title: Marginal zone lymphomas: factors that affect the final outcome.
abstract: BACKGROUND
  A retrospective review and analysis of 275 patients with marginal zone lymphoma (MZL) was performed to determine prognostic factors. An effort was also made to establish a specific prognostic score for patients with extranodal MZL.
  
  
  METHODS
  Patients were divided into 3 groups according to the type of MZL: extranodal, nodal, and splenic. Factors analyzed included age; gender; presence of B symptoms; Zubrod performance score; clinical stage; serum β(2)-microglobulin, lactate dehydrogenase, albumin, and hemoglobin levels; and presence of autoimmune disorder.
  
  
  RESULTS
  The 5-year overall survival rates of patients with extranodal, nodal, and splenic MZL were 87%, 89%, and 93%, respectively (P = .95). On multivariate analysis, splenic MZL patients had the best prognosis (hazard ratio, 0.18; P = .018). An elevated serum β(2)-microglobulin level (P = .010), B symptoms (P = .021), and male gender (P = .036) were found to be correlated with decreased recurrence-free survival (RFS) on multivariate analysis. Using these 3 variables, a 3-tier prognostic scoring system was created for patients with extranodal MZL: low-risk with no adverse factors, intermediate-risk with 1 adverse factor, and high-risk with ≥ 2 adverse factors. The 5-year RFS rates for the low-risk, intermediate-risk, and high-risk groups were 80%, 71%, and 44%, respectively (P = .01).
  
  
  CONCLUSIONS
  Patients with extranodal and nodal MZL have a similar prognosis, whereas patients with splenic MZL have a better prognosis despite the increased prevalence of negative prognostic indicators. With the use of 3 readily available factors, a prognostic scoring system was identified for patients with extranodal MZL.
authors.affiliation: Division of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Mazloom
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
authors.forename: Peter W
authors.initials: PW
authors.lastname: McLaughlin
authors.forename: Valerie
authors.initials: V
authors.lastname: Reed
authors.forename: Fernando F
authors.initials: FF
authors.lastname: Cabanillas
authors.forename: Luis E
authors.initials: LE
authors.lastname: Fayad
authors.forename: Barbara
authors.initials: B
authors.lastname: Pro
authors.forename: Graciela
authors.initials: G
authors.lastname: Gonzalez
authors.forename: Puneeth
authors.initials: P
authors.lastname: Iyengar
authors.forename: Diana L
authors.initials: DL
authors.lastname: Urbauer
authors.forename: Bouthaina S
authors.initials: BS
authors.lastname: Dabaja
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D018442:Lymphoma, B-Cell, Marginal Zone / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012737:Sex Factors; D013160:Splenic Neoplasms / Q000401:mortality* / Q000473:pathology*