Amaç: Çalışmamızda; hastanemize başvuran hematolojik maligniteli hastaların sıklığının cinsiyet, ... more Amaç: Çalışmamızda; hastanemize başvuran hematolojik maligniteli hastaların sıklığının cinsiyet, yaş ve tanıya göre dağılımının saptanması, hastalara eşlik eden kronik hastalıkların, hastaların yaşam sürelerinin ve hayatta kalma durumlarının belirlenmesi amaçlandı. Yöntem: Çanakkale Onsekiz Mart Üniversitesi Uygulama ve Araştırma Hastanesi Hematoloji Bölümü’ne Mart 2019-Temmuz 2020 tarihleri arasında başvuran veya burada tanı konulan hematolojik maligniteli hastalar retrospektif olarak incelenmiştir. Bulgular: Çalışmamızda hematolojik maligniteli toplam 411 olgunun 191 tanesi (%46) kadın, 220 tanesi (%54) erkek olarak saptanmıştır. Toplamda ölüm oranı %11.7’dir. Hematolojik maligniteli olguların %1’ini ALL, %4’ünü AML, %4’ünü HL, %21’ini NHL, %18’ini plazma hücre diskrazisi, %7’sini MDS ve %33’ünü kronik miyeloproliferatif hastalıklar oluşturmaktadır. En sık NHL alt tipi DBBHL iken en sık KMPH alt tipi ise esansiyel trombositoz olarak saptandı. Hematolojik malignitelere en sık eşlik...
İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi, 2018
Introduction: Demografic features, respond the treatment of 90 Non-Hodgkin lymphoma (NHL) patient... more Introduction: Demografic features, respond the treatment of 90 Non-Hodgkin lymphoma (NHL) patients observed at depertman of hematology, Bozyaka Traning and Research Hospital in our study. Material and Method: Data of 90 NHL patients were evaluated retrospectively. Results: We found that 47 of the patients were women and 43 of the patients and were men and median age were 62. The patients were diagnosed with diffuse large B-cell lymphoma (DBBHL) in 61 patients, marginal zone lymphoma in 15 patients, follicular lymphoma in 6 patients and other lymphoma in 10 patients 18 patients died, and 72 of them lived. We found the median survival 73 months all of the patients. All patients survival (OS) was 75% and disease free-survival rates 68% of 5 year. Conclusion: Demografic features of patients are similar to another studies. Our treatment response and survival rates were also found to be consistent with the literature.
Bulgular: Çalışmaya alınan 90 hastadan 47'i kadın,43'i erkekdi. Ortanca yaş 62 olarak sap... more Bulgular: Çalışmaya alınan 90 hastadan 47'i kadın,43'i erkekdi. Ortanca yaş 62 olarak saptandı. Hastaların tanılarına bakıldığında 61 hastanın Diffüz büyük B hücreli lenfoma (DBBHL), 15 hastanın marjinal zon lenfoma, 6 hastanın folikuler lenfoma ve 10 hastanın diğer lenfoma tanısı aldığı görüldü. Hastaların 18 tanesi ölmüş, 72 tanesi ise yaşıyor olarak saptandı. Tüm NHL hastalarında ortalama sağkalım süresi 73 ay olarak bulundu. 5 yıllık toplam sağkalım %75, 5 yıllık hastalıksız sağkalım % 68 olarak saptandı.
Pregnancy‐associated atypical haemolytic uraemic syndrome is a rare and potentially lethal comple... more Pregnancy‐associated atypical haemolytic uraemic syndrome is a rare and potentially lethal complement-mediated disorder. It can mimic preeclampsia, gestational hypertension, thrombotic thrombocytopenic purpura and hemolysis, elevated liver enzymes and low platelets syndrome. Thus, it can be hard to distinguish pregnancy‐associated atypical haemolytic uraemic syndrome from other causes in peri/post-partum women presenting with features of microangiopathic haemolytic anemia, thrombocytopenia and acute kidney injury. We present a case of a 35-year-old woman in her third pregnancy at 32 weeks’ gestation who underwent caesarean section due to fetal distress. She developed severe renal impairment, thrombocytopenia and neurologic symptoms within 24 hours after delivery. A diagnosis of pregnancy‐associated atypical haemolytic uraemic syndrome was provided, and treatment with plasma therapy followed by eculizumab was initiated. A rapid improvement of both clinical and laboratory parameters w...
