Clinical features and possible prognostic factors in patients with Marginal Zone Lymphoma: Retrospective analysis from two centers

Clinical features and possible prognostic factors in patients with Marginal Zone Lymphoma: Retrospective analysis from two centers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical features and possible prognostic factors in patients with Marginal Zone Lymphoma: Retrospective analysis from two centers Pınar Akyol, Abdulkerim Yıldız, Murat Albayrak, Murat Yıldırım, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-311979/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives Marginal zone lymphoma accounts 5%-17% of all non-Hodgkin lymphomas and has an indolent clinical course. The parameters that predict prognosis and the need for treatment are still unclear. The aim of the current study was to examine the impact of parameters on the course of disease and the need for treatment in marginal zone lymphoma. Methods A retrospective study was conducted with marginal zone lymphoma patients in the two centres between 2010 and 2018. The demographic and disease characteristics, and also hematological and biochemical parameters at the time of diagnosis were examined. The effect of the parameters on overall survival and need for treatment were analyzed. Results During the follow-up, 25 patients required treatment and 15 patiens were followed up without treatment. Overall survival was significantly higher in patients with nodal marginal zone lymphoma than in extranodal and splenic marginal zone lymphoma patients. overall survival of patients who required treatment was 92.9 months while untreated patients was 58.4 months and there was no significant difference among the groups. The platelet count of untreated patients at the time of diagnosis were significantly higher than patients who received treatment. No significant relationship was found between any parameter and overall survival. Conclusions We demonstrated platelet count at the time of diagnosis as a predictive factor for future treatment need. It is an objective and simple blood test that may be helpful to predict the course of the disease although further studies are warranted. Hematology Oncology Marginal zone lymphoma platelet prognosis survival Introduction Marginal zone lymphoma (MZL) is characterized by the proliferation of B cells in postgerminal centers found in mucosa-associated lymphoid tissue (MALT), lymph nodes, and the spleen [ 1 ]. MZL has indolent clinical course commonly and present with limited stage of disease [ 2 ]. Median age of MZL is about 60 years and there is slight female predominance. MZL accounts 5–17% of all non-Hodgkin lymphomas (NHL) [ 3 ]. MZL includes three subtypes: extranodal (EMZL), splenic(SMZL) and nodal MZL (NMZL) depending on site of involvement [ 4 ]. Although many morphologic and immunophenotypic features of these subtypes are similar with their indolent course, there are also differences in frequency, pathogenesis, clinical presentation and treatment [ 5 ]. According to the 2016 Revised WHO Classification, extranodal MZL is the most frequent subtype while nodal MZL is the least common form [ 6 ]. EMZL involves the organs with low lymphoid tissue like stomach, lungs, salivary glands that have accumulated B cells in response to chronic infections or autoimmunity. The most common site is stomach. Bone marrow (BM) and peripheral lymph node involvement is rare. Patients with SMZL, present with splenomegaly, abdominal lymphadenopathy (LAP) and cytopenia due to BM involvement. Patients with NMZL have lymphnode-based disease and spleen or extranodal sites have not been affected [ 7 ]. NMZL has worse prognosis than EMZL and SMZL [ 8 ]. Treatment options depends on disease subtypes, localization of involvement and symptoms [ 9 ]. Some patients can be followed with watch-and-wait principle where as some require treatment during follow-up period. Recurrence usually occurs within 5 years after treatment [ 10 ]. As it is a rare disease group, the prognostic factors of MZL have been studied in small cohorts [ 11 ]. Although studies have determined factors such as age, serum lactate dehydrogenase (LDH), B symptoms, and beta 2 microglobulin to be associated with prognosis or OS of the disease, the results are heterogeneous [ 9 ]. Parameters predicting the need for treatment are still unclear. Therefore, in the current study, the impact of parameters on the course of disease and need for treatment was analysed in patients with MZL. Material And Methods A retrospective study was conducted with MZL patients in the HematologyDepartments of two centres (Diskapi Yildirim Beyazit Training and Research Hospital and Gulhane Training and Research Hospital) between 2010 and 2018. Patients were classified in 3 groups: nodal, extranodal and splenic MZL. Demographic data, date of diagnosis, chemotherapy regimen, treatment response and follow-up periods were recorded for all patients. Hematological parameters including hemoglobin (Hb) level, hematocrit (Hct) level, platelet count, white blood cell count (WBC), neutrophil count, lymphocyte count, monocyte count, plateletcrit, platelet distribution width, mean platelet volume (mpv), albumin, LDH levels, ferritin and B12 vitamin levels were examined at the time of diagnosis. Response rates, OS and time to treatment duration (TTD) were calculated and the effect of parameters on OS and TTD were analyzed. Statistical analysis SPSS Statistics 20 software (IBM, Armonk, NY, USA) was used for statistical analysis. Descriptive data were given as a percentage. The Independent Samplest-test (t-table value) was used to compare two independent groups with normal distribution and the Mann-Whitney U-test (Z-table value) was used for data not showing normal distribution. χ 