Treatment of marginal zone lymphoma.
Disease | Treatment | Comment |
---|---|---|
Gastric ENMZL | H. pylori eradication | - PPI+clarithromycin+(amoxicillin or metronidazole) |
RT | - H.pylori(-), or eradication failure | |
Rituximab | - For radiotherapy ineligible patients | |
Gastrectomy | - Major gastric bleeding | |
Non-gastric ENMZL | Watch and wait | - Stable asymptomatic disease |
Targeting infectious agents | - HCV treatment for HCV(+) disease | |
- Doxycycline for ocular adnexal ENMZL | ||
RT | - Definitive or palliative | |
Rituximab | - Higher response in CTx-naïve patients | |
CIT | - R-chlorambucil, R-bendamustine | |
Lenalidomide+Rituximab | - To avoid chemotherapy | |
Surgery | - Mostly for diagnosis (thyroid, breast, intestine, etc.) | |
Splenic MZL | Watch and wait | - Stable asymptomatic disease |
HCV eradication | - For HCV(+) disease | |
Rituximab | - Offer the most risk/benefit ratio [106] | |
Splenectomy | - After rituximab failure | |
CIT | - For symptomatic disseminated disease after rituximab or splenectomy failure | |
Nodal MZL | Treated as guidelines for FL | - Studies enrolled solely MZL are rare |
Abbreviations: CIT, chemoimmunotherapy; CTx, chemotherapy; ENMZL, extranodal marginal zone lymphoma; HCV, hepatitis C virus; PPI, proton-pump inhibitor; RT, radiotherapy.