Clinical course of MCL. Stages
Most patients diagnosed with MCL are which we call chronic disease phase.
- In the chronic phase of the disease, patients have increased levels of mature neutrophils, thrombocytosis, and often splenomegaly (enlargement of the spleen). In this phase the disease is easily controlled and patient often respond well if given the right treatment.
- The accelerated phase is characterized by a progressive change in the disease in which the patient begins to develop symptoms such as fever, adenopathy, anemia, bone pain, and increased liver or spleen size. There is also an increase in basophils and blasts in the peripheral blood or bone marrow (over 10%).
Early diagnosis is crucial in this stage, as beginning treatment while the disease is in an early phase improves outcomes. More aggressive treatment may be necessary if the patient does not exhibit a favorable clinical course.
- The blastic crisis phase consist of presence of the symptoms described above in the accelerated phase in addition to a greater than 20% presence of blasts in the blood and bone marrow. The treatment of this disease is similar to that of acute leukemia and requires polychemotherapy to control the disease as well as specific Bcr-Abl tyrosine kinase inhibitors (i.e., imatinib, dasatinib, ponatinib).