Pharmacy and Wellness Review


Mantle cell lymphoma (MCL) is a rare and moderately aggressive form of non-Hodgkin's lymphoma (NHL) that predominantly presents at an advanced stage in older males. Patients often present with multiple involvement in the lymph nodes, blood, spleen, bone marrow and gastrointestinal tract (GIT). Some patients may be asymptomatic in early stages or present with an incurable, indolent (slow progressing) form, while other patients display rapid growth of more aggressive lymphomas. Overall survival for patients diagnosed with MCL is four to five years and treatment should be initiated in those who are symptomatic. Mantle cell lymphoma responds well to first-line treatment, but recurrent relapses are common, and no regimen has been proven superior for relapsed or refractory MCL. The U.S. Food and Drug Administration (FDA) has recently approved ibrutinib (lmbruvica™) as breakthrough MCL therapy. lbrutinib is a Bruton's tyrosine kinase (BTK) inhibitor that interferes with malignant B-cell proliferation and survival. In a recent clinical study, ibrutinib proved to be a highly active monotherapy with a favorable toxicity profile in 111 patients with relapsed or refractory MCL. As an oral chemotherapy drug, ibrutinib has the potential to improve patient compliance. Additionally, specialty pharmacies dispensing ibrutinib will be able to play an important role in patient counseling and monitoring.



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