Real-world single-center analysis of efficacy and safety in newly diagnosed marginal zone lymphoma.

[UNLABELLED] This study aimed to analyze newly diagnosed marginal zone lymphoma (MZL) patients treated in the Department of Hematology at our center. A retrospective analysis was conducted to evaluate the efficacy and safety profiles of various treatment regimens for MZL. Data were retrospectively collected from 177 newly diagnosed MZL patients hospitalized in the Department of Hematology at Shandong Provincial Hospital Affiliated to Shandong First Medical University between October 2006 and October 2024. Compared to chemotherapy alone, treatment combining CD20 monoclonal antibody with chemotherapy significantly improved the complete response (CR) rate in patients with MZL. Additionally, the incidence of progression of disease within 24 months (POD24) was significantly lower in patients receiving CD20 monoclonal antibody ± chemotherapy than in those treated with chemotherapy alone (11.7% vs. 35.7%,  = 0.018). Comparative analysis of rituximab combined with various chemotherapy regimens revealed no statistically significant differences in either short-term or long-term efficacy ( > 0.05). When comparing short-term outcomes at initial diagnosis, numerically higher CR rates (86.7% vs. 56.3%) and overall response rates (ORR) (100% vs. 90.6%) were observed with the obinutuzumab (G) regimen ± chemotherapy compared to the rituximab (R) regimen ± chemotherapy; however, these differences were not statistically significant ( = 0.144 and  = 0.541, respectively). Compared with chemotherapy alone, CD20 monoclonal antibody-containing regimens significantly improved CR rates and effectively prolonged progression-free survival (PFS) and overall survival (OS) in MZL patients. No statistically significant differences were found among various chemotherapy regimens combined with rituximab, irrespective of whether short-term or long-term outcomes were assessed. Similarly, no significant differences were observed between obinutuzumab (G) ± chemotherapy and rituximab (R) ± chemotherapy in terms of PFS, CR rate, or ORR. However, grade 3–4 adverse events occurred more frequently in patients treated with the G ± chemotherapy regime.

[SUPPLEMENTARY INFORMATION] The online version contains supplementary material available at 10.1007/s10238-026-02116-4.