Mantle cell lymphoma, as reported by The Leukemia and Lymphoma Society in January 2007, accounts for approximately 6 percent of all non-Hodgkin's lymphoma cases, and affects the B lymphocytes---a specific type of white blood cell that produces antibodies. Mantle cell lymphomas begin in the B cells found in the mantle zone of lymph nodes, a characteristic that differentiates them from other B cell lymphomas. Because mantle cell lymphoma fails to remain localized to one place in the body, treatment differs from other non-Hodgkin B cell lymphomas.
Chemotherapy
Chemotherapy uses anti-cancer chemicals, or drugs, to damage and destroy cancer cells. Although most non-Hodgkin's lymphomas respond well to typical chemotherapy cocktails, such as CHOP---a combination of cyclophosphamide, doxorubicin, vincristine and prednisone, clinical studies reveal that mantle cell lymphoma fails to respond to these treatments. The most effective chemotherapy treatment, known as hyperCVAD, combines four chemotherapy agents--cyclophosphamide, vincristine, doxorubicin, and the steroid dexamethasone--alternately administered with cytarabine and methotrexate.
This chemotherapy regimen is aggressive, causing many difficult-to-handle side effects such as nausea, diarrhea and mouth sores. To alleviate the severity of side effects, the doses are hyperfractionated---noted as the "hyper" in hyperCVAD, meaning given in small frequent doses, as specified by CancerCare.org.
Radiation
Most non-Hodgkin's lymphomas respond well to radiation therapy---the use of high-energy rays to damage or kill cancer cells. External beam radiation, administered from a source outside the body, sends radiation to a specific area of the body. Although mantle cell lymphoma cells respond to radiation, this type of treatment fails to work since mantle cell lymphoma rarely occurs in one localized site in the body.
Monoclonal Antibody
Monoclonal antibody therapy uses synthetically-produced proteins that mimic proteins naturally produced by the immune system, to specifically target the lymphoma cells. Monoclonal antibodies then trigger the immune system to fight and destroy the cells. Rituximab, one monoclonal antibody medication, specifically targets B cells and when administered along with hyperCVAD successfully induces complete remission, according to CancerCare.org.
Radioactive compounds attached to monoclonal antibodies deliver radiation directly to the abnormal B cells. Radiation delivered this way produces successful results since the radiation can reach the lymphoma cells wherever they occur in the body.
Transplantation
Using high dose chemotherapy, although effective in killing the cancer cells of mantle cell lymphoma, destroys the bone marrow. The bone marrow continually produces new blood cells, including red cells, white cells and platelets, to replace old and dying blood cells. Without bone marrow, new cells cannot form causing life-threatening infections, bleeding disorders and complications of low blood counts, according to the American Cancer Society. To remedy this, doctors combine intense chemotherapy treatments designed to kill as many cancer cells as possible with a transplant procedure, which replaces the destroyed bone marrow with new bone marrow able to produce new healthy B lymphocytes.
