Mantle Cell Lymphoma Treatment
Mantle cell lymphoma (MCL) is a rare and complex form of non-Hodgkin lymphoma that begins in the “mantle zone,” a specific region within a lymph node. A crucial part of the immune system, lymph nodes are small, bean-shaped structures that help the body filter out harmful substances and fight infection.
Inside each lymph node are groups of antibody-producing B lymphocytes (B cells), which are organized in layers. The germinal center is the inner layer where the B cells actively divide and mutate to improve their ability to recognize pathogens. Surrounding the germinal center is the mantle zone, a ring of mature, resting B cells that have not yet been activated. Because mantle zone B cells circulate throughout the body via the lymphatic system, MCL can spread to multiple lymph nodes as well as the bone marrow, spleen and digestive tract.
Mantle cell lymphoma accounts for approximately 6% of all non-Hodgkin lymphoma cases in the United States. Most often, the cancer affects men 60 and older, and because it tends to spread quickly, it is typically diagnosed at an advanced stage.
In many cases, MCL is treated with a combination of therapies tailored to the patient’s overall health and lymphoma stage. Treatment usually begins with chemotherapy and immunotherapy to control the cancer, followed by targeted therapy or bone marrow transplantation (BMT) to achieve long-term remission. Emerging treatment options, such as chimeric antigen receptor (CAR)-T cell therapy and Bruton tyrosine kinase (BTK) inhibitors, may be considered for relapsed or treatment-resistant lymphoma.
Chemotherapy for mantle cell lymphoma
The cornerstone of MCL treatment, chemotherapy uses powerful cancer-fighting drugs that enter the bloodstream and circulate throughout the body to destroy rapidly dividing cells. Common drug regimens for mantle cell lymphoma include cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) combined with rituximab (R-CHOP) or a more intensive therapy, such as hyper-CVAD. Depending on the patient’s health and lymphoma stage, chemotherapy may be used alone or in combination with targeted therapy, immunotherapy or bone marrow transplantation.
Side effects and risks of chemotherapy for mantle cell lymphoma
Because chemotherapy affects all rapidly dividing cells throughout the body, it can affect cancerous cells as well as normal cells with a naturally high growth rate, such as those in the hair, mouth and digestive tract. Damage to healthy cells may lead to temporary side effects, such as fatigue, hair loss, nausea, vomiting, lowered blood cell counts and increased infection risk. Some chemotherapy drug regimens may also cause mouth sores or nerve damage (neuropathy). Throughout treatment, the patient will be closely monitored to manage any symptoms and help prevent complications.
Preparation and recovery from chemotherapy for mantle cell lymphoma
Before starting chemotherapy, the patient may undergo lab testing and heart and lung function assessments to help ensure they can safely tolerate the treatment. During and after chemotherapy, proper hydration, nutrition and rest will be important to support recovery. The patient will also be scheduled for follow-up visits and blood testing to monitor their remission and detect any late effects.
Immunotherapy for mantle cell lymphoma
Immunotherapy is an advanced treatment that harnesses the body’s natural capacity to identify and destroy cancer cells. Rituximab, a monoclonal antibody that targets the CD20 protein on B cells, is commonly used in combination with chemotherapy for MCL.
New immunotherapies, such as chimeric antigen receptor (CAR)-T cell therapy, have shown promising results for patients with relapsed or treatment-resistant mantle cell lymphoma. CAR-T cell therapy involves engineering the patient’s own immune cells in a lab to improve their ability to recognize and attack lymphoma cells, providing a powerful and personalized approach to MCL treatment.
Side effects and risks of immunotherapy for mantle cell lymphoma
The side effects of immunotherapy can vary depending on the specific drugs used. Rituximab may cause mild infusion-related symptoms, such as fever, chills and rash. CAR-T cell therapy can cause more serious effects, such as cytokine release syndrome (CRS) and neurological changes, which require close monitoring in a hospital setting.
Preparation and recovery from immunotherapy for mantle cell lymphoma
If the immunotherapy regimen includes rituximab, the patient may be given premedication to help prevent infusion-related reactions. Throughout treatment, the patient will be monitored closely for side effects.
Typically, chemotherapy is administered before CAR-T cell therapy. This can help prepare the patient’s immune system for the treatment.
Full recovery from immunotherapy can take several weeks. The healthcare team will provide ongoing follow-up care to monitor the patient’s progress and manage any late-onset side effects.
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75%
mantle cell lymphoma cases diagnosed are men over age 60
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1 in 200,000
Americans are diagnosed with mantle cell lymphoma annually
Targeted therapy for mantle cell lymphoma
Targeted therapy focuses on the specific molecules involved in cancer growth and survival, offering a more precise treatment approach than traditional chemotherapy. For example, specialized drugs such as ibrutinib, acalabrutinib and zanubrutinib are designed to target the BTK pathway, which plays a key role in lymphoma cell survival. These oral medications have become an important treatment option for relapsed or refractory MCL and may be used as a component of frontline treatment in select cases.
