B-Cell Lymphomas, Version 4.2026, NCCN Clinical Practice Guidelines In Oncology

Mantle cell lymphoma (MCL) is a heterogenous subtype of B-cell non-Hodgkin lymphoma (NHL). The treatment landscape of newly diagnosed MCL has evolved in recent years with the incorporation of covalent BTK inhibitors, sensitive assays for the assessment of measurable residual disease (MRD), and predefined maintenance or continuous therapy. Covalent BTK inhibitor-based regimens are also appropriate options for patients with previously untreated classic MCL with TP53 mutations. Pirtobrutinib (a highly selective noncovalent BTK inhibitor) and CAR T-cell therapy (brexucabtagene autoleucel or lisocabtagene maraleucel) have emerged as effective treatment options for refractory or progressive disease after prior treatment with covalent BTK inhibitors. This selection from NCCN Guidelines for B-Cell Lymphomas focuses on the recommendations for the diagnosis and treatment of MCL.