Follicular & Mantle Cell Lymphoma Treatment Algorithm: Dr. Jonathan Friedberg

Treatment algorithms for follicular and mantle cell lymphoma prioritize clinical outcomes and toxicity management. For follicular lymphoma, bone marrow biopsies are largely unnecessary, and rituximab maintenance is increasingly omitted due to infection risks and lack of overall survival benefits. In relapsed settings, bispecific antibodies offer promising alternatives to traditional chemotherapy. Mantle cell lymphoma management requires TP53 testing to guide therapy, with BTK inhibitors serving as the frontline standard. Emerging data from studies like Triangle suggest that autologous stem cell transplant can often be omitted when using aggressive BTK-based induction. Pirtobrutinib provides a critical bridge for patients progressing on covalent BTK inhibitors, while CAR-T therapy remains a vital option for later-line disease. Lymphoma expert Jonathan Friedberg emphasizes the importance of partnering with specialized centers to navigate these complex, evolving treatment paradigms effectively.