Mantle Cell Lymphoma Remission and Relapse: Rates and More

Mantle cell lymphoma (MCL) is generally considered incurable. Many people with MCL go into remission after initial treatment. But in most cases, their condition relapses within a few years. Remission happens when the cancer comes back.

A growing number of medications are available to treat MCL. If your condition relapses, the cancer might not respond to the medications used in your initial treatment. But there are second-line therapies that may help you achieve remission again.

Talk to your doctor to learn how you can reduce your risk of relapse and manage relapse if it happens.

In recent years, new medications have helped to lengthen the lives of people with MCL.

A recent study in the United Kingdom found that roughly 44 percent of people with this cancer lived for 3 years or longer. Among people who were first treated in 2004–2011, the median survival time was 2 years. In people treated between 2012 to 2015, the median survival time was 3.5 years.

If your initial treatment is successful and the cancer goes into remission, your doctor might recommend maintenance therapy. This may help you stay in remission for longer.

During maintenance therapy, you will likely receive an injection of rituximab, sold under the brand name Rituxan, every two to three months for up to two years. In some cases, your doctor might recommend a shorter maintenance period.

If you go into remission from MCL, it's important to schedule regular follow-up appointments with your doctor.

For example, they might ask you to visit them every two to three months. To monitor you for signs of relapse, they will likely order blood tests and imaging tests. Those imaging tests might include CT scans, PET/CT scans, MRI scans, or ultrasound exams.

Ask your doctor when you should schedule follow-up appointments.

If your condition relapses and the cancer returns, your doctor's recommended treatment plan will depend on:

• your age and overall health
• how long remission lasted
• the treatments you received in the past for MCL
• how well previous treatments worked
• how the cancer is acting now

Depending on your condition and health history, your doctor might prescribe one or more of the following treatments:

• medications
• radiation therapy
• stem cell transplant (SCT)

Your doctor can help you understand the potential benefits and risks of different treatment options.

Medication

To treat relapsed MCL, your doctor might prescribe one or more medications, such as:

• acalabrutinib (Calquence)
• bendamustine (Treanda)
• bortezomib (Velcade)
• ibrutinib (Imbruvica)
• lenalidomide (Revlimid)
• rituximab (Rituxan)
• combination chemotherapy

In some cases, they might prescribe the same type of medication that you received in earlier treatment. But that medication might not work as well as it did before. If that happens, your doctor will likely turn to other options.

Radiation therapy

In some cases, radiation therapy may help bring relapsed MCL back into remission. This type of treatment uses high-energy X-rays to kill cancer cells. Your doctor can help you decide if it's the right choice for you.

Stem cell transplant

Depending on your condition, your doctor might recommend a stem cell transplant (SCT). This treatment replaces bone marrow that's been destroyed by cancer, chemotherapy drugs, or radiation therapy.

SCT is more commonly used during initial treatment for MCL rather than in relapse. But if you're relatively young and healthy, it might be an option for you. To learn if you're a good candidate, talk to your doctor.

Several clinical trials are underway to study other treatments that might be effective for relapsed MCL. If you're interested in trying an experimental treatment, you might be a good candidate for one of these trials.

To learn more about clinical trials in your area, visit ClinicalTrials.gov.

If the cancer isn't responding to treatment or you're not well enough to continue it, your doctor might encourage you to stop active treatment for MCL.

You might also decide to stop active treatment if your quality of life is too negatively affected by the side effects. It's hard to predict how long you will live after ending active treatment.

If you decide to end active treatment, your doctor can still prescribe medications and other therapies to help manage pain or other symptoms. They might refer you to a mental health specialist for psychological and emotional support. They might also encourage you to speak with a financial or legal advisor, who can help you plan for the end of your life.

If you're having trouble managing your condition from home, they might refer you to a hospice for palliative care. While staying in a hospice, you can receive support from nurses and other health professionals. Some hospices also offer help with end-of-life planning.

If you go into remission from MCL, it's important to visit your doctor regularly to check for signs of relapse. If the cancer returns, your doctor can help you learn about your treatment options and long-term outlook.