al. Prognostic value of Ki‐67 Index, cytology, and growth pattern in mantle‐cell lymphoma: results from randomized trials of the European mantle cell lymphoma network. J Clin Oncol. 2016;34(12):1386‐1394. 10.1200/jco.2015.63.8387 PubMed DOI

Scheubeck G, Jiang L, Hermine O, et al. Clinical outcome of Mantle Cell Lymphoma patients with high‐risk disease (high‐risk MIPI‐c or high p53 expression). Leukemia. 2023;37(9):1887‐1894. 10.1038/s41375-023-01977-y PubMed DOI PMC

Klapper W, Hoster E, Determann O, et al. Ki‐67 as a prognostic marker in mantle cell lymphoma—consensus guidelines of the pathology panel of the European MCL Network. J Hematop. 2009;2(2):103‐111. 10.1007/s12308-009-0036-x PubMed DOI PMC

Epperla N, Switchenko JM, Geyer SM, et al. Ki‐67 expression of 50% is the optimal cut‐off to predict survival outcomes in mantle cell lymphoma (MCL): a pooled analysis from CALGB 50403 (Alliance) and MCL real‐world study cohort. Blood. 2023;142(Suppl 1):380. 10.1182/blood-2023-189505 DOI

Nadeu F, Martin‐Garcia D, Clot G, et al. Genomic and epigenomic insights into the origin, pathogenesis, and clinical behavior of mantle cell lymphoma subtypes. Blood. 2020;136(12):1419‐1432. 10.1182/blood.2020005289 PubMed DOI PMC

Rodrigues JM, Hassan M, Freiburghaus C, et al. p53 is associated with high‐risk and pinpoints PubMed DOI PMC

Delfau‐Larue MH, Klapper W, Berger F, et al. High‐dose cytarabine does not overcome the adverse prognostic value of PubMed DOI

Eskelund CW, Dahl C, Hansen JW, et al. PubMed DOI

Ferrero S, Rossi D, Rinaldi A, et al. KMT2D mutations and TP53 disruptions are poor prognostic biomarkers in mantle cell lymphoma receiving high‐dose therapy: a FIL study. Haematologica. 2020;105(6):1604‐1612. 10.3324/haematol.2018.214056 PubMed DOI PMC

de Haan LM, de Groen RAL, de Groot FA, et al. Real‐world routine diagnostic molecular analysis for PubMed DOI PMC

Aukema SM, Hoster E, Rosenwald A, et al. Expression of TP53 is associated with the outcome of MCL independent of MIPI and Ki‐67 in trials of the European MCL Network. Blood. 2018;131(4):417‐420. 10.1182/blood-2017-07-797019 PubMed DOI

Khouja M, Jiang L, Pal K, et al. Comprehensive genetic analysis by targeted sequencing identifies risk factors and predicts patient outcome in Mantle Cell Lymphoma: results from the EU‐MCL network trials. Leukemia. 2024;38(12):2675‐2684. 10.1038/s41375-024-02375-8 PubMed DOI PMC

López C, Silkenstedt E, Dreyling M, Beà S. Biological and clinical determinants shaping heterogeneity in mantle cell lymphoma. Blood Adv. 2024;8(14):3652‐3664. 10.1182/bloodadvances.2023011763 PubMed DOI PMC

Sarkozy C, Tessoulin B, Chiron D. Unraveling MCL biology to understand resistance and identify vulnerabilities. Blood. 2025;145(7):696‐707. 10.1182/blood.2023022351 PubMed DOI

Cheng J, Hashem MA, Barabé F, et al. CCND1 genomic rearrangement as a secondary event in high grade B‐cell lymphoma. HemaSphere. 2021;5(1):e505. 10.1097/hs9.0000000000000505 PubMed DOI PMC

Özoğul E, Montaner A, Pol M, et al. Large B‐cell lymphomas with PubMed DOI PMC

Albano D, Treglia G, Gazzilli M, Cerudelli E, Giubbini R, Bertagna F. PubMed DOI

Ródenas Quiñonero I, Marco‐Ayala J, Chen‐Liang TH, et al. The value of bone marrow assessment by FDG PET/CT, biopsy and aspirate in the upfront evaluation of mantle cell lymphoma: a nationwide cohort study. Cancers (Basel). 2024;16(24):4189. 10.3390/cancers16244189 PubMed DOI PMC

