Ibrutinib in Relapsed or Refractory Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia

Authors' disclosures of potential conflicts of interest are found at the end of this article. T argeted scientific advancements have produced novel therapies and made significant improvements in the clinical landscape of non-Hodg-kin lymphoma (NHL) treatment. Although mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL) are both B-cell lymphocyte subtypes of NHL neoplasms, there are several notable differences. Mantle cell lymphoma is an aggressive subtype of NHL characterized by a poor prognosis. Approximately 6% of all newly diagnosed NHL patients present with MCL The clinical course of MCL features a declining survival curve resulting in a median overall survival (OS) of 4 to 6 years (Dreyling & Hid-demann, 2009). Chronic lymphocytic leukemia is an indolent leukemia/NHL sub-type. It is the most common leukemia in adults. US trends for CLL predict 15,720 new cases and 4,600 deaths among adults in 2014 (Siegel et al., 2014). Chronic lymphocytic leukemia has a variable clinical course due to an assortment of mutations that display resistance to conventional therapy. Both MCL and CLL are fundamentally caused by a malfunction in the standard B-cell maturation process. However, each is distinct, as the respective disorders occur in separate phases of B-cell differentiation. Mantle cell lymphoma is considered to be a pregerminal center neoplasm resulting from a mutation to naive B cells; CLL is known as a postgerminal center neoplasm developing into a monoclonal expansion of a mutated memory B Currently, there are no cura-tive therapeutic courses for MCL and CLL. Standard frontline therapies for both MCL and CLL consist primarily of chemotherapeutic and chemoimmunotherapeutic agents. Specifically, MCL induction therapy includes a chemotherapeutic backbone along with rituximab (Ritux-an) treatment. Current treatment regimens are often followed by stem cell transplants and do demonstrate