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Mantle cell lymphoma

Examined under the microscope, the Mantle cell lymphoma appears as an expansion of the mantle zone area of the lymph nodes.It is represented by a homogenous population of malignant small lymphoid cells, which are cancerous cells that travel from the bone marrow to the lymph nodes and spleen. They are different from the normal lymphocytes, they are not mature properly. Mantle cell lymphoma is a rare type of Non- hodgkin's lymphoma.

The lymphocytes are white blood cells produced by the immune system of the human body. Regarding their origin, there are two types of immune cells, the B cells which are made in the bone marrow and the T cells which are made in the thymus. After they are made they are eliminated in the lymph which is a clear liquid that bathes tissues and circulates in the lymphatic system. The lymphatic system in the place where occur the cancers known as lymphomas. If the B cells are affected there can be a Non-Hodgkin's lymphoma which include follicular lymphomas, small non-cleaved cell lymphomas (Burkitt's lymphomas), marginal zone lymphomas (MALT lymphomas), small lymphocyte lymphomas, large cell lymphomas. In this category of diseases is included the mantle cell lymphomas too.

At the beginning, the MCL cells develops in limited areas. Regarding this aspect there are three subsets of MCL cells: the mantle zone type, the nodular type and the blastic or immature type. In the most cases these various types develop together and the diagnoses are of mixed mantle and nodular type. During the development of the MCL the non-cancerous mantle centers also become invaded by cancerous cells. In about 20% of these cases, the cells become larger and they are imature ones.

As it is initially slow-growing, this type of cancer it was first believed to be a low-grade cancer, but the average survival rate it was substantially shortened. Because of the mixed nature of MCL cells, specialists tend to give this disease a new classification. The presence of the blastic type of cells is considered as a high-grade cancer because it spreads at about the rate of other lymphomas belonging to that category. It is very important to describe the precise nature of these cells, because this may help specialists involved in the study of MCL to get to an agreement.

Mantle cell lymphoma affects persons with ages between 50 - 70 years and it is diagnosed more frequently in women. This type of cancer has the shortest average survival of all lymphomas.

Nowadays the cause of MCL is unknown. It has many symptoms that appears in other lymphomas too. Patients generally complain of fatigue, low grade fevers, night sweats, weight loss, anemia, rashes, digestive disturbances, chronic sinus irritation, recurrent infections, sore throat, shortness of breath, muscle and bone aches and edema. A more specific symptom is the spleen enlargement. This clinical aspect is present especially in the nodular type of MCL. An early stage is the swollen lymph nodes. At the beginning this has no explanation because the general health of the patient is good. Anemia is another syptom that characterizes MCL, but it is a mild type of anemia. Some patients can also report lower back pain and burning pain in the legs and testicles. In an advanced stage of the MCL the lymph nodes increase in volume, the general health is compromised and the symptoms become more pronounced. In the end stage the MCL spreads to the central nervous system and appear the neurological symptoms.

As MCL is very similar to several other lymphoma types, imunologic tests are recommended for a correct diagnosis. One of this kind of tests is Immunophenotyping which determine what kind of surface molecules are present on cells, and which is the exact type of lymphoma, from a tissue sample.

When the diagnosis is sure it must be known that mantle cell lymphoma has already spread into many other tissues such as the lymph nodes, spleen, bone marrow or to the ring of adenoid, palatine and lingual tonsils at the back of the mouth or even to the gastrointestinal tract. If the MCL spread to the colon it is diagnosed as multiple lymphomatous polyposis.

The treatment for MCL is established depending on the type of MCL and it stage.

There is no standard treatment for MCL patients. The patients diagnosed with MCL have been treated with surgery, radiation, single drug or combination chemotherapy and stem cell transplants. The most common chemotherapy regimens for treating MCL includes the drugs: Cyclophosphamide (cytoxan, neosar), adriamycin (doxorubicin or Hydroxydoxorubicin), vincristine (Oncovin), and Prednisone and it is called CHOP.

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