Pott C, Hoster E, Delfau‐Larue MH, et al. Molecular remission is an independent predictor of clinical outcome in patients with mantle cell lymphoma after combined immunochemotherapy: a European MCL intergroup study. Blood. 2010;115(16):3215‐3223. 10.1182/blood-2009-06-230250 PubMed DOI PMC

Fenske TS, Wang XV, Till BG, et al. Lack of benefit of autologous hematopoietic cell transplantation (auto‐HCT) in mantle cell lymphoma (MCL) patients (pts) in first complete remission (CR) with undetectable minimal residual disease (uMRD): initial report from the ECOG‐ACRIN EA4151 phase 3 randomized trial. Blood. 2024;144(Suppl 2):LBA‐6‐LBA‐6. 10.1182/blood-2024-212973 DOI

Cheah CY, George A, Giné E, et al. Central nervous system involvement in mantle cell lymphoma: clinical features, prognostic factors and outcomes from the European mantle cell lymphoma network. Ann Oncol. 2013;24(8):2119‐2123. 10.1093/annonc/mdt139 PubMed DOI

Hoster E, Dreyling M, Klapper W, et al. A new prognostic index (MIPI) for patients with advanced‐stage mantle cell lymphoma. Blood. 2008;111(2):558‐565. 10.1182/blood-2007-06-095331 PubMed DOI

Morello L, Rattotti S, Giordano L, et al. Mantle cell lymphoma of mucosa‐associated lymphoid tissue: a European Mantle Cell Lymphoma Network Study. HemaSphere. 2020;4(1):e302. 10.1097/hs9.0000000000000302 PubMed DOI PMC

Wilson MR, Barrett A, Cheah CY, Eyre TA. How I manage mantle cell lymphoma: indolent versus aggressive disease. Br J Haematol. 2023;201(2):185‐198. 10.1111/bjh.18697 PubMed DOI

Mant S, Naylor GU, Crosbie N, et al. A prospective analysis of newly diagnosed mantle cell lymphoma: predictors and survival of indolent disease. presented at: EHA24; 2024; Frankfurt.

Jain P, Zhao S, Lee HJ, et al. Ibrutinib with rituximab in first‐line treatment of older patients with mantle cell lymphoma. J Clin Oncol. 2022;40(2):202‐212. 10.1200/jco.21.01797 PubMed DOI PMC

Giné E, de la Cruz F, Jiménez Ubieto A, et al. Ibrutinib in combination with rituximab for indolent clinical forms of mantle cell lymphoma (IMCL‐2015): a multicenter, open‐label, single‐arm, phase II trial. J Clin Oncol. 2022;40(11):1196‐1205. 10.1200/jco.21.02321 PubMed DOI PMC

Jerkeman M, Wader KF, Glimelius I, et al. Acalabrutinib and rituximab in elderly patients with newly diagnosed mantle cell lymphoma including a matched population‐based external comparator—the Nordic Lymphoma Group NLG‐MCL8 (ALTAMIRA) phase II trial. Blood. 2024;144(Suppl 1):747. 10.1182/blood-2024-192939 DOI

Lewis DJ, Jerkeman M, Sorrell L, et al. Ibrutinib‐rituximab is superior to rituximab‐chemotherapy in previously untreated older mantle cell lymphoma patients: results from the international randomised controlled trial, Enrich. Blood. 2024;144(Suppl 1):235. 10.1182/blood-2024-199710 DOI

Albertsson‐Lindblad A, Ekberg S, Glimelius I, et al. Limited stage mantle cell lymphoma: a real‐world study of primary treatment and prognosis in Sweden 2006‐2018. HemaSphere. 2025;9(1):e70080. 10.1002/hem3.70080 PubMed DOI PMC

Leitch HA, Gascoyne RD, Chhanabhai M, Voss NJ, Klasa R, Connors JM. Limited‐stage mantle‐cell lymphoma. Ann Oncol. 2003;14(10):1555‐1561. 10.1093/annonc/mdg414 PubMed DOI

Abrisqueta P, Scott DW, Slack GW, et al. Observation as the initial management strategy in patients with mantle cell lymphoma. Ann Oncol. 2017;28(10):2489‐2495. 10.1093/annonc/mdx333 PubMed DOI

Dabaja BS, Zelenetz AD, Ng AK, et al. Early‐stage mantle cell lymphoma: a retrospective analysis from the International Lymphoma Radiation Oncology Group (ILROG). Ann Oncol. 2017;28(9):2185‐2190. 10.1093/annonc/mdx334 PubMed DOI

