Distinct clinical characteristics draw a new prognostic model for splenic marginal zone lymphoma in HBV high prevalent region

// Shuhua Yi 1, * , Yuting Yan 1, * , Wenjie Xiong 1 , Rui Lv 1 , Zhen Yu 1 , Wei Liu 1 , Enbin Liu 1 , Heng Li 1 , Huimin Liu 1 , Zengjun Li 1 , Gang An 1 , Yan Xu 1 , Kun Ru 1 , Dehui Zou 1 and Lugui Qiu 1 1 State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China * These authors have contributed equally to this work Correspondence to: Lugui Qiu, email: qiulg@ihcams.ac.cn Keywords: splenic marginal zone lymphoma (SMZL); hepatitis B virus (HBV); cytogenetic aberration; IGH gene, prognosis Received: June 30, 2017     Accepted: August 27, 2017     Published: October 19, 2017 ABSTRACT Splenic marginal zone lymphoma (SMZL) is a rare indolent B-cell neoplasm with hepatitis virus supposed to involve in the pathogenesis. The characteristics of SMZL derived from Caucasia population and high hepatitis C virus (HCV) infection region have been widely investigated, but few was reported in the Eastern population with HBV prevalent region. We analyzed the clinical characteristics, cytogenetic aberrations and prognostic factors in 160 SMZL patients from China. 25 patients (16%) were HBsAg-positive and 54 (34%) patients with resolved HBV infection. IGH gene usage was analyzed in 39 patients. The preferential usages of IGHV genes were IGHV1-2 (26%), followed by IGHV4-34 (18%) and IGHV2-70 (10%). The patients with HBV infection presented biased IGHV-D-J rearrangements and mutational status. Using three independent factors hemoglobin level, HBsAg positivity and complex karyotype, we developed a new hierarchical prognostic model, which showed a better c-index than the previously reported IIL and HPLL scoring systems in SMZL. In conclusion, SMZL in HBV prevalent region have unique clinical and biological characteristics and new prognostic scoring model should be adopted in this population.