Overview
Mantle cell lymphoma is a type of lymphoma. Lymphoma is cancer that affects the lymphatic system. The lymphatic system is made up of organs, glands, tubelike vessels and clusters of cells called lymph nodes. It's part of the body's germ-fighting immune system. Mantle cell lymphoma typically affects the lymph nodes, but it also can affect the blood, bone marrow and other tissues throughout the body.
There are many types of lymphoma. Lymphoma types are often divided into two categories: Hodgkin lymphoma and non-Hodgkin lymphoma. Mantle cell lymphoma is a type of non-Hodgkin lymphoma.
Mantle cell lymphoma gets its name from the fact that the cancer starts inside an area called the mantle zone of a lymph node. The mantle zone is a ring of cells surrounding the inner part of the lymph node. These cells are germ-fighting white blood cells called B lymphocytes. In mantle cell lymphoma, changes happen that turn the B lymphocytes into cancer cells. The cancer cells build up in the lymph nodes and other parts of the body.
Mantle cell lymphoma is a rare and often aggressive type of cancer. Treatment for mantle cell lymphoma may include radiation therapy, immunotherapy, chemotherapy, targeted therapy, CAR-T cell therapy and bone marrow transplant, also called a bone marrow stem cell transplant. While mantle cell lymphoma often can't be cured, treatments can shrink the cancer size and help contain it. Treatment may increase the time that the cancer stays away, known as remission, and help prolong life.
Types
The types of mantle cell lymphoma include:
- Classic mantle cell lymphoma. Also known as nodal mantle cell lymphoma, this is the most common type of mantle cell lymphoma. It is typically found in the lymph nodes but also can be found in the bone marrow, spleen and digestive system.
- Leukemic nonnodal mantle cell lymphoma. This type of mantle cell lymphoma grows slowly and is mainly found in the blood and spleen. This type may not cause symptoms and may not need treatment right away. Your healthcare team may watch it over time.
- In situ mantle cell neoplasia. This type is a very early form of mantle cell lymphoma. It is often found accidentally during testing for other reasons. In situ mantle cell lymphoma is found in small areas of lymph tissue and doesn't cause symptoms. This type usually never turns into cancer and may only need monitoring.
Classic and leukemic nonnodal mantle cell lymphomas can have variants called blastoid and pleomorphic variants. These are rare but aggressive types of mantle cell lymphoma. They are found in the lymph nodes and bone marrow and can spread to other organs. These variants are often harder to treat and need stronger therapy.
Symptoms
Mantle cell lymphoma may not cause symptoms at first. When they happen, signs and symptoms may include:
- Painless swelling in the neck, armpit or groin.
- Fever.
- Fatigue.
- Decreased appetite.
- Weight loss without trying.
- Nausea.
- Diarrhea.
- Bloating.
If the cancer involves the digestive system, symptoms may include changes in bowel habits and blood in the stool.
When to see a doctor
Make an appointment with a healthcare professional if you have any symptoms that worry you.
Causes
It's not clear what causes mantle cell lymphoma. This cancer starts inside the mantle zone of a lymph node. The mantle zone is a ring of cells surrounding the inner part of the lymph node, called the germinal center. These cells are germ-fighting white blood cells called B cells. In mantle cell lymphoma, gene changes cause the cell's DNA to rearrange. This is known as translocation. Certain translocations cause the B cells to turn into cancer cells that multiply rapidly and invade and destroy healthy body tissue.
Mantle cell lymphoma can affect the:
- Lymph nodes.
- Bone marrow.
- Blood.
- Spleen.
- Liver.
- Digestive tract.
- Rarely, the central nervous system.
Risk factors
Factors that can increase the risk of mantle cell lymphoma include:
- Older age. Mantle cell lymphoma can happen at any age. But it's most common in people 60 or older.
- Race. White people are more likely to develop mantle cell lymphoma than are people of other races.
There is no known way to prevent mantle cell lymphoma.
Complications
Complications of mantle cell lymphoma can include risk of relapse, complications of advanced cancer and side effects of treatment.
Risk of relapse
Even after successful treatment, mantle cell lymphoma usually comes back. This is called a relapse. Sometimes the relapse happens years later. The risk of relapse continues throughout life, so most people have a lifetime of monitoring after treatment.
Complications of advanced cancer
Complications of advanced mantle cell lymphoma may include swollen lymph nodes that can press on nearby parts of the body and cause issues. This may include pressing on the throat and causing difficulty swallowing or breathing. When swollen, the lymph nodes also may not be able to drain properly. This can cause swelling in the legs. Advanced mantle cell lymphoma also can cause fluid to build up in the chest and belly. This can cause breathing troubles, heart troubles, discomfort and swelling in the belly.
Side effects of treatment
Treatments for mantle cell lymphoma may have side effects. These may include nausea, vomiting, fatigue, fever, rash, diarrhea and more. Harmful side effects from treatments may include:
- Bone marrow suppression. The bone marrow can't make enough blood cells, including white blood cells and platelets. White blood cells help fight infections. When you have fewer white blood cells, you are at a higher risk of infections. Platelets prevent bleeding, so a low amount can increase the risk of bleeding.
- Medicine toxicity. Some medicines used to treat cancer can be harmful to the body. They can cause organ damage and other issues. Whether a medicine is toxic depends on the type and how much you take. There are many different medicine options. Your healthcare team can work with you to find the best ones for you.
- Reactivating viruses. If you have had a viral infection in the past, such as hepatitis B or hepatitis C, some treatments can cause the virus to become active again. This can lead to liver inflammation, liver damage and other complications.
- Tumor lysis syndrome. Tumor lysis syndrome is a serious condition that can happen when cancer cells break down quickly after treatment. When these cells die, they release substances into the bloodstream, such as potassium and uric acid, that can overwhelm the organs. This can lead to problems with the kidneys, heart and other organs. Medicines may help prevent or treat harmful side effects.