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

Öz:

Objective: Chronic antigenic stimulation is frequently blamed inthe pathogenesis of extranodal marginal zone lymphomas includingsplenic marginal zone lymphoma (SMZL). Chronic hepatitis C isfrequently 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 multicenterstudy we aimed to identify the clinical characteristics of SMZL patientsin Turkey, including viral hepatitis status and treatment details.Materials and Methods: Data were gathered from participatingcenters from different regions of Turkey using IBM SPSS Statistics23 for Windows. Hepatitis B virus surface antigen (HBsAg), anti-HBsantibody, anti-HB core antigen antibody (anti-HBcAg), HB viral load,anti-hepatitis C virus (HCV) antibody, HCV viral load results wereanalyzed.Results: One hundred and four patients were reported. Hepatitis Cvirus positivity was observed in only one patient. However, hepatitisB 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 was60 years (range=35-87). Median follow-up duration was 21.2 months(range=00.2-212; 23.2 months for surviving patients). Median overallsurvival was not reached. Estimated 3-year and 10-year survivalrates were 84.8% and 68.9%, respectively. Older age, no splenectomyduring follow-up, platelet count of <90x103/µL, lower albumin, higherlactate dehydrogenase, higher β2-microglobulin, and HBsAg positivitywere associated with increased risk of death. Only albumin remainedsignificant in multivariable analysis.Conclusion: These results indicate that hepatitis B virus may be apossible risk factor for SMZL in our population. It may also be anindirect prognostic factor.

Anahtar Kelime:

Türkiye’de Splenik Marjinal Zon Lenfoma: Hepatit C Virüs Yerine Hepatit B Virüsünün Etiyolojik ve Olası Prognostik Faktör Oluşu-Çok Merkezli Kohort Çalışması

Öz:

Amaç: Splenik marjinal zon lenfoma’yı da (SMZL) içeren ekstranodal marjinal zon lenfomaların patogenezinde, kronik antijenik stimülasyon sorumlu olan mekanizmadır. Bazı coğrafik bölgelerde SMZL hastalarında kronik hepatit C sıklıkla gözlenir. Fakat bu çalışmalar sıklıkla kuzey Amerika ve Avrupa’dandır. Diğer ülkelerden veriler sınırlıdır. Bu çalışma ile Türkiye’deki SMZL hastalarının hepatit serolojisi durumları ve tedavi yöntemlerinin ortaya konulması amaçlanmıştır. Gereç ve Yöntemler: Türkiye’de farklı merkezlerden IBM SPSS Statistics for Windows v23 elektronik tablo kullanılarak veriler toplanmıştır. Hepatit B virüs yüzey antijeni (HBsAg), Anti-HBs antikor, Anti-HB kor antijen antikoru (anti-HBcAg), HB virüs yükü, anti-hepatit C virüs (HCV) antikoru, HCV virüs yükü sonuçları analiz edilmiştir. Bulgular: Yüz dört hastanın verilerine ulaşılmıştır. Hepatit C virüs pozitifliği sadece 1 hastada tespit edilmiştir. Hepatit B virüs yüzey antijeni (HBsAg) pozitifliği %11,2, HBsAg ve/veya hepatit B kor antijen antikoru (anti-HBcAg) pozitifliği %34,2 oranında tespit edilmiştir. Ortanca yaş 60 yıl (35-87) olarak saptanmıştır. Ortanca izlem süresi 21,2 (0,2-212) ay (yaşayan hastalar için 23,2 ay) olarak bulunmuştur. Ortanca genel sağkalım (GS) süresine ulaşılamamıştır. Tahmini 3-yıl ve 10-yıl GS oranları %84,8 ve %68,9 olarak bulunmuştur. İleri yaş, splenektomi yapılmaması, <90x103/µL platelet sayısı, hipoalbuminemi, laktat dehidrogenaz yüksekliği, β2-mikroglobulin yüksekliği ve HBsAg pozitifliği sağkalımla ilişkili faktörler olarak bulunmuştur. Çok değişkenli analizde, sadece albumin düşüklüğü istatistiksel olarak anlamlı saptanmıştır. Sonuç: Bu çalışmanın sonuçlarına göre, toplumumuzda SMZL için hepatit B virüsü olası bir risk faktörü olabilir. Aynı zamanda indirek bir prognostik gösterge olabilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, Advani R, Ghielmini M, Salles GA, Zelenetz AD, Jaffe ES. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127:2375-2390.