Rosenbluth BD, Yahalom J. Highly effective local control and palliation of mantle cell lymphoma with involved‐field radiation therapy (IFRT). Int J Radiat Oncol Biol Phys. 2006;65(4):1185‐1191. 10.1016/j.ijrobp.2006.02.011 PubMed DOI

Zoellner AK, Unterhalt M, Stilgenbauer S, et al. Long‐term survival of patients with mantle cell lymphoma after autologous haematopoietic stem‐cell transplantation in first remission: a post‐hoc analysis of an open‐label, multicentre, randomised, phase 3 trial. Lancet Haematol. 2021;8(9):e648‐e657. 10.1016/s2352-3026(21)00195-2 PubMed DOI

Eskelund CW, Kolstad A, Jerkeman M, et al. 15‐year follow‐up of the second nordic mantle cell Lymphoma trial (MCL2): prolonged remissions without survival plateau. Br J Haematol. 2016;175(3):410‐418. 10.1111/bjh.14241 PubMed DOI

Ladetto M, Cortelazzo S, Ferrero S, et al. Lenalidomide maintenance after autologous haematopoietic stem‐cell transplantation in mantle cell lymphoma: results of a Fondazione Italiana Linfomi (FIL) multicentre, randomised, phase 3 trial. Lancet Haematol. 2021;8(1):e34‐e44. 10.1016/s2352-3026(20)30358-6 PubMed DOI

Hermine O, Jiang L, Walewski J, et al. High‐dose cytarabine and autologous stem‐cell transplantation in mantle cell lymphoma: long‐term follow‐up of the randomized mantle cell lymphoma younger trial of the European mantle cell lymphoma network. J Clin Oncol. 2023;41(3):479‐484. 10.1200/jco.22.01780 PubMed DOI

Sarkozy C, Thieblemont C, Oberic L, et al. Long‐term follow‐up of rituximab maintenance in young patients with mantle‐cell lymphoma included in the LYMA trial: a LYSA study. J Clin Oncol. 2024;42(7):769‐773. 10.1200/jco.23.01586 PubMed DOI

Dreyling M, Doorduijn J, Giné E, et al. Ibrutinib combined with immunochemotherapy with or without autologous stem‐cell transplantation versus immunochemotherapy and autologous stem‐cell transplantation in previously untreated patients with mantle cell lymphoma (TRIANGLE): a three‐arm, randomised, open‐label, phase 3 superiority trial of the European mantle cell lymphoma network. Lancet (London, England). 2024;403(10441):2293‐2306. 10.1016/s0140-6736(24)00184-3 PubMed DOI

Dreyling M, Campo E, Hermine O, et al. Newly diagnosed and relapsed mantle cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow‐up. Ann Oncol. 2017;28(suppl_4):iv62‐iv71. 10.1093/annonc/mdx223 PubMed DOI

Martin P, Cohen JB, Wang M, et al. Treatment outcomes and roles of transplantation and maintenance rituximab in patients with previously untreated mantle cell lymphoma: results from large real‐world cohorts. J Clin Oncol. 2023;41(3):541‐554. 10.1200/jco.21.02698 PubMed DOI PMC

Tisi MC, Moia R, Patti C, et al. Long‐term follow‐up of rituximab plus bendamustine and cytarabine in older patients with newly diagnosed MCL. Blood Adv. 2023;7(15):3916‐3924. 10.1182/bloodadvances.2023009744 PubMed DOI PMC

Ladetto M, Gutmair K, Doorduijn JK, et al. Impact of rituximab maintenance added to ibrutinib‐containing regimens with and without ASCT in younger, previously untreated MCL patients: an analysis of the triangle data embedded in the multiply project. Blood. 2024;144(Suppl 1):237. 10.1182/blood-2024-201441 DOI

Tessoulin B, Chiron D, Thieblemont C, et al. Oxaliplatin before autologous transplantation in combination with high‐dose cytarabine and rituximab provides longer disease control than cisplatin or carboplatin in patients with mantle‐cell lymphoma: results from the LyMA prospective trial. Bone Marrow Transplant. 2021;56(7):1700‐1709. 10.1038/s41409-020-01198-2 PubMed DOI

Sarkozy C, Callanan M, Thieblemont C, et al. Obinutuzumab vs rituximab for transplant‐eligible patients with mantle cell lymphoma. Blood. 2024;144(3):262‐271. 10.1182/blood.2024023944 PubMed DOI

