ALSG consensus for advanced stage MCL in elderly, unfit patients The choice of therapy in Asia is limited by drug availability and reimbursement status. R-CHOP, R-BAC, CHOP, and VR-CAP are used in this setting in Asia, while BR is the preferred regimen in elderly, unfit patients. Bendamustine is associated with lower CD4 counts and an increased risk of infection. These risks must be monitored closely when considering this agent and prophylaxis for pneumocystis pneumonia should be considered. Clinical trial enrollment is strongly suggested where possible, especially for patients with TP53 mutation, which is associated with poor prognosis by conventional treatment.