Amac: Kronik Miyeloid Losemi (KML) pluripotent kok hucrelerin anormal cogalmasi ile olusan miyelo... more Amac: Kronik Miyeloid Losemi (KML) pluripotent kok hucrelerin anormal cogalmasi ile olusan miyeloproliferatif bir hastaliktir ve eriskin losemilerinin %15’ini olusturur. Tirozin kinaz inhibitorleri (TKI) KML’nin ana tedavisi haline gelmistir. Yeni kusak TKI’lerinin kullanimi ile direncli vakalarda etkin tedavi saglanmistir. Calismamizda KML tanili hastalarin retrospektif olarak verilerini inceleyerek literature katki amacli sunmayi planladik. Gerec ve yontem: Calismamiza 2003 –2014 tarihleri arasinda KML tanisi ile tedavi edilen 88 hastanin, demografik ozelikleri, birinci ve ikinci sira TKI alan hastalarin tedavi yanitlari,TKI yan etkileri, tum sagkalim (OS) durumlari retrospektif olarak incelendi. Bulgular: Olgularin 36'si kadin, 52'si erkek olup medyan yas 52 idi. TKI ile hematolojik, sitogenetik ve molekuler yanitlar European Leukemia Net 2013 kilavuzuna gore degerlendirildi. Hastalarin (n=88) TKI’ne tedavi yanitlari 3. ay Tam Hematolojik Yanit (THY) %80, 12. ay Tam Sitog...
Akut miyeloid losemi (AML), hemopoetik kok hucresinin neoplastik hastaligidir. AML insidansi yas ... more Akut miyeloid losemi (AML), hemopoetik kok hucresinin neoplastik hastaligidir. AML insidansi yas ile birlikte artis gosterir ve erkeklerde kadinlara gore daha fazla oranda tespit edilmektedir. Remisyon induksiyon kemoterapisi, AML tedavisinin birinci basamagidir. Standart induksiyon tedavisinde sitarabin ve antrasiklin kombinasyonu kullanilir. Bu calismada amacimiz, AML remisyon induksiyon kemoterapisinde farkli antrasiklin tiplerinin remisyon elde etmede ve destek tedavi gereksiniminde fark yaratip yaratmadigini belirlemektir. Bunun icin Ocak 2004–Aralik 2009 arasinda toplam 6 yillik surede Uludag Universitesi Hastanesi Hematoloji Klinigi’nde yatarak tedavi goren, AML tanisiyla 3+7 remisyon induksiyon kemoterapisi alan 123 olgudan tam remisyona giren 96 olgu geriye donuk olarak degerlendirildi. Alinan 96 hastanin 44’u (%45,8) kadin, 52’si (%54,2) erkekti. En sik FAB alt tipleri: M2 (%29,3), M3 (%15,4) ve M4 (%13,0) idi. Hasta sayilari ve aldiklari antrasiklin tipleri: idarubisin (7...
Introduction: High-dose chemotherapy (HDC) and autologous stem cell transplantation(ASCT) still r... more Introduction: High-dose chemotherapy (HDC) and autologous stem cell transplantation(ASCT) still remains in the treatment of myeloma patients even during the period of new agents. Materials and Methods: We analysed the prognostic affect of pretransplant characteristics and transplant modalities on response, in 150 autologous transplant of 144 multiple myeloma (MM) patients who were transplanted in our centre between 2008 to 2017. We evaluated the affect of age, type of MM, previous treatment regimens, status pre and postfrom transplantation, time of ASCT, neutrophil and platelet engraftmant days, dose of reinfused CD34+ cells, plasma cell infiltration, international staging system(ISS) and Durie -Salmon stage at diagnosis. We examined the affect of these status on overall survival(OS) and eventfree survival(EFS). Results: The median OS and EFS after transplanation were 41 and 28 months, respectively. Median OS after the diagnosis was 57 months. Transplant-related mortality was 3,3%. We found that the lower β2- microglobulin levels,lower ISS stage,lower plasma cell infiltration, achievement good responds at the +100th day of post transplant were statistically significant independent predictor factors for longer EFS and OS. When the patients were given chemotherapy regimen with bortezomib before transplantation, these patients were seen to be a better response rate. There was showed a relationship between the using of bortezomib before transplantation with EFS(P = 0.017), but there was no relationship with OS. Conclusions: Our analysis confirms HDCT-ASCT as an effective and safe therapeutic strategy in multiple myeloma patients. This results were independent of age, first line treatment regimens and renal insufficiency. Patients with a high ISS stage were found to have shorter survival(P = 0.002). However, the EFS and OS were longer of the patients whose have good response at the 100th day of transplantation(P = 0,002, P = 0,02).
Indian Journal of Hematology and Blood Transfusion, Jan 23, 2018
Peripheral blood is the prefered source for hematopoietic stem cells for hematopoietic stem cell ... more Peripheral blood is the prefered source for hematopoietic stem cells for hematopoietic stem cell transplantation. The efficiency of peripheral blood stem cell (PBSC) collection can vary among devices. In this study we aimed to compare feasibility and effectivity of apheresis procedures of the different systems. Two apheresis systems [Com.Tec (Fresenius Healthcare) and Spectra Optia (Caridian BCT)] were used in our center for the collection of PBSCs for autologous and allogeneic transplantation. We retrospectively analysed 190 apheresis procedures performed in healthy donors and patients between June 2012 and November 2014 in Department of Hematology, Dokuz Eylul University. PBSCS were collected by Fresenius cell separator (64 procedure) or Spectra Optia cell separator (126 procedure). Mobilization treatments were G-CSF (26.8%), cyclophosphamide plus G-CSF (48.4%), prelixafor plus G-CSF (14.7%), ESHAP (10%) and others. Patient and donor characteristics (age, weight, volume processed, disease, mobilization regimes) were similar in Fresenius and Spectra Optia apheresis groups. Altough both collected PBSCs efficiently, the amount of CD34+ cell in product collected by Spectra Optia device was significantly higher (p < 0.05) and product volume was lower than Fresenius Com.Tec significantly (p < 0.05). “CD34+ collection efficiency” with Spectra Optia was significantly higher than Fresenius Com.Tec (CE2: 87%, 70%, p = 0.033) regarding all procedures. High collection efficiency and low product volume may be a significant characteristic of Spectra Optia device (mean 187 mL, product CD34+ cell: 1576 µL).
Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, 2014
Amac: Klasik olarak kronik intravaskuler hemoliz bulgulari, kemik iligi yetersizligi ve trombozla... more Amac: Klasik olarak kronik intravaskuler hemoliz bulgulari, kemik iligi yetersizligi ve trombozla kendini gosteren Paroksismal Nokturnal Hemoglobinuri (PNH), hematopoietik kok hucrenin klonal bir hastaligidir. Eculizimab ise PNH tedavisinde hemolizi ve trombotik ataklari azalttigi kanitlanmis bir monoklonal antikordur. Biz de nadir bir hastalik olan PNH olgularimizi ve eculizumab tedavi deneyimimizi paylasmak istedik. Yontemler: Dokuz Eylul Universitesi Tip Fakultesi Hematoloji AD ve Katip Celebi Universitesi hematoloji kliniginde PNH tanisi almis olan 18 hastanin demografik, klinik ozellikleri, tromboz oykusu, eculizumab tedavisi alanlar ve yanitlari, tum sagkalim oranlari retrospektif olarak incelenmistir. Bulgular: Hastalarin ortanca izlem suresi 41 ay (endusuk 3 ay, en yuksek 127 ay) olup olgularin 8'i kadin (%44,4), 10'u erkek (%55,6)’tir. Ortanca yas 38,5 idi. Hastalarin tani anindaki laboratuvar degerleri incelendiginde tani aninda Hb ortalama 9g/dL, WBC ortalama 3,89 10^3/µL, plt ortalama 87,6 10^3/µL,LDH ortalama 609 U/L, Retikulosit ortalama 3,38 oldugu gozlendi. Olgulardan 5 tanesi eculizumab tedavisi almis, 2’si tam yanitli, digerleri kismi yanitlidir. Ortalama 41 aylik izlem suresi sonunda %5,6 olgunun ex oldugu, %94,4’un yasadigi izlendi. Sonuc: PNH hematolojik nadir hastaliklardan birisidir. Klasik tedavi yontemleri disinda patogenezinin anlasilmasindan sonra bulunan populer tedavi modalitesi eculizumabdir. Olgularimizdan eculizumab tedavi gereksinimi olan 5 hastamizda tedavi sonrasinda hastalarin hemolizinin, kan transfuzyon sikligini azalmis oldugu, yasam kalitesinin artirmis oldugu gozlenmistir.
BACKGROUND: Recent reports showed neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ra... more BACKGROUND: Recent reports showed neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as a predictor of progression-free survival (PFS) and overall survival (OS) in various malignancies. MATERIALS AND METHODS: We retrospectively examined the PLR, NLR, and MLR in a cohort of 186 newly diagnosed multiple myeloma (MM) patients. This study investigated the prognostic relevance of NLR, PLR, and MLR in MM patients. NLR, PLR, and MLR were calculated from whole blood counts before therapy. The Kaplan–Meier curves and multivariate Cox models were used for the evaluation of survival. RESULTS: Applying cutoff of 1.9 (NLR), 120.00 (PLR), and 0.27 (MLR), decreased PLR showed a negative impact on the outcome. Decreased PLR is an independent predictor for PFS and OS. There were no significant differences in median survival between the high and low NLR (P = 0.80) and MLR (P = 0.87) groups. CONCLUSIONS: In this study, thrombocytopenia and...
Turkish journal of haematology : official journal of Turkish Society of Haematology, Jan 20, 2018
High dose melphalan chemotherapy and autologous stem cell transplantation in multiple myeloma ( M... more High dose melphalan chemotherapy and autologous stem cell transplantation in multiple myeloma ( MM ) is still important treatment modality in transplant eligible patients. At least 2 x 106 /kg CD 34+ cell dose is preferred for sufficient engraftment. Some patients need multiple leukapheresis procedures to reach a required number of the CD34+ cell but this can cause high volume of stem cell product that can not be given in a single day. Whether the number of infusion days affect engraftment or not, isn't studied before. We want to evaluate the effect of reinfusion of stem cell in multiple day on engraftment results. Demographic features, CD 34+ cell doses, neutrophil and platelet engraftment days, hospitalization days, number of infusion days of 149 autologous transplantation of 143 multiple myeloma patients were evaluated retrospectively. The data of 143 multiple myeloma patients who were transplanted were analyzed retrospectively. Median age was 55 ± 8,5 (26-70) with 91/58 Male...
The serum albumin (SA) level has been reported to be an independent prognostic biomarker that may... more The serum albumin (SA) level has been reported to be an independent prognostic biomarker that may serve as a surrogate representative of disease biology in patients diagnosed with myelodysplastic syndrome (MDS). However, its prognostic ability has not been tested in a model adjusting for comorbidities. We analyzed 200 patients who were diagnosed as having de novo MDS. Median overall survival (OS) of all patients was 25 months and median leukemia-free survival (LFS) was 24 months. Median OS according to the SA level groups of ≤ 3.5, 3.6-4.0 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 4.0 mg/dL were 24, 39 and 77 months, respectively. SA level remained an independent predictor of both LFS and OS even when adjusting for the hematopoietic cell transplant comorbidity index (HCT-CI) and the International Prognostic Scoring System (IPSS) or World Health Organization classification-based Prognostic Scoring System (WPSS). Our findings indicate that SA level at the time of diagnosis is a significant and independent predictor of LFS and OS even when adjusting for commonly used prognostic systems and comorbidities.
Essential thrombocythemia (ET) is the most common of the myeloproliferative neoplasms. For better... more Essential thrombocythemia (ET) is the most common of the myeloproliferative neoplasms. For better predicting the occurrence of thrombotic events, an International Prognostic Score of Thrombosis for ET (IPSET-Thrombosis) was recently developed. We aimed to investigate the validity of IPSET-Thrombosis in a Turkish patient cohort and to compare the efficacy of IPSET-Thrombosis and conventional risk scoring systems in predicting thrombosis-free survival. We retrospectively evaluated the clinical characteristics and risk factors for thrombosis in 112 Turkish patients. Median thrombosis-free survival and Harrell C concordance indexes were calculated for both conventional and IPSET-Thrombosis. Median age of 112 patients included in the study was 61 (range, 27-90) years at the time of diagnosis. When patients were stratified according to the conventional risk stratification system, 43.8% of patients were in the low-risk group and 56.2% in the high-risk group. A total of 22.4% of low-risk and 42.9% of high-risk patients had at least one thromboembolic event. When patients were stratified according to the IPSET-Thrombosis, 33% were in the low-risk group, 26.8% in the intermediate-risk group, and 40.2% in the high-risk group. Considering IPSET-Thrombosis risk groups, 5.4% of low-risk, 26.7% of intermediate-risk, and 66.2% of high-risk patients had at least one thromboembolic event. Regarding IPSET-Thrombosis risk groups, 10-year thrombosis-free survival was 86.8% for low-risk, 39.4% for intermediate-risk, and 32.9% for high-risk groups (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Harrell C concordance indexes of conventional and IPSET-Thrombosis were 0.60 and 0.77, respectively. By validating the reproducibility of IPSET-Thrombosis in Turkish ET patients, we found that IPSET-Thrombosis identifies thrombosis-free survival better than the conventional risk stratification system.
