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Permalink 11:20:12 pm, Categories: Background, 1072 words   English (US)

What is MCL?

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What is mantle cell lymphoma?

Non-Hodgkin's lymphoma is a cancer of the lymphatic system. The lymphatic system is part of the body's immune system and helps us fight infection. It is a complex system made up of organs, such as the bone marrow, the thymus, and the spleen, and the lymph nodes (or lymph glands). These are connected by a network of tiny lymphatic vessels. Lymph nodes are found all over the body.

Lymph is a colourless fluid. It circulates through the lymphatic system. Lymph contains cells called lymphocytes. Lymphocytes are a type of white blood cell and are an essential part of the body's defence against infection and disease.

There are two main types of lymphocytes: B-cells and T-cells. Most lymphocytes start growing in the bone marrow. The B-cells continue to develop in the bone marrow. The T-cells go from the bone marrow to the thymus gland (behind the breast bone) and mature there. When they are mature, both B-cells and T-cells help us to fight infections.

There are more than 20 different types of non-Hodgkin's lymphoma. Mantle cell is an uncommon type and makes up about 5% of all cases of non-Hodgkin's lymphomas. It is a cancer of the B-lymphocytes. Mantle cell lymphoma can occur at any time from the late 30s to old age. It is three times more common in men than in women.

Causes of mantle cell lymphoma
The causes of mantle cell lymphoma are not known. Mantle cell lymphoma, like other cancers, is not infectious and cannot be passed on to other people.

Signs and symptoms
The first sign of the condition is often a painless swelling in the neck, armpit or groin, caused by enlarged lymph nodes. Sometimes more than one group of nodes is affected. The lymphoma may spread to affect various organs in the body, such as the bone marrow, liver or spleen. About one in four people with mantle cell lymphoma will also have the disease in the stomach or bowel. Some people have loss of appetite and tiredness.

Other symptoms may include night sweats, unexplained high temperatures and weight loss. These are described as B symptoms.

How it is diagnosed
A diagnosis is made by removing an enlarged lymph node, or part of it, and examining the cells under the microscope. This is known as a biopsy. It is a very small operation and may be done under local or general anaesthetic. Biopsies may also be taken from other body tissues.

Additional tests, including blood tests, x-rays, scans and bone marrow samples, are then used to get more information about the type of lymphoma and how far it has spread in the body. This information is used to help decide which treatment is most appropriate.

The stage of non-Hodgkin's lymphoma indicates how many groups of lymph nodes are affected, where they are in the body and whether other organs such as the bone marrow or liver are involved.

Stage 1
The lymphoma is only in one group of lymph nodes in one particular area of the body.

Stage 2
More than one group of lymph nodes is affected, but all the affected nodes are contained within either the upper half or lower half of the body. The upper half of the body is above the sheet of muscle underneath the lungs (the diaphragm) and the lower half is below the diaphragm.

Stage 3
Lymphoma is present in lymph nodes in both the upper and lower parts of the body (i.e. in lymph nodes both above and below the diaphragm. Your spleen is considered as a lymph node in this staging system.

Stage 4
The lymphoma has spread beyond lymph nodes to other lymphatic organs for example, to sites such as the bone marrow, liver or lungs.
The stage usually includes the letter A or B, which describes whether any B symptoms are present or not (e.g. stage 2B ). Sometimes the lymphoma can start in areas outside the lymph nodes, and this is represented by the letter E, which stands for extranodal (e.g. stage 3AE).

For practical purposes non-Hodgkin's lymphomas are also divided into one of two groups: low- and high-grade. Low-grade lymphomas are usually slow-growing and high-grade lymphomas tend to grow more quickly.

Mantle cell lymphoma has the appearance of low-grade lymphoma, but may behave in a more aggressive way like a faster-growing lymphoma.

Chemotherapy The most commonly used treatment for mantle cell lymphoma is chemotherapy. Usually, quite an intensive form of chemotherapy is needed, with a combination of different drugs being given by injections or drips into a vein. This will normally involve some time in hospital.

High-dose treatment with stem cell support High-dose chemotherapy with bone marrow or stem cell infusions has been used for some patients. This type of treatment involves very intensive chemotherapy and sometimes radiotherapy.

As the side effects can be severe, some types of high-dose treatment are not given to people over the age of 45, while others can be given to people of up to 65 years who are fit enough. This is because the intensity of the treatment increases the risks of serious side effects for people over this age.

Radiotherapy Radiotherapy may be used when the lymphoma cells are contained in one or two areas of lymph nodes in the same part of the body (stage 1 or 2). It may also be given in addition to chemotherapy.

Steroid therapy
Steroids are drugs which are often given with chemotherapy to help treat lymphomas. They also help you to feel better and can reduce feelings of sickness.

Monoclonal antibody therapy Another treatment that may be used is a monoclonal antibody called rituximab. Monoclonal antibodies are drugs that recognise, target and stick to particular proteins on the surface of cancer cells.

Interferon is a protein that occurs naturally in the body. It is sometimes used to boost the body's own immune system to control the lymphoma. Interferon is given as an injection just under the skin (subcutaneously).

Clinical Trials
New treatments for mantle cell lymphoma are being researched all the time, and you might be invited by your doctor to take part in a clinical trial to compare a new treatment against the best available standard treatment. Your doctor must discuss the treatment with you and have your informed consent before entering you into any clinical trial.


These are my trials and tribulations of R-Hyper CVAD treatment for Stage 4 Mantle Cell Lymphoma

At the start of treatment (7/2005) I was a 38 year old male in good physical condition who was diagnosed with Stage 4 Mantle Cell Lymphoma on June 14th, 2005. I chose to begin R-Hyper CVAD treatment in Hackensack, N.J., under care of Dr. Goy - previously of MD Anderson in Texas, and prior to that Memorial Sloan Kettering in New York.

Thanks to my brother Alex for setting up this Blog!!

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