Mantle Cell Lymphoma (MCL): Symptoms, Treatments, and Emerging Therapies

Mantle Cell Lymphoma (MCL) is a rare and aggressive subtype of non-Hodgkin lymphoma (NHL), arising from the malignant transformation of B-lymphocytes in the "mantle zone" of lymph nodes. Accounting for approximately 5-7% of all NHL cases, MCL primarily affects older adults, with a higher prevalence in men. MCL often presents at an advanced stage due to its indolent onset and non-specific symptoms, such as:

• Fatigue
• Weight loss
• Lymphadenopathy (swollen lymph nodes)

As a result, treatment is challenging, and relapse is common despite initial responses to therapy.

Traditional Treatment Approaches

Traditional treatment regimens for MCL include combination chemotherapy, immunotherapy (such as rituximab), and autologous stem cell transplantation (ASCT) in eligible patients. However, these approaches often have high relapse rates, necessitating the exploration of novel therapeutic options.

Orphan Drugs and Targeted Therapies

• Ibrutinib: A Bruton's tyrosine kinase (BTK) inhibitor that blocks signaling pathways critical for B-cell survival and proliferation. It has demonstrated significant efficacy in relapsed and refractory MCL patients, offering improved survival outcomes and tolerability compared to conventional therapies.
• Acalabrutinib: A second-generation BTK inhibitor that provides a more targeted approach with fewer side effects.
• Lenalidomide and Bortezomib: These orphan drugs modulate the immune system and disrupt protein degradation in cancer cells, respectively, showing promise when used in combination therapies to enhance effectiveness and extend remission durations.

Current Research and Clinical Trials

Ongoing clinical trials aim to refine these treatments, develop new combinations, and improve drug efficacy, with the goal of achieving longer-lasting remissions and improving the overall prognosis for MCL patients.

Conclusion

Mantle Cell Lymphoma presents a significant challenge due to its aggressive nature and high relapse rates. However, the introduction of orphan drugs and targeted therapies like BTK inhibitors offers hope for improved outcomes. Continued research and innovation in treatment approaches will be key to advancing the care of MCL patients.

Blog by: Arshnoor Kaur, PHARM.D 3 Yr.

Supervised by: Dr. Sushama Maratha

Editor: Prof. (Dr.) Vijay Bhalla

Faculty: SGT College of Pharmacy