Amaç: Çalışmamızda; hastanemize başvuran hematolojik maligniteli hastaların sıklığının cinsiyet, ... more Amaç: Çalışmamızda; hastanemize başvuran hematolojik maligniteli hastaların sıklığının cinsiyet, yaş ve tanıya göre dağılımının saptanması, hastalara eşlik eden kronik hastalıkların, hastaların yaşam sürelerinin ve hayatta kalma durumlarının belirlenmesi amaçlandı. Yöntem: Çanakkale Onsekiz Mart Üniversitesi Uygulama ve Araştırma Hastanesi Hematoloji Bölümü’ne Mart 2019-Temmuz 2020 tarihleri arasında başvuran veya burada tanı konulan hematolojik maligniteli hastalar retrospektif olarak incelenmiştir. Bulgular: Çalışmamızda hematolojik maligniteli toplam 411 olgunun 191 tanesi (%46) kadın, 220 tanesi (%54) erkek olarak saptanmıştır. Toplamda ölüm oranı %11.7’dir. Hematolojik maligniteli olguların %1’ini ALL, %4’ünü AML, %4’ünü HL, %21’ini NHL, %18’ini plazma hücre diskrazisi, %7’sini MDS ve %33’ünü kronik miyeloproliferatif hastalıklar oluşturmaktadır. En sık NHL alt tipi DBBHL iken en sık KMPH alt tipi ise esansiyel trombositoz olarak saptandı. Hematolojik malignitelere en sık eşlik...
İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi, 2018
Introduction: Demografic features, respond the treatment of 90 Non-Hodgkin lymphoma (NHL) patient... more Introduction: Demografic features, respond the treatment of 90 Non-Hodgkin lymphoma (NHL) patients observed at depertman of hematology, Bozyaka Traning and Research Hospital in our study. Material and Method: Data of 90 NHL patients were evaluated retrospectively. Results: We found that 47 of the patients were women and 43 of the patients and were men and median age were 62. The patients were diagnosed with diffuse large B-cell lymphoma (DBBHL) in 61 patients, marginal zone lymphoma in 15 patients, follicular lymphoma in 6 patients and other lymphoma in 10 patients 18 patients died, and 72 of them lived. We found the median survival 73 months all of the patients. All patients survival (OS) was 75% and disease free-survival rates 68% of 5 year. Conclusion: Demografic features of patients are similar to another studies. Our treatment response and survival rates were also found to be consistent with the literature.
Bulgular: Çalışmaya alınan 90 hastadan 47'i kadın,43'i erkekdi. Ortanca yaş 62 olarak sap... more Bulgular: Çalışmaya alınan 90 hastadan 47'i kadın,43'i erkekdi. Ortanca yaş 62 olarak saptandı. Hastaların tanılarına bakıldığında 61 hastanın Diffüz büyük B hücreli lenfoma (DBBHL), 15 hastanın marjinal zon lenfoma, 6 hastanın folikuler lenfoma ve 10 hastanın diğer lenfoma tanısı aldığı görüldü. Hastaların 18 tanesi ölmüş, 72 tanesi ise yaşıyor olarak saptandı. Tüm NHL hastalarında ortalama sağkalım süresi 73 ay olarak bulundu. 5 yıllık toplam sağkalım %75, 5 yıllık hastalıksız sağkalım % 68 olarak saptandı.
