What is mantle cell lymphoma?

Mantle cell lymphoma (MCL) is a rare type of non-Hodgkin lymphoma (NHL). MCL develops when B-cells become abnormal (cancerous). B-cells are white blood cells that normally help fight infection. They are sometimes called B-lymphocytes.

The abnormal B-cells (lymphoma cells) usually build up in lymph nodes, but they can affect other parts of the body.

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Symptoms of mantle cell lymphoma

Some people do not have any symptoms, but a painless swelling in the neck, armpit or groin is the most common sign of MCL. It is caused by lymphoma cells building up in the lymph nodes, which makes them bigger.

Other symptoms

Sometimes MCL can affect other areas of the body. These can include the spleen, bowel and bone marrow.

Depending on where the lymphoma spreads to, this can cause symptoms such as:

loss of appetite
diarrhoea
sickness (nausea)
a full feeling in the tummy – this is caused by an enlarged spleen
anaemia – this is caused by the low number of red blood cells in your blood.

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Causes of mantle cell lymphoma

The causes of mantle cell lymphoma (MCL) are mostly unknown. MCL is most common in people over the age of 70. It is more common in men than women.

Like other cancers, MCL is not infectious. It cannot be passed on to other people.

We have more information about causes and risk factors for non-Hodgkin lymphoma.

Diagnosis of mantle cell lymphoma

Sometimes MCL can be found with a routine blood test. But usually the most common test for diagnosing lymphoma is a biopsy. A doctor will take a sample of tissue from the affected area. The most common place to take a biopsy from is an enlarged lymph node. This is called a lymph node biopsy. You may have all or a part of the lymph node removed. The tissue will be sent to a laboratory for testing.

You may also have biopsies taken from other areas of your body, such as your bowel. This is done during a test called a colonoscopy.

You can read more about the tests you may have in our information about non-Hodgkin lymphoma.

Waiting for test results can be difficult. You may find it helpful to talk to your family, friends or specialist nurse.

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The stages and grades of mantle cell lymphoma

Your test results give your cancer team more information about the lymphoma. This includes:

The stage

Staging describes how many areas of the body are affected by lymphoma and where these areas are.
The grade

Grading describes how quickly the lymphoma cells are likely to grow. Burkitt lymphoma is a high grade lymphoma. High grade lymphoma grows more quickly and needs urgent treatment.

Knowing the stage and grade of the lymphoma helps your cancer team plan the right treatment for you.

We have more information about staging and grading non-Hodgkin lymphoma.

Treatment for mantle cell lymphoma

A team of specialists will meet to discuss the best possible treatment for you. They are called a multidisciplinary team (MDT).

Your doctor, cancer specialist or nurse will explain the different treatments and their side effects to you. They will also talk to you about things to consider when making treatment decisions.

The aim of treatment is to get rid of as much of the lymphoma as possible.

Treatment for mantle cell lymphoma (MCL) may depend on:

the stage of the lymphoma
whether it has become active again after previous treatment
whether you have symptoms that are causing problems.

The most common treatments for MCL include:

Immunotherapy and chemotherapy
MCL is often treated with a combination of the immunotherapy drug rituximab and chemotherapy. This is called chemoimmunotherapy. If the MCL responds well to rituximab and chemotherapy, you may continue to have regular treatments of rituximab on its own. The aim is to keep the lymphoma in remission. This is called rituximab maintenance. Your doctor can tell you how long maintenance treatment might continue.

Combinations of rituximab and chemotherapy that may be used include rituximab and bendamustine, R-CHOP or rituximab and chlorambucil.

People who are well enough to cope with the side effects of intensive treatments may be given a combination that includes high doses of the chemotherapy drug cytarabine. You may have the following treatments:

R-DHAP

R-DHAOx – rituximab, the steroid dexamethasone, high-dose cytarabine (ARA-C), oxaliplatin

R-Maxi CHOP/H Ara-C – rituximab, cyclophosphamide, doxorubicin (or hydroxydaunorubicin, vincristine (oncovin), the steroid prednisolone, high dose cytarabine (Ara-C).
Targeted therapy

The targeted therapy bortezomib may sometimes be used as the first treatment for MCL. Ibrutinib is used to treat MCL that has become active again after first treatment. Other targeted therapies that are less commonly used include temsirolimus and lenalidomide.
Steroids

Steroids are drugs that are often given with chemotherapy to treat lymphomas. They can help make chemotherapy more effective.

Stem cell transplant
A stem cell transplant is an intensive treatment, so it is not suitable for everyone. Usually for MCL your own stem cells are used (autologous stem cell transplant).
Radiotherapy

Radiotherapy uses high-energy rays to destroy cancer cells, while doing as little harm as possible to nearby healthy cells. It can be used to treat stage 1 or 2 MCL, or to relieve symptoms such as pain.

MCL usually comes back after treatment. Doctors are trying to find improved ways of treating it and controlling it for longer periods. We have more information about treating lymphoma that has come back.

You may have some treatments as part of a clinical research trial.

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After treatment for mantle cell lymphoma

Talk to someone about mantle cell lymphoma

Everyone has their own way of dealing with illness and the different emotions they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse.

Macmillan is also here to support you. If you would like to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our Mantle cell lymphoma forum to talk with people who have been affected by Mantle cell lymphoma, share your experience, and ask an expert your questions.

Support for people with mantle cell lymphoma

You can:

ask your GP or someone from your cancer team for advice about support in your area
find cancer support services near you
call the Macmillan Support Line for free on 0808 808 00 00.
chat to our cancer information specialists online.
visit our non-Hodgkin lymphoma forum to talk to people who have been affected by lymphoma, share your experience, and ask your questions.

You may also find the HOPE programme helpful. The programme is a free 6 week self-management course designed to help you develop techniques and strategies when living with or after cancer. Topics include goal setting, fatigue management, and wellbeing.

You can sign up for the online HOPE programme. Or to find out more about face to face programmes in your area, email ServiceOpsSupport@macmillan.org.uk

Other organisations who offer information and support

Blood Cancer UK offers support and information to people affected by blood cancers, including lymphoma.

Lymphoma Action provides high quality information and support for people affected by lymphoma. It provides helpline services and a range of peer support including online support meetings, educational events and webinars. Its website includes TrialsLink, a database of lymphoma clinical trials.

More information and advice

We know cancer can affect you physically, emotionally and financially. We have information and advice about different ways cancer might impact you, such as help with: