Dr Jerkeman on Symptom Identification for Earlier MCL Diagnosis

"The typical symptoms of MCL are [similar to those seen] with other lymphomas. It’s [commonly characterized by] enlarged lymph nodes, but MCL can also include gastrointestinal symptoms because MCL often involves the bowel. To differentiate [MCL] from CLL, flow cytometry of the blood is needed."

Mats Jerkeman, MD, head of Medical Oncology at Lund University and a principal investigator at Lund University Cancer Centre in Sweden, outlined symptoms that may warrant patient referral for further evaluation and facilitate the diagnosis of mantle cell lymphoma (MCL).

To ensure an earlier, more accurate diagnosis of MCL, Jerkeman emphasized the importance of recognizing the unique symptoms of this disease, which often mirror those of other lymphomas. He shared that the disease is commonly characterized by enlarged lymph nodes. Moreover, MCL often involves the bowel, meaning that patients could also present with gastrointestinal symptoms such as diarrhea or abdominal discomfort, Jerkeman highlighted. MCL may also present as lymphocytosis, which could be asymptomatic and appears very similar to chronic lymphocytic leukemia (CLL), he asserted.

To ensure an earlier or more accurate diagnosis and to differentiate MCL from CLL, flow cytometry of the blood is needed, Jerkeman said. Patients exhibiting either enlarged lymph nodes or lymphocytosis should be promptly referred to an expert hematologist or oncologist for comprehensive workup and evaluation, Jerkeman concluded.

Notably, in a presentation at the 2025 EHA Congress, Jerkeman and colleagues presented long-term follow-up from the Nordic phase 2 MCL2 (ISRCTN87866680) and MCL3 (NCT00514475) trials evaluating frontline treatment with rituximab (Rituxan) and intensive chemotherapy. At a median follow-up of 18 years, 35% of patients (n = 319) were still in first complete remission (CR1) at last follow-up. Although excess mortality was noted compared with the general Nordic population, survival appeared to plateau for patients younger than 50 years, suggesting that this younger group might experience no excess mortality.

Jerkeman concluded that although therapeutic progress has been made in MCL overall, patients with high-risk genetic and histologic features remain underserved.