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Marginal zone lymphoma (MZL) is the name given to a group of closely related forms of non-Hodgkin lymphoma (NHL) including mucosal associated lymphoid tissue (MALT) lymphoma, nodal-marginal zone lymphoma and splenic marginal zone lymphoma.
They all affect a type of white blood cells called B lymphocytes. Unlike leukaemia, in lymphoma the abnormal cells are present in lymphoid tissues, which make up the lymphatic system although marginal zone lymphoma can initially present with bone marrow involvement. The lymphatic system is a network of fine vessels, glands and channels which occur throughout the body. It also conveys nutrients and cells, and is responsible for draining fluid and waste products away from tissues, and into the blood stream to be processed. The lymphatic system is an important part of the immune system and is made up of lymph nodes and vessels and of collections of lymphocytes in other tissues.
Marginal zone lymphoma is a low-grade form of NHL. This means that it develops slowly and, even if not treated, it grows slowly. It is called marginal zone because it mainly affects lymphocytes at the edges of lymphoid tissue or nodes.
There are three types of marginal zone lymphoma:
Treatment for most patients is similar to that given for other slow-growing NHL. After treatment most patients have a period of no active disease, this is known as remission and may last for many years. MZL may come back, this is known as a relapse and it can usually be treated again, using similar treatments as were used the first time. Many patients have a good response to treatment with a long survival.
The main ways in which MZL is treated are:
Chemotherapy is the use of cell-killing drugs. These kill the cancer cells and/or stop them from dividing. Chemotherapy is usually given in blocks or ‘cycles’ of treatment. One cycle of treatment will consist of a series of doses of chemotherapy followed by a break for the healthy cells to recover.
Chemotherapy is normally given as a combination of drugs, which may include steroids. Steroids used to treat MZL are a laboratory-made version of chemicals naturally made by the body. They are very different from the type of steroids sometimes misused by
The details of your treatment will vary depending on the type and stage of your MZL and your general fitness. You will be given a chance to discuss treatment options and detailed information on your treatment plan before it starts. The side effects of treatment vary between different types of treatment and different patients. You will be given detailed information about any likely side effects before you start treatment.
H. pylori eradication
If gastric MALToma is diagnosed early it may be possible to cure the condition by giving antibiotic treatment to kill the H. pylori bacteria. Later
For patients with SMZL who have symptoms caused by an enlarged spleen, having the spleen removed (splenectomy) may delay the need for further treatment. Although splenectomy may control symptoms for years, it is not a cure and almost all patients will need further treatment.
We understand going through a blood cancer through journey can be difficult. It may help to talk to a close friend or relative about how you are feeling. Here are some questions that may be useful to ask your doctor.