Kluin‐Nelemans HC, Hoster E, Hermine O, et al. Treatment of older patients with mantle cell lymphoma (MCL): long‐term follow‐up of the randomized European MCL elderly trial. J Clin Oncol. 2020;38(3):248‐256. 10.1200/jco.19.01294 PubMed DOI

Rummel MJ, Niederle N, Maschmeyer G, et al. Bendamustine plus rituximab versus CHOP plus rituximab as first‐line treatment for patients with indolent and mantle‐cell lymphomas: an open‐label, multicentre, randomised, phase 3 non‐inferiority trial. Lancet. 2013;381(9873):1203‐1210. 10.1016/s0140-6736(12)61763-2 PubMed DOI

Rummel MJ, Knauf W, Goerner M, et al. Two years rituximab maintenance vs. observation after first‐line treatment with bendamustine plus rituximab (B‐R) in patients with mantle cell lymphoma: First results of a prospective, randomized, multicenter phase II study (a subgroup study of the StiL NHL7‐2008 MAINTAIN trial). J Clin Oncol. 2016;34(15_suppl):7503. 10.1200/JCO.2016.34.15_suppl.7503 DOI

Wang M, Mayer J, Belada D, et al. Acalabrutinib plus bendamustine and rituximab in untreated mantle cell lymphoma: results from the phase 3, double‐blind, placebo‐controlled echo trial. presented at: EHA24; 2024; Frankfurt.

Wang ML, Jurczak W, Jerkeman M, et al. Ibrutinib plus bendamustine and rituximab in untreated mantle‐cell lymphoma. N Engl J Med. 2022;386(26):2482‐2494. 10.1056/NEJMoa2201817 PubMed DOI

Robak T, Jin J, Pylypenko H, et al. Frontline bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone (VR‐CAP) versus rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP) in transplantation‐ineligible patients with newly diagnosed mantle cell lymphoma: final overall survival results of a randomised, open‐label, phase 3 study. Lancet Oncol. 2018;19(11):1449‐1458. 10.1016/s1470-2045(18)30685-5 PubMed DOI

Fischer L, Jiang L, Dürig J, et al. The addition of bortezomib to rituximab, high‐dose cytarabine and dexamethasone in relapsed or refractory mantle cell lymphoma—a randomized, open‐label phase III trial of the European mantle cell lymphoma network. Leukemia. 2024;38(6):1307‐1314. 10.1038/s41375-024-02254-2 PubMed DOI PMC

Ribrag V, Safar V, Kluin‐Nelemans H, et al. Induction and maintenance therapy in elderly patients with mantle cell lymphoma: double‐randomized MCL R2 elderly clinical trial by the European mantle cell lymphoma network. Blood. 2023;142(Suppl 1):979. 10.1182/blood-2023-188788 DOI

Ning MS, Pinnix CC, Chapman BV, et al. Low‐dose radiation (4 Gy) with/without concurrent chemotherapy is highly effective for relapsed, refractory mantle cell lymphoma. Blood Adv. 2019;3(13):2035‐2039. 10.1182/bloodadvances.2019030858 PubMed DOI PMC

Dreyling M, Doorduijn JK, Gine E, et al. Role of autologous stem cell transplantation in the context of ibrutinib‐containing first‐line treatment in younger patients with mantle cell lymphoma: results from the randomized triangle trial by the European MCL network. Blood. 2024;144(Suppl 1):240. 10.1182/blood-2024-200735 DOI

Kumar A, Soumerai J, Abramson JS, et al. Zanubrutinib, obinutuzumab, and venetoclax for first‐line treatment of mantle cell lymphoma with a PubMed DOI PMC

Le Gouill S, Morschhauser F, Chiron D, et al. Ibrutinib, obinutuzumab, and venetoclax in relapsed and untreated patients with mantle cell lymphoma: a phase 1/2 trial. Blood. 2021;137(7):877‐887. 10.1182/blood.2020008727 PubMed DOI

Visco C, Tabanelli V, Sacchi MV, et al. Rituximab, bendamustine and cytarabine followed by venetoclax (V‐RBAC) in high‐risk older patients with mantle cell lymphoma: a phase 2 study by the Fondazione Italiana Linfomi (FIL). Blood. 2023;142(Suppl 1):737. 10.1182/blood-2023-179169 DOI

Le Gouill S, Długosz‐Danecka M, Rule S, et al. Final results and overall survival data from a phase II study of acalabrutinib monotherapy in patients with relapsed/refractory mantle cell lymphoma, including those with poor prognostic factors. Haematologica. 2024;109(1):343‐350. 10.3324/haematol.2022.282469 PubMed DOI PMC

