Mediastinal large B cell lymphoma (MLBCL) belongs to the group of cancers known as non-Hodgkin's lymphoma. MLBCL begins in the B lymphocytes, white blood cells that function to produce antibodies, in the mediastinum---the area between the lungs behind the breast bone, located deep inside the chest cavity. Often localized in the thymus, this type of lymphoma is rare, accounting for approximately 2 percent of all lymphomas, as reported in July 2009 by the American Cancer Society. Although this form of cancer grows rapidly, it responds well to treatments, resulting in about half of the patients experiencing a cure.
Chemotherapy
Because of the rapid growth rate of MLBCL, chemotherapy is often the treatment of choice. Chemotherapy uses anticancer drugs to damage and kill cancer cells. Usually administered either orally or intravenously, chemotherapy medications enter the bloodstream, allowing them to reach cancer cells anywhere in the body. This also means that healthy cells throughout the body can become damaged by the chemotherapy causing many side effects. Common side effects include hair loss, mouth sores, loss of appetite, nausea, vomiting, diarrhea, fatigue and an increased risk of infections.
Chemotherapy often utilizes a combination of medications, known as cocktails, to improve the effectiveness. A commonly used cocktail, known as CHOP, uses a combination of cyclophosphamide, doxorubicin, vincristine and prednisone. A study published in the November 2007 issue of Community Oncology revealed that other chemotherapy cocktails may improve treatment outcomes. Two treatment regimens used include MACOP-B---methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin; and VACOP-B---vincristine, doxorubicin, cyclophosphamide, etoposide, prednisone, bleomycin.
Radiation Therapy
Radiation therapy uses high-energy radio waves, similar to X-rays, to destroy cancer cells. Radiation therapy may be administered internally, externally or systemically. External beam radiation, administered from a source outside the body, can treat MLBCL by focusing the radiation to the mediastinal area and the thymus. General side effects, including sunburn-like skin irritation and fatigue, often occur. Damage to normal healthy cells in the area around the cancer can cause additional side effects such as nausea, vomiting, diarrhea and difficulty breathing.
Monoclonal Antibody Therapy
Monoclonal antibody therapy, often used in combination with chemotherapy, may increase the effectiveness of the chemotherapy. Rituximab, a drug engineered to mimic a protein produced by the immune system, targets a substance known as CD20, which is found on B lymphocytes. Because the medication targets the cancer cells, side effects, including chills, fever, nausea, rashes and fatigue, remain mild. In addition to helping the drugs find the cancer cells, rituximab stimulates the immune system to help fight off the cancer.