2. Arcaini L, Lazzarino M, Colombo N, Burcheri S, Boveri E, Paulli M, Morra E, Gambacorta M, Cortelazzo S, Tucci A, Ungari M, Ambrosetti A, Menestrina F, Orsucci L, Novero D, Pulsoni A, Frezzato M, Gaidano G, Vallisa D, Minardi V, Tripodo C, Callea V, Baldini L, Merli F, Federico M, Franco V, Iannitto E; Integruppo Italiano Linfomi. Splenic marginal zone lymphoma: a prognostic model for clinical use. Blood 2006;107:4643-4649.
3. Olszewski AJ, Castillo JJ. Survival of patients with marginal zone lymphoma: analysis of the Surveillance, Epidemiology, and End Results database. Cancer 2013;119:629-638.
4. Peveling-Oberhag J, Crisman G, Schmidt A, Döring C, Lucioni M, Arcaini L, Rattotti S, Hartmann S, Piiper A, Hofmann WP, Paulli M, Küppers R, Zeuzem S, Hansmann ML. Dysregulation of global microRNA expression in splenic marginal zone lymphoma and influence of chronic hepatitis C virus infection. Leukemia 2012;26:1654-1662.
5. Montalbán C, Abraira V, Arcaini L, Domingo-Domenech E, Guisado-Vasco P, Iannitto E, Mollejo M, Matutes E, Ferreri A, Salar A, Rattotti S, Carpaneto A, Pérez Fernández R, Bello JL, Hernández M, Caballero D, Carbonell F, Piris MA; Splenic Marginal Zone Lymphoma Study Group. Risk stratification for splenic marginal zone lymphoma based on haemoglobin concentration, platelet count, high lactate dehydrogenase level and extrahilar lymphadenopathy: development and validation on 593 cases. Br J Haematol 2012;159:164- 171.
6. Thieblemont C, Felman P, Berger F, Dumontet C, Arnaud P, Hequet O, Arcache J, Callet-Bauchu E, Salles G, Coiffier B. Treatment of splenic marginal zone B-cell lymphoma: an analysis of 81 patients. Clin Lymphoma 2002;3:41-47.
7. Troussard X, Valensi F, Duchayne E, Garand R, Felman P, Tulliez M, HenryAmar M, Bryon PA, Flandrin G. Splenic lymphoma with villous lymphocytes: clinical presentation, biology and prognostic factors in a series of 100 patients. Groupe Francais d’Hématologie Cellulaire (GFHC). Br J Haematol 1996;93:731-736.
8. Parry-Jones N, Matutes E, Gruszka-Westwood AM, Swansbury GJ, Wotherspoon AC, Catovsky D. Prognostic features of splenic lymphoma with villous lymphocytes: a report on 129 patients. Br J Haematol 2003;120:759- 764.
9. Chacón JI, Mollejo M, Muñoz E, Algara P, Mateo M, Lopez L, Andrade J, Carbonero IG, Martínez B, Piris MA, Cruz MA. Splenic marginal zone lymphoma: clinical characteristics and prognostic factors in a series of 60 patients. Blood 2002;100:1648-1654.
10. Lenglet J, Traullé C, Mounier N, Benet C, Munoz-Bongrand N, Amorin S, Noguera ME, Traverse-Glehen A, Ffrench M, Baseggio L, Felman P, CalletBauchu E, Brice P, Berger F, Salles G, Brière J, Coiffier B, Thieblemont C. Long-term follow-up analysis of 100 patients with splenic marginal zone lymphoma treated with splenectomy as first-line treatment. Leuk Lymphoma 2014;55:1854-1860.
