The optimal care pathway for low-grade lymphomas (LGLs) covers follicular lymphoma (FL), marginal zone lymphoma (MZL) and mantle cell lymphoma (MCL).

Prevention

The causes of most LGLs are not fully understood and there are currently no clear prevention strategies. Some LGLs such as gastric mucosa-associated lymphoid tissue (MALT) lymphoma are, however, preventable through identifying and eradicating a Helicobacter pylori infection.

Risk factors

Risk factors common across all LGLs are:

• advanced age and family history of LGL
• obesity
• prior radiation or chemotherapy
• weakened immune system
• autoimmune disease
• exposure to glyphosate-based agricultural pesticides (a possible risk).

Specific risk factors for MZL include:

• Helicobacter pylori gastritis – in gastric MALT lymphomas
• splenic MZL (SMZL), in people with chronic hepatitis C infection.

Specific risk factors for MCL include:

• gender – males have a greater risk

Early detection

There is no established role for screening for LGLs. People at risk of developing lymphomas related to immunodeficiency should be told of this increased risk.

General health checklist

• Recent weight changes discussed and recorded
• Alcohol intake and smoking status discussed and support offered if appropriate
• Physical activity recorded
• Referral to a dietitian, physiotherapist or exercise physiologist considered
• Sun smart advice