Nodal Marginal Zone Lymphoma

Nodal Marginal Zone Lymphoma (NMZL) is an indolent B-cell lymphoma that is found mostly in the lymph nodes. The disease is rare and only accounts for 1% of all Non-Hodgkin’s Lymphomas (NHL). It is most commonly diagnosed in older patients, with women more susceptible than men.

The disease is classified as a marginal zone lymphoma because the mutation occurs in the marginal zone of the B-cells. Due to its confinement in the lymph nodes, this disease is also classified as nodal.

Diagnosis and Staging

Symtoms include:

  • Painless swelling of the lymph nodes
  • Fever
  • Night sweats
  • Fatigue
  • Weight loss

Diagnosis is made using a lymph node biopsy. Other tests, such as X-rays, CT scan, PET scan, ultrasound, and bone marrow biopsy are used to stage the disease. Staging is as follows:

Stage I
Only one group of lymph nodes is involved,
Stage II
Two groups of lymph nodes are involved, but they are on the same side of the diaphragm.
Stage III
Lymph nodes on both sides of the diaphragm are involved. The spleen is considered a lymph node in this staging system, so its involvement marks stage III.
Stage IV
The bone marrow, liver, or other organs are involved.

Most patients are diagnosed in the earlier stages of disease.

Treatment

As this is a very slow growing disease, the "Watch and Wait" method may be employed for patients who don’t have many symptoms. Other treatment include:

Chemotherapy
NMZL is very reactive to chemotherapy. Administration of the drugs chlorambucil and/or fludarabine usually results in remission of the disease.
Radiation
Radiotherapy is given alone in the early stages of disease, or in combination with chemotherapy for late stages of the disease.
Radiolabeled Isotopes
Radioimmunotherapy treatments such as the Zevalin regimen are being researched as a treatment for marginal zone lymphomas and shows promising results.
Clinical Trials
Patients who are looking for more advanced treatment or who have lymphoma that does not respond to standard treatment may want to consider a clinical study. Click here to find clinical trials in your area.

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