Marginal zone lymphomas: second most common lymphomas in older patients

Abstract

Purpose of review Choosing an optimal treatment in older patients with indolent lymphomas is a challenge for hematooncologists. They must concomitantly treat some potentially curable entities, manage other symptomatic incurable diseases and protect their patients from life-threatening toxicities. Specific recommendations for older patients with different subtypes of marginal zone lymphomas are thus required in terms of treatment and supportive care. Recent findings All the data in the literature agree that the therapeutic approach of older patients with malignant hemopathies should include the appraisal of their life expectancy and of the prognostic factors of their tumor, the evaluation of their physiological and cognitive functions and their socioeconomic environment, and their expectancy in terms of quality of life. Major progresses have, therefore, been achieved in the management of lymphoma patients of 80 years and older. Summary With an optimal ‘geriatric assessment’, most of the recommended treatments are also appropriate in older marginal zone lymphoma patients. Extranodal MALT lymphoma: eradication of the pathogen is a major part of the first-line therapy. Prognosis is excellent in early stages. In advanced stages, observation and anti-CD20 antibodies with or without cytostatic drugs are recommended. Nodal MZL: Usually confined to lymph nodes, bone marrow and peripheral blood, they should be managed as follicular lymphomas. Splenic MZL: in this unique entity involving the spleen, the bone marrow and the peripheral blood. Hepatitis infection should be eradicated before considering treatment. Only symptomatic patients require to be treated by splenectomy and/or anti-CD20 antibodies.

Clinical significance and impact of gastric non‐Helicobacter pylori Helicobacter species in gastric disease

“…Sections were examined by either of two experienced gastrointestinal pathologists (blinded to all clinical data) and graded according to the updated Sydney classification for gastritis and gastropathy 25 . MALT lymphomas were graded according to recent clinical, histopathological and immunophenotypical guidelines 28,30 …”

Supportive Care in Older Lymphoma Patients to Reduce Toxicity and Preserve Quality of Life

“…Lymphomas are the most common hematological malignancies, accounting for 30% of these malignant hemopathies. Diagnosis and treatment of lymphoma patients have become increasingly complex, with new approaches such as bispecific antibodies and CAR-T cells therapies showing specific side effects [4][5][6][7].…”

Orelabrutinib for the treatment of relapsed or refractory marginal zone lymphoma: A phase 2, multicenter, open‐label study

“…MZL can be categorized as splenic MZL (SMZL), extra‐nodal MZL of mucosa‐associated lymphoid tissue (MALT), and nodal MZL (NMZL) depending on the location of the disease. MZL accounts for 7%–8% of NHL cases and is the second most prevalent lymphoma among elderly adults, especially those over 80 years old 1–3 . The annual incidence of MZL has increased globally and by approximately 1% each year from 2001 to 2017 in the United States 2 …”

“…MZL accounts for 7%-8% of NHL cases and is the second most prevalent lymphoma among elderly adults, especially those over 80 years old. [1][2][3] The annual incidence of MZL has increased globally and by approximately 1% each year from 2001 to 2017 in the United States. 2 MZL is considered incurable at the relapsed/refractory (r/r) stage with limited therapeutic options.…”