Wang M, Rule S, Zinzani PL, et al. Acalabrutinib in relapsed or refractory mantle cell lymphoma (ACE‐LY‐004): a single‐arm, multicentre, phase 2 trial. Lancet. 2018;391(10121):659‐667. 10.1016/s0140-6736(17)33108-2 PubMed DOI PMC

Wang ML, Blum KA, Martin P, et al. Long‐term follow‐up of MCL patients treated with single‐agent ibrutinib: updated safety and efficacy results. Blood. 2015;126(6):739‐745. 10.1182/blood-2015-03-635326 PubMed DOI PMC

Wang ML, Rule S, Martin P, et al. Targeting BTK with ibrutinib in relapsed or refractory mantle‐cell lymphoma. N Engl J Med. 2013;369(6):507‐516. 10.1056/NEJMoa1306220 PubMed DOI PMC

Deng LJ, Zhou KS, Liu LH, et al. Orelabrutinib for the treatment of relapsed or refractory MCL: a phase 1/2, open‐label, multicenter, single‐arm study. Blood Adv. 2023;7(16):4349‐4357. 10.1182/bloodadvances.2022009168 PubMed DOI PMC

Song Y, Zhou K, Zou D, et al. Treatment of patients with relapsed or refractory mantle‐cell lymphoma with zanubrutinib, a selective inhibitor of Bruton's tyrosine kinase. Clin Cancer Res. 2020;26(16):4216‐4224. 10.1158/1078-0432.Ccr-19-3703 PubMed DOI

Song Y, Zhou K, Zou D, et al. Zanubrutinib in relapsed/refractory mantle cell lymphoma: long‐term efficacy and safety results from a phase 2 study. Blood. 2022;139(21):3148‐3158. 10.1182/blood.2021014162 PubMed DOI PMC

Wang ML, Jurczak W, Zinzani PL, et al. Pirtobrutinib in covalent bruton tyrosine kinase inhibitor pretreated mantle‐cell lymphoma. J Clin Oncol. 2023;41(24):3988‐3997. 10.1200/jco.23.00562 PubMed DOI PMC

Novak U, Fehr M, Schär S, et al. Combined therapy with ibrutinib and bortezomib followed by ibrutinib maintenance in relapsed or refractory mantle cell lymphoma and high‐risk features: a phase 1/2 trial of the European MCL network (SAKK 36/13). EClinicalMedicine. 2023;64:102221. 10.1016/j.eclinm.2023.102221 PubMed DOI PMC

Tam CS, Anderson MA, Pott C, et al. Ibrutinib plus venetoclax for the treatment of mantle‐cell lymphoma. N Engl J Med. 2018;378(13):1211‐1223. 10.1056/NEJMoa1715519 PubMed DOI

Wang M, Jurczak W, Trneny M, et al. Ibrutinib plus venetoclax in relapsed or refractory mantle cell lymphoma (SYMPATICO): a multicentre, randomised, double‐blind, placebo‐controlled, phase 3 study. Lancet Oncol. 2025;26(2):200‐213. 10.1016/S1470-2045(24)00682-X PubMed DOI

Tam CS, Lasica M, Soumerai JD, et al. Combination treatment with novel BCL2 inhibitor sonrotoclax (BGB‐11417) and zanubrutinib induces high rate of complete remission (CR) in patients with relapsed/refractory mantle cell lymphoma (MCL). presented at: EHA 2025; 2025; Milan, Italy.

Jerkeman M, Eskelund CW, Hutchings M, et al. Ibrutinib, lenalidomide, and rituximab in relapsed or refractory mantle cell lymphoma (PHILEMON): a multicentre, open‐label, single‐arm, phase 2 trial. The Lancet Haematology. 2018;5(3):e109‐e116. 10.1016/s2352-3026(18)30018-8 PubMed DOI

Jerkeman M, Kolstad A, Hutchings M, et al. MRD‐driven treatment with venetoclax‐R2 in mantle cell lymphoma: the Nordic Lymphoma Group MCL7 VALERIA trial. Blood Adv. 2024;8(2):407‐415. 10.1182/bloodadvances.2023011920 PubMed DOI PMC

Martin P, Bartlett NL, Blum KA, et al. A phase 1 trial of ibrutinib plus palbociclib in previously treated mantle cell lymphoma. Blood. 2019;133(11):1201‐1204. 10.1182/blood-2018-11-886457 PubMed DOI PMC