11. Dreyling M, Thieblemont C, Gallamini A, Arcaini L, Campo E, Hermine O, Kluin-Nelemans JC, Ladetto M, Le Gouill S, Iannitto E, Pileri S, Rodriguez J, Schmitz N, Wotherspoon A, Zinzani P, Zucca E. ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma. Ann Oncol 2013;24:857-877.
12. Matutes E, Oscier D, Montalban C, Berger F, Callet-Bauchu E, Dogan A, Felman P, Franco V, Iannitto E, Mollejo M, Papadaki T, Remstein ED, Salar A, Solé F, Stamatopoulos K, Thieblemont C, Traverse-Glehen A, Wotherspoon A, Coiffier B, Piris MA. Splenic marginal zone lymphoma proposals for a revision of diagnostic, staging and therapeutic criteria. Leukemia 2008;22:487-495.
13. Yakut U, Güney M, Doğanay ÜD, Koçak A, Avcı İ. Bir kan merkezinde bağışçılara uygulanan mikrobiyolojik tarama testleri sonuçlarının on yıllık değerlendirilmesi. Türk Mikrobiyol Cem Derg 2010;40:201-206.
14. Çelebi D, Çelebi Ö, Altoparlak Ü, Kök A. Kan donörlerinde HBsAg, anti-HCV, anti-HIV, sifiliz seroprevalansı ve macro-ELISA sonuçlarının optik dansite değerleri ile doğrulama testlerinin karşılaştırılması. Türk Mikrobiyol Cem Derg 2012;42:137-141.
15. Özkan H. Epidemiology of chronic hepatitis B in Turkey. Euroasian J Hepatogastroenterol 2018;8:73-74.
16. Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, Kaymakoglu S, Ergonul O. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect 2015;21:1020-1026.
17. Sonmez M, Bektas O, Yilmaz M, Durmus A, Akdogan E, Topbas M, Erturk M, Ovali E, Omay SB. The relation of lymphoma and hepatitis B virus/ hepatitis C virus infections in the region of East Black Sea, Turkey. Tumori 2007;93:536-539.
18. Aslan T, Ozdemir E, Uner A, Gungor E, Alayvaz Aslan N, Yildizhan E, Agit A, Korkmaz S, Akgun Cagliyan G, Barista I, Ozhamam E, Pamuk GE, Turgut M, Eser B, Ozet G, Yıldırım R, Buyukasik Y. Splenic marginal zone lymphoma in an East Mediterranean/Middle Eastern population cohort: possible association with hepatitis B instead of hepatitis C virus as an etiologic and prognostic factor (ThREG-NHL01 Study). Blood 2016;128:5332.
19. Koot AW, Visscher AP, Huits RM. Remission of splenic marginal zone lymphoma in a patient treated for hepatitis B: a case of HBV-associated lymphoma. Acta Clin Belg 2015;70:301-303.
20. Christou L, Kalambokis G, Bai M, Kamina S, Tsianos E. Splenic marginal zone lymphoma in a patient with chronic hepatitis B. J Gastrointestin Liver Dis 2009;18:511-512.
21. Mathew J, Aldean I. Splenic marginal zone lymphoma associated with hepatitis B virus infection: a case report. Internet J Surg 2002;5:3.
22. Zhang SH, Xu AM, Zheng JM, He MX. Coexistence of splenic marginal zone lymphoma with hepatocellular carcinoma: a case report. Diagn Pathol 2007;2:5.
23. Iannitto E, Minardi V, Callea V, Stelitano C, Calvaruso G, Tripodo C, Quintini G, De Cantis S, Ambrosetti A, Pizzolo G, Franco V, Florena AM, Abbadessa V. Assessment of the frequency of additional cancers in patients with splenic marginal zone lymphoma. Eur J Haematol 2006;76:134-140.
