{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:51:18Z","timestamp":1791366678998,"version":"4.3.1"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Marked by significant biological and clinical heterogeneity, mantle cell lymphoma (MCL) in older adults represents a growing clinical challenge, driven by an aging population, increasing burden of comorbidities, and reduced tolerance to intensive chemotherapy. This paper tackles contemporary therapeutic strategies for older and less fit patients with MCL. We conducted a structured review of the English literature using PubMed, Embase, and the Cochrane Library, including studies published between January 2000 and November 2025. Geriatric vulnerabilities are associated with increased toxicity and mortality and may preclude participation in clinical trials. As frontline, bendamustine\u2010based chemoimmunotherapy followed by rituximab maintenance remains a feasible option. Second\u2010generation Bruton tyrosine kinase inhibitors (BTKis) constitute valid options in both treatment\u2010na\u00efve and relapsed disease, being preferred in patients with high Ki\u201067 or when chemotherapy is contraindicated or refused. In TP53\u2010mutated MCL, a second\u2010generation BTKi combined with BCL2 inhibition\u2009\u00b1\u2009anti\u2010CD20 therapy appears promising, but larger trials are needed. In this age category, autologous stem cell transplantation and CAR\u2010T therapy pose significant morbidity risks. Antibody\u2010drug conjugates and bispecifics may offer additional options in later lines. Optimal management requires individualized, fitness\u2010adapted strategies integrating biological risk and geriatric assessment. Continued development of well\u2010tolerated regimens and rational sequencing is essential to improve outcomes.<\/jats:p>","DOI":"10.1111\/ejh.70272","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:57:38Z","timestamp":1784703458000},"page":"1206-1217","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mantle Cell Lymphoma in Geriatric Patients: Biologic Risk Stratification, Fitness\u2010Adapted Strategies, and Unmet Needs"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3445-7546","authenticated-orcid":false,"given":"Victor M.","family":"Samperio","sequence":"first","affiliation":[{"name":"Department of Medicine Eisenhower Health  Rancho Mirage California 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