Splenic marginal zone lymphoma in Turkey: Association with hepatitis b instead of hepatitis c virus as an etiologic and possible prognostic factor-A multicenter cohort study Türkiye’de splenik marjinal zon lenfoma: Hepatit c virüs yerine hepatit b virüsünün etiyolojik ve olası prognostik faktör oluşu-çok merkezli kohort çalışması

Okay M., Aslan T., Özdemir E., Üner A., Sağlam A., Güngör E., ...More

Turkish Journal of Hematology, vol.37, no.2, pp.84-90, 2020 (Journal Indexed in SCI Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 37 Issue: 2
  • Publication Date: 2020
  • Doi Number: 10.4274/tjh.galenos.2019.2019.0177
  • Title of Journal : Turkish Journal of Hematology
  • Page Numbers: pp.84-90
  • Keywords: Hepatitis B virus, Hepatitis C virus, Low-grade lymphoma, Risk factors


© 2020 by Turkish Society of Hematology.Objective: Chronic antigenic stimulation is frequently blamed in the pathogenesis of extranodal marginal zone lymphomas including splenic marginal zone lymphoma (SMZL). Chronic hepatitis C is frequently observed in SMZL patients in some geographical regions. However, these reports are largely from North America and Europe, and data from other countries are insufficient. In this multicenter study we aimed to identify the clinical characteristics of SMZL patients in Turkey, including viral hepatitis status and treatment details. Materials and Methods: Data were gathered from participating centers from different regions of Turkey using IBM SPSS Statistics 23 for Windows. Hepatitis B virus surface antigen (HBsAg), anti-HBs antibody, anti-HB core antigen antibody (anti-HBcAg), HB viral load, anti-hepatitis C virus (HCV) antibody, HCV viral load results were analyzed. Results: One hundred and four patients were reported. Hepatitis C virus positivity was observed in only one patient. However, hepatitis B virus surface antigen (HBsAg) positivity was observed in 11.2% and HBsAg and/or anti-HB core antigen antibody (anti-HBcAg) positivities were seen in 34.2% of the patients. The median age was 60 years (range=35-87). Median follow-up duration was 21.2 months (range=00.2-212; 23.2 months for surviving patients). Median overall survival was not reached. Estimated 3-year and 10-year survival rates were 84.8% and 68.9%, respectively. Older age, no splenectomy during follow-up, platelet count of <90x103/µL, lower albumin, higher lactate dehydrogenase, higher β2-microglobulin, and HBsAg positivity were associated with increased risk of death. Only albumin remained significant in multivariable analysis. Conclusion: These results indicate that hepatitis B virus may be a possible risk factor for SMZL in our population. It may also be an indirect prognostic factor.