Mantle cell lymphoma
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Mantle cell lymphoma (MCL) is a rare type of non-Hodgkin lymphoma (NHL). It develops when B-cells (also called B-lymphocytes) become abnormal. B-cells are white blood cells that fight infection.
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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Painless swelling in neck, armpit or groin
This is the most common sign of MCL. It is caused by lymphoma cells building up in the lymph nodes, which makes them bigger.
Some people also have:
- drenching night sweats
- high temperatures (fevers) with no obvious cause
- unexplained weight loss
Doctors call this group of symptoms B symptoms.
Sometimes other areas of the body may be affected, such as the spleen, bowel, or bone marrow.
Depending on where the lymphoma spreads to, this can cause symptoms such as:
- loss of appetite
- sickness (nausea)
- anaemia - due to low number of red blood cells in your blood
- bruising or bleeding easily - due to low number of blood-clotting cells (platelets) in your blood.
The causes of mantle cell lymphoma are mostly unknown. Like other cancers, it is not infectious and cannot be passed on to other people.
It mainly occurs in people over the age of 60 and is more common in men than women.
We have more information about causes and risk factors for non-Hodgkin lymphoma.
Biopsy for lymphoma
The most common test for this lymphoma is to remove part or all of an enlarged lymph node (a biopsy). This may be done under local or general anaesthetic. The biopsy is then sent to a laboratory to be checked for lymphoma cells. You may also have biopsies taken from other areas of the body.
You can read more about further tests you may have in our information about non-Hodgkin lymphoma.
Waiting for test results can be a difficult time. It may help to talk to your family, friends or specialist nurse.
The results of your tests help your doctors find out how many areas of the body are affected by lymphoma and where these areas are. This is called staging.
Lymphomas are also grouped as either low-grade or high-grade. Low-grade lymphomas are usually slow growing and high-grade lymphomas grow more quickly. MCL is usually treated as a high-grade lymphoma.
We have more information about staging and grading of non-Hodgkin lymphoma.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. 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. If there are no signs of MCL after treatment, this is called a complete remission.
MCL 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.
The main treatment for MCL is a combination of a targeted therapy drug called rituximab and chemotherapy.
Rituximab is often used in combination with chemotherapy.
If the MCL responds well to rituximab, you may continue to have regular treatments. The aim is to keep the lymphoma in remission. This is called maintenance treatment. Your lymphoma doctor can tell you how long maintenance treatment might continue for.
Combinations of rituximab and chemotherapy that may be used include the following:
- R-chlorambucil – this is made up of rituximab and chlorambucil.
- R-bendamustine – this is made up of rituximab and bendamustine.
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. The following treatments may be given before high-dose chemotherapy with stem cell treatment:
R-Maxi CHOP/H Ara-C
R-Maxi CHOP/H Ara-C This is made up of rituximab, cyclophosphamide, hydroxy-doxorubicin, vincristine (oncovin), the steroid prednisolone and high dose cytarabine (Ara-C).
Other treatments include:
Stem cell and bone marrow transplant
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 mantle cell lymphoma, or to relieve symptoms such as pain.
You have regular follow-up appointments after treatment. These appointments are a good opportunity for you to talk to your doctor or nurse about any concerns you have. Your doctor will want to know how you are feeling generally, and to check you are recovering from any side effects of treatment.
Sometimes a side effect may continue or develop months or years after treatment. This is called a late effect.
We have more information about long-term and late effects of treatment for 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:
The organisations below also offer information and support:
Blood Cancer UK
Below is a sample of the sources used in our mantle cell lymphoma (MCL) information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
Dreyling M, Geisler C, et al on behalf of the ESMO Guidelines Working Group. Newly diagnosed and relapsed mantle cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2014. 25 (Supplement 3): iii83–iii92. Available from www.annalsofoncology.org/action/showPdf?pii=S0923-7534%2819%2934092-X
McKay P, Leach M, et al. British Committee for Standards in Haematology. Guidelines for the investigation and management of mantle cell lymphoma. British Journal of Haematology. 2012. 159 (4), 405–426.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.
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