Visco C, Di Rocco A, Evangelista A, et al. Outcomes in first relapsed‐refractory younger patients with mantle cell lymphoma: results from the MANTLE‐FIRST study. Leukemia. 2021;35(3):787‐795. 10.1038/s41375-020-01013-3 PubMed DOI

Malinverni C, Bernardelli A, Glimelius I, et al. Outcomes of younger patients with mantle cell lymphoma experiencing late relapse (>24 months): the LATE‐POD study. Blood. 2024;144(9):1001‐1009. 10.1182/blood.2023023525 PubMed DOI

Dreyling M, Goy A, Hess G, et al. Long‐term outcomes with ibrutinib treatment for patients with relapsed/refractory mantle cell lymphoma: a pooled analysis of 3 clinical trials with nearly 10 years of follow‐up. HemaSphere. 2022;6(5):e712. 10.1097/hs9.0000000000000712 PubMed DOI PMC

Rusconi C, Cheah CY, Eyre TA, et al. Ibrutinib improves survival compared with chemotherapy in mantle cell lymphoma with central nervous system relapse. Blood. 2022;140(17):1907‐1916. 10.1182/blood.2022015560 PubMed DOI

McCulloch R, Lewis D, Crosbie N, et al. Ibrutinib for mantle cell lymphoma at first relapse: a United Kingdom real‐world analysis of outcomes in 211 patients. Br J Haematol. 2021;193(2):290‐298. 10.1111/bjh.17363 PubMed DOI

Sharman J, Kabadi SM, Clark J, Andorsky D. Treatment patterns and outcomes among mantle cell lymphoma patients treated with ibrutinib in the United States: a retrospective electronic medical record database and chart review study. Br J Haematol. 2021;192(4):737‐746. 10.1111/bjh.16922 PubMed DOI

Byrd JC, Hillmen P, Ghia P, et al. Acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia: results of the first randomized phase III trial. J Clin Oncol. 2021;39(31):3441‐3452. 10.1200/jco.21.01210 PubMed DOI PMC

Hillmen P, Eichhorst B, Brown JR, et al. Zanubrutinib versus ibrutinib in relapsed/refractory chronic lymphocytic leukemia and small lymphocytic lymphoma: interim analysis of a randomized phase III trial. J Clin Oncol. 2023;41(5):1035‐1045. 10.1200/jco.22.00510 PubMed DOI PMC

Tam CS, Opat S, D'sa S, et al. A randomized phase 3 trial of zanubrutinib vs ibrutinib in symptomatic Waldenström macroglobulinemia: the ASPEN study. Blood. 2020;136(18):2038‐2050. 10.1182/blood.2020006844 PubMed DOI PMC

Rogers KA, Thompson PA, Allan JN, et al. Phase II study of acalabrutinib in ibrutinib‐intolerant patients with relapsed/refractory chronic lymphocytic leukemia. Haematologica. 2021;106(9):2364‐2373. 10.3324/haematol.2020.272500 PubMed DOI PMC

Rule S, Dreyling M, Goy A, et al. Outcomes in 370 patients with mantle cell lymphoma treated with ibrutinib: a pooled analysis from three open‐label studies. Br J Haematol. 2017;179(3):430‐438. 10.1111/bjh.14870 PubMed DOI PMC

Villa D, Jiang A, Visco C, et al. Time to progression of disease and outcomes with second‐line BTK inhibitors in relapsed/refractory mantle cell lymphoma. Blood Adv. 2023;7(16):4576‐4585. 10.1182/bloodadvances.2023009804 PubMed DOI PMC

Eyre TA, Bishton MJ, McCulloch R, et al. Diagnosis and management of mantle cell lymphoma: a British Society for Haematology Guideline. Br J Haematol. 2024;204(1):108‐126. 10.1111/bjh.19131 PubMed DOI

Handunnetti SM, Anderson MA, Burbury K, et al. Seven‐year outcomes of venetoclax‐ibrutinib therapy in mantle cell lymphoma: durable responses and treatment‐free remissions. Blood. 2024;144(8):867‐872. 10.1182/blood.2023023388 PubMed DOI PMC

Wang ML, Lee H, Chuang H, et al. Ibrutinib in combination with rituximab in relapsed or refractory mantle cell lymphoma: a single‐centre, open‐label, phase 2 trial. Lancet Oncol. 2016;17(1):48‐56. 10.1016/s1470-2045(15)00438-6 PubMed DOI

Portell CA, Wages NA, Kahl BS, et al. Dose‐finding study of ibrutinib and venetoclax in relapsed or refractory mantle cell lymphoma. Blood Adv. 2022;6(5):1490‐1498. 10.1182/bloodadvances.2021005357 PubMed DOI PMC

Jurczak W, Wang M, Trneny M, et al. Efficacy and safety of ibrutinib plus venetoclax in patients with mantle cell lymphoma (MCL) and TP53 mutations in the sympatico study. presented at: EHA24; 2024; Frankfurt.

