Prognostic Factors and Survival Outcomes in Marginal Zone Lymphoma: Real-Life Experience

This study evaluates the clinical and prognostic features of patients with marginal zone lymphoma (MZL) and examines the impact of key prognostic factors including lactate dehydrogenase (LDH), β2-microglobulin, immunoglobulin M (IgM), and International Prognostic Index (IPI) score on survival outcomes. It also compares survival rates among extranodal, nodal, and splenic subtypes to reveal prognostic heterogeneity and provide real-world evidence for personalized treatment strategies in MZL management.

A total of 79 patients aged ≥18 years with pathologically confirmed MZL diagnosed between 2015 and 2025 were retrospectively analyzed. Demographic characteristics, clinical findings, laboratory results, treatment modalities, and survival data were recorded. Survival outcomes were assessed using the Kaplan-Meier method with statistical significance set at p<0.05.

The study included 79 patients (59.5% female; mean age: 62±12.1 years). Advanced-stage disease (Ann Arbor stages III-IV) was present in 81%. Extranodal MZL had the longest disease-free survival (median: 59.5 months), while nodal MZL had the poorest prognosis (median: 19 months). Elevated β2-microglobulin, C-reactive protein, and IgM levels correlated with inferior survival (p=0.006, p=0.040, and p=0.015). Patients with an IPI score of ≥3 had a 3.5-fold higher mortality risk (p=0.026). Complete remission occurred in 53.2% of cases and relapse in 17%.

MZL is typically an indolent malignancy, though some patients may exhibit aggressive disease. In addition to lymphocytosis, MZL should be considered in cases with lymphopenia or monoclonal gammopathy. Advanced age, elevated LDH, high IPI scores, and advanced stage have been linked to poorer survival outcomes. These findings underline the prognostic heterogeneity among MZL subtypes.