Even though some patients have the same condition, the treatment plan differs. Why is that? Cure Today spoke to Dr. Elizabeth Bengtson, MD, a hematology expert, to learn more about the differing prognoses and treatment plans for patients with mantle cell lymphoma (MCL). According to Dr. Bengtson, there are numerous factors which go into treating these patients.
Dr. Bengtson’s Insights
According to Dartmouth-Hitchcock, Dr. Elizabeth Bengtson is Assistant Professor of Medicine at the Geisel School of Medicine, Dartmouth. She was named Top Doctor by Castle Connolly in 2019, 2020, and 2021. Her areas of expertise and focus include:
- Non-Hodgkin’s lymphoma (NHL)
- Hodgkin’s lymphoma
- Hematologic malignancies
- Primary central nervous system (CNS) lymphoma
- Chronic lymphocytic leukemia (CLL)
- Autologous stem cell transplant (ASCT)
Discussing MCL
In her most recent discussion with Cure Today, Dr. Bengtson discussed the multiple elements which dictate MCL treatment. First, she explains that there are certain factors which indicate disease severity. For example, patients with leukemic non-nodal cancer, which makes up under 20% of MCL diagnoses, do not typically see the cancer affecting their lymph nodes. While patients with non-nodal MCL may still experience spleen enlargement or high white blood cell levels, these patients often have a less aggressive type of cancer. As a result, patients whose MCL does not overexposes SOX11 or whose MCL is non-nodal may not need as frequent or urgent treatment.
Alternately, she explains, those with blastoid or pleomorphic variants, TP53 markers, NOTCH1 markers, or CDKN2A markers often have more aggressive MCL. Thus, these patients will often need more monitoring and more aggressive treatment.
Next, Dr. Bengtson discussed how to target and treat specific MCL-related biomarkers. Although this is still in the works, she is hopeful that research over the next few years will discover more insight into how to achieve this. In the meantime, patients have the following treatment options:
- Allogeneic stem cell transplantation
- Chemotherapy in conjunction with immunotherapy
- Watch and wait (i.e. monitoring and adapting as needed)
- Clinical trial enrollment
Mantle Cell Lymphoma (MCL)
Mantle cell lymphoma (MCL) exists under the umbrella of non-Hodgkin’s lymphoma (NHL), cancers affecting the body’s lymphatic system. In patients with MCL, the cancer forms in lymphocytes (white blood cells) within the mantle zone. While doctors are not exactly sure what causes MCL, some hypothesize that genetic mutations cause an excess of cyclin D1 protein to be released, causing uncontrolled B-cell growth. The overall survival rate for this aggressive cancer is usually 6-7 years, though this depends on what stage it is diagnosed. Symptoms include:
- Appetite loss
- Nausea and vomiting
- Unintended weight loss
- Persistent lymph node swelling, often in the neck or throat
- Enlarged tonsils, liver, and/or spleen
- Indigestion or heart burn
- Bloating
- Diarrhea
- Pressure or pain in the lower back which extends down the legs
- Fever