24. Fetica B, Pop B, Blaga ML, Fulop A, Dima D, Zdrenghea MT, Vlad CI, Bojan AS, Achimas-Cadariu P, Lisencu CI, Irimie A, Weisenburger DD. High prevalence of viral hepatitis in a series of splenic marginal zone lymphomas from Romania. Blood Cancer J 2016;6:498.
25. Yi S, Yan Y, Xiong W, Lv R, Yu Z, Liu W, Liu E, Li H, Liu H, Li Z, An G, Xu Y, Ru K, Zou D, Qiu L. Distinct clinical characteristics draw a new prognostic model for splenic marginal zone lymphoma in HBV high prevalent region. Oncotarget 2017;8:98757-98770.
26. Rossotti R, Travi G, Pazzi A, Baiguera C, Morra E, Puoti M. Rapid clearance of HCV-related splenic marginal zone lymphoma under an interferon-free, NS3/NS4A inhibitor-based treatment. A case report. J Hepatol 2015;62:234- 237.
27. Bracci PM, Benavente Y, Turner JJ, Paltiel O, Slager SL, Vajdic CM, Norman AD, Cerhan JR, Chiu BC, Becker N, Cocco P, Dogan A, Nieters A, Holly EA, Kane EV, Smedby KE, Maynadié M, Spinelli JJ, Roman E, Glimelius B, Wang SS, Sampson JN, Morton LM, de Sanjosé S. Medical history, lifestyle, family history, and occupational risk factors for marginal zone lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project. J Natl Cancer Inst Monogr 2014;2014:52-65.
28. Perrone S, D’Elia GM, Annechini G, Ferretti A, Tosti ME, Foà R, Pulsoni A. Splenic marginal zone lymphoma: prognostic factors, role of watch and wait policy, and other therapeutic approaches in the rituximab era. Leuk Res 2016;44:53-60.
29. Hermine O, Lefrère F, Bronowicki JP, Mariette X, Jondeau K, EclacheSaudreau V, Delmas B, Valensi F, Cacoub P, Brechot C, Varet B, Troussard X. Regression of splenic lymphoma with villous lymphocytes after treatment of hepatitis C virus infection. N Engl J Med 2002;347:89-94.

APA	okay m, Aslan T, Ozdemir E, Uner A, Saglam A, GÜNGÖR E, Uysal A, Alayvaz Aslan N, Yildizhan E, AĞIT A, SİNAN DAL M, Korkmaz S, NAMDAROGLU S, Sivgin S, Akgun Cagliyan G, Demircioğlu S, Barista I, ucaryilmaz ozhamam e, vural f, Eser B, özet g, YILDIRIM R, Doğu M, BERBER İ, ERKURT M, Malkan U, Altuntaş F, BÜYÜKAŞIK Y (2020). 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. , 84 - 90. 10.4274/tjh.galenos.2019.2019.0177
Chicago	okay mufide,Aslan Tuncay,Ozdemir Evren,Uner Aysegul,Saglam Arzu,GÜNGÖR Elif Sena,Uysal Ayse,Alayvaz Aslan Nevin,Yildizhan Esra,AĞIT Abdullah,SİNAN DAL MEHMET,Korkmaz Serdal,NAMDAROGLU SİNEM,Sivgin Serdar,Akgun Cagliyan Gulsum,Demircioğlu Sinan,Barista Ibrahim,ucaryilmaz ozhamam esra,vural filiz,Eser Bülent,özet gülsüm,YILDIRIM Rahsan,Doğu Mehmet Hilmi,BERBER İlhami,ERKURT Mehmet Ali,Malkan Umit Yavuz,Altuntaş Fevzi,BÜYÜKAŞIK Yahya 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. (2020): 84 - 90. 10.4274/tjh.galenos.2019.2019.0177
