This video reviews updates on the treatment and biology of splenic and nodal marginal zone lymphoma.
Marginal Zone Lymphoma
The FDA recently approved the oral BTK inhibitor ibrutinib for the treatment of patients with relapsed or refractory marginal zone lymphoma who require systemic therapy and have had at least one prior anti-CD20 therapy.
(S038) Treatment of Gastric Marginal Zone Lymphoma Utilizing a Magnetic Resonance Imaging–Guided Radiation Therapy (MRIgRT) System: Evaluation of Interfractional Target Volume Changes
This analysis demonstrates that significant interfractional target variation exists in the treatment of GMZL; this variation could lead to difficulties in target localization and/or reproducibility of treatment. MRIgRT is a promising method to evaluate and allow for adaptation to these variations.
(S017) A Margin Reduction Study for the Treatment of Gastric Marginal Zone Lymphoma Utilizing a Magnetic Resonance Imaging–Guided Radiation Therapy (MRIgRT) System
Significant variability in clinical target volume localization of gastric marginal zone lymphoma occurs if daily RT is delivered based on alignment to bony anatomy. MRI-guided RT allows for significant reduction in planning target volumes expansions without compromising coverage.
No definite guidelines exist for the management of nongastric MALT lymphoma. Retrospective series have included patients treated with different modalities, and excellent cause-specific and overall survival have been demonstrated, independent of the type of treatment adopted.
MZL comprises three different entities that require integration of clinical and pathologic features to make a diagnosis. Treatment is chosen and initiated on the basis of presentation, symptoms, and underlying subtype.
In this article, we review the current knowledge on the biological findings, clinical features, and therapeutic approaches for splenic marginal zone lymphoma.
The article by Thieblemont and colleagues very nicely summarizes the key pathogenetic and diagnostic features and present treatment of splenic marginal zone lymphoma (SMZL).
Typically, when one authors a commentary piece, a good template to follow is to start with some background material, review the major findings of the paper in question, and then focus on areas of controversy and unanswered questions.
Until we fully engage in understanding the biologic mechanisms that separate NMZL from other indolent NHLs, however, we will continue to deliver “impersonalized medicine” that does not exploit the unique properties of the former.