Efficacy and safety of zanubrutinib combined with age-adapted bendamustine and rituximab followed by zanubrutinib maintenance therapy in elderly patients with mantle cell lymphoma: a retrospective analysis.

We retrospectively evaluated the efficacy and safety of zanubrutinib combined with age-adapted bendamustine and rituximab followed by zanubrutinib maintenance in 23 elderly patients with mantle cell lymphoma (MCL). Patients received six induction cycles of this regimen, followed by zanubrutinib maintenance for ≥2 years. After induction, the complete response rate was 73.9% and the overall response rate was 91.3%. The 24-month progression-free survival rate was 75.4% and the overall survival rate was 90.7%. Undetectable minimal residual disease (uMRD) was achieved in 88% of patients after induction and increased to 94% during maintenance. CD4 + T cell and NK cell counts declined to nadir post-induction but recovered by 12 months. Zanubrutinib combined with age-adapted bendamustine and rituximab, followed by zanubrutinib maintenance, is an active and feasible regimen for elderly patients with MCL, offering a potential treatment option in clinical practice.