Lymphoma is a type of blood cancer that affects the white blood cells called lymphocytes, which reproduce and grow in an abnormal manner. There are two main types of lymphoma, Hodgkin’s and non-Hodgkin’s, which are separated into subdivisions, according to their characteristics.
Cancerous lymphocytes tend to manifest first in the lymph nodes, which become swollen, but can appear in other body parts, such as the spleen and bone marrow, other internal organs or in the blood, creating a cancerous mass.
Non-Hodgkin’s tumors are the most common type and can develop either in the B-cells or T-cells, which determines the type of lymphoma. Mantle cell lymphoma is among the rarest kind of B-cell lymphoma, mostly affecting older men. It is also usually an aggressive and fast-growing type of cancer, and it comprises about 5 percent of the total cases of non-Hodgkin’s lymphomas.
Mantle Cell Lymphoma Characteristics
This type of cancer is named after the cells where it originated. The tumor cells of mantle cell lymphoma affect primarily the mantle zone of the lymph node. Almost every patient suffering from mantle cell lymphoma produces an excess of the Cyclin D1 protein, as well as abnormally high levels of other proteins found in the blood, including lactate dehydrogenase (LDH) and beta-2 microglobulin. Like other types of lymphoma, the first symptoms are swollen but painless lymph nodes in the neck, armpits, or other parts of the body.
Diagnosis of Mantle Cell Lymphoma
Lymphoma symptoms are similar to the ones found in other diseases, which makes diagnosis difficult. In the case of mantle cell lymphoma, the diagnosis is especially difficult. Initial, or A symptoms, include night sweats; chills or fevers; unexpected weight loss; loss of appetite; lack of energy or tiredness; itching or rash; coughing; difficulty in breathing; enlarged tonsils; or headaches, in addition to swollen lymph nodes.
More severe, or B symptoms, include abdominal or chest pressure; pain; diarrhea; indigestion; swollen members; lower back pain; and a lack of capacity to fight infections.
In the majority of the cases, the diagnosis is only confirmed when the disease is already in advanced stages, making treatment more difficult. Blood tests and a biopsy are the most common exams conducted when there are suspicions about mantle cell lymphoma, to seek elevated levels of Cyclin D1, lactate dehydrogenase, and beta-2 microglobulin.
When the disease is in advanced stages, it may have already spread to the gastrointestinal tract and bone marrow, which can be tested in a biopsy and through additional examinations.
Treatment of Mantle Cell Lymphoma
The treatment chosen for patients with mantle cell lymphoma depends on several factors, such as disease stage and extent, or patient’s age and additional diseases the patient may have. Watchful waiting may be an option, but only in cases of the disease’s early stage, while a combination of chemotherapy is usually the most appropriate treatment course. Chemotherapy is often administered with the monoclonal antibody rituximab.
In older patients, this combination is the most recommended, while in younger and stronger patients, it may be combined with HyperCVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with methotrexate and cytarabine). Stem cell transplants may also be an option in mantle cell lymphoma cases.
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