2 -cross tables were used to detect the relationship between qualitative variables. Only significant statistical variables in univariate analysis were included in the multivariate Cox regression model. Two-sided p -values < 0.05 were considered statistically significant. Receiver operating characteristic curve (ROC) and area under the curve (AUC) analysis were used to determine the cut-off value of ferritin to assess its relationship with survival. Survival was estimated from Kaplan-Meier curves. OS was calculated from the time of diagnosis to death or until the final visit. Comparisons between patient groups were made using the log-rank test. Ethical approval and informed consent All procedures performed in this study were conducted in accordance with the ethical standards of the institutional and / or national research committee and the 1964 Declaration of Helsinki and its subsequentamendments or comparable ethical standards. Patient records from Ankara Diskapi Yildirim Beyazit and Gulhane Training and Research Hospitals confirmed that all patients gave informed consent before hospitalization and prior to chemotherapy and for other relevant diagnostic / therapeutic procedures. Results Evaluation was made of 40 MZL patients, comprising 25 (62.5%) females and 15 (37.5%) males with a mean age of 64.13 ± 10.39 years. The demographic and clinical characteristics of the patients are shown in Table 1 . The total follow-up period was mean 19.6 months (range, 0.1–92.9 months). Table 1 The clinical and dermographic characteristics of patients All patients (n = 40) Median age , year (range) 64.13 (35–81) Gender n (%) Male Female 15 (37.5%) 25 (62.5%) Number of comorbidity [Median (Min-Max)] 0.5 [0.0–4.0] IPI score [Median (Min-Max)] 2.0 [1.0–5.0] Hb (gr/dL) [mean ± SD] 11.73 ± 2.81 Plt (x10 6 /L) [mean ± SD] 194000 ± 13200 Wbc (x10 6 /L) [mean ± SD] 10280 ± 9360 LDH (U/L) [mean ± SD] 294.4 ± 149.6 Final status Alive Exitus 32 (80.0%) 8 (20.0%) Follow up period (month) [Medyan (Min-Max)] 19.6 [0.1–92.9] IPI: International Prognostic Index, Hb: Hemoglobin, Plt: Platelet, WBC: White blood cell count, LDH: Lactate dehydrogenase During the follow-up period, 25 patients required treatment and 15 patients were followed up without treatment. The median TTD was 29.9 months (range,13.7–30.9 months). In the comparison of treated and untreated patients, there was a significant difference in respect of platelet count. The initial platelet count of patients who received treatment was significantly lower than untreated patients (p = 0.040). Table 2 shows the comparisons of these two groups. Logistic regression analysis was performed and platelet count was found to be an independent risk factor for treatment need (OR: 0.93, 95% CI: 0.87–0.99, p = 0.029) (Table 3 ). According to receiver operating characteristics (ROC), the platelet cut-off value was determined as 148500x10 6 /L with 80.0% sensitivity and 52% specificity (AUC = 0.703; p < 0.05). Table 2 The comparison of patients with and without treatment (N = 40) Patients with treatment (n = 25) Patients without treatment (n = 15) p Age year [mean ± SD] 62,68 ± 10,81 66,53 ± 9,52 p = 0,262 Gender n (%) Male Female 11 (%44,0) 14 (%56,0) 4 (%26,7) 11 (%73,3) p = 0,448 Number of comorbidity , n [Median (Min-Max) 1,0 [0,0–4,0] 0,0 [0,0–3,0] p = 0,174 Stage (%) 1 or 2 3 4 5 (%20,0) 3 (%12,0) 17 (%68,0) 6 (%40,0) 2 (%13,3) 7 (%46,7) p = 0,352 IPI score (%) 4 5 (%20,0) 19 (%76,0) 1 (%4,0) 5 (%33,3) 10 (%66,7) - p = 0,502 Hb (gr/dL) [mean ± SD] 11,0 [ 7 , 3 – 17 , 6 ] 13 [ 7 , 6 – 14 , 8 ] p = 0,102 Plt (x10 6 /L) [mean ± SD] 155840,00 ± 90097,48 258466,67 ± 165829,03 p = 0,040 Wbc (x10 6 /L) [mean ± SD] 4700,0 [1900,0-37800,0] 9900,0 [1670,0-30600,0] p = 0,175 Neut (x10 6 /L) [mean ± SD] 2480,0 [1100,0-21600,0] 5090,0 [770,0-11000,0] p = 0,094 LLR 2,5 [ 1 , 3 – 12 , 4 ] 2,7 [1,4–41,3] p = 0,967 Lenf (x10 6 /L) [mean ± SD] 2000,0 [300,0-28900,0] 2800,0 [200,0-19200,0] p = 0,567 LDH (U/L) [mean ± SD] 281,5 [122,0-739,0] 218,0 [158,0-574,0] p = 0,161 Albumin (mg/dl) [mean ± SD] 4,1 [ 2 , 4 – 4 , 9 ] 4,2 [ 3 , 4 – 4 , 6 ] p = 0,084 Ferritin (ng/mL) [mean ± SD] 87,0 [7,0-1500,0] 62,5 [12,0-290,0] p = 0,146 Vitamin B12 (ng/mL) [mean ± SD] 205,0 [85,0-546,0] 254,5 [116,0-756,0] p = 0,299 IPI: International Prognostic Index, Hb: Hemoglobin, Plt: Platelet, WBC: White blood cell count, LDH: Lactate dehydrogenase, LLR: Leukocyte/lymphocyte ratio, Table 3 Logistic regression model according to treatment requirement Variable B Standart error Wald Sd p OR 95% CI OR Lower Lower Plt (x10.000) -0,069 0,032 4,777 1 0,029 0,933 0,877 0,993 Constant 1,897 0,731 6,738 1 0,009 6,664 *Ref.kategory CCR = 72,5% χ 2 (8) = 9,474, p = 0,304 According to the survival analysis, the median OS of all MZL patients was 58.4 months (range, 53.5–95.9 months). A statistically significant difference was found in terms of OS according to diagnostic subtypes (p = 0.009). OS was significantly higher in patients with nodal MZL than in extranodal and splenic MZL patients ( Table 4 ). There was no significant effect on OS of age, gender, IPI score, hemogram parameters including hemoglobin, platelet count, WBC, neutrophil count, lymphocyte count, and monocyte count. The OS of patients who received treatment was mean 92.9 months and for untreated patients it was 58.4 months, with no significant difference determined between the groups (p < 0.05) Table 4 Comparison of some characteristics according to diagnosis subtype Variable (N = 40) Diagnostic subtypes p Nodal (n = 15) (1) Extranodal (n = 9) (2) Splenic (n = 16) (3) OS (month) [Median (Min-Max)] 32,2 [5,0–65,5] 15,5 [0,2–23,3] 15,8 [ 20 , 1 ] 0,009 [ 1 – 2 , 3 ] Need to treatment Yes No 4 (%26,7) 11 (%73,3) 4 (%44,4) 5 (%55,6) 7 (%43,8) 9 (%56,2) 0,548 Discussion Factors