Non-Hodgkin lymphoma

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Mantle cell lymphoma

Mantle cell lymphoma is a B-cell non-Hodgkin lymphoma (NHL). It develops in the outer edge of a lymph node called the mantle zone. Mantle cell lymphoma occurs more often in men than in women. It is usually diagnosed in people in their early 60s.

Mantle cell lymphoma is usually diagnosed at stage III or IV. It has often spread to other lymph nodes, the bone marrow, the spleen and the liver. Mantle cell lymphoma is sometimes found along the gastrointestinal (GI) tract. When it is found in the GI tract, it may be called lymphomatous polyposis.

Mantle cell lymphoma may be slow growing (indolent), but there can also be fast-growing (aggressive) variations, called the blastoid variant and the pleomorphic variant.

Treatments

The main treatment for mantle cell lymphoma is chemotherapy. Other treatments include targeted therapy, biological therapy, radiation therapy and stem cell transplant.

Chemotherapy

Chemotherapy is commonly used to treat mantle cell lymphoma. It is usually given as a combination of drugs and may be given with a targeted therapy drug. The combinations of chemotherapy drugs used may include:

  • CHOP – cyclophosphamide (Cytoxan, Procytox), doxorubicin (Adriamycin), vincristine (Oncovin) and prednisone
  • R-CHOP – CHOP with rituximab (Rituxan)
  • CVP – cyclophosphamide, vincristine and prednisone
  • R-CVP – CVP with rituximab
  • hyperCVAD – cyclophosphamide, vincristine, doxorubicin, dexamethasone (Decadron, Dexasone), methotrexate and cytarabine (Cytosar, Ara-C)
  • R-hyperCVAD – hyperCVAD with rituximab
  • EPOCH – etoposide (Vepesid), vincristine, doxorubicin, cyclophosphamide and prednisone

The following drugs may be used if mantle cell lymphoma doesn’t respond to treatment, progresses during treatment or comes back (recurs) after treatment. They may be given alone or combined with other drugs or a targeted therapy:

  • bendamustine (Treanda)
  • cladribine (Leustatin)
  • fludarabine (Fludara)

Targeted therapy

Targeted therapy uses drugs to target specific molecules (such as proteins) on the surface of cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells.

Rituximab is a targeted therapy drug commonly used alone or in combination with chemotherapy to treat mantle cell lymphoma.

Bortezomib (Velcade) and ibrutinib (Imbruvica) are targeted therapy drugs that may be given for mantle cell lymphoma that comes back after treatment or stops responding to treatment.

Biological therapy

Biological therapy uses natural or artificial substances to change the way cells behave. Lenalidomide (Revlimid) is the biological therapy drug that may be used for mantle cell lymphoma that comes back after treatment or stops responding to treatment.

Radiation therapy

External beam radiation therapy is sometimes used for mantle cell lymphoma. It may be given to the areas of lymph nodes that are affected. It is used for early stage disease or to relieve symptoms (called palliative therapy).

Stem cell transplant

A stem cell transplant may be an option for some people in first remission. It may also be used to treat mantle cell lymphoma that comes back after treatment or that stops responding to treatment.

People with mantle cell lymphoma who can’t have a stem cell transplant, or people whose cancer comes back after a stem cell transplant, may be treated with targeted therapy, biological therapy or other chemotherapy regimens.

gastrointestinal (GI)

Referring to or having to do with the digestive organs.

The gastrointestinal (GI) tract, or digestive tract, includes the mouth, pharynx (throat), esophagus, stomach, small intestine and large intestine.

remission

A decrease in or the disappearance of signs and symptoms of a disease (such as cancer).

Complete remission means the disappearance of all signs or symptoms. Partial remission means a decrease in or disappearance of some, but not all, signs and symptoms. Spontaneous remission is an unexpected improvement that occurs with little or no treatment.

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