Splenic Marginal Zone Lymphoma in Turkey: Association with Hepatitis B

Abstract

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 <90x10(3)/mu L, lower albumin, higher lactate dehydrogenase, higher beta(2)-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.

C1 [Okay, Mufide; Aslan, Tuncay; Buyukasik, Yahya] Hacettepe Univ, Dept Internal Med, Div Hematol, Fac Med, Ankara, Turkey.

[Ozdemir, Evren] Medicana Int Ankara Hosp, Clin Med Oncol, Ankara, Turkey.

[Uner, Aysegul; Saglam, Arzu] Hacettepe Univ, Dept Pathol, Fac Med, Ankara, Turkey.

[Gungor, Elif] Trakya Univ, Dept Internal Med, Fac Med, Edirne, Turkey.

[Uysal, Ayse] Univ Hlth Sci, Trabzon Kanuni Training & Res Hosp, Div Hematol, Trabzon, Turkey.

[Aslan, Nevin Alayvaz] Ondokuz Mayis Univ, Dept Hematol, Fac Med, Samsun, Turkey.

[Yildizhan, Esra; Eser, Bulent] Erciyes Univ, Dept Hematol, Fac Med, Kayseri, Turkey.

[Agit, Abdullah; Ozet, Gulsum] Ankara Numune Training & Res Hosp, Div Hematol, Ankara, Turkey.

[Dal, Mehmet Sinan; Altuntas, Fevzi] Univ Hlth Sci, Ankara Oncol Training & Res Hosp, Clin Hematol & BMT Unit, Ankara, Turkey.

[Korkmaz, Serdal] Kayseri Training & Res Hosp, Div Hematol, Kayseri, Turkey.

[Namdaroglu, Sinem] Univ Hlth Sci, Izmir, Turkey.

[Sivgin, Serdar] Acibadem Kayseri Hosp, Kayseri, Turkey.

[Cagliyan, Gulsum Akgun] Denizli State Hosp, Div Hematol, Denizli, Turkey.

[Demircioglu, Sinan] Yuzuncu Yil Univ, Dept Hematol, Fac Med, Van, Turkey.

[Barista, Ibrahim] Hacettepe Univ, Dept Med Oncol, Fac Med, Ankara, Turkey.

[Ozhamam, Esra] Ankara Numune Training & Res Hosp, Div Pathol, Ankara, Turkey.

[Vural, Filiz] Ege Univ, Dept Internal Med, Div Hematol, Fac Med, Izmir, Turkey.

[Yildirim, Rahsan] Ataturk Univ, Dept Hematol, Fac Med, Erzurum, Turkey.

[Dogu, Mehmet Hilmi] Istanbul Training & Res Hosp, Clin Hematol, Istanbul, Turkey.

[Berber, Ilhami] Malatya Training & Res Hosp, Div Hematol, Malatya, Turkey.

[Erkurt, Mehmet Ali] Inonu Univ, Dept Internal Med, Div Hematol, Fac Med, Malatya, Turkey.

[Malkan, Umit Yavuz] Univ Hlth Sci, Diskapi Yildirim Beyazit Training & Res Hosp, Clin Hematol, Ankara, Turkey.

[Altuntas, Fevzi] Yildirim Beyazit Univ, Dept Internal Med, Div Hematol, Fac Med, Ankara, Turkey.