that may affect the need for treatment, prognosis and survival of MZL patients have been investigated for many years [ 1 , 9 ]. Since MZL has indolent low grade lymphoma like follicular lymphoma, the need for treatment can be determined according to the Groupe pourl'Etude de Lymphome Folliculaire (GELF) criteria. GELF recommends treatment for patients with involvement of ≥ 3 nodal sites, eachwith a diameter of ≥ 3 cm, any nodal or extranodal tumor mass with a diameter of ≥ 7 cm, B symptoms, splenomegaly, pleural effusions or peritoneal ascites, or cytopenia [ 12 ],[ 13 ]. Therefore, some MZL patients require treatment where as others are followed up without treatment. The parameters, especially at the time of diagnosis, which can predict the need for treatment during follow-up are still unclear. Mayer et al determined that age, serum LDH, a high IPI score and transformation into aggressive lymphoma are independent risk factors for reduced OS in MZL [ 14 ]. In the current study, it was demonstrated that an initial lower platelet count is a predictive parameter for the need for treatment. However, no significant relationship was found between platelet count and OS. Previous studies have reported that platelet count was prognostic for some hematological malignancies, such as splenic marginal zone lymphoma and acute lymphoblastic leukemia [ 15 , 16 ]. Bone marrow infiltration, the side-effects of drugs, splenic sequestration, or infections may be the cause of thrombocytopenia in lymphoma [ 17 ]. A previous study showed that thrombocytopenia was an independently poor prognostic factor of OS and progression-free survival in patients with diffuse large B-cell lymphoma [ 18 ]. Another current study reported that SMZL patients with anemia, hypoalbuminemia, International Prognostic Index (IPI) scores of 2 to 3, higher LDH levels, age > 60 years and platelet counts < 100000/L, had required treatment [ 19 ]. In the current study, there was no correlation between Hb, IPI, LDH levels, and the age of receiving treatment. From a scan of literature, it can be seen that the survival rate of extranodal MZL is higher. A previous study determined that prognosis was significantly better for patients with extranodal MZL [ 8 ]. Mazloom et al reported that splenic MZL patients had the best prognosis in a study of 275 MZL patients [ 20 ]. Unlike these findings in literature, the results of the current study determined the OS of nodal MZL to be higher than that of extranodal and splenic MZL. Limitations of this study were the retrospective design and low number of patients. In addition, the prognostic impact of molecular/genetic characteristics and pathological features was not evaluated due to unavailable data. Therefore, larger prospective studies are needed to confirm the prognostic factors. In conclusion, platelet count was identified as a risk factor for the need for treatment. Platelet count at diagnosis is an objective and simple blood test that may be helpful to predict the course of the disease, although further studies are warranted. Declarations Conflict of interest: The Authors declare that there is no conflict of interest. Funding: There is no funding source. Ethics approval: Approval for this study was given by the Local Ethics Committee. (approval number :87/11, 08.05.2020) References Kahl B, Yang D. Marginal zone lymphomas: management of nodal, splenic, and MALT NHL. Hematology Am Soc Hematol Educ Program. 2008:359–64. doi: 10.1182/asheducation-2008.1.359 . Ferreri AJ, Zucca E. Marginal-zone lymphoma. Crit Rev Oncol Hematol. 2007;63(3):245–56. Armitage JO. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin's lymphoma. Blood. 1997;89(11):3909–18. Thieblemont C. Clinical presentation and management of marginal zone lymphomas. ASH Education Program Book. 2005;2005(1):307–13. Campo E, Swerdlow S, Harris N, Pileri S, Stein H, Jaffe E. World Health Organization classification of tumors. Pathology and genetics of tumours of hematopoietic and lymphoid tissues. 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Marginal Zone Lymphoma: Factors That Affect the Final Outcome, a Study of 275 Patients. Am Soc Hematology; 2008. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-311979","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":46791441,"identity":"203807d1-6203-43ff-9c27-023f92517c7b","order_by":0,"name":"Pınar 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MZL has indolent clinical course commonly and present with limited stage of disease [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Median age of MZL is about 60 years and there is slight female predominance. MZL accounts 5\u0026ndash;17% of all non-Hodgkin lymphomas (NHL) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMZL includes three subtypes: extranodal (EMZL), splenic(SMZL) and nodal MZL (NMZL) depending on site of involvement [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Although many morphologic and immunophenotypic features of these subtypes are similar with their indolent course, there are also differences in frequency, pathogenesis, clinical presentation and treatment [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. According to the 2016 Revised WHO Classification, extranodal MZL is the most frequent subtype while nodal MZL is the least common form [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEMZL involves the organs with low lymphoid tissue like stomach, lungs, salivary glands that have accumulated B cells in response to chronic infections or autoimmunity. The most common site is stomach. Bone marrow (BM) and peripheral lymph node involvement is rare. Patients with SMZL, present with splenomegaly, abdominal lymphadenopathy (LAP) and cytopenia due to BM involvement. Patients with NMZL have