Side effects and risks of targeted therapy for mantle cell lymphoma
While targeted therapy generally causes fewer side effects than traditional chemotherapy, it can still lead to issues such as diarrhea, fatigue, muscle pain, easy bruising and high blood pressure. Some BTK inhibitors may also increase the risk of excessive bleeding or irregular heartbeat.
Preparation and recovery from targeted therapy for mantle cell lymphoma
Because targeted therapy is typically administered orally in pill form, most patients can take their medications on an outpatient basis. Through periodic blood work and heart monitoring, the physician can track the safety and effectiveness of the treatment. Many patients continue targeted therapy over the long term to help maintain remission.
Radiation therapy for mantle cell lymphoma
Radiation therapy may be used to treat early-stage MCL or to target specific areas of the body where the cancer is causing symptoms. This treatment approach uses high-energy rays to destroy cancerous cells or inhibit their growth. Radiation therapy is often combined with other treatments, such as chemotherapy, for heightened effectiveness. In advanced cases, it may also be used to help relieve pain, swelling or other discomfort related to the lymphoma.
Side effects and risks of radiation therapy for mantle cell lymphoma
The side effects of radiation therapy can vary depending on the treatment site, but most are temporary and manageable. Common experiences include fatigue, skin irritation, nausea and reduced blood cell counts.
Preparation and recovery from radiation therapy for mantle cell lymphoma
Before radiation therapy, the patient will undergo simulation imaging to help the physician plan the treatment and ensure precise targeting. During recovery, any lingering effects, such as mild fatigue or skin irritation, can usually be managed with gentle skin care, hydration and rest.
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Schedule an AppointmentBone marrow transplantation for mantle cell lymphoma
For certain patients with MCL, BMT may offer the best chance for long-term cancer remission. This intensive treatment replaces damaged bone marrow with healthy blood-forming cells after a course of high-dose chemotherapy. Autologous stem cell transplantation, which uses the patient’s own cells, is often performed in the first remission. Allogeneic transplantation, which uses donor cells, may be considered for recurrent or aggressive MCL.
Side effects and risks of bone marrow transplantation for mantle cell lymphoma
Before BMT, the patient will receive high-dose chemotherapy, which can lead to overwhelming fatigue, increased infection risk and temporary organ or tissue damage. Additionally, a potentially serious complication known as graft-versus-host disease (GVHD) may occur after an allogeneic transplant, requiring careful monitoring and immunosuppressive therapy.
Preparation and recovery from bone marrow transplantation for mantle cell lymphoma
BMT preparation includes pretransplant testing and conditioning chemotherapy. After transplantation, the patient will be closely monitored for infections and graft health. Full recovery can take several months, and supportive care will play a key role in helping the patient regain strength.
Surgery for mantle cell lymphoma
Surgery is rarely used as a primary treatment for MCL, mainly because the cancer usually affects multiple lymph nodes or organs by the time it is diagnosed. However, a surgical excision may be performed to obtain a tissue sample for testing to confirm the diagnosis. Also, in rare cases, surgery may be performed to remove a single affected lymph node or treat complications of mantle cell lymphoma, such as a bowel obstruction caused by cancer growth.
Side effects and risks of surgery for mantle cell lymphoma
The risks of surgery can vary based on the specific procedure performed. General surgical risks include pain, infection and delayed healing.
Preparation and recovery from surgery for mantle cell lymphoma
Most procedures used to diagnose or treat MCL can be performed using minimally invasive techniques. Recovery typically involves rest, incision care and follow-up appointments to confirm the diagnosis and ensure proper healing.
Clinical trials for mantle cell lymphoma
MCL clinical trials offer select patients early access to cutting-edge therapies that are not yet widely available. Options may include next-generation targeted therapies, novel immunotherapies or combination approaches designed to improve the outcome and reduce side effects. Participation in a clinical trial can provide a new source of hope for a patient with relapsed or refractory lymphoma.
Benefit from world-class care at Moffitt Cancer Center
Moffitt offers comprehensive, multispecialty care for patients with mantle cell lymphoma. Each patient’s case is reviewed by a team of hematologists, oncologists, radiologists and transplant specialists who work together to develop an individualized treatment plan. Through our renowned Malignant Hematology Program, our patients have access to the latest therapies, a robust portfolio of clinical trials and a full range of supportive care services, ensuring they receive world-class treatment and compassionate support throughout every stage of their journey.
If you would like to explore your treatment options for mantle cell lymphoma with a specialist at Moffitt, you can request an appointment by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.
Mantle Cell Lymphoma