What Are Treatments for Mantle Cell Lymphoma?

Mantle cell lymphoma (MCL) is a rare and aggressive type of non-Hodgkin lymphoma. It is characterized by the abnormal growth of lymphocytes, a type of white blood cell, in the mantle zone of the lymph nodes. The disease is often diagnosed at a late stage and has a poor prognosis. However, several treatment options are available, including chemotherapy, targeted therapy, immunotherapy, and stem cell transplant. The choice of treatment depends on various factors such as the patient's age, overall health, and the stage of the disease.

1. Chemotherapy

Chemotherapy is the main treatment for MCL. It involves the use of drugs to kill cancer cells or stop them from growing. The most commonly used regimen is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Another regimen is hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone) alternated with high-dose methotrexate and cytarabine. These regimens are usually given in cycles, with each cycle followed by a rest period.

2. Targeted Therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. In MCL, targeted therapies such as ibrutinib (Imbruvica), acalabrutinib (Calquence), and zanubrutinib (Brukinsa) are used. These drugs inhibit Bruton's tyrosine kinase (BTK), a protein that helps B cells to survive and proliferate. By blocking BTK, these drugs can kill cancer cells or slow their growth.

3. Immunotherapy

Immunotherapy is a treatment that uses the patient's immune system to fight cancer. In MCL, the most commonly used immunotherapy is rituximab (Rituxan), a monoclonal antibody that targets the CD20 protein on the surface of B cells. Other immunotherapies include lenalidomide (Revlimid), which stimulates the immune system to attack cancer cells, and CAR-T cell therapy, which involves modifying the patient's T cells to recognize and kill cancer cells.

4. Stem Cell Transplant

Stem cell transplant is a procedure that replaces the patient's diseased bone marrow with healthy stem cells. It can be autologous (using the patient's own stem cells) or allogeneic (using stem cells from a donor). This treatment is usually considered for patients who are in remission after initial treatment but are at high risk of relapse. It can also be used for patients whose disease has relapsed after initial treatment.