lymphnode-based disease and spleen or extranodal sites have not been affected [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. NMZL has worse prognosis than EMZL and SMZL [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Treatment options depends on disease subtypes, localization of involvement and symptoms [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Some patients can be followed with watch-and-wait principle where as some require treatment during follow-up period. Recurrence usually occurs within 5 years after treatment [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs it is a rare disease group, the prognostic factors of MZL have been studied in small cohorts [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Although studies have determined factors such as age, serum lactate dehydrogenase (LDH), B symptoms, and beta 2 microglobulin to be associated with prognosis or OS of the disease, the results are heterogeneous [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Parameters predicting the need for treatment are still unclear. Therefore, in the current study, the impact of parameters on the course of disease and need for treatment was analysed in patients with MZL.\u003c/p\u003e"},{"header":"Material And Methods","content":"\u003cp\u003eA retrospective study was conducted with MZL patients in the HematologyDepartments of two centres (Diskapi Yildirim Beyazit Training and Research Hospital and Gulhane Training and Research Hospital) between 2010 and 2018. Patients were classified in 3 groups: nodal, extranodal and splenic MZL.\u003c/p\u003e \u003cp\u003eDemographic data, date of diagnosis, chemotherapy regimen, treatment response and follow-up periods were recorded for all patients. Hematological parameters including hemoglobin (Hb) level, hematocrit (Hct) level, platelet count, white blood cell count (WBC), neutrophil count, lymphocyte count, monocyte count, plateletcrit, platelet distribution width, mean platelet volume (mpv), albumin, LDH levels, ferritin and B12 vitamin levels were examined at the time of diagnosis. Response rates, OS and time to treatment duration (TTD) were calculated and the effect of parameters on OS and TTD were analyzed.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eSPSS Statistics 20 software (IBM, Armonk, NY, USA) was used for statistical analysis. Descriptive data were given as a percentage. The Independent Samplest-test (t-table value) was used to compare two independent groups with normal distribution and the Mann-Whitney U-test (Z-table value) was used for data not showing normal distribution. \u003cb\u003eχ\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e-cross tables were used to detect the relationship between qualitative variables. Only significant statistical variables in univariate analysis were included in the multivariate Cox regression model. Two-sided\u003cem\u003ep\u003c/em\u003e-values\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered statistically significant. Receiver operating characteristic curve (ROC) and area under the curve (AUC) analysis were used to determine the cut-off value of ferritin to assess its relationship with survival. Survival was estimated from Kaplan-Meier curves. OS was calculated from the time of diagnosis to death or until the final visit. Comparisons between patient groups were made using the log-rank test.\u003c/p\u003e \u003cp\u003e \u003cspan type=\"BoldItalic\" class=\"BoldItalic\" name=\"Emphasis\"\u003eEthical approval and informed consent\u003c/span\u003e \u003c/p\u003e \u003cp\u003eAll procedures performed in this study were conducted in accordance with the ethical standards of the institutional and / or national research committee and the 1964 Declaration of Helsinki and its subsequentamendments or comparable ethical standards. Patient records from Ankara Diskapi Yildirim Beyazit and Gulhane Training and Research Hospitals confirmed that all patients gave informed consent before hospitalization and prior to chemotherapy and for other relevant diagnostic / therapeutic procedures.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eEvaluation was made of 40 MZL patients, comprising 25 (62.5%) females and 15 (37.5%) males with a mean age of 64.13\u0026thinsp;\u0026plusmn;\u0026thinsp;10.39 years. The demographic and clinical characteristics of the patients are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The total follow-up period was mean 19.6 months (range, 0.1\u0026ndash;92.9 months).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe clinical and dermographic characteristics of patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAll patients (n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMedian age\u003c/b\u003e, year (range)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.13 (35\u0026ndash;81)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e n (%)\u003c/p\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (37.5%)\u003c/p\u003e \u003cp\u003e25 (62.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of comorbidity\u003c/b\u003e [Median (Min-Max)]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.5 [0.0\u0026ndash;4.0]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIPI score\u003c/b\u003e [Median (Min-Max)]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.0 [1.0\u0026ndash;5.0]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHb (gr/dL)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.73\u0026thinsp;\u0026plusmn;\u0026thinsp;2.