Diagnosis and Staging of Mantle Cell Lymphoma

Mantle cell lymphoma (MCL) is a rare type of B-Cell lymphoma. It presents itself in the mantle zone of lymph nodes, which is the outer ring of lymphocytes in a node. The cancer begins in the mantle zone but may spread to the spleen, liver, bone marrow, and GI tract. It is generally a low-grade, indolent cancer but it can be more aggressive than other slow-growing tumors.

Mantle cell lymphoma accounts for about 1 in 20 Non-Hodgkin’s Lymphoma diagnoses in the United States; it has a higher occurrence in Europe. It typically occurs in patients over 30 years old and is more frequent in patients over 50. Males are three times more likely to be diagnosed than females. Research is still being conducted to find effective treatments, as it has one of the poorer prognoses of the lymphomas.

Diagnosis and Staging

Patients usually present with symptoms common to all lymphomas: swollen glands, night sweats, weight loss, and fevers. Patients with mantle cell lymphoma may present with appetite loss as well because of the common involvement of the GI tract.

A doctor will take a biopsy to diagnose the disease. The biopsy will remove a portion of an affect lymph node or the whole lymph node for examination under a microscope.

Once a diagnosis of MCL is confirmed, the doctor may use other tests, such as blood tests, CT scans, PET scans, and/or bone marrow biopsies to determine the extent of the cancer in order to stage it.

Like most other lymphomas, staging depends on the spread of the lymphoma. If only one group of nodules in the lymph system is involved, then the disease is Stage I. Stage II disease includes the involvement of two lymph groups on the same side of the diaphragm, which divides the body into upper and lower sections. Or, one lymph group and the spleen may be involved in Stage II. Stage III disease is indicated by tumors in lymph groups on both sides of the diaphragm. Stage IV involves spread to other organs, such as the liver or bone marrow.

The disease is grade “A” if there are no common symptoms, such as night sweats. It is grade “B” if those symptoms are present. There is a third grade – grade “E”, which stands for extranodal – that indicates the cancer began in organs other than the lymph nodes; that is possible in MCL.

The treatment method depends on the stage of the disease. There are many clinical trials, as affective treatments for this disease are still being researched.

Follow this link to identify a conveniently located cancer treatment center and begin the process of enrollment.

The radioimmunotherapy regimen Zevalin® is currently being researched as a treatment for mantle-cell lymphoma.

Common treatment approaches for Mantle Cell Lymphoma include:

  • Monoclonal antibody treatment using drugs such as Rituximab, which trains the body’s immune system to target and destroy cancer cells.
  • Interferon, which is an immune system booster, is sometimes injected into patients to help them fight the disease.
  • Chemotherapy agents, such as the R-CHOP, or FCR regiments. R-CHOP combines Rituximab with a steroid, Prednisone, and three chemotherapy agents: cyclophosphamide, vincritine, and doxorubicin. FCR uses cyclophosphamide, Rituximab, and a newer chemotherapy drug called Fludarabine.
  • Radiation treatment is typically used in Stage I or II patients as a stand alone treatment, or in combination with chemotherapy in the later stages of the disease.
  • Stem Cell Therapy is an aggressive therapy used for late stages of the disease.

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