A Phase II Study Using Rituximab Plus Venetoclax in the Front Line Treatment of Marginal Zone Lymphoma

Inclusion Criteria

• •Age greater than or equal to 18 years
• •Histologically confirmed Marginal Zone Lymphoma
• •Patients must have measurable disease as defined by at least one lymph node ≥1.5 cm or spleen \>13 cm.
• •°Patients with intestinal MALT lymphoma must have disease that is detectable by EGD or colonoscopy with biopsy
• •Patients with gastric MALT lymphoma must be h. pylori negative
• •°Patients who are h. pylori positive are allowed if they have failed a trial of h.pylori eradication
• •Patients with gastric MALT lymphoma who are h. pylori negative or who have relapsed/refractory disease after h. pylori eradication must be ineligible for, have refused or failed gastric radiation therapy
• •ECOG performance status ≤ 1
• •Life expectancy of greater than 2 years
• •Patients must have normal organ function as defined below:
• •* Platelet count ≥ 50,000 cells/mm\^3
• •* Hemoglobin ≥ 8.0 g/dL
• •* Absolute neutrophil count ≥ 1000 cells/mcL. If there is documented bone marrow involvement, ANC must be \>/= 500 cells/mcL
• •* Total bilirubin \< 1.5 x upper normal institutional limits. In patients with Gilbert's disease or documented liver involvement, total bilirubin up to 3x ULN will be allowed
• •* AST(SGOT)/ALT(SGPT) \<3 x institutional upper limit of normal unless elevation is caused by liver involvement with MZL
• •AST(SGOT)/ALT(SGPT) \<3 x institutional upper limit of normal unless elevation is caused by liver involvement with MZL
• •°OR Creatinine clearance \>60 mL/min for patients with creatinine levels above institutional normal (by Cockcroft-Gault estimate or 12-24h creatinine clearance measurements).
• •Ability to understand and the willingness to sign a written informed consent document.
• •Able to swallow pills
• •Patients with Hepatitis B surface antibody serum positivity due to prior immunization, as well as those with Hepatitis B core antibody positivity with negative PCR on antiviral therapy will be eligible.