MLA	okay mufide,Aslan Tuncay,Ozdemir Evren,Uner Aysegul,Saglam Arzu,GÜNGÖR Elif Sena,Uysal Ayse,Alayvaz Aslan Nevin,Yildizhan Esra,AĞIT Abdullah,SİNAN DAL MEHMET,Korkmaz Serdal,NAMDAROGLU SİNEM,Sivgin Serdar,Akgun Cagliyan Gulsum,Demircioğlu Sinan,Barista Ibrahim,ucaryilmaz ozhamam esra,vural filiz,Eser Bülent,özet gülsüm,YILDIRIM Rahsan,Doğu Mehmet Hilmi,BERBER İlhami,ERKURT Mehmet Ali,Malkan Umit Yavuz,Altuntaş Fevzi,BÜYÜKAŞIK Yahya 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. , 2020, ss.84 - 90. 10.4274/tjh.galenos.2019.2019.0177
AMA	okay m,Aslan T,Ozdemir E,Uner A,Saglam A,GÜNGÖR E,Uysal A,Alayvaz Aslan N,Yildizhan E,AĞIT A,SİNAN DAL M,Korkmaz S,NAMDAROGLU S,Sivgin S,Akgun Cagliyan G,Demircioğlu S,Barista I,ucaryilmaz ozhamam e,vural f,Eser B,özet g,YILDIRIM R,Doğu M,BERBER İ,ERKURT M,Malkan U,Altuntaş F,BÜYÜKAŞIK Y 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. . 2020; 84 - 90. 10.4274/tjh.galenos.2019.2019.0177
Vancouver	okay m,Aslan T,Ozdemir E,Uner A,Saglam A,GÜNGÖR E,Uysal A,Alayvaz Aslan N,Yildizhan E,AĞIT A,SİNAN DAL M,Korkmaz S,NAMDAROGLU S,Sivgin S,Akgun Cagliyan G,Demircioğlu S,Barista I,ucaryilmaz ozhamam e,vural f,Eser B,özet g,YILDIRIM R,Doğu M,BERBER İ,ERKURT M,Malkan U,Altuntaş F,BÜYÜKAŞIK Y 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. . 2020; 84 - 90. 10.4274/tjh.galenos.2019.2019.0177
IEEE	okay m,Aslan T,Ozdemir E,Uner A,Saglam A,GÜNGÖR E,Uysal A,Alayvaz Aslan N,Yildizhan E,AĞIT A,SİNAN DAL M,Korkmaz S,NAMDAROGLU S,Sivgin S,Akgun Cagliyan G,Demircioğlu S,Barista I,ucaryilmaz ozhamam e,vural f,Eser B,özet g,YILDIRIM R,Doğu M,BERBER İ,ERKURT M,Malkan U,Altuntaş F,BÜYÜKAŞIK Y "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." , ss.84 - 90, 2020. 10.4274/tjh.galenos.2019.2019.0177
ISNAD	okay, mufide vd. "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". (2020), 84-90. https://doi.org/10.4274/tjh.galenos.2019.2019.0177

APA	okay m, Aslan T, Ozdemir E, Uner A, Saglam A, GÜNGÖR E, Uysal A, Alayvaz Aslan N, Yildizhan E, AĞIT A, SİNAN DAL M, Korkmaz S, NAMDAROGLU S, Sivgin S, Akgun Cagliyan G, Demircioğlu S, Barista I, ucaryilmaz ozhamam e, vural f, Eser B, özet g, YILDIRIM R, Doğu M, BERBER İ, ERKURT M, Malkan U, Altuntaş F, BÜYÜKAŞIK Y (2020). 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. Turkish Journal of Hematology, 37(2), 84 - 90. 10.4274/tjh.galenos.2019.2019.0177
