Treatment of Primary Ovarian Lymphoma in Extra-Gastric Extranodal Marginal Zone Lymphoma

Clinical Scenario

This protocol covers primary ovarian lymphoma occurring in the setting of extra-gastric extranodal marginal zone lymphoma (EMZL) or non-gastric marginal zone lymphoma (NMZL). The therapeutic strategy is shaped by disease extent — localised versus disseminated — and whether an infectious aetiology has been identified.


Treatment Approach (Partial Overview)

Localised extra-gastric EMZL is primarily addressed with involved-site radiotherapy. When a specific causative microorganism is detected, targeted antimicrobial therapy may be used. Symptomatic or disseminated presentations involve systemic regimens — the full selection of options, eligibility criteria, and sequencing are detailed in the complete protocol.

References

DOI: 10.1016/j.annonc.2025.07.014

  1. ISRT can be recommended as the preferred treatment of localised extra-gastric EMZL (24 Gy; lower doses can be considered according to the site and clinical setting) [III, B].
  2. Specific antimicrobial therapy can be recommended in non-gastric MZL where an aetiopathogenetic microorganism [Campylobacter jejuni, Chlamydia psittaci, hepatitis C virus (HCV)] is detected [IV, B].
  3. R—chlorambucil [I, A].
  4. BR [III, A].
  5. R monotherapy [III, B].
  6. R—lenalidomide [III, C; not EMA or FDA approved].
  7. R-CVP [III, C].
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