Lymphoma is a malignant tumor originating from lymphoid tissue. It is divided into Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. More than 8 in 10 (82.1%) people in England diagnosed with Non-Hodgkin lymphoma aged 15-44 survive their disease for ten years or more. Among them, mantle cell lymphoma is often asymptomatic in the early stage. It is not easy to detect, and 70% are diagnosed at an advanced stage, resulting in a median survival period of only 42 months. In recent years, the medical community has introduced new treatments, one of which is a new generation of BTK inhibitors, which is expected to target people in their 60s and 70s who are prone to developing the disease. Extend survival and strive for a better prognosis.

What exactly is mantle cell lymphoma, and what are its symptoms and main treatments? Here we explain in detail the classification and age of onset of MCL in lymphoma, as well as the diagnosis, symptoms and treatment of MCL; we also explain the effectiveness of the new generation of BTK inhibitors and the differences between them and other treatment methods.

What is mantle cell lymphoma (MCL)?

Lymphoma, also known as lymphoma, can be divided into the following two types based on different cell types:

1. Hodgkin Lymphoma (HL)
   
2. Non-Hodgkin’s Lymphoma (NHL)

The incidence rates of the two lymphomas are different in different countries, races and ages. There is a huge gap between the two. The incidence rate of non-Hodgkin’s lymphoma is 90%, while the incidence rate of Hodgkin’s lymphoma is only 10%. .

Lymphocytes in the human immune system are mainly composed of B cells and T cells. Most lymphomas evolve from these two cells; therefore, common non-Hodgkin’s lymphomas are generally divided into B-cell lymphomas. or T-cell lymphoma.

Mantle cell lymphoma is a B-cell lymphoma. Compared with other types of lymphoma, it is less malignant and worsens more slowly, so it is more difficult to detect in the early stages. In addition, the recurrence rate is high, and patients are generally 60 to 70 years old. However, the treatment is as difficult as that of highly malignant lymphoma.

MCL develops slowly, has insignificant symptoms, and is difficult to detect in the early stages.

The human body’s lymphatic system is spread throughout the body, with 500 to 600 lymph nodes. When lymphoid tissue becomes cancerous, in addition to lymph node enlargement, different symptoms will also occur depending on the affected organ. For example, lymphoma in the brain may cause Confusion, weakness in hands and feet, and abdominal lymphoma can cause edema or ascites in the lower body. Therefore, compared with other cancers, the symptoms of lymphoma are more complex and diverse, making it more difficult for patients to detect them at the first time.

After suffering from lymphoma, patients will develop systemic or local lymph node enlargement, such as lymph node enlargement in the neck, armpits and groin. This is why many patients discover that they have lymphoma.

Compared with other lymphomas, mantle cell lymphoma grows very slowly and does not cause obvious symptoms. Therefore, patients usually do not know that they have cancer. By the time the lymph nodes begin to swell and they seek medical examination, the condition is usually in the third or fourth stage.

Mantle cell lymphoma has a high recurrence rate and past treatment options have limited effectiveness

Another difficult aspect of mantle cell lymphoma is that it has a high recurrence rate and is prone to drug resistance.

First-line treatments for MCL include:

1. Chemotherapy
   
2. Targeted therapy
   
3. Autologous bone marrow transplant

Patients usually receive chemotherapy first, and then decide whether to use more aggressive targeted therapy or autologous bone marrow transplantation depending on the severity of the disease, the patient’s age and physical condition. However, most patients will still relapse after receiving chemotherapy. , and tumors will become resistant to drugs, making the effects worse; even if more aggressive targeted therapy and autologous bone marrow transplantation are adopted, if the patient’s condition is severe, there is still a high chance of recurrence.

In 2013, the medical community launched BTK inhibitors; BTK is a protein, formally known as Bruton’s tyrosine kinase. BTK has high activity in cancerous B cells, causing B cells to proliferate and expand; The drug can inhibit the activity of BTK and interrupt the transmission of cell messages, thereby controlling cancer cells and causing them to undergo apoptosis.

Compared with other therapies, although BTK inhibitors are more effective and improve disease progression-free survival, they also have blood and heart-related side effects, such as atrial fibrillation, high blood pressure, or poor coagulation function. Therefore, some people who are older or have physical conditions Poor patients find it difficult to continue taking medication.

New progress in MCL treatment

Fortunately, with the advancement of medicine, new breakthroughs have been made in the specificity of BTK inhibitors in recent years. It is expected that this breakthrough can benefit more patients, help extend the survival years of patients, reduce side effects, and improve the quality of life of MCL patients. , providing patients with more treatment options.

There is a 70-year-old MCL patient who has been taking a new generation of BTK inhibitor drugs for more than a year. So far, his condition has been stably controlled and he rarely experiences adverse drug reactions, which has improved the patient’s living conditions.

However, the carcinogenesis pathway of tumors is often not a single cause. For some MCL patients, chemotherapy or other existing treatments also have good effects. Therefore, patients should first actively cooperate with the doctor’s advice to jointly evaluate the development of their disease and life goals, and through different Treatment options achieve complementary therapeutic effects.

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