NCCN Guidelines for Patients® | Mantle Cell Lymphoma

18 NCCN Guidelines for Patients ® : Mantle Cell Lymphoma, 2017 2 Treatment planning Imaging tests damaged. Thus, a high level of LDH is a sign of cell damage. High levels can be caused by cancer or other health problems. If related to cancer, high levels may be a sign that treatment may be needed now or soon. Beta-2 microglobulin Beta-2 microglobulin is a small protein made by many types of cells, including lymphoma cells. It is measured with a blood chemistry test. If related to cancer, high levels may be a sign that treatment may be needed now or soon. Hepatitis testing Hepatitis B can be an important factor in the treatment of mantle cell lymphoma. Hepatitis B can become active again due to the cancer or some of its treatments. Thus, tell your treatment team if you’ve ever been infected with hepatitis. If you’re unsure, ask your treatment team if you should get tested. Testing may be needed if you will be treated with a drug called rituximab. Uric acid Some people with mantle cell lymphoma are at risk for TLS ( t umor l ysis s yndrome). This syndrome can be life threatening. It occurs when the waste released by dead cells is not quickly cleared out of your body. This results in kidney damage and severe blood electrolyte disturbances. TLS can occur among people with mantle cell lymphoma who are undergoing strong cancer treatments. The cancer treatment kills many cancer cells. In turn, too much tumor cell waste is released within in a short period of time. Your doctors may want to know your uric acid level before starting treatment. You may be given certain medications that can help prevent TLS. Also, drinking plenty of water throughout chemotherapy can help. Ask your treatment team for more information. Imaging tests Imaging tests make pictures (images) of the insides of your body. They can show which sites have cancer. This information helps your doctors stage the cancer. More information on cancer staging is in Part 4. Your treatment team will tell you how to prepare for the test. You may need to stop taking some medicines and stop eating and drinking for a few hours before the scan. Tell your doctors if you get nervous when in small spaces. You may be given a sedative to help you relax. Imaging machines are large. You will likely be lying down during testing. At least part of your body will be in the machine. Figure 6 shows a CT machine, which is described next. After the test, you will likely be able to resume your activities right away. If you took a sedative, you will have a waiting period. You may not learn of the results for a few days since a radiologist needs to see the pictures. A radiologist is a doctor who’s an expert in reading the images. Diagnostic CT A CT ( c omputed t omography) of your chest, belly area, and between your hip bones is needed. A CT of your neck is sometimes useful to learn if cancer is present. CT takes many pictures of a body part from different angles using x-rays. A computer combines the x-rays to make detailed pictures. The picture is saved for later viewing by the radiologist. A contrast dye is used for diagnostic CT. It makes the pictures clearer. The dye will be injected into a vein in your hand or arm. You will also be given a liquid contrast to drink.