Wang M, Fayad L, Wagner‐Bartak N, et al. Lenalidomide in combination with rituximab for patients with relapsed or refractory mantle‐cell lymphoma: a phase 1/2 clinical trial. Lancet Oncol. 2012;13(7):716‐723. 10.1016/s1470-2045(12)70200-0 PubMed DOI

Hess G, Dreyling M, Oberic L, et al. Real‐world experience among patients with relapsed/refractory mantle cell lymphoma after Bruton tyrosine kinase inhibitor failure in Europe: the SCHOLAR‐2 retrospective chart review study. Br J Haematol. 2023;202(4):749‐759. 10.1111/bjh.18519 PubMed DOI PMC

McCulloch R, Visco C, Eyre TA, et al. Efficacy of R‐BAC in relapsed, refractory mantle cell lymphoma post BTK inhibitor therapy. Br J Haematol. 2020;189(4):684‐688. 10.1111/bjh.16416 PubMed DOI

Sawalha Y, Goyal S, Switchenko JM, et al. A multicenter analysis of the outcomes with venetoclax in patients with relapsed mantle cell lymphoma. Blood Adv. 2023;7(13):2983‐2993. 10.1182/bloodadvances.2022008916 PubMed DOI PMC

Wang M, Schuster SJ, Phillips T, et al. Observational study of lenalidomide in patients with mantle cell lymphoma who relapsed/progressed after or were refractory/intolerant to ibrutinib (MCL‐004). J Hematol Oncol. 2017;10(1):171. 10.1186/s13045-017-0537-5 PubMed DOI PMC

Wang M, Munoz J, Goy A, et al. KTE‐X19 CAR T‐cell therapy in relapsed or refractory mantle‐cell lymphoma. N Engl J Med. 2020;382(14):1331‐1342. 10.1056/NEJMoa1914347 PubMed DOI PMC

Wang M, Munoz J, Goy A, et al. Three‐year follow‐up of KTE‐X19 in patients with relapsed/refractory mantle cell lymphoma, including high‐risk subgroups, in the ZUMA‐2 study. J Clin Oncol. 2023;41(3):555‐567. 10.1200/jco.21.02370 PubMed DOI PMC

Wang M, Siddiqi T, Gordon LI, et al. Lisocabtagene maraleucel in relapsed/refractory mantle cell lymphoma: primary analysis of the mantle cell lymphoma cohort from TRANSCEND NHL 001, a phase I multicenter seamless design study. J Clin Oncol. 2024;42(10):1146‐1157. 10.1200/jco.23.02214 PubMed DOI PMC

Mato AR, Shah NN, Jurczak W, et al. Pirtobrutinib in relapsed or refractory B‐cell malignancies (BRUIN): a phase 1/2 study. Lancet. 2021;397(10277):892‐901. 10.1016/s0140-6736(21)00224-5 PubMed DOI PMC

Woyach JA, Stephens DM, Flinn IW, et al. First‐in‐human study of the reversible BTK inhibitor nemtabrutinib in patients with relapsed/refractory chronic lymphocytic leukemia and B‐cell non‐Hodgkin lymphoma. Cancer Discovery. 2024;14(1):66‐75. 10.1158/2159-8290.Cd-23-0670 PubMed DOI

Phillips TJ, Carlo‐Stella C, Morschhauser F, et al. Glofitamab in relapsed/refractory mantle cell lymphoma: results from a phase I/II study. J Clin Oncol. 2025;43(3):318‐328. 10.1200/jco.23.02470 PubMed DOI PMC

Phillips TJ, Matasar M, Eyre TA, et al. GLOBRYTE: a phase III, open‐label, multicenter, randomized trial evaluating glofitamab monotherapy in patients with relapsed or refractory mantle cell lymphoma. Blood. 2023;142(Suppl 1):3052. 10.1182/blood-2023-173946 DOI

