Refractory Mantle Cell Lymphoma

Mantle cell lymphoma (MCL) is an aggressive form of non-Hodgkin’s lymphoma (NHL). It is characterized by abnormal B-cell lymphocytes that tend to cluster in the mantle zone of the lymph node. MCL is relatively uncommon, accounting for about six percent of all NHL cases in the United States.

Refractory mantle cell lymphoma (rMCL) is a very aggressive form of MCL. It is defined as a disease that does not respond to initial treatment, or if it responds, any response is short-lived (less than six months). It is estimated that up to 30 percent of patients with MCL will eventually develop refractory disease.

Signs and Symptoms

The usual signs and symptoms of mantle cell lymphoma include: swollen lymph nodes, enlarged spleen, abdominal and bone pain, fatigue, fever, night sweats, and weight loss. Some patients may also experience more specific and severe symptoms, such as anemia, pneumonia, breathing difficulty due to swollen lymph nodes, or skin lesions.

Diagnosis

The diagnosis of refractory mantle cell lymphoma is based on tests such as biopsy of affected lymph nodes, CT/PET scans, blood tests, and bone marrow tests. The biopsy of affected lymph nodes is the most important test used to diagnose MCL, as it can indicate which type of lymphoma is present. In cases of rMCL, blood tests may reveal an elevated white blood cell count and anemia.

Treatment

Treatment for refractory mantle cell lymphoma is usually very aggressive, and may include:

Chemotherapy: Chemotherapy may be used to reduce the size of the tumor and slow disease progression.
Radiation Therapy: Radiation may be used to destroy any remaining cancerous cells.
Stem Cell Transplant: This is a procedure in which healthy stem cells are transplanted into the patient’s body to replace the damaged cells and help restore the body’s ability to fight off the cancer.
Targeted therapy: This is a newer type of treatment that targets specific molecules associated with cancer growth.
Immunotherapy: Immunotherapy uses the body’s own immune system to help fight cancer.

In some cases, clinical trials may be available for treatment of refractory mantle cell lymphoma. These trials may offer promising new treatments or therapies that could be beneficial to patients who cannot be treated with standard treatments.