 2. Patients with MCL must be symptomatic and need immediate therapy. Symptoms and nature of MCL include any of the following: a blastoid variant; b pleomorphic variant; c B symptoms, d MIPI 3, e Ki 67 30, f bulky tumors 7 cm or in case of 2 tumors, each 5 cm in diameter, g disease threatening organ function, h elevated LDH, i PB WBC 50,000, j pancytopenia due to bone marrow MCL, k patients choice due to anxiety; l pain due to lymphoma; m somatic mutations in the TP53, c-MYC or NOTCH genes; n size of spleen 20 cm 