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Mantle cell lymphoma

Mantle cell lymphoma is a rare type of non Hodgkin 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 include swollen lymph glands and sometimes temperatures, weight loss, sweating and itching.

The grade of a non Hodgkin lymphoma (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 grows fairly quickly, more 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

Unfortunately, mantle cell lymphoma can be difficult to cure. It is a quickly growing type of NHL and many people are diagnosed in the later stages. Chemotherapy is the most common treatment. The type of chemotherapy used will depend on your age, general health and the extent of the lymphoma. The chemotherapies most commonly used include chlorambucil or the combination CHOP. These may be combined with a biological therapy drug such as rituximab.

Treatment can often get rid of mantle cell lymphoma completely but it often comes back relatively soon afterwards. People under 65 who are very healthy may be offered high dose chemotherapy with a stem cell transplant. This increases the chances of getting rid of the lymphoma for good.
 

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What mantle cell lymphoma is

Mantle cell lymphoma is a rare type of non Hodgkin lymphoma (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 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.

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.

 

Symptoms of mantle cell lymphoma

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 lymphoma have them, but most don't. 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, abdominal (tummy) pain and sickness.

It is important for you to tell your doctor about any symptoms like this. Knowing that you have these symptoms helps your doctor to know which type of non Hodgkin lymphoma you have. Then they know which type of treatment you need. There is more information about the symptoms of NHL in this section.

 

Stage and grade of mantle cell lymphoma

Doctors put non Hodgkin lymphomas into 2 groups.  The groups depend on how quickly they are likely to grow and spread

  • Low grade or indolent (slow growing)
  • High grade or aggressive (fast growing)

The appearance of the cells under the microscope (grade of NHL) helps doctors to decide on the best treatment for you. Mantle cell lymphoma looks like a low grade lymphoma under the microscope. But it often grows quickly, more like a high grade lymphoma. Unfortunately, it is often widespread when it is diagnosed. This means the lymphoma cells may be in the lymph nodes, the bone marrow and the spleen.

The stage is also very important in deciding about treatment. The stage of NHL means the number and position of the lymph nodes or other affected organs. 

We have detailed information about the stages of NHL.

 

Treating mantle cell lymphoma

Treatment for mantle cell lymphoma can be similar to treatment for other types of NHL. But it can be difficult to cure. It is a quickly growing type of NHL and people are often diagnosed in the later stages of the disease. Treatment can sometimes get rid of the lymphoma completely but it often comes back fairly soon afterwards.

 

Chemotherapy

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

You can click on the links above to find out the specific side effects of these drugs.

We have information about chemotherapy for NHL.

 

Stem cell or bone marrow transplant

If you are fit and under 65 years old you may have more intensive chemotherapy. This may be R-CHOP alternating with rituximab (Mabthera) and high dose cytarabine followed by a stem cell transplant. Or you may have high dose BEAM chemotherapy. These treatments are followed by a transplant using your own stem cells

You may also have high dose chemotherapy and a stem cell transplant if your mantle cell lymphoma has come back after previous chemotherapy. High dose chemotherapy increases the risk of complications, such as infection, but gives the best chance of curing the lymphoma. 

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

We have detailed information about stem cell transplants.

 

Radiotherapy

If you have stage 1 or 2 mantle cell lymphoma, you may have radiotherapy as a treatment on its own. Or you may have radiotherapy and chemotherapy together for advanced stages of the disease. 

There is information about radiotherapy for NHL in this section.

 

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 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 include

  • Prednisolone
  • Dexamethasone
  • Methylprednisolone

We have detailed information about steroid therapy for NHL.

 

Biological therapy

There are many different types of biological therapy. They act on processes in cancer cells. For example they can change the way cells signal to each other. Or they can stimulate the body to attack or control the growth of cancer cells. One of these drugs is rituximab. It is a type of monoclonal antibody. You may have it with chemotherapy for mantle cell lymphoma. 

To find out more, look at the page about biological therapy treatment for NHL.

 

Research into mantle cell lymphoma

Your doctor may suggest that you join a clinical trial. Trials help to improve treatments for lymphoma and most often compare the best known standard treatment with a newer treatment that doctors hope will work better. 

Drugs being tested for mantle cell lymphoma include

You can find out more about research into treatment for mantle cell lymphoma on our page about non Hodgkin lymphoma research

You can also find details of clinical trials on our clinical trials database.

 

More about NHL

We have detailed information about non Hodgkin lymphoma treatments in this section.

If you would like more information about any aspect of non Hodgkin lymphoma, you can phone the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday. They will be happy to answer any questions that you have.

Our non Hodgkin lymphoma organisations page gives details of other people who can provide information about NHL and its treatment. Some organisations can put you in touch with a cancer support group. They often have free factsheets and information which they can send to you. There are also books, booklets, CDs and other resources available about non Hodgkin lymphoma. Some of these are free. Look at our NHL reading list for details.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 1 September 2014