If your mantle cell lymphoma (MCL) relapses after remission, the cancer may not respond to the medications used in your initial treatment. But other therapies may help you achieve remission again.

While there is no cure for mantle cell lymphoma (MCL), doctors use a number of medications to help treat it.

Talk with your doctor to learn how you can reduce your risk of relapse and manage relapse if it happens.

Learn what to expect from remission and relapse with MCL.

There is currently no cure for MCL. But many people with MCL go into remission after initial treatment. Remission is a period when cancer activity stops or disappears. How long it lasts can vary from person to person.

In most cases, MCL relapses, or returns, within a few years. Relapse happens when the cancer comes back.

People with MCL may experience multiple periods of remission and relapse.

If you experience a relapse, the cancer may no longer respond to the medications used in your previous treatment. Doctors can use second-line therapies to help you enter remission again.

Refractory mantle cell lymphoma

There may come a period when MCL stops responding to approved treatments altogether. This is called refractory disease. If you have refractory MCL, you may qualify for clinical trials or decide to focus on maintaining your quality of life rather than treating your cancer.

If your initial treatment is successful and the cancer goes into remission, a doctor typically recommends maintenance therapy. This may help you stay in remission for longer.

The length of remission from MCL can depend on many factors and varies from person to person.

Generally, the first remission you experience is the longest. With newer treatments and maintenance therapy, the length of remission may vary from around 2–5 years, or as many as 8 years or more, according to a 2022 review of research.

Maintenance therapy

During maintenance therapy, you will likely receive an injection of rituximab (Rituxan) every 2–3 months for up to 2 years. Your doctor may recommend a shorter maintenance period or different medications, depending on your situation.

Maintenance therapy can help prolong remission.

Monitoring

If you go into remission from MCL, it’s important to schedule and keep regular follow-up appointments with your care team. You may have every 2–3 months to monitor for signs of relapse. This typically includes:

  • blood tests
  • CT or PET/CT scans
  • MRI scans
  • ultrasound exams

They may also ask you to contact them if you experience any indicators that the cancer has relapsed. This can include symptoms like:

  • night sweats
  • unexplained weight loss
  • unexplained fever

If your condition relapses and the cancer returns, a doctor’s recommended treatment plan can depend on:

  • your age and overall health
  • how long your remission lasted
  • the treatments you received in the past for MCL
  • how well your previous treatments worked and how you tolerated them
  • how the cancer is acting now

Depending on your condition and health history, they might prescribe one or more of the following treatments:

  • medications
  • radiation therapy
  • stem cell transplant (SCT)

A doctor can explain the potential benefits and risks of different treatment options.

Medication

To treat relapsed MCL, your doctor might prescribe one or more medications, such as:

  • acalabrutinib (Calquence)
  • bortezomib (Velcade), with or without rituximab
  • lenalidomide (Revlimid), with or without rituximab
  • rituximab (Rituxan)
  • zanubrutinib (Brukinsa)
  • brexucabtagene autoleucel (Tecartus)
  • pirtobrutinib (Jaypirca)
  • bendamustine (Treanda), with or without rituximab

In some cases, they might prescribe the same type of medication that you received in earlier treatment. But that medication might not work as well as it did before. If that happens, the doctor will likely turn to other options.

Stem cell transplant

In some cases, your doctor might recommend a stem cell transplant (SCT), where they replace damaged or destroyed stem cells.

This treatment allows doctors to use stronger chemotherapy drugs to destroy cancer cells.

SCT is more commonly used during initial treatment for MCL rather than in relapse. But if you’re relatively young and healthy, it might be an option for you. To learn if you’re a good candidate, talk with a doctor.

In some cases, SCT can be curative for MCL, but it can also pose serious health risks, including increasing your risk of infections, and is not safe for all people with MCL.

Experimental treatments

Several clinical trials are underway to study other treatments that might be effective for relapsed MCL. If you’re interested in trying an experimental treatment, you might be a good candidate for one of these trials.

Some clinical trials are studying the oral proteasome inhibitor ixazomib (Ninlaro) along with other treatments, such as chemotherapy and immunotherapy.

To learn more about clinical trials in your area, visit ClinicalTrials.gov.

Palliative care

Palliative care can help you manage physical and emotional effects and other side effects relating to your cancer. This type of treatment helps maintain your quality of life. You can receive palliative care while on treatment for MCL.

You can ask a doctor for a referral to a palliative care specialist.

If your cancer is not responding to treatment, palliative care can continue to support you as you make decisions to ensure your quality of life is maximized at the end of life.

End-of-life planning

If the cancer isn’t responding to treatment, you’re not well enough to continue it, or your quality of life is negatively affected by side effects, you may decide to stop active treatment.

It’s hard to predict your chances of survival after ending active treatment. A doctor can recommend hospice care if they believe you have 6 months or fewer to live.

Hospice care can provide treatment to help you manage side effects and psychological and emotional support. Some hospices also offer help with end-of-life planning.

You may also decide to speak with a financial or legal advisor, who can help you with estate planning and other considerations.

Researchers are currently studying ways to prolong remission with MCL. There isn’t a specific way to avoid relapse, but sticking to your treatment plan may help delay it. This typically includes:

  • attending appointments with your care team
  • getting regular testing and monitoring
  • adhering to maintenance therapy

Taking steps to support your overall health may also help with treatment recovery and reduce symptoms from treatment. Your overall health can also play a role in the type of treatments your care team can recommend.

Some steps you can take to support your overall health may include:

Support can help you manage treatment and the emotional impact of MCL. You may consider:

How long is remission for mantle cell lymphoma?

How long remission for MCL lasts can depend on many factors, including previous treatments and maintenance treatment. It may last between 2 and 8 years, though could also be shorter or longer.

What is the 10-year survival rate for mantle cell lymphoma?

The average 10-year survival rate for MCL is around 32%, according to 2022 research based on people treated for MCL between 2000 and 2020.

What is the breakthrough for mantle cell lymphoma?

The FDA-approved pirtobrutinib (Jaypirca) for relapsed or refractory MCL in 2023.

If you go into remission from MCL, it’s important to visit your doctor regularly to check for signs of relapse. If the cancer returns, a doctor can help you learn about your treatment options and long-term outlook.