Mantle cell lymphoma treatments may include the "watch and wait" method, radiation therapy, immunotherapy, chemotherapy, targeted therapy, CAR-T cell therapy and bone marrow transplant, also called bone marrow stem cell transplant. Which treatment is best for you depends on the extent of your cancer, called the stage. Your healthcare team also considers how quickly the cancer is growing, your overall health and what you prefer.
Watch and wait
If your mantle cell lymphoma doesn't cause symptoms, you might not need treatment right away. Instead, you may have checkups every few months. The checkups help your healthcare team watch your condition to see if your cancer is growing.
Radiation therapy
Radiation therapy for cancer is a treatment that uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.
Radiation therapy is not a common treatment option because mantle cell lymphoma often affects multiple parts of the body by the time it is diagnosed. However, radiation therapy may be used for people with early-stage mantle cell lymphoma or for people who may not handle other treatments well. Radiation therapy also may be used to relieve symptoms and improve quality of life.
Immunotherapy
Immunotherapy for cancer is a treatment with medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells.
Immunotherapy may be used as a first line treatment for mantle cell lymphoma. It is often combined with chemotherapy. Immunotherapy also may be combined with other medicines to treat advanced cancer or cancer that has come back after treatment, known as relapsed mantle cell lymphoma.
Immunotherapy also may be used after successful treatment to help keep the cancer away longer. This is called maintenance therapy.
Chemotherapy
Chemotherapy treats cancer with strong medicines. There are many chemotherapy medicines. Most chemotherapy medicines are given through a vein. Some come in pill form.
Chemotherapy may be used as a first line treatment for mantle cell lymphoma. It is often combined with immunotherapy. Chemotherapy may be combined with other medicines in people with advanced cancer or cancer that has come back after treatment, known as relapsed mantle cell lymphoma.
Targeted therapy
Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. For mantle cell lymphoma, targeted therapy medicines often target a protein that the cancer cells make. This protein is called Bruton tyrosine kinase (BTK). Medicines that target this protein are called BTK inhibitors.
For mantle cell lymphoma, targeted therapy may be used as a first line treatment. Targeted therapy also may be used when cancer comes back after treatment, known as relapsed mantle cell lymphoma. Targeted therapy also may be an option when other treatments haven't worked. This is known as refractory mantle cell lymphoma.
CAR-T cell therapy
Chimeric antigen receptor (CAR)-T cell therapy trains the immune system cells to fight mantle cell lymphoma. This treatment begins with removing some white blood cells, including T cells, from the blood.
The cells are sent to a lab. In the lab, the T cells are treated so that they make special receptors. The receptors help the cells recognize a marker on the surface of the lymphoma cells. Then the cells are put back into the body. There the CAR-T cells find and destroy the mantle cell lymphoma cells.
CAR-T cell therapy might be a treatment option for mantle cell lymphoma that has not responded to other treatments, called refractory mantle cell lymphoma. It also may be an option for mantle cell lymphoma that has come back after treatment, called relapsed mantle cell lymphoma.
Bone marrow transplant
A bone marrow transplant, also called a bone marrow stem cell transplant, involves putting healthy bone marrow stem cells into the body. These cells replace cells hurt by chemotherapy and other treatments.
Stem cells can come from your own body, called an autologous transplant. Or they can come from a donor, called an allogeneic transplant. For some mantle cell lymphomas, a bone marrow transplant can slow the progression of the cancer and extend the amount of time the cancer stays away, known as remission.
A bone marrow transplant may be an option for some people who are younger and in good health. Chemotherapy typically is done before the transplant. Maintenance therapy using immunotherapy typically is done after the transplant.