eMedicine Specialties > Hematology > Stem Cells and Disorders

Lymphoma, Mantle Cell: Follow-up

Author: Muhammad Rashid Abbasi, MD, Assistant Professor of Medicine, Albert Einstein College of Medicine; Consulting Staff, Department of Internal Medicine, Division of Hematology/Oncology, Jacobi Medical Center, Morristown Memorial Hospital, and St Clare's Hospital
Coauthor(s): Joseph A Sparano, MD, Professor of Medicine, Albert Einstein College of Medicine/Cancer Center; Program Director, Director of Breast Medical Oncology, Department of Internal Medicine, Division of Oncology, Montefiore Medical Center
Contributor Information and Disclosures

Updated: May 14, 2007

Follow-up

Further Inpatient Care

  • Admit patients for complications or disease progression.
  • Admit patients for adverse chemotherapy effects, such as neutropenic fever or mucositis.

Further Outpatient Care

  • Usually, treatment and follow-up care of patients with MCL is performed in an outpatient setting.
  • Carefully monitor blood cell count prior to administering chemotherapy and 10-14 days after each treatment cycle.
  • Evaluate disease by monitoring history, physical examination findings, and imaging study results.
  • Monitor adverse effects of chemotherapy by monitoring history, physical examination findings, and CBC counts.
  • Provide symptomatic treatment for adverse effects such as nausea, vomiting, diarrhea, mucositis, and fatigue.
  • Provide psychosocial support.

Complications

  • Complications from disease progression
    • Cytopenias (neutropenia, anemia, thrombocytopenia) secondary to bone marrow infiltration
    • GI, pulmonary, or CNS complications secondary to extranodal involvement
    • Leukocytosis (lymphocytosis) in the leukemic phase of disease
  • Complications from chemotherapy
    • Infection, neutropenia, anemia, and thrombocytopenia
    • Fatigue
    • Neuropathy
    • Dehydration after diarrhea or vomiting
    • Cardiac toxicity from doxorubicin

Prognosis

  • MCL exhibits a moderately aggressive course similar to that of intermediate-grade NHL. Unlike intermediate-grade lymphomas, it is rarely curable with currently available standard treatment.
  • Median overall survival is 2-5 years. Younger age and limited disease are favorable prognostic features. Complete responses are rare with standard chemotherapy. Median time to treatment failure is less than 18 months.

Patient Education

  • Clearly explain all available treatment options and provide detailed instruction about the adverse effects of chemotherapy. Consider enrollment of the patient into a clinical trial.
  • Provide psychosocial counseling.
  • For excellent patient education resources, visit eMedicine's Blood and Lymphatic System Center. Also, see eMedicine's patient education article Lymphoma.

Miscellaneous

Medicolegal Pitfalls

  • Failure to ensure that the patient understands this disease and the available treatment options prior to starting a treatment modality, such as chemotherapy
  • Failure to discuss all risks (including, but not limited to, death) and benefits, answer questions, or obtain informed consent prior to initiating chemotherapy
  • Failure to prevent medication errors (a common source of lawsuits)
  • Failure to pay special attention while writing and administering chemotherapy, with chemotherapy checks at the pharmacy and nursing levels prior to administration
 


More on Lymphoma, Mantle Cell

Overview: Lymphoma, Mantle Cell
Differential Diagnoses & Workup: Lymphoma, Mantle Cell
Treatment & Medication: Lymphoma, Mantle Cell
Follow-up: Lymphoma, Mantle Cell
References
Further Reading
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References

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Keywords

mantle cell lymphoma, MCL, lymphocytic lymphoma of intermediate differentiation, intermediate lymphocytic lymphoma, ILL, diffuse poorly differentiated lymphocytic lymphoma, PDL, centrocytic lymphoma, diffuse small-cleaved cell lymphoma, DSCCL, mental zone lymphoma

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Contributor Information and Disclosures

Author

Muhammad Rashid Abbasi, MD, Assistant Professor of Medicine, Albert Einstein College of Medicine; Consulting Staff, Department of Internal Medicine, Division of Hematology/Oncology, Jacobi Medical Center, Morristown Memorial Hospital, and St Clare's Hospital
Muhammad Rashid Abbasi, MD is a member of the following medical societies: American College of Physicians, American Medical Association, and American Society of Hematology
Disclosure: Nothing to disclose.

Coauthor(s)

Joseph A Sparano, MD, Professor of Medicine, Albert Einstein College of Medicine/Cancer Center; Program Director, Director of Breast Medical Oncology, Department of Internal Medicine, Division of Oncology, Montefiore Medical Center
Joseph A Sparano, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, and American Society of Hematology
Disclosure: Nothing to disclose.

Medical Editor

Michael Paul Kosty, MD, Associate Director, Associate Professor, Department of Internal Medicine, Divisions of Supportive Care Services and Hematology and Oncology, Ida M and Cecil H Green Cancer Center, Scripps Clinic
Michael Paul Kosty, MD is a member of the following medical societies: American College of Physicians, American Society of Hematology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Wendy Hu, MD, Consulting Staff, Department of Hematology/Oncology and Bone Marrow Transplantation, Huntington Memorial Medical Center
Wendy Hu, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Blood and Marrow Transplantation, American Society of Hematology, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Emmanuel C Besa, MD, Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Thomas Jefferson University
Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, and New York Academy of Sciences
Disclosure: Nothing to disclose.

 
 
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