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Patient pathway

This is an overview of the patient pathway, from symptoms to potential treatments, which may be helpful for your patients who want to know what their journey may look like.

Patient pathway

Treatment options


Although there is no standard of care for MCL, a range of treatment options are well established for patients.[1]

  • Aggressive chemo-immunotherapy regimens, followed by autologous stem cell transplantation and maintenance immunotherapy, are the most commonly used approach in younger, fit patients[1][2][3]
  • Chemo-immunotherapy, followed by immunotherapy maintenance, is most commonly used in older patients[1][2]
  • For frail patients, a less-intense chemo-immunotherapy regimen may be considered, aiming primarily at symptom control[1][2][3]
    – Targeted therapy exhibiting a low toxicity profile may also be suitable in this population[1][2][3]

Recently, there has been a shift in the treatment landscape in MCL to include the use of chemotherapy-free treatments with orally administered targeted agents in certain circumstances.[1][2][3][4]

Unfortunately, despite the improvement in response durations with currently available therapies, patients will inevitably relapse.[2][3]

patient doctor

What to discuss with your patient with MCL


Symptoms

Key symptoms your patients should be aware of include[5]:

fever
Fever
Abdominal pain
Abdominal pain
Bleeding
Bleeding
Fatigue
Fatigue
Atypical lymphocytes
Atypical lymphocytes
Hepatomegaly
Hepatomegaly
Itching
Itching
CNS involvement
CNS involvement
Unintentional weight loss
Unintentional weight loss
Enlarged spleen
Enlarged spleen
Night sweats
Night sweats

Causes and diagnosis

Your patients might be eager to know the cause of MCL, but while the cause is unknown, they can be made aware of the risk factors. These include[6]

  • Infection with certain viruses or bacteria
  • A weakened immune system
  • Autoimmune disease
  • History of cancer
  • Having a close blood relative with MCL

Diagnosis through a biopsy may be intimidating for patients, so it is important to reassure them that it is performed under general or local anaesthetics.[7]

Staging and treatment

Your patients will want to know what treatments are available to them. It is important to make them aware that some treatment options are more intensive than others, and that treatment choice can depend on what type of MCL they have, their age and fitness, and quality of life considerations. The aim of treatment is to achieve a balance between efficacy outcomes and toxicity.[8]

After treatment

Patients will need to expect follow-up appointments after treatment to check their response to therapy, monitor their recovery and treat any delayed side effects.[7]

Read through frequently asked questions from patients
Discover your patients’ treatment plan options
See our range of useful resource materials
Download this information on mantle cell lymphoma

MCL=mantle cell lymphoma.

This site has been developed by Janssen-Cilag International NV. Janssen-Cilag International NV is the responsible editor of this document

ITEM CODE: CP-233134 | DATE OF PREPARATION: June 2021

References

Dreyling M, et al. Newly diagnosed and relapsed mantle cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(S4):iv62–iv71.
Maddocks K. Update on mantle cell lymphoma. Blood. 2018:132(16):1647–1656.
Rule S. The modern approach to mantle cell lymphoma. Hematol Oncol. 2019;37(S1):66–69.
Jain P, Wang M. Mantle cell lymphoma: 2019 update on the diagnosis, pathogenesis, prognostication, and management. Am J Hematol. 2019;94:710–725.
Cortelazzo S, et al. Mantle cell lymphoma. Crit Rev Oncol Hematol. 2012;82:78–101.
Macmillan Cancer Support. Cancer information and support. Causes and risk factors of non-Hodgkin Lymphoma (NHL). Accessed May 2021. https://www.macmillan.org.uk/cancer-information-and-support/lymphoma/causes-and-risk-factors-of-non-hodgkin-lymphoma
Macmillan Cancer Support. Diagnosis of mantle cell lymphoma. Accessed May 2021. https://www.macmillan.org.uk/cancer-information-and-support/lymphoma/mantle-cell-lymphoma
Yoon DH, et al. Treatment of mantle cell lymphoma in Asia: a consensus paper from the Asian Lymphoma Study Group. J Hematol Oncol. 2020;13(1):21.