Pregnancy‐associated atypical haemolytic uraemic syndrome is a rare and potentially lethal comple... more Pregnancy‐associated atypical haemolytic uraemic syndrome is a rare and potentially lethal complement-mediated disorder. It can mimic preeclampsia, gestational hypertension, thrombotic thrombocytopenic purpura and hemolysis, elevated liver enzymes and low platelets syndrome. Thus, it can be hard to distinguish pregnancy‐associated atypical haemolytic uraemic syndrome from other causes in peri/post-partum women presenting with features of microangiopathic haemolytic anemia, thrombocytopenia and acute kidney injury. We present a case of a 35-year-old woman in her third pregnancy at 32 weeks’ gestation who underwent caesarean section due to fetal distress. She developed severe renal impairment, thrombocytopenia and neurologic symptoms within 24 hours after delivery. A diagnosis of pregnancy‐associated atypical haemolytic uraemic syndrome was provided, and treatment with plasma therapy followed by eculizumab was initiated. A rapid improvement of both clinical and laboratory parameters w...
Amac: Kronik Miyeloid Losemi (KML) pluripotent kok hucrelerin anormal cogalmasi ile olusan miyelo... more Amac: Kronik Miyeloid Losemi (KML) pluripotent kok hucrelerin anormal cogalmasi ile olusan miyeloproliferatif bir hastaliktir ve eriskin losemilerinin %15’ini olusturur. Tirozin kinaz inhibitorleri (TKI) KML’nin ana tedavisi haline gelmistir. Yeni kusak TKI’lerinin kullanimi ile direncli vakalarda etkin tedavi saglanmistir. Calismamizda KML tanili hastalarin retrospektif olarak verilerini inceleyerek literature katki amacli sunmayi planladik. Gerec ve yontem: Calismamiza 2003 –2014 tarihleri arasinda KML tanisi ile tedavi edilen 88 hastanin, demografik ozelikleri, birinci ve ikinci sira TKI alan hastalarin tedavi yanitlari,TKI yan etkileri, tum sagkalim (OS) durumlari retrospektif olarak incelendi. Bulgular: Olgularin 36'si kadin, 52'si erkek olup medyan yas 52 idi. TKI ile hematolojik, sitogenetik ve molekuler yanitlar European Leukemia Net 2013 kilavuzuna gore degerlendirildi. Hastalarin (n=88) TKI’ne tedavi yanitlari 3. ay Tam Hematolojik Yanit (THY) %80, 12. ay Tam Sitog...
Akut miyeloid losemi (AML), hemopoetik kok hucresinin neoplastik hastaligidir. AML insidansi yas ... more Akut miyeloid losemi (AML), hemopoetik kok hucresinin neoplastik hastaligidir. AML insidansi yas ile birlikte artis gosterir ve erkeklerde kadinlara gore daha fazla oranda tespit edilmektedir. Remisyon induksiyon kemoterapisi, AML tedavisinin birinci basamagidir. Standart induksiyon tedavisinde sitarabin ve antrasiklin kombinasyonu kullanilir. Bu calismada amacimiz, AML remisyon induksiyon kemoterapisinde farkli antrasiklin tiplerinin remisyon elde etmede ve destek tedavi gereksiniminde fark yaratip yaratmadigini belirlemektir. Bunun icin Ocak 2004–Aralik 2009 arasinda toplam 6 yillik surede Uludag Universitesi Hastanesi Hematoloji Klinigi’nde yatarak tedavi goren, AML tanisiyla 3+7 remisyon induksiyon kemoterapisi alan 123 olgudan tam remisyona giren 96 olgu geriye donuk olarak degerlendirildi. Alinan 96 hastanin 44’u (%45,8) kadin, 52’si (%54,2) erkekti. En sik FAB alt tipleri: M2 (%29,3), M3 (%15,4) ve M4 (%13,0) idi. Hasta sayilari ve aldiklari antrasiklin tipleri: idarubisin (7...
