Mantle cell lymphoma

Mantle cell lymphoma is a B-cell non-Hodgkin lymphoma (NHL). It develops in the outer edge of a lymph node called the mantle zone. Mantle cell lymphoma occurs more often in men than in women. It is usually diagnosed in people in their early 60s.

Mantle cell lymphoma is usually diagnosed at stage 3 or 4. It has often spread to other lymph nodes, the bone marrow, the spleen and the liver. Mantle cell lymphoma is sometimes found along the gastrointestinal (GI) tract. When it is found in the GI tract, it may be called lymphomatous polyposis.

Mantle cell lymphoma may be slow growing (indolent), but there can also be fast-growing (aggressive) variations, called the blastoid variant and the pleomorphic variant.


The main treatment for mantle cell lymphoma is chemotherapy. Other treatments include targeted therapy, biological therapy, radiation therapy and stem cell transplant.


Chemotherapy is commonly used to treat mantle cell lymphoma. It is usually given as a combination of drugs and may be given with a targeted therapy drug. The combinations of chemotherapy drugs used may include:

  • CHOP – cyclophosphamide (Cytoxan, Procytox), doxorubicin (Adriamycin), vincristine (Oncovin) and prednisone
  • R-CHOP – CHOP with rituximab (Rituxan)
  • CVP – cyclophosphamide, vincristine and prednisone
  • R-CVP – CVP with rituximab
  • hyperCVAD – cyclophosphamide, vincristine, doxorubicin, dexamethasone (Decadron, Dexasone), methotrexate and cytarabine (Cytosar, Ara-C)
  • R-hyperCVAD – hyperCVAD with rituximab
  • EPOCH – etoposide (Vepesid), vincristine, doxorubicin, cyclophosphamide and prednisone

The following drugs may be used if mantle cell lymphoma doesn’t respond to treatment, progresses during treatment or comes back (recurs) after treatment. They may be given alone or combined with other drugs or a targeted therapy:

  • bendamustine (Treanda)
  • cladribine (Leustatin)
  • fludarabine (Fludara)

Targeted therapy

Targeted therapy uses drugs to target specific molecules (such as proteins) on the surface of cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells.

Rituximab is a targeted therapy drug commonly used alone or in combination with chemotherapy to treat mantle cell lymphoma.

Bortezomib (Velcade), ibrutinib (Imbruvica) and acalabrutinib (Calquence) are targeted therapy drugs that may be given for mantle cell lymphoma that comes back after treatment or stops responding to treatment.


Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer. Lenalidomide (Revlimid) is an immunotherapy drug that may be used for mantle cell lymphoma that comes back after treatment or stops responding to treatment.

Brexucabtagene autoleucel (Tecartus) may be used to treat mantle cell lymphoma that comes back after treatment or stops responding to treatment. It is used if you have already received treatment with calabrutinib (Calquence) or ibrutinib (Imbruvica).

Radiation therapy

External beam radiation therapy is sometimes used for mantle cell lymphoma. It may be given to the areas of lymph nodes that are affected. It is used for early stage disease or to relieve symptoms (called palliative therapy).

Stem cell transplant

A stem cell transplant may be an option for some people in first remission. It may also be used to treat mantle cell lymphoma that comes back after treatment or that stops responding to treatment.

People with mantle cell lymphoma who can’t have a stem cell transplant, or people whose cancer comes back after a stem cell transplant, may be treated with targeted therapy, biological therapy or other chemotherapy regimens.

Expert review and references

  • American Cancer Society. Non-Hodgkin Lymphoma. 2014:
  • American Society of Clinical Oncology . Lymphoma Non-Hodgkin Overview . 2014 :
  • Freedman AS, Jacobson CA, Mauch P, Aster JC . Non-Hodgkin lymphoma. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 103:1552-1583.
  • Manson SD & Porter C . Lymphomas. Yarbro, CH, Wujcki D, & Holmes Gobel B (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 60: pp. 1458-1512.
  • Medeiros L J . Pathology of non-Hodgkin's and Hodgkin's lymphomas. Wiernik PH, Goldman JM, Dutcher JP, Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 42: 867-918.
  • National Cancer Institute. Adult Non-Hodgkin LymphomaTreatment (PDQ®) Health Professional Version. 2015:
  • Gilead Sciences Canada Inc . Product Monograph Brexucabtagene Autoleucel (Tecartus) .

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

We do our best to make sure that the information we provide is accurate and reliable but cannot guarantee that it is error-free or complete.

The Canadian Cancer Society is not responsible for the quality of the information or services provided by other organizations and mentioned on, nor do we endorse any service, product, treatment or therapy.

1-888-939-3333 | | © 2024 Canadian Cancer Society