If you have a cancer called mantle cell lymphoma (MCL), you have a greater chance of getting COVID-19, the disease caused by the new coronavirus. But there are steps you can take to lower your risk.
Mantle cell lymphoma and some of its treatments can weaken your immune system -- your body's defense against germs. That makes it more likely you'll catch the virus. And if you do get sick, the infection could be more severe.
You're at especially high risk for COVID-19 if you:
- Get chemotherapy or you've had the treatment within the last year
- Had a stem cell transplant in the last year, or you take medicines that curb your immune system
- Are over 65
- Also have another disease that raises your COVID-19 risk, such as heart disease, lung disease, or diabetes
Your doctor might make changes to your treatment to help protect you from COVID-19.
How Mantle Cell Lymphoma Affects Your COVID-19 Risk
Your immune system has an army of white blood cells that help it fight off bacteria, viruses, and other foreign invaders so you don't get sick.
Mantle cell lymphoma starts in a type of white blood cell called a B-cell lymphocyte. Some of your B cells change into cancer cells. They divide more than normal, but the new B cells aren't healthy. They can't fight infections as well as normal B cells. So if you're exposed to the coronavirus, you're more likely to get sick, and to have a more severe illness than someone without MCL.
Poor nutrition is another reason for the higher risk of COVID-19. Your immune system needs vitamins, minerals, calories, and protein to fight off germs. Cancer cells eat up a lot of your body's nutrients. At the same time, nausea and appetite loss from your cancer treatments can make it hard for you to eat enough.
Cancer Treatments and COVID-19
One of the main treatments for mantle cell lymphoma combines four chemotherapy drugs and the monoclonal antibody rituximab (Rituxan). It's a drug combo known as R-CHOP. Another treatment combines the chemo drug bendamustine (Treanda) with Rituxan. Either of these treatments could raise your chances of getting COVID-19 because they curb your immune system.
Chemotherapy kills cancer cells, but it also destroys white blood cells and other immune cells your body needs to fight infections. This weakens your immune system, which is called immunosuppression. A weak immune system can't fight off viruses as well as a healthy one.
Another problem is that you have to visit a clinic for some MCL treatments. You could come into contact with someone who has COVID-19 during these appointments, although your doctor will do everything to protect you. And they may consider some tweaks to your treatment plan to help lower your COVID-19 risk.
If you don't have MCL symptoms and your cancer grows slowly, you may be able to wait to start treatment. This is called active surveillance or watchful waiting. Your doctor will check you regularly and will put you on treatment as soon as your cancer grows.
If you do need to start treatment now, you may get Rituxan alone instead of R-CHOP. Rituxan is less likely than chemotherapy to lower your immune defenses.
Rituxan comes as an IV that takes about 90 minutes. After your first dose, your doctor might switch you to an injected form of the drug so that you don't have to spend as much time in a clinic. Or you might change to ibrutinib (Imbruvica). It comes as a pill that you can take at home.
Another way to limit your time at the doctor's office is to get fewer chemo cycles. This may be an option if your cancer has responded well to treatment.
If you do take R-CHOP, your doctor will give you growth factors with it. These drugs help your bone marrow make more white blood cells to replace the ones you've lost.
Watch for Coronavirus Symptoms
Because you have a greater chance of getting COVID-19, be on high alert for symptoms like these:
- Fever of 100.4 F or higher
- Shortness of breath
- Nausea or diarrhea
- Body aches
- Stuffy or runny nose
- Sore throat
- Loss of sense of smell or taste
These symptoms are also caused by diseases besides COVID-19. But if you have any of them, call your doctor for advice.