Table 3.

Final clinical practice guidelines consensus statements for transplantation and CAR T-cell treatments in the front-line setting for mantle cell lymphoma

Consensus Statements	Grading of Recommendations †	Percentage of Panelists in Agreement
1. The panel recommends autologous HCT as consolidation therapy in eligible, newly diagnosed MCL patients (without TP53 mutation or bi-allelic deletion) in complete remission or partial remission after first line therapies.	A	87.9%
2. The panel does not recommend autologous transplantation as consolidation therapy in MCL patients with disease not responsive to most recent anti-lymphoma therapy.	B	100%
3. The panel does not recommend using measurable residual disease (MRD) testing to guide use of autologous transplant consolidation after first line therapies in MCL, outside the setting of a clinical trial.	C	100%
4. The panel does not recommend using MIPI or MIPI-c prognostic score as a criterion determining use of autologous transplantation as consolidation therapy in eligible newly diagnosed MCL patients in first complete remission or partial remission after first line therapies.	C	100%
5. The panel does not recommend allogeneic transplant consolidation in MCL patients (without TP53 mutation or bi-allelic deletion), achieving a complete or partial remission after first line therapies.	B	97%
6. The panel does not recommend consolidation with CAR T-cell therapy in MCL patients, achieving a complete or partial remission after first line therapies, outside the setting of a clinical trial.	C	100%
7. If a TP53 mutation (or bi-allelic deletion) is present, the panel recognizes that outcomes are poor for MCL patients in complete or partial remission after first line therapies who then undergo autologous transplantation. However, no specific alternative strategy has yet been shown to improve outcomes in such patients. Therefore, the panel recommends considering autologous transplant consolidation as well as alternative consolidation strategies (e.g. CAR T-cell therapy or allogeneic transplantation), ideally in the context of a clinical trial, for such patients.	C	100%

Abbreviation: HCT – hematopoietic cell transplantation; PET/CT – positron emission tomography/computed tomography; MCL - mantle cell lymphoma

^†Agency of Healthcare Research and Quality (AHRQ) grading of recommendations based on level of evidence ¹⁵:

A = There is good research-based evidence to support the recommendation;

B = There is fair research-based evidence to support the recommendation;

C = The recommendation is based on expert opinion and panel consensus:

X = There is evidence of harm from this intervention.