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Below, week by week, is what OnCo's record of Marginal zone lymphoma says about the first two months: the order is typical, the timing is yours to ask about. Marginal zone lymphoma is a slow B-cell lymphoma that often grows where the body has been fighting a chronic infection: the stomach with Helicobacter pylori, the eye, the skin or the spleen. Curing the infection cures many early cases; the rest are treated with rituximab, chemotherapy or BTK inhibitors. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Ask which of these were tested and what the results were; see the report reader for what each value means.
Written by hand for this cancer from NHS, Macmillan, Cancer Research UK and charity pages, each item naming the page it came from. The days and weeks are the typical order those pages describe, not a schedule; tick what applies to you.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Low-dose involved-site radiotherapy (as little as 4 Gy in two fractions for some sites); surgery rarely.
Eradication therapy and endoscopic follow-up; radiotherapy if the lymphoma persists or carries t(11;18).
Watch and wait if asymptomatic; antiviral therapy if hepatitis C-positive; rituximab alone or with chemotherapy; splenectomy now rare.
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) arises at a site of chronic inflammation, most often the stomach, and is the one that can sometimes be cured with antibiotics. Splenic marginal zone lymphoma presents with a large spleen, cytopenias and circulating villous lymphocytes, and is associated with hepatitis C. Nodal marginal zone lymphoma behaves much like follicular lymphoma and is treated like it. The three share a cell of origin and very little else in the way of treatment, so the first question is which one it is. Two tests change the plan at diagnosis. Helicobacter pylori status in gastric MALT, because eradication is the first treatment. Hepatitis C status in splenic and nodal disease, because antiviral treatment alone can produce lymphoma remission in hepatitis C-associated cases. Other site-specific associations are recorded and occasionally actionable: Chlamydia psittaci in ocular adnexal MALT, Borrelia burgdorferi in cutaneous MALT, Campylobacter jejuni in immunoproliferative small intestinal disease.
Rituximab with bendamustine or chlorambucil, lenalidomide-rituximab; zanubrutinib or ibrutinib for relapsed disease.
Treatment is indicated for symptoms, organ compromise, cytopenias or rapid progression, not for the presence of disease. Rituximab alone produces responses in about half. Chemoimmunotherapy with bendamustine and rituximab is the usual choice when more is needed, and rituximab with chlorambucil has the only randomised evidence in MALT (IELSG-19: five-year event-free survival 68 per cent for the combination against 51 per cent for chlorambucil and 50 per cent for rituximab alone, with five-year overall survival about 90 per cent in each arm, so the combination delays events without changing survival). At relapse, the BTK inhibitors are the newest class: MAGNOLIA treated relapsed or refractory marginal zone lymphoma of all subtypes with zanubrutinib and reported an objective response of 68 per cent, complete response 26 per cent and 15-month progression-free survival of 83 per cent, with fewer cardiac events than ibrutinib. Lenalidomide with rituximab is an option and marginal zone patients were included in AUGMENT. Lisocabtagene maraleucel received United States approval for relapsed or refractory marginal zone lymphoma after two or more prior lines on 4 December 2025. Local radiotherapy at 24 Gy remains the right answer for a single symptomatic site whatever the line.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.