Mantle cell lymphomaMantle cell lymphoma is an aggressive variety of lymphoma which is typically found in the lymph nodes, spleen, marrow and blood. It is unique in that it is classified as an indolent variety of lymphoma and sometimes behaves as an indolent lymphoma. But more typically it behaves aggressively and is more difficult to treat than other indolent lymphomas.
Mantle cell lymphoma is called that because it usually infiltrates the Mantle Zone of the lymph nodes. That is the area surrounding the lymphoid follicles. When it remains in the mantle zone it generally follows a more indolent course. When it spreads outside this area, in a more diffuse growth pattern, its behaviours becomes less indolent and more aggressive.
Diagnosis and PrognosisIt is typically characterized by the expression of CD5, over expression of Cyclin D1 and the t(11:14) chromosomal translocation.
Historically mantle cell lymphoma has had a much poorer prognosis than other indolent types, with a median survival of only 3-5 years. Newer chemotherapy protocols, and stem cell transplants may offer a chance for improved survival but it is too early to say with any certainty.
TreatmentsMantle cell lymphoma is generally treated as an aggressive type of NHL and aggressive combination chemotherapy is used. R-CHOP is a standard course of treatment, but there is some evidence to show that R HyperCVAD may offer improved response and survival rates.
Stem cell transplants are often used, either for relapsed MCL, or upfront as part of the initial therapy in order to avoid relapse. This is becoming more common as results from studies show it offers a good opportunity for long term survival. Here is a link to a recent study about using an SCT with in-vivo Rituxan purging. With a 70% overall survival at 6 years it is a remarkable improvement over past options.
Another treatment that is showing great result is Bortezomib (brand name Velcade) in many studies.
Due to the difficulty in achieving long term disease free survival there are many studies that are attempting to get better results. We have a page that is dedicated to these studies.
Here is an article from Annnals of Oncology that reviews the current status of MCL treatments. Current treatment standards and future strategies in mantle cell lymphoma
Click here for a list of medical abstracts about the latest treatments for Mantle Cell Lymphoma
Other informationFor a detailed look at Mantle Cell Lymphoma visit this site. http://www.emedicine.com/med/topic1361.htm
MCL Resource. This is an outstanding site dedicated to Mantle Cell Lymphoma. It has a wealth of highly detailed information and resources for you to check.
http://www.emedicine.com/med/topic1361.htm
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