From the Guidelines
Complications of marginal zone lymphoma include transformation to aggressive lymphoma, cytopenias, recurrent infections, hyperviscosity syndrome, autoimmune disorders, and organ-specific complications, which can significantly impact quality of life and require careful monitoring and management by healthcare providers. These complications can arise from the disease itself or as a result of treatment, and may include:
- Transformation to aggressive lymphoma, occurring in 5-10% of cases 1
- Cytopenias, particularly anemia and thrombocytopenia, which can be present in up to 25% of patients with nodal marginal zone lymphoma 2
- Recurrent infections due to immune dysfunction, which can be a result of the disease or treatment with rituximab 3
- Hyperviscosity syndrome, especially in splenic marginal zone lymphoma with paraproteinemia 4
- Autoimmune disorders, such as autoimmune hemolytic anemia, which can occur in some patients with marginal zone lymphoma 1
- Organ-specific complications, depending on the site of involvement, such as gastric bleeding or perforation in gastric MALT lymphoma, visual disturbances in ocular adnexal lymphoma, or respiratory symptoms in pulmonary involvement 3
- Treatment-related complications, including chemotherapy side effects, increased infection risk from rituximab, and secondary malignancies 3 Long-term surveillance is essential, as marginal zone lymphoma can recur even after prolonged remission, and patients have an increased risk of developing other cancers 5.
From the Research
Complications of Marginal Zone Lymphoma
- Transformation to diffuse large B-cell lymphoma (DLBCL) is a significant complication, with studies suggesting that the presence of increased large cells in marginal zone lymphoma may serve as a useful prognostic indicator 6
- Higher stage at diagnosis, increased frequency of relapse, and worse progression-free survival are associated with marginal zone lymphoma with increased large cells 6
- Transformation into aggressive lymphoma is an important independent risk factor for a shortened overall survival in marginal zone lymphoma patients 7
- Additional malignancies are also a leading risk factor for an adverse course of disease in marginal zone lymphoma 7
- Age >60 years and elevated serum lactate dehydrogenase (LDH) are associated with inferior outcomes in nodal marginal zone lymphoma 8
- Histologic transformation to an aggressive lymphoma is a rare event that can occur in any subtype of marginal zone lymphoma, with optimal treatment remaining unknown 9