Chemotherapy in combination with a monoclonal antibody drug called rituximab (Mabthera ®) is the main treatment for mantle cell lymphoma. Some people may also have stem cell treatments. The aim of treatment is to get rid of as much of the lymphoma as possible. If there are no signs of MCL after treatment, this is called a complete remission.
Other treatments that may be used include steroids or radiotherapy. You may have a combination of treatments.
Mantle cell lymphoma usually comes back after treatment. Doctors are trying to find improved ways of treating it and controlling it for longer periods. Treatments may be given as part of a clinical research trial.
Monoclonal antibody therapy
Monoclonal antibodies are drugs that recognise, target and stick to particular proteins on the surface of cancer cells, and can stimulate the body’s immune system to destroy these cells. Rituximab is the monoclonal antibody commonly used to treat MCL. It's given as a drip into a vein (intravenous infusion) and is usually given with chemotherapy. Some people who have a good response to treatment may continue to be given regular rituximab infusions for up to two years. This is known as maintenance treatment. Other monoclonal antibodies may be given, usually as part of a cancer research trial.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It can be given into a vein (intravenously) or as tablets. It is usually given in combination with rituximab.
There are several chemotherapy drugs that can be used to treat MCL. The chemotherapy you have will depend on your general fitness and how the side effects of chemotherapy may affect you.
Combinations of rituximab and chemotherapy that may be used include:
People who are fit enough to cope with the side effects of intensive treatments may be given treatment that includes high doses of the chemotherapy drug cytarabine. These treatments may be given before high-dose chemotherapy with stem cell treatment.
- R-HCVAD (rituximab, cytarabine, cyclophosphamide, vincristine, doxorubicin and the steroid dexamethasone)
- R_Maxi CHOP/H Ara-C (rituximab, cyclophosphamide, vincristine, doxorubicin, cytarabine and the steroid prednisolone).
Steroids are often given with chemotherapy to help treat lymphomas. They also help you feel better and can reduce feelings of sickness.
Stem cell treatment (transplants)
Some people with lymphoma may have treatments using their own stem cells or stem cells from a donor. Stem cells are a special type of blood cell that can make all other types of blood cells.
This is an intensive treatment and is only suitable for people who are fit enough to cope with the side effects.
Some people have some of their own stem cells collected and stored. This allows them to have higher doses of chemotherapy to destroy the lymphoma cells.
After the chemotherapy, their stem cells are returned by a drip (like a blood transfusion) to help their blood cells recover from the effects of chemotherapy. This is called high-dose treatment with stem cell support.
Some people may have treatment using stem cells from another person (a donor). This is called a donor stem cell (allogeneic) transplant.
Radiotherapy uses high-energy rays to destroy cancer cells while doing as little harm as possible to healthy cells.
It may be used when the lymphoma cells are contained in one or two groups of lymph nodes in the same part of the body (stage 1 or 2).
It may also sometimes be used to relieve symptoms such as pain in a particular area.
Bortezomib (Velcade ®)
Bortezomib blocks signals in cells that are involved in cell growth. This may cause the lymphoma cells to die. It is given as an injection into a vein and may be used when other treatments have been tried.
Temsirolimus interferes with signals that tell cells to grow and divide. Temsirolimus is known as an mTOR inhibitor. It's given into a vein as a drip (infusion).
Lenalidomide (Revlimid ®)
Lenalidomide blocks the development of new blood vessels. Cancer cells need to make new blood vessels so they can grow and spread. It's taken as a tablet.