Mantle Cell Lymphoma
A type of non-Hodgkin lymphoma arising from B cells in the mantle zone of lymph nodes. Bortezomib is approved for mantle cell lymphoma treatment, representing one of the non-myeloma indications for peptide-based proteasome inhibitors.
Technical Context
MCL arises from B cells in the mantle zone of lymph node follicles. Characterised by the t(11;14)(q13;q32) translocation → cyclin D1 overexpression → dysregulated cell cycle. MCL accounts for approximately 5-7% of NHL. Clinical course: historically aggressive (median survival 3-5 years) but newer therapies improving outcomes. Bortezomib is approved for relapsed/refractory MCL based on the PINNACLE trial (overall response rate approximately 33%, complete response approximately 8%). MCL treatment has evolved: first-line induction with R-DHAP or R-HyperCVAD including bortezomib, consolidation with ASCT in younger patients, and maintenance therapy. BTK inhibitors (ibrutinib, acalabrutinib) have become important for relapsed MCL. Bortezomib's role in MCL illustrates the broader applicability of peptide-based proteasome inhibition beyond myeloma.