New NCCN Patient Guidelines for Marginal Zone Lymphoma Helps Patients, Caregivers Understand Rare Form of Blood Cancer


Management of marginal zone lymphoma was impacted by the COVID-19 pandemic because some treatment options can reduce B-cell-produced antibodies.

The newly published National Comprehensive Care Network (NCCN) Guidelines for Patients: Marginal Zone Lymphoma (MZL) seeks to help patients better understand the distinctive features of MZL. The new guidance is part of other major guidelines published under NCCN and are the recognized standard for clinical direction and policy in cancer management.

MZL is developed from immune cells, or B cells. Management of the disease was affected immensely by the COVID-19 pandemic because some treatment options can reduce B-cell-produced antibodies and diminish the overall immune system response. Additionally, MZL is generally diagnosed in people in their late 50s and mid 60s, although it can occur in individuals as young as 20 to 30 years of age.

MZL has a reputation of being less talked about and an “indolent” lymphoma compared to other forms of the disease, according to NCCN.

“As a result of its rarity, many people lack awareness of marginal zone lymphoma. During the diagnosis phase, patients should consider the possibility of having their pathology reviewed at a medical center that sees a lot of lymphoma patients, in order to confirm the diagnosis” said Leo I. Gordon, MD, professor in Medicine at Northwestern University Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, in a press release.

MZL has 3 main subtypes based on where they originate in the body—either in the spleen, bone marrow, or in the lymphatic tissues throughout the body.

“MZL can be extranodal, which can involve virtually any organ in the body, including skin, stomach, lung, prostate, or breast,” said Andrew D. Zelenetz, MD, PhD, medical oncologist, Memorial Sloan Kettering Cancer Center, in a press release. “Splenic MZL involves the spleen, blood, and bone marrow, and is sometimes associated with hepatitis C infection. And nodal MZL primarily forms in the lymph nodes. All 3 subtypes are managed differently.”

Recent treatment options are moving past cytotoxic chemotherapy and toward more targeted chemotherapy and immunotherapy, with the emergence of clinical trials using chimeric antigen receptor T-cell therapy.

NCCN Guidelines for Patients are available online at and via the NCCN Patient Guides for Cancer App.


NCCN’s New Patient Guidelines for Marginal Zone Lymphoma Help Patients and Caregivers Better Understand a Rare Form of Blood Cancer. National Comprehensive Cancer Network. September 12, 2022. Accessed September 15, 2022.

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