Wang ML, Assouline S, Kamdar M, et al. Fixed duration mosunetuzumab plus polatuzumab vedotin has promising efficacy and a manageable safety profile in patients with BTKi relapsed/refractory mantle cell lymphoma: initial results from a phase Ib/II study. Blood. 2023;142(Suppl 1):734. 10.1182/blood-2023-174956 DOI

Danilov A, Tees MT, Patel K, et al. A first‐in‐human phase 1 trial of NX‐2127, a first‐in‐class Bruton's tyrosine kinase (BTK) dual‐targeted protein degrader with immunomodulatory activity, in patients with relapsed/refractory B cell malignancies. Blood. 2023;142(Suppl 1):4463. 10.1182/blood-2023-179872 DOI

Seymour JF, Cheah CY, Parrondo R, et al. First results from a phase 1, first‐in‐human study of the Bruton's tyrosine kinase (BTK) degrader Bgb‐16673 in patients (Pts) with relapsed or refractory (R/R) B‐cell malignancies (BGB‐16673‐101). Blood. 2023;142(Suppl 1):4401. 10.1182/blood-2023-180109 DOI

Wang ML, Barrientos JC, Furman RR, et al. Zilovertamab vedotin targeting of ROR1 as therapy for lymphoid cancers. NEJM Evidence. 2022;1(1):EVIDoa2100001. 10.1056/EVIDoa2100001 PubMed DOI

Fenske TS, Zhang MJ, Carreras J, et al. Autologous or reduced‐intensity conditioning allogeneic hematopoietic cell transplantation for chemotherapy‐sensitive mantle‐cell lymphoma: analysis of transplantation timing and modality. J Clin Oncol. 2014;32(4):273‐281. 10.1200/jco.2013.49.2454 PubMed DOI PMC

Robinson SP, Boumendil A, Finel H, et al. Long‐term outcome analysis of reduced‐intensity allogeneic stem cell transplantation in patients with mantle cell lymphoma: a retrospective study from the EBMT Lymphoma Working Party. Bone Marrow Transplant. 2018;53(5):617‐624. 10.1038/s41409-017-0067-3 PubMed DOI

Le Gouill S, Kröger N, Dhedin N, et al. Reduced‐intensity conditioning allogeneic stem cell transplantation for relapsed/refractory mantle cell lymphoma: a multicenter experience. Ann Oncol. 2012;23(10):2695‐2703. 10.1093/annonc/mds054 PubMed DOI

Lin RJ, Ho C, Hilden PD, et al. Allogeneic haematopoietic cell transplantation impacts on outcomes of mantle cell lymphoma with PubMed DOI PMC

Lew TE, Cliff ERS, Dickinson M, et al. Allogeneic stem cell transplantation achieves long‐term remissions in mantle cell lymphoma, including in PubMed DOI

Liebers N, Boumendil A, Finel H, et al. Brexucabtagene autoleucel versus allogeneic hematopoietic cell transplantation in relapsed and refractory mantle cell lymphoma. Blood Cancer Discov. 2025;6(3):182‐190. 10.1158/2643-3230.Bcd-24-0178 PubMed DOI PMC

Gutierrez A, Bento L, Novelli S, et al. Allogeneic stem cell transplantation in mantle cell lymphoma; Insights into its potential role in the era of new immunotherapeutic and targeted therapies: the GETH/GELTAMO experience. Cancers. 2022;14(11):2673. 10.3390/cancers14112673 PubMed DOI PMC

Bishop MR. Late complications and long‐term care of adult CAR T‐cell patients. Hematology. 2024;2024(1):109‐115. 10.1182/hematology.2024000534 PubMed DOI PMC

Tabbara N, Dioverti‐Prono MV, Jain T. Mitigating and managing infection risk in adults treated with CAR T‐cell therapy. Hematology. 2024;2024(1):116‐125. 10.1182/hematology.2024000535 PubMed DOI PMC

Cordas Dos Santos DM, Tix T, Shouval R, et al. A systematic review and meta‐analysis of nonrelapse mortality after CAR T cell therapy. Nat Med. 2024;30(9):2667‐2678. 10.1038/s41591-024-03084-6 PubMed DOI PMC

Thompson JA, Schneider BJ, Brahmer J, et al. NCCN guidelines® insights: management of immunotherapy‐related toxicities, version 2.2024. J Natl Compr Cancer Netw. 2024;22(9):582‐592. 10.6004/jnccn.2024.0057 PubMed DOI