Practice-Changing Proficiency for the Management of Marginal Zone Lymphoma

Recently, i3 Health provided an educational activity that has challenged knowledge gaps experienced by clinicians regarding new clinical perspectives in the management of marginal zone lymphoma (MZL). 

Marginal zone lymphoma comprises approximately 7% of all mature non-Hodgkin lymphomas (NHLs). According to the Leukemia and Lymphoma Society®, there are three subtypes: extranodal MZL, also referred to as mucosa-associated lymphatic tissue (MALT) lymphoma; splenic MZL, which originates from memory B lymphocytes located in the marginal zone of secondary lymphoid follicles present in the spleen; and nodal MZL, which originates in the lymph nodes. Diagnosis and treatment for MZL can be challenging for practitioners because it is relatively rare and can mimic the features of other hematologic malignancies, leading to delays in diagnosis and confusion about the best treatment strategy. Additionally, a standard of care for MZL is not well established, making optimal treatment selection a challenge. Due to this, it is vital that clinicians receive educational opportunities to remain proficient in the management of MZL.

To address the knowledge gaps experienced by clinicians regarding the management of MZL, i3 Health provided a continuing medical education (CME)–/nursing continuing professional development (NCPD)–approved podcast activity. The podcast activity was made available August 16, 2022, and remained available until August 15, 2023. The activity was led by two leading experts in the MZL field: Matthew Matasar, MD, a Professor of Medicine at Rutgers Robert Wood Johnson Medical School and Chief of the Division of Blood Disorders at Rutgers Cancer Institute; and Ariela Noy, MD, an Attending Physician at Memorial Sloan Kettering Cancer Center.

A total of 1,213 learners participated in the podcast activity with 577 completing the activity for credit. Most learners were registered nurses and physicians, followed by nurse practitioners, physician assistants, and those who chose “other” as their profession. The average number of patients seen with MZL amongst those who completed the activity was 16, and the average number of years in practice was 13.

The baseline data collected revealed knowledge gaps in the following areas: evaluating factors that can inform initiation of therapy for MZL; assessing the clinical application of novel therapeutic strategies with Bruton tyrosine kinase (BTK) inhibitors, phosphatidylinositol-3 kinase (PI3K) inhibitors, and immunomodulatory drugs for relapsed/refractory MZL; and appraising the adverse event profiles of novel therapeutic strategies for relapsed/refractory MZL.

Participants were given a posttest at the end of activity to gauge their knowledge of MZL after listening to the podcast. The posttest assessment revealed that 43% of participants were proficient in understanding factors to inform treatment of patients with gastrointestinal mucosal–associated lymphatic tissue lymphoma; 44% were proficient in understanding the efficacy of ibrutinib for second-line therapy for nodal MZL; 83% were proficient in understanding the efficacy of copanlisib for relapsed/refractory MZL; and 70% were proficient in understanding the safety of lenalidomide/rituximab treatment for relapsed/refractory MZL.

Upon completion of the activity, 81% of participants reported they felt more confident in treating their patients with MZL, and 82% reported that they felt that the material presented would be used to improve the outcomes of their patients with MZL.

The data revealed by the posttest assessment affirm the effectiveness of online educational content pertaining to the topic of new clinical perspectives in the management of MZL. Based on these data, i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide marginal zone lymphoma education on factors that inform therapy selection for marginal zone lymphoma; recent clinical trial findings on efficacy and safety of emerging therapies; and clinical advances for supporting patients and meeting their individual care needs.


i3 Health (2023). New clinical perspectives in the management of marginal zone lymphoma: activity outcomes report. Data on file.

Leukemia and Lymphoma Society® (2024). Marginal zone lymphoma. Available at:

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