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlt (x10\u003c/b\u003e\u003csup\u003e\u003cb\u003e6\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/L)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e194000\u0026thinsp;\u0026plusmn;\u0026thinsp;13200\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWbc (x10\u003c/b\u003e\u003csup\u003e\u003cb\u003e6\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/L)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10280\u0026thinsp;\u0026plusmn;\u0026thinsp;9360\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLDH (U/L)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e294.4\u0026thinsp;\u0026plusmn;\u0026thinsp;149.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFinal status\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAlive\u003c/p\u003e \u003cp\u003eExitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (80.0%)\u003c/p\u003e \u003cp\u003e8 (20.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFollow up period (month)\u003c/b\u003e [Medyan (Min-Max)]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.6 [0.1\u0026ndash;92.9]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eIPI: International Prognostic Index, Hb: Hemoglobin, Plt: Platelet, WBC: White blood cell count, LDH: Lactate dehydrogenase\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eDuring the follow-up period, 25 patients required treatment and 15 patients were followed up without treatment. The median TTD was 29.9 months (range,13.7\u0026ndash;30.9 months). In the comparison of treated and untreated patients, there was a significant difference in respect of platelet count. The initial platelet count of patients who received treatment was significantly lower than untreated patients (p\u0026thinsp;=\u0026thinsp;0.040). Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the comparisons of these two groups. Logistic regression analysis was performed and platelet count was found to be an independent risk factor for treatment need (OR: 0.93, 95% CI: 0.87\u0026ndash;0.99, p\u0026thinsp;=\u0026thinsp;0.029) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). According to receiver operating characteristics (ROC), the platelet cut-off value was determined as 148500x10\u003csup\u003e6\u003c/sup\u003e/L with 80.0% sensitivity and 52% specificity (AUC\u0026thinsp;=\u0026thinsp;0.703; p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe comparison of patients with and without treatment\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatients with treatment (n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePatients without treatment (n\u0026thinsp;=\u0026thinsp;15)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge year\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62,68\u0026thinsp;\u0026plusmn;\u0026thinsp;10,81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66,53\u0026thinsp;\u0026plusmn;\u0026thinsp;9,52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,262\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e n (%)\u003c/p\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (%44,0)\u003c/p\u003e \u003cp\u003e14 (%56,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (%26,7)\u003c/p\u003e \u003cp\u003e11 (%73,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,448\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of comorbidity\u003c/b\u003e, n\u003c/p\u003e \u003cp\u003e[Median (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,0 [0,0\u0026ndash;4,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,0 [0,0\u0026ndash;3,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,174\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStage\u003c/b\u003e (%)\u003c/p\u003e \u003cp\u003e1 or 2\u003c/p\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (%20,0)\u003c/p\u003e \u003cp\u003e3 (%12,0)\u003c/p\u003e \u003cp\u003e17 (%68,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (%40,0)\u003c/p\u003e \u003cp\u003e2 (%13,3)\u003c/p\u003e \u003cp\u003e7 (%46,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,352\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIPI score\u003c/b\u003e (%)\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2\u003c/p\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003cp\u003e\u0026gt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (%20,0)\u003c/p\u003e \u003cp\u003e19 (%76,0)\u003c/p\u003e \u003cp\u003e1 (%4,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (%33,3)\u003c/p\u003e \u003cp\u003e10 (%66,7)\u003c/p\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,502\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHb (gr/dL)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11,0 [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR4 CR5 CR6 CR7 CR8 CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR7 CR8 CR9 CR10 CR11 CR12 CR13\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,102\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlt (x10\u003c/b\u003e\u003csup\u003e\u003cb\u003e6\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/L)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e155840,00\u0026thinsp;\u0026plusmn;\u0026thinsp;90097,48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e258466,67\u0026thinsp;\u0026plusmn;\u0026thinsp;165829,03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0,040\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWbc (x10\u003c/b\u003e\u003csup\u003e\u003cb\u003e6\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/L)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4700,0 [1900,0-37800,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9900,0 [1670,0-30600,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,175\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNeut (x10\u003c/b\u003e\u003csup\u003e\u003cb\u003e6\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/L)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2480,0 [1100,0-21600,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5090,0 [770,0-11000,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,094\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLLR\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,5 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan additionalcitationids=\"CR4 CR5 CR6 CR7 CR8 CR9 CR10 CR11\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2,7 [1,4\u0026ndash;41,3]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,967\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLenf (x10\u003c/b\u003e\u003csup\u003e\u003cb\u003e6\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/L)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2000,0 [300,0-28900,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2800,0 [200,0-19200,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,567\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLDH (U/L)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e281,5 [122,0-739,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e218,0 [158,0-574,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,161\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlbumin (mg/dl)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4,1 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4,2 [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,084\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFerritin (ng/mL)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87,0 [7,0-1500,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62,5 [12,0-290,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,146\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVitamin B12 (ng/mL)\u003c/b\u003e [mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e205,0 [85,0-546,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e254,5 [116,0-756,0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0,299\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eIPI: International Prognostic Index, Hb: Hemoglobin, Plt: Platelet, WBC: White blood cell count, LDH: Lactate dehydrogenase, LLR: Leukocyte/lymphocyte ratio,\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic regression model according to treatment requirement\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c3\" namest=\"c2\" rowspan=\"2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStandart error\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWald\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSd\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e95%\u0026nbsp;\u003cem\u003eCI OR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eLower\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003eLower\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlt\u003cb\u003e(x10.000)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0,069\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4,777\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0,029\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0,933\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0,877\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,993\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eConstant\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,897\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,731\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6,738\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6,664\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e*Ref.kategory\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003eCCR\u0026thinsp;=\u0026thinsp;72,5%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c8\" namest=\"c5\"\u003e \u003cp\u003e\u003cb\u003eχ\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003csub\u003e\u003cb\u003e(8)\u003c/b\u003e\u003c/sub\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;9,474, p\u0026thinsp;=\u0026thinsp;0,304\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to the survival analysis, the median OS of all MZL patients was 58.4 months (range, 53.5\u0026ndash;95.9 months). A statistically significant difference was found in terms of OS according to diagnostic subtypes (p\u0026thinsp;=\u0026thinsp;0.009). OS was significantly higher in patients with nodal MZL than in extranodal and splenic MZL patients \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e There was no significant effect on OS of age, gender, IPI score, hemogram parameters including hemoglobin, platelet count, WBC, neutrophil count, lymphocyte count, and monocyte count. The OS of patients who received treatment was mean 92.9 months and for untreated patients it was 58.4 months, with no significant difference determined between the groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of some characteristics according to diagnosis subtype\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eDiagnostic subtypes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNodal (n\u0026thinsp;=\u0026thinsp;15)\u003c/b\u003e\u003csup\u003e\u003cb\u003e(1)\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eExtranodal (n\u0026thinsp;=\u0026thinsp;9)\u003c/b\u003e\u003csup\u003e\u003cb\u003e(2)\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eSplenic (n\u0026thinsp;=\u0026thinsp;16)\u003c/b\u003e\u003csup\u003e\u003cb\u003e(3)\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOS (month)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e[Median (Min-Max)]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32,2 [5,0\u0026ndash;65,5]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15,5 [0,2\u0026ndash;23,3]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15,8 [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0,009\u003c/b\u003e\u003c/p\u003e \u003cp\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNeed to treatment\u003c/b\u003e\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (%26,7)\u003c/p\u003e \u003cp\u003e11 (%73,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (%44,4)\u003c/p\u003e \u003cp\u003e5 (%55,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (%43,8)\u003c/p\u003e \u003cp\u003e9 (%56,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,548\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eFactors that may affect the need for treatment, prognosis and survival of MZL patients have been investigated for many years [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSince MZL has indolent low grade lymphoma like follicular lymphoma, the need for treatment can be determined according to the Groupe pourl'Etude de Lymphome Folliculaire (GELF) criteria. GELF recommends treatment for patients with involvement of \u0026ge;\u0026thinsp;3 nodal sites, eachwith a diameter of \u0026ge;\u0026thinsp;3 cm, any nodal or extranodal tumor mass with a diameter of \u0026ge;\u0026thinsp;7 cm, B symptoms, splenomegaly, pleural effusions or peritoneal ascites, or cytopenia [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e],[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Therefore, some MZL patients require treatment where as others are followed up without treatment. The parameters, especially at the time of diagnosis, which can predict the need for treatment during follow-up are still unclear. Mayer et al determined that age, serum LDH, a high IPI score and transformation into aggressive lymphoma are independent risk factors for reduced OS in MZL [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In the current study, it was demonstrated that an initial lower platelet count is a predictive parameter for the need for treatment. However, no significant relationship was found between platelet count and OS.\u003c/p\u003e \u003cp\u003ePrevious studies have reported that platelet count was prognostic for some hematological malignancies, such as splenic marginal zone lymphoma and acute lymphoblastic leukemia [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Bone marrow infiltration, the side-effects of drugs, splenic sequestration, or infections may be the cause of thrombocytopenia in lymphoma [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. A previous study showed that thrombocytopenia was an independently poor prognostic factor of OS and progression-free survival in patients with diffuse large B-cell lymphoma [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother current study reported that SMZL patients with anemia, hypoalbuminemia, International Prognostic Index (IPI) scores of 2 to 3, higher LDH levels, age\u0026thinsp;\u0026gt;\u0026thinsp;60 years and platelet counts\u0026thinsp;\u0026lt;\u0026thinsp;100000/L, had required treatment [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In the current study, there was no correlation between Hb, IPI, LDH levels, and the age of receiving treatment.\u003c/p\u003e \u003cp\u003eFrom a scan of literature, it can be seen that the survival rate of extranodal MZL is higher. A previous study determined that prognosis was significantly better for patients with extranodal MZL [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Mazloom et al reported that splenic MZL patients had the best prognosis in a study of 275 MZL patients [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Unlike these findings in literature, the results of the current study determined the OS of nodal MZL to be higher than that of extranodal and splenic MZL.\u003c/p\u003e \u003cp\u003eLimitations of this study were the retrospective design and low number of patients. In addition, the prognostic impact of molecular/genetic characteristics and pathological features was not evaluated due to unavailable data. Therefore, larger prospective studies are needed to confirm the prognostic factors.\u003c/p\u003e \u003cp\u003eIn conclusion, platelet count was identified as a risk factor for the need for treatment. Platelet count at diagnosis is an objective and simple blood test that may be helpful to predict the course of the disease, although further studies are warranted.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003eConflict of interest: The Authors declare that there is no conflict of interest.\u003c/p\u003e\n\u003cp\u003eFunding: There is no funding source.\u003c/p\u003e\n\u003cp\u003eEthics approval: Approval for this study was given by the Local Ethics Committee. (approval number :87/11, 08.05.2020)\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKahl B, Yang D. Marginal zone lymphomas: management of nodal, splenic, and MALT NHL. Hematology Am Soc Hematol Educ Program. 2008:359\u0026ndash;64. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1182/asheducation-2008.1.359\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFerreri AJ, Zucca E. Marginal-zone lymphoma. Crit Rev Oncol Hematol. 2007;63(3):245\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eArmitage JO. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin's lymphoma. Blood. 1997;89(11):3909\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eThieblemont C. Clinical presentation and management of marginal zone lymphomas. ASH Education Program Book. 2005;2005(1):307\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCampo E, Swerdlow S, Harris N, Pileri S, Stein H, Jaffe E. World Health Organization classification of tumors. Pathology and genetics of tumours of hematopoietic and lymphoid tissues. Lyon: IARC Press; 2008.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSwerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375\u0026ndash;90.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZinzani PL. The many faces of marginal zone lymphoma. ASH Education Program Book. 2012;2012(1):426\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOlszewski AJ, Castillo JJ. Survival of patients with marginal zone lymphoma: analysis of the Surveillance, Epidemiology, and End Results database. Cancer. 