Iron deficiency anemia (IDA) is a major public health problem especially in underdeveloped and developing countries. Zinc is the co-factor of several enzymes and plays a role in iron metabolism, so zinc deficiency is associated with IDA. In this study, it was aimed to investigate the relationship of symptoms of IDA and zinc deficiency in adult IDA patients. The study included 43 IDA patients and 43 healthy control subjects. All patients were asked to provide a detailed history and were subjected to a physical examination. The hematological parameters evaluated included hemoglobin (Hb); hematocrit (Ht); red blood cell (erythrocyte) count (RBC); and red cell indices mean corpuscular volume (MCV), mean corpuscular hemoglobin (МСН), mean corpuscular hemoglobin concentration (МСНС), and red cell distribution width (RDW). Anemia was defined according to the criteria defined by the World Health Organization (WHO). Serum zinc levels were measured in the flame unit of atomic absorption spectrophotometer. Symptoms attributed to iron deficiency or depletion, defined as fatigue, cardiopulmonary symptoms, mental manifestations, epithelial manifestations, and neuromuscular symptoms, were also recorded and categorized. Serum zinc levels were lower in anemic patients (103.51 ± 34.64 μ/dL) than in the control subjects (256.92 ± 88.54 μ/dL; <0.001). Patients with zinc level <99 μ/dL had significantly more frequent mental manifestations (p < 0.001), cardiopulmonary symptoms (p = 0.004), restless leg syndrome (p = 0.016), and epithelial manifestations (p < 0.001) than patients with zinc level > 100 μ/dL. When the serum zinc level was compared with pica, no statistically significant correlation was found (p = 0.742). Zinc is a trace element that functions in several processes in the body, and zinc deficiency aggravates IDA symptoms. Measurement of zinc levels and supplementation if necessary should be considered for IDA patients.

Nivolumab represents a novel option for patients with cHL refractory to brentuximab vedotin, and may serve as a bridge to transplantation; however, it may be associated with increased toxicity.

Conclusions: Nivolumab represents a novel option for patients with cHL refractory to brentuximab vedotin, and may serve as a bridge to transplantation; however, it may be associated with increased toxicity.

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 /µL, lower albumin, higher lactate dehydrogenase, higher β 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. 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 hastal...

Splenic marginal zone lymphoma (SMZL) is a rare disease. It constitutes less than 2% of lymphoid neoplasms. Chronic antigenic stimulation is frequently blamed in the pathogenesis of extranodal marginal zone lymphomas including SMZL. Chronic hepatitis C is frequently observed in SMZL patients. However these reports are largely from North America and Europe. Data from various countries with different hepatitis prevalence are lacking. In this multicenter cohort study we aimed to find out clinical characteristics of SMZL patients in Turkey including viral hepatitis status and treatment details. Data were gathered from voluntary centers under auspices of Hematolojik Onkoloji Dernegi using a SPSS database. Categorical and continuous data were expressed as ratio (%) and median (range) and they were compared by the Chi-square and Mann Whitney U tests, respectively. Survival analyses were computed by the Kaplan-Meier method. Overall survival (OS) was calculated from diagnosis to the date of mortality of any reason. Patients who did not die at last follow-up were censored at this time for OS computations. Parameters related to survival were investigated by Cox regression univariate and multivariate analyses. 66 patients were reported from 8 tertiary care hematology/oncology centers. The diagnosis of SMZL was established by local hematopathologists. Data on baseline clinical characteristics are presented in table 1. Median follow-up duration was 20.4 months (0.3-208) (23 months for surviving patients). 13 patients died during follow-up. Median OS was not reached. Estimated 6 year survival was 59.5% (Figure 1). Older age, no splenectomy during follow-up, <90 x 103 platelet count, lower albumin, higher lactate dehydrogenase, higher b2-microglobulin and HBsAg positivity were associated with increased risk of death. Age, albumin and HBsAg positivity remained significant in multivariate analysis (table 2). HCV positivity was not observed in any patient in this East Mediterranean/Middle Eastern cohort. However 12.1% HBsAg and 32% HBsAg and/or anti-HBcAg positivities are higher than expected for our population. This finding should be confirmed in a larger cohort. Risk factors associated with worse prognosis were generally similar to those reported in European/North American populations. However, HBsAg positivity has not been reported as a risk factor previously. Figure 1 Overall survival Figure 1. Overall survival Table 1 Baseline characteristics Table 1. Baseline characteristics Table 2 Univariate and multivariate analyses for survival Table 2. Univariate and multivariate analyses for survival Disclosures No relevant conflicts of interest to declare.