Les mantle cell lymphomas Are lymphomas of B cells. They originate in cells on the outer periphery (mantle zone) of the lymph nodes.

What does the MIPI index correspond to?

The prognosis is usually established using an index called MIPI (International Prognostic Index of Mantle Cell Lymphomas) which makes it possible to determine how likely the lymphoma is to respond to existing treatments as well as the probability of relapse following treatment. The four factors taken into account in establishing this index are:

• THEAge of the patient : the risk is greater for people over 50
• Son lactic dehydrogenase levels (LDH): the higher it is, the greater the risk
• The Number of white blood cells : If it is greater than 6.7x10⁹ per liter, the risk increases
• THEfunctional index : a number ranging from 1 to 4 is assigned according to the patient's ability to perform daily tasks and his physical condition. The lower the latter, the more independent the patient is.

Each of these factors is associated with a number (from 1 to 3) which are then added together to obtain a total score. The risk is low if the score is between 0 and 3, intermediate if it is 4 or 5 and becomes high if the MIPI reaches a score between 6 and 11. Once this index has been determined, the most appropriate treatment will be offered to the patient.

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How is mantle cell lymphoma treated?

To treat mantle cell lymphoma, several solutions are possible depending on the stage of the cancer and the condition of the patient. Treatments of chemotherapy can be set up. The chemotherapy combinations most frequently used for this type of lymphoma are:

• BR : Bendamustine (Treanda®, Benvyon®, Esamuze®) and Rituximab (Rituxan®)
• R-CHOP : Rituximab, Cyclophosphamide (Procytox®), Doxorubicin, Vincristine, and Prednisone
• R-DHAP : Rituximab, Dexamethasone, Cytarabine (Cytosar®) and Cisplatin

Of targeted therapies are also used to treat these lymphomas. The medication that is mainly used is Rituximab, a monoclonal antibody, used alone or combined with chemotherapy. Other treatments, such as Ibrutinib (Imbruvica®) or Acalabrutinib (Calquence®), are also effective especially in the event of a relapse.

In addition, for patients whose first treatment no longer works or who have relapsed, a stem cell transplant may be done, depending on the overall health condition of the patient. This transplant involves bringing new healthy stem cells to the patient. Stem cells can come from the patient himself from whom the cells were taken beforehand (autograft) or from a compatible donor (allograft).

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There are also other therapeutic options available via clinical trials.

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Sources: Canadian Cancer Society, Leukemia & Lymphoma Society, Arcagy-gyneco