2013;119(3):629\u0026ndash;38.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eThieblemont C, Coiffier B. Management of marginal zone lymphomas. Curr Treat Options Oncol. 2006;7(3):213\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBerger F, Felman P, Sonet A, Salles G, Bastion Y, Bryon P, et al. Nonfollicular small B-cell lymphomas: a heterogeneous group of patients with distinct clinical features and outcome. Blood. 1994;83(10):2829\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKahl B, Yang D. Marginal zone lymphomas: management of nodal, splenic, and MALT NHL. ASH Education Program Book. 2008;2008(1):359\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKato H, Yamamoto K, Taji H, Hirano D, Yatabe Y, Nakamura S, et al. Prognostic Value Of GELF Criteria and FLIPI2 For Newly Diagnosed Follicular Lymphoma Receiving R-CHOP Chemotherapy. Blood. 2013;122(21):4368-.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrice P, Bastion Y, Lepage E, Brousse N, Haioun C, Moreau P, et al. Comparison in low-tumor-burden follicular lymphomas between an initial no-treatment policy, prednimustine, or interferon alfa: a randomized study from the Groupe d'Etude des Lymphomes Folliculaires. Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 1997;15(3):1110\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMeyer A, Stroux A, Lerch K, Eucker J, Eitle J, Hohloch K, et al. Transformation and additional malignancies are leading risk factors for an adverse course of disease in marginal zone lymphoma. Ann Oncol. 2014;25(1):210\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDonadieu J, Auclerc MF, Baruchel A, Leblanc T, Landman-Parker J, Perel Y, et al. Critical study of prognostic factors in childhood acute lymphoblastic leukaemia: differences in outcome are poorly explained by the most significant prognostic variables. Br J Haematol. 1998;102(3):729\u0026ndash;39.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eParry-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(5):759\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiebman H. Other immune thrombocytopenias. Semin Hematol. 2007;44(4 Suppl 5):24\u0026ndash;34. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1053/j.seminhematol.2007.11.004\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen L-P, Lin S-J, Yu M-S. Prognostic value of platelet count in diffuse large B-cell lymphoma. Clin Lymphoma Myeloma Leuk. 2012;12(1):32\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eArcaini L, Lazzarino M, Colombo N, Burcheri S, Boveri E, Paulli M, et al. Splenic marginal zone lymphoma: a prognostic model for clinical use. Blood. 2006;107(12):4643\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMazloom A, Reed VK, Cabanillas F, Fayad L, Pro B, Iyengar P, et al. Marginal Zone Lymphoma: Factors That Affect the Final Outcome, a Study of 275 Patients. Am Soc Hematology; 2008.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Marginal zone lymphoma, platelet, prognosis, survival","lastPublishedDoi":"10.21203/rs.3.rs-311979/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-311979/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eMarginal zone lymphoma accounts 5%-17% of all non-Hodgkin lymphomas and has an indolent clinical course. The parameters that predict prognosis and the need for treatment are still unclear. The aim of the current study was to examine the impact of parameters on the course of disease and the need for treatment in marginal zone lymphoma.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective study was conducted with marginal zone lymphoma patients in the two centres between 2010 and 2018. The demographic and disease characteristics, and also hematological and biochemical parameters at the time of diagnosis were examined. The effect of the parameters on overall survival and need for treatment were analyzed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eDuring the follow-up, 25 patients required treatment and 15 patiens were followed up without treatment. Overall survival was significantly higher in patients with nodal marginal zone lymphoma than in extranodal and splenic marginal zone lymphoma patients. overall survival of patients who required treatment was 92.9 months while untreated patients was 58.4 months and there was no significant difference among the groups. The platelet count of untreated patients at the time of diagnosis were significantly higher than patients who received treatment. No significant relationship was found between any parameter and overall survival.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eWe demonstrated platelet count at the time of diagnosis as a predictive factor for future treatment need. It is an objective and simple blood test that may be helpful to predict the course of the disease although further studies are warranted.\u003c/p\u003e","manuscriptTitle":"Clinical features and possible prognostic factors in patients with Marginal Zone Lymphoma: Retrospective analysis from two centers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-08-20 14:33:45","doi":"10.21203/rs.3.rs-311979/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2cb4c472-9fde-474c-8fec-d42a92646b77","owner":[],"postedDate":"August 20th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":6581285,"name":"Hematology"},{"id":6581286,"name":"Oncology"}],"tags":[],"updatedAt":"2021-09-22T19:13:46+00:00","versionOfRecord":[],"versionCreatedAt":"2021-08-20 14:33:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-311979","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-311979","identity":"rs-311979","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}