Mantle cell lymphoma

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What is Mantle cell lymphoma?

Lymphoma is divided into 2 broad groups: Hodgkin's lymphoma and non-Hodgkin's lymphoma. Non-Hodgkin's lymphoma has many subtypes - and one of them is Mantle Cell Lymphoma. It is a B-cell lymphoma, which means it primarily affects the B lymphocytes.

Lymphoma means cancer of the lymphatic system. The lymphatic system is important to our immune system where it helps to combat infection. The lymphatic system consists of several organs, e.g. lymph nodes, spleen, thymus and bone marrow, where all these are connected by tiny vessels. Lymphatic fluid is the medium that circulates in these tiny vessels. Like blood, it has cells in them. These cells can be divided into 2 types: T cells and B cells.

Who gets Mantle cell lymphoma?

The following figures are according to the Australian Institute of Health and Welfare:

The incidence of non-Hodgkin's lymphoma is increasing over the years.

In 2001, there were 3499 cases of non-Hodgkin's lymphoma reported in Australia.

For non-Hodgkin's lymphoma, the male:female ratio is 1.22:1

In 2000, there were 2938 reported cases of B cell lymphoma (i.e. a subgroup of non-Hodgkin's lymphoma affecting primarily B lymphocytes) in Australia. B cell lymphoma is the commonest subgroup of non-Hodgkin's lymphoma.

The male to female ratio for mantle cell lymphoma is 3 to 1.
Most patients are in their sixties (around 63) when the disease is diagnosed.
Of these, about 70% of the patients are in stage IV disease (see below regarding staging)

Predisposing Factors

Like most lymphomas, no causes has been found for mantle cell lymphoma. Yet based on statistics, several factors can be identified:

Age: The disease mostly affects late middle age to elderly people
Sex: Male predominance
Race: Caucasians are affected more than Asians and Africans/African-Americans

Progression

Clinically and historically, non-Hodgkin's lymphoma can be subdivided into 2 groups: indolent (low grade) and aggressive (high grade) lymphomas. Mantle cell lymphoma is under the indolent group - which means it has better prognosis but may not respond to treatment when compared to aggressive groups of lymphomas.

As for the course of the disease, it is dependent on the clinical stage when the disease is diagnosed.

The Ann-Arbor staging for non-Hodgkin's lymphoma (which is applicable for mantle cell lymphoma) can be summarised as below:

Stage I - involvement of a single lymph node region or organ or site other than lymph nodes

Stage II - 2 or more lymph node regions involved on the same side of diaphragm

Stage III - 2 or more lymph node regions involved on both sides of diaphragm

Stage IV - one or more organs (e.g. bone marrow) involved

Each stage is subclassified into A and B (e.g. IIA), where B means presence of B symptoms (see below) while A means abscence of the following symptoms:

Unexplained a href="symptoms.asp?sid=24">fever> 38 Centigrade

Unexplained weight loss (defined as >10% of body weight in 6 months)

Night sweats

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