Marginal zone lymohoma

[Dek07]

My partner was diagnosed with marginal zone lymphoma in Jan 08. It's an indolent form of NHL & most likely caused by co-infection with HepC geno 1b which he has had for over 30yrs.
Desperately looking for some answers here with regards to the best way to go about treating this.
He relapsed after 12mths tx with Pegasys over 2 years ago. He has cirrhosis & has had a liver resection for a hepatoma post tx in 2006. Main issues of concern with bloods ATM are raised LFT's & thrombocytopenia.

Really would appreciate any info since we seem to be getting no joy from his Specialists.

Cheers
Dek07

[Dek07]

Thank you for your response
I agree that the liver problem is a concern. He has cirrhosis & has had a surgical resection to remove a hepatoma post tx(2 yrs ago).
The lymphoma is flaring in his neck which led to the diagnosis in Jan 08.
He also has a patch in the bone but not any nodes elsewhere. So it's sort of stage 1 & 4 at the same time with not much in between, if that makes sense.
His haematologist agrees the best chance of remission is to treat the causative infective agent, the HepC & will back him up on that.
It will be tricky & I'm anticipating some resistance from his gastro regarding re-treating with pegasys or similar.
The other option is radiation to his neck but this is best to avoid unless absolutely necessary.
If there is some way to even reduce viral load (of the HepC) by interferon or another drug, that would certainly help the lymphoma.

Cheers
Dek  

[PaulMD]

Hi there.

It is more likely that the liver problem would be the main problem compared to the indolent lymphoma.  Indolent lymphomas may not be treated as long as there are no specific symptoms related to it such as compression of other organs or hematologic manifestations.  In your partner's situation, the cause of the low platelets may be the liver problem.  Treating the lymphoma will be really tricky, since some drugs are really excreted by the liver and this will complicate things.  In summary, relapsed indolent lymphomas may not be treated immediately, and that make sure the liver is OK before ongoing any form of treatment if necessary.  Regards and God bless.