Chicago	okay mufide,Aslan Tuncay,Ozdemir Evren,Uner Aysegul,Saglam Arzu,GÜNGÖR Elif Sena,Uysal Ayse,Alayvaz Aslan Nevin,Yildizhan Esra,AĞIT Abdullah,SİNAN DAL MEHMET,Korkmaz Serdal,NAMDAROGLU SİNEM,Sivgin Serdar,Akgun Cagliyan Gulsum,Demircioğlu Sinan,Barista Ibrahim,ucaryilmaz ozhamam esra,vural filiz,Eser Bülent,özet gülsüm,YILDIRIM Rahsan,Doğu Mehmet Hilmi,BERBER İlhami,ERKURT Mehmet Ali,Malkan Umit Yavuz,Altuntaş Fevzi,BÜYÜKAŞIK Yahya 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. Turkish Journal of Hematology 37, no.2 (2020): 84 - 90. 10.4274/tjh.galenos.2019.2019.0177
MLA	okay mufide,Aslan Tuncay,Ozdemir Evren,Uner Aysegul,Saglam Arzu,GÜNGÖR Elif Sena,Uysal Ayse,Alayvaz Aslan Nevin,Yildizhan Esra,AĞIT Abdullah,SİNAN DAL MEHMET,Korkmaz Serdal,NAMDAROGLU SİNEM,Sivgin Serdar,Akgun Cagliyan Gulsum,Demircioğlu Sinan,Barista Ibrahim,ucaryilmaz ozhamam esra,vural filiz,Eser Bülent,özet gülsüm,YILDIRIM Rahsan,Doğu Mehmet Hilmi,BERBER İlhami,ERKURT Mehmet Ali,Malkan Umit Yavuz,Altuntaş Fevzi,BÜYÜKAŞIK Yahya 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. Turkish Journal of Hematology, vol.37, no.2, 2020, ss.84 - 90. 10.4274/tjh.galenos.2019.2019.0177
AMA	okay m,Aslan T,Ozdemir E,Uner A,Saglam A,GÜNGÖR E,Uysal A,Alayvaz Aslan N,Yildizhan E,AĞIT A,SİNAN DAL M,Korkmaz S,NAMDAROGLU S,Sivgin S,Akgun Cagliyan G,Demircioğlu S,Barista I,ucaryilmaz ozhamam e,vural f,Eser B,özet g,YILDIRIM R,Doğu M,BERBER İ,ERKURT M,Malkan U,Altuntaş F,BÜYÜKAŞIK Y 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. Turkish Journal of Hematology. 2020; 37(2): 84 - 90. 10.4274/tjh.galenos.2019.2019.0177
Vancouver	okay m,Aslan T,Ozdemir E,Uner A,Saglam A,GÜNGÖR E,Uysal A,Alayvaz Aslan N,Yildizhan E,AĞIT A,SİNAN DAL M,Korkmaz S,NAMDAROGLU S,Sivgin S,Akgun Cagliyan G,Demircioğlu S,Barista I,ucaryilmaz ozhamam e,vural f,Eser B,özet g,YILDIRIM R,Doğu M,BERBER İ,ERKURT M,Malkan U,Altuntaş F,BÜYÜKAŞIK Y 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. Turkish Journal of Hematology. 2020; 37(2): 84 - 90. 10.4274/tjh.galenos.2019.2019.0177
IEEE	okay m,Aslan T,Ozdemir E,Uner A,Saglam A,GÜNGÖR E,Uysal A,Alayvaz Aslan N,Yildizhan E,AĞIT A,SİNAN DAL M,Korkmaz S,NAMDAROGLU S,Sivgin S,Akgun Cagliyan G,Demircioğlu S,Barista I,ucaryilmaz ozhamam e,vural f,Eser B,özet g,YILDIRIM R,Doğu M,BERBER İ,ERKURT M,Malkan U,Altuntaş F,BÜYÜKAŞIK Y "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." Turkish Journal of Hematology, 37, ss.84 - 90, 2020. 10.4274/tjh.galenos.2019.2019.0177
ISNAD	okay, mufide vd. "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". Turkish Journal of Hematology 37/2 (2020), 84-90. https://doi.org/10.4274/tjh.galenos.2019.2019.0177