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Mantle cell lymphoma

Mantle cell lymphoma is a rare type of B cell non Hodgkin lymphoma (NHL). Find out about the symptoms and treatment.

What lymphoma is

Non Hodgkin lymphoma (NHL) is a 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. It carries a colourless liquid called lymph. This liquid circulates around the body tissues. It contains a high number of white blood cells (lymphocytes) which fight infection.

When you have lymphoma, some of your white blood cells (lymphocytes) don't work properly. They start to divide constantly but don't develop fully. So they can't fight infection as normal white blood cells do.

There are two main types of lymphocytes – B cells and T cells. Mantle cell lymphoma affects the B cells. The abnormal B 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 where they are growing.

How common is it

Mantle cell lymphoma is rare. 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.

Symptoms

The symptoms of mantle cell lymphoma are similar to those of most other types of NHL.

Painless swellings

The most common symptom of non Hodgkin lymphoma is one or more painless swellings in the:

  • neck
  • armpit
  • groin

Each swelling is an enlarged lymph node.

See your GP if you have a swollen lymph node that does not go away after 6 weeks.

General symptoms (B symptoms)

You might 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 may also have unexplained itching.

Some people with NHL have these symptoms, but many don't.

It is important to tell your doctor about any symptoms like this. It helps them to decide which type of NHL you have, and what treatment you need.

Other symptoms

Mantle cell lymphoma can spread to the bowel and in rare cases to the stomach. If this happens, it can cause symptoms such as diarrhoea, tummy pain and sickness. 

Stages and grades

Doctors put NHLs into 2 groups, depending on how quickly they are likely to grow and spread. The 2 groups are:

  • low grade (slow growing)
  • high grade (fast growing)

Mantle cell lymphoma looks like a low grade lymphoma under the microscope. But it often grows more quickly, more like a high grade lymphoma.

Doctors use your stage to decide on the best treatment. Your stage means the number and position of lymph nodes or other organs affected by lymphoma.

Mantle cell lymphoma can grow quickly. So unfortunately it's often widespread at diagnosis. This means you may have lymphoma cells in your lymph nodes, bone marrow and spleen. 

Treatment

Treatment for mantle cell lymphoma can be similar to treatment for other types of NHL.

But unfortunately, mantle cell lymphoma can be difficult to cure. It grows quickly and is often diagnosed when it is in a later stage. Treatment can sometimes get rid of the lymphoma completely. But it often comes back fairly soon afterwards.

Chemotherapy

Chemotherapy is the most common treatment for people with mantle cell lymphoma. The most commonly used chemotherapy drugs are:

  • cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP), sometimes combined with the biological therapy drug rituximab (Mabthera) to make R-CHOP
  • fludarabine and cyclophosphamide
  • cyclophosphamide, vincristine and prednisolone (CVP combination chemotherapy)
  • chlorambucil

Stem cell or bone marrow transplant

You might have this treatment if you are fit enough and under 65 years old. You may also have it if your mantle cell lymphoma has come back after previous chemotherapy. High dose chemotherapy increases the risk of complications such as infection. But it gives the best chance of curing the lymphoma.

You might have:

  • R-CHOP alternating with the biological therapy drug rituximab (Mabthera) and high dose cytarabine
  • high dose BEAM chemotherapy

These treatments are followed by a transplant using your own stem cells. 

You need to stay in hospital for a few weeks to have these treatments. It is hard going, but you get a lot of support from the staff during your stay in hospital.

Radiotherapy

You might have radiotherapy as a treatment on its own if you have stage 1 or 2 mantle cell lymphoma.

Or you might have radiotherapy and chemotherapy together (chemoradiotherapy) for advanced stages of the disease.

Steroids

Steroids are substances made naturally in the body. They can also be made artificially and used as drugs.

For NHL, you take steroids along with your chemotherapy drugs. The treatment is more successful when you have steroids and chemotherapy together. Commonly used steroid drugs include prednisolone, dexamethasone and methylprednisolone.

Biological therapy

Biological therapy drugs act on processes in cancer cells. They can change the way cells signal to each other, or they can stimulate your body to attack or control the growth of cancer cells.

Rituximab (Mabthera) is a type of biological therapy drug called a monoclonal antibody. You might have it with chemotherapy for mantle cell lymphoma.

Research

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to:

  • improve treatment
  • make existing treatments better
  • develop new treatments

Drugs being tested for mantle cell lymphoma include:

  • alemtuzumab (MabCampath)
  • lenalidomide (Revlimid)
  • temsirolimus (Torisel)
  • bortezomib (Velcade)
  • ibrutinib
  • olaparib
For information, you can call the Cancer Research UK nurses free on 0808 800 4040, from 9am to 5pm, Monday to Friday. They are happy to help. They can give advice about who can help you and what kind of support is available.
Last reviewed: 
01 Sep 2014
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    K Shankland and others
    Lancet 2012 September, Volume 380, Issue 9844, Pages 848-57.

  • Front-line treatment of mantle cell lymphoma.
    ​C Geisler 
    Haematologica. 2010 August; Volume 95, Issue 8, Pages 1241-3

  • Mantle cell lymphoma - does primary intensive immunochemotherapy improve overall survival for younger patients?
    C Geisler and others
    Leukaemia and Lymphoma. 2009 August, Volume 50, Issue 8, Pages1249-56.

  • Long-term progression-free survival of mantle cell lymphoma after intensive front-line immunochemotherapy with in vivo-purged stem cell rescue: a nonrandomized phase 2 multicenter study by the Nordic Lymphoma Group.
    C Geisler and others
    Blood. 2008 October, Volume 112, Issue 7, Pages 2687-93.

  • Investigation and Management of Mantle Cell Lymphoma
    British Society of Haematology
    British Journal of Haematology, September 2012, Volume 159, Issue 4, 

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