Mantle cell lymphoma
This page is about mantle cell lymphoma. It includes information on
Mantle cell lymphoma
Mantle cell lymphoma is a rare type of non Hodgkin's lymphoma (NHL). Only about 5 out of every 100 people (5%) diagnosed with NHL have mantle cell lymphoma. It mainly affects men who are over 50. The symptoms of mantle cell lymphoma are similar to those of most other types of NHL.
The grade of an NHL (the appearance of the cells under the microscope) helps doctors to decide on the most appropriate treatment. Mantle cell lymphoma looks like a low grade lymphoma under the microscope. But it often behaves aggressively, like a high grade lymphoma. Unfortunately it is often widespread when it is diagnosed, involving lymph nodes, bone marrow, and, very often, the spleen.
Treating mantle cell lymphoma
Treatment for mantle cell lymphoma is similar to treatment for other types of NHL. But it is difficult to cure. It is an aggressive type of NHL and people are often diagnosed in the later stages of the disease. Aggressive means that the lymphoma grows very quickly. Unfortunately, it often comes back relatively soon after you get it into remission.
Mantle cell lymphoma is a rare type of non Hodgkin's lymphoma (NHL). There are about 20 different types of NHL. Only about 5 to 10 out of every 100 people (5 to 10%) diagnosed with NHL have mantle cell lymphoma. It mainly affects men who are over 50.
Non Hodgkin’s lymphoma is cancer of the lymphatic system. The lymphatic system has tubes that branch through all parts of the body, similar to the arteries and veins that carry blood in the circulatory system. The lymphatic system carries a colourless liquid called 'lymph'. This fluid circulates around the body tissues. It contains a high number of white blood cells (lymphocytes), which fight infection.
If you have lymphoma then some of your white blood cells (lymphocytes) are working overtime. They are 'out of control' and start to divide abnormally. They do not have any resting time, like normal cells, and go from one cycle of growth straight into the next. There are two main types of lymphocytes - B cells and T cells. Mantle cell lymphoma affects the B cells.
The big problem with NHL is that these cells start to divide before they are fully mature. So they can't fight infection as normal white blood cells do. All these abnormal, ineffective lymphocytes start to collect in the lymph nodes or body organs. They can then form tumours and begin to cause problems within the lymphatic system or the organ in which they are growing.
The symptoms of mantle cell lymphoma are similar to those of most other types of NHL. The most common symptom is one or more painless swellings in the
- Neck
- Armpit
- Groin
Each swelling is an enlarged lymph node. If you have a swollen lymph node that does not go away after 6 weeks, you should see your GP.
You may have other general symptoms such as
- Heavy sweating at night
- Temperatures that come and go with no obvious cause
- Losing a lot of weight (more than one tenth of your total weight)
Doctors call this group of symptoms 'B symptoms'. Some people with non Hodgkin's lymphoma have them, but most don't. Mantle cell lymphoma can spread to the bowel and stomach. If this happens, it can cause symptoms such as diarrhoea and sickness.
It is important for you to tell your doctor about any symptoms like this, because it helps to decide which type of non Hodgkin's lymphoma you have, and so what type of treatment you need. There is more information about the symptoms of NHL in this section of CancerHelp UK.
Doctors put non Hodgkin's lymphomas into two groups depending on how quickly they are likely to grow and spread
- Low grade or slow growing
- High grade or fast growing
The grade of an NHL (the appearance of the cells under the microscope) helps doctors to decide on the most appropriate treatment. Mantle cell lymphoma looks like a low grade lymphoma under the microscope. But it often behaves aggressively, like a high grade lymphoma. Unfortunately it is often widespread when it is diagnosed, involving lymph nodes, bone marrow, and, very often, the spleen.
The stage is also very important in deciding about treatment. The number and position of the lymph nodes or other organs in the body that are affected gives the doctor the stage of NHL. There is more information about the stages of NHL in this section of CancerHelp UK.
Treatment for mantle cell lymphoma is similar to treatment for other types of NHL. But it is difficult to cure. It is an aggressive type of NHL and people are often diagnosed in the later stages of the disease. By 'aggressive', we mean that the lymphoma grows very quickly. Unfortunately, it often comes back fairly soon after you get it into remission. If you have mantle cell lymphoma your doctor may suggest you join a clinical trial. Trials most often compare the best known standard treatment with an experimental treatment that doctors hope will work better.
Doctors treat mantle cell lymphoma with one or more of these treatments
Chemotherapy
Chemotherapy is the most common type of treatment for people with mantle cell lymphoma. For people who are not fit enough to have very aggressive chemotherapy, the most common drugs used are
- Chlorambucil
- Cyclophosphamide, vincristine, and the steroid drug prednisolone (CVP) or
- Cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP)
Click on the links to find out the specific side effects of these drugs. Mantle cell lymphoma may also be treated with a combination of chemotherapy and rituximab.
Some people with mantle cell lymphoma have high dose chemotherapy with a bone marrow or stem cell transplant. High dose chemotherapy increases the risk of complications, such as infection, but gives the best chance of curing the lymphoma. You will need to stay in hospital for a few weeks to have this treatment. This treatment is hard going but you will get a lot of support from the staff during your stay in hospital. Look at the section on transplants for more about this type of treatment.
Radiotherapy
If you have stage 1 or 2 mantle cell lymphoma, your doctor may treat you with radiotherapy. Or you may have this in combination with chemotherapy for advanced stages of the disease. There is more about radiotherapy in the non Hodgkin’s lymphoma section of CancerHelp UK.
Steroid therapy
Steroids are substances made naturally in the body. They can also be made artificially and used as drugs. Steroids are used for many different reasons, and for many different illnesses and conditions. In non Hodgkin's lymphoma, you take steroids along with your chemotherapy drugs. Doctors have found that the treatment is more successful when you have steroids and chemotherapy together. The common steroid drugs are
- Prednisolone
- Dexamethasone and
- Methylprednisolone
There is more information about steroid therapy in the treating non Hodgkin’s lymphoma section of CancerHelp UK.
Biological therapy
Biological therapy means using a drug made from natural substances produced by the body to fight cancer. One of these drugs is bortezomib (Velcade). Bortezomib is a 'proteasome inhibitor'. This means that it interferes with the chemicals inside cells, making proteins build up and kill the cells. Cancer cells are more sensitive to proteasome inhibitors than normal cells. A trial is looking at giving bortezomib with CHOP chemotherapy for mantle cell lymphoma. Researchers want to find out if this works better than just the chemotherapy on its own. There is more information about this trial on our clinical trials database.
Rituximab is another type of biological therapy used to treat mantle cell lymphoma. Rituximab is a type of monoclonal antibody. It may be used in combination with chemotherapy. Other newer monoclonal antibodies are being researched for treating mantle cell lymphoma. Look in treating non Hodgkin’s lymphoma for more information about treatment with biological therapies. There is also information about new monoclonal antibody treatments for NHL in the non Hodgkin's lymphoma research section.
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