Standard first-line treatment approaches in adult NMZL not associated with HCV. Treatment follows the approach used with follicular lymphoma. *R-bendamustine > R-CHOP: PFS, 69.5 vs 32.1 months (hazard ratio, 0.58; 95% CI, 0.44-0.74; P < .0001).⁴⁹  **Fludarabine > chlorambucil; PFS, 36.3 vs 27.1 months, P = .012⁵⁰ ; because of the toxicity profile, R-fludarabine or R-fludarabine-cyclophosphamide should only be proposed to patients <70 years of age. Note: There is no evidence for recommending maintenance with rituximab or an intensive treatment plus autologous stem cell transplantation in first line.