Mantle Cell Lymphoma and its Treatment
- Mantle cell lymphoma is a type of non-Hodgkin lymphoma
- The disease can either grow slowly or quickly, which affects doctors’ approach to treatment
- Aggressive treatment is needed for fast-growing mantle cell lymphoma
In people with mantle cell lymphoma, some of the lymphocytes change into cancer cells and multiply quickly. This type of lymphoma affects B cell lymphocytes, the immune cells that make proteins called antibodies to help the body fight off germs and other invaders. B cells on the outer edge of a lymph node — an area called the “mantle zone” — are the ones that turn cancerous.
Read MoreTreatment Decisions For People With Mantle Cell Lymphoma
Dr. Chong explains that a big challenge with mantle cell lymphoma is that doctors are still working to determine the best ways to treat it. "We have lots of upfront options for newly diagnosed mantle cell lymphoma, but I think the biggest things to figure out when it’s first diagnosed are whether or not it’s behaving more indolently, meaning less aggressively, or if it’s behaving more aggressively," she explains.Another important factor that influences the treatment plan is "how healthy the patient is in general," she explains, "because that really impacts our ability to select the most appropriate treatment."
Treatment for Indolent Mantle Cell Lymphoma
In cases where people have more slow-growing disease, doctors may start with active surveillance, also known as “watch and wait.” This involves holding off on treatment, but carefully monitoring the person. Some people may not need treatment at all.
In these cases, "We observe the patient with physical examination, laboratory results, and imaging and keep a close eye on them," she explains. If the cancer hasn’t spread much and is still in the early stages, it can sometimes be treated with radiation therapy.
Treatment for Aggressive Mantle Cell Lymphoma
Unfortunately, often mantle cell lymphoma isn’t diagnosed until it has already spread and is in the later stages. People with aggressive disease will probably need to start on a treatment right away. The approach to therapy may be a combination of the monoclonal antibody, rituximab (Rituxan) and chemotherapy. Rituxan targets a protein called CD20 on the surface of the cancer cells. The chemotherapy regimen used is intense, aimed at wiping out as much of the cancer as possible.
Lenalidomide (Revlimid) combined with Rituxan is another treatment option. This drug is an immunomodulatory agent, meaning that it modifies the immune response or the functioning of the immune system to help it find and target the cancer. Treatment can yield durable results, meaning patients can have a long-lasting and positive result from their therapy.
People whose cancer responds well to these treatments may become good candidates for a stem cell transplant. This starts with very high doses of chemotherapy to get rid of as much of the cancer as possible, followed by an infusion of stem cells to replenish the healthy young blood cells the chemo destroyed.
Newer approaches, including targeted drugs and CAR T-cell therapy, may be a possibility for people who don’t respond to these treatments, or whose cancer returns after treatment. Other investigational treatments are being studied in clinical trials. If you haven’t had much success with the treatments you’ve tried, ask your doctor if one of these studies might be appropriate for you.
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