At Dana-Farber’s Mantle Cell Lymphoma Center, our team of specialists is focused on delivering advanced, personalized care to patients with mantle cell lymphoma. We are one of a select few centers nationwide dedicated to advancing research efforts to better understand and treat this cancer.
Our team at the Mantle Cell Lymphoma Center has extensive experience and expertise, combining lab and clinical research to better understand this specific lymphoma type and optimize care for patients.
We focus on delivering compassionate, patient-centered care that addresses the specific challenges faced by those with mantle cell lymphoma. Services include:
Mantle cell lymphoma is a form of non-Hodgkin B-cell lymphoma. It develops in the mantle cell, a ring of cells within the lymph nodes where B cells—a type of lymphocyte—grow. Most patients with mantle cell lymphoma have an aggressive form of the disease that can spread throughout the bloodstream, digestive system, and bone marrow. Approximately 10-20 percent of patients with mantle cell lymphoma have a slow-growing, non-aggressive version of the disease.
A key aspect of mantle cell lymphoma is the variation observed in patients with this disease. How the lymphoma affects a given patient, and how a patient responds to treatment is highly variable between different individuals. This highlights the need for deeper insights to inform new treatment approaches that are more broadly effective or that can be matched to patients who are most likely to benefit.
Mantle cell lymphoma occurs when B lymphocytes acquire genetic mutations that alter their function and growth. The most common abnormality, found in 90 percent of cases, causes B lymphocytes to overproduce cyclin D1, a protein that drives the cells’ growth. Other mutations can interfere with B cells’ ability to overcome DNA damage and produce infection-fighting antibodies, leaving patients vulnerable to treatment resistance and long-term complications such as low blood counts and infections.
Mantle cell lymphoma is usually first diagnosed in individuals between the ages of 60 to 70 years. Its cause is unknown for most patients, but farmers and people from rural areas are more likely to develop mantle cell lymphoma, suggesting that environmental exposures may play a role in some patients.
The most common symptoms of mantle cell lymphoma are:
Patients with mantle cell lymphoma can also experience a variety of other symptoms often mistaken as common physical problems, including:
Tests used to diagnose and evaluate mantle cell lymphoma can include:
At the time of diagnosis, nearly all patients have disease that has spread beyond one lymph node group in the body.
Lymphoma staging describes how much the cancer has spread in your body and helps guide treatment decisions. It uses a scale from I to IV, with higher numbers indicating more widespread disease.
Treatment selection for mantle cell lymphoma is based on a patient’s characteristics such as age, medical conditions, and symptoms, as well as disease features such as stage, proliferation rate, and genetic mutations. Choosing a treatment plan also depends on whether the patient is newly diagnosed, or has disease that has grown back after prior therapy. Our team takes a personalized approach to care, identifying the most effective and tolerable treatment options for each patient.
Some people diagnosed with mantle cell lymphoma may not need immediate treatment if they do not have symptoms. These patients may be recommended for “active surveillance” — close monitoring of their health through regular checkups and lab tests. When lymphoma-related symptoms appear or tests show a worsening of the disease, active treatment may begin.
Patients who follow an active surveillance treatment plan can expect to meet with their doctor every 3-4 months to monitor for disease progression or development of symptoms. Visits may also be more frequent if needed.
For patients who require treatment, initial treatment in younger patients includes upfront intensive chemotherapy in combination with an antibody-based treatment, followed by maintenance treatment with antibodies and/or oral targeted therapies. Older patients may receive less intensive chemotherapy in combination with an antibody-based treatment often followed by maintenance treatment. Chemotherapy-free treatment approaches are also being used in certain situations.
Our center is involved in research and clinical trials to improve the initial treatment for mantle cell lymphoma. This includes evaluation of drugs known as BTK inhibitors which interfere with lymphoma cells’ internal growth signals. Our overall goal is to establish treatment approaches that maximize the duration of time a patient’s lymphoma remains in remission after initial treatment while minimizing treatment side effects.
Patients with aggressive, relapsed, or refractory mantle cell lymphoma may be treated with:
Our center is focused on developing better treatments for those who have relapsed/refractory mantle cell lymphoma, including for those whose disease has high-risk genetic mutations. While initial treatment for the disease is often successful, most patients eventually relapse, highlighting the need for better treatments. Our team is dedicated to improving treatments and outcomes for patients with mantle cell lymphoma. We have trials for patients with relapsed/refractory mantle cell lymphoma exploring new treatments such as targeted combination therapies and novel immune-based therapies.