Introduction: High-dose chemotherapy (HDC) and autologous stem cell transplantation(ASCT) still r... more Introduction: High-dose chemotherapy (HDC) and autologous stem cell transplantation(ASCT) still remains in the treatment of myeloma patients even during the period of new agents. Materials and Methods: We analysed the prognostic affect of pretransplant characteristics and transplant modalities on response, in 150 autologous transplant of 144 multiple myeloma (MM) patients who were transplanted in our centre between 2008 to 2017. We evaluated the affect of age, type of MM, previous treatment regimens, status pre and postfrom transplantation, time of ASCT, neutrophil and platelet engraftmant days, dose of reinfused CD34+ cells, plasma cell infiltration, international staging system(ISS) and Durie -Salmon stage at diagnosis. We examined the affect of these status on overall survival(OS) and eventfree survival(EFS). Results: The median OS and EFS after transplanation were 41 and 28 months, respectively. Median OS after the diagnosis was 57 months. Transplant-related mortality was 3,3%. We found that the lower β2- microglobulin levels,lower ISS stage,lower plasma cell infiltration, achievement good responds at the +100th day of post transplant were statistically significant independent predictor factors for longer EFS and OS. When the patients were given chemotherapy regimen with bortezomib before transplantation, these patients were seen to be a better response rate. There was showed a relationship between the using of bortezomib before transplantation with EFS(P = 0.017), but there was no relationship with OS. Conclusions: Our analysis confirms HDCT-ASCT as an effective and safe therapeutic strategy in multiple myeloma patients. This results were independent of age, first line treatment regimens and renal insufficiency. Patients with a high ISS stage were found to have shorter survival(P = 0.002). However, the EFS and OS were longer of the patients whose have good response at the 100th day of transplantation(P = 0,002, P = 0,02).
Indian Journal of Hematology and Blood Transfusion, Jan 23, 2018
Peripheral blood is the prefered source for hematopoietic stem cells for hematopoietic stem cell ... more Peripheral blood is the prefered source for hematopoietic stem cells for hematopoietic stem cell transplantation. The efficiency of peripheral blood stem cell (PBSC) collection can vary among devices. In this study we aimed to compare feasibility and effectivity of apheresis procedures of the different systems. Two apheresis systems [Com.Tec (Fresenius Healthcare) and Spectra Optia (Caridian BCT)] were used in our center for the collection of PBSCs for autologous and allogeneic transplantation. We retrospectively analysed 190 apheresis procedures performed in healthy donors and patients between June 2012 and November 2014 in Department of Hematology, Dokuz Eylul University. PBSCS were collected by Fresenius cell separator (64 procedure) or Spectra Optia cell separator (126 procedure). Mobilization treatments were G-CSF (26.8%), cyclophosphamide plus G-CSF (48.4%), prelixafor plus G-CSF (14.7%), ESHAP (10%) and others. Patient and donor characteristics (age, weight, volume processed, disease, mobilization regimes) were similar in Fresenius and Spectra Optia apheresis groups. Altough both collected PBSCs efficiently, the amount of CD34+ cell in product collected by Spectra Optia device was significantly higher (p < 0.05) and product volume was lower than Fresenius Com.Tec significantly (p < 0.05). “CD34+ collection efficiency” with Spectra Optia was significantly higher than Fresenius Com.Tec (CE2: 87%, 70%, p = 0.033) regarding all procedures. High collection efficiency and low product volume may be a significant characteristic of Spectra Optia device (mean 187 mL, product CD34+ cell: 1576 µL).
Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, 2014
Amac: Klasik olarak kronik intravaskuler hemoliz bulgulari, kemik iligi yetersizligi ve trombozla... more Amac: Klasik olarak kronik intravaskuler hemoliz bulgulari, kemik iligi yetersizligi ve trombozla kendini gosteren Paroksismal Nokturnal Hemoglobinuri (PNH), hematopoietik kok hucrenin klonal bir hastaligidir. Eculizimab ise PNH tedavisinde hemolizi ve trombotik ataklari azalttigi kanitlanmis bir monoklonal antikordur. Biz de nadir bir hastalik olan PNH olgularimizi ve eculizumab tedavi deneyimimizi paylasmak istedik. Yontemler: Dokuz Eylul Universitesi Tip Fakultesi Hematoloji AD ve Katip Celebi Universitesi hematoloji kliniginde PNH tanisi almis olan 18 hastanin demografik, klinik ozellikleri, tromboz oykusu, eculizumab tedavisi alanlar ve yanitlari, tum sagkalim oranlari retrospektif olarak incelenmistir. Bulgular: Hastalarin ortanca izlem suresi 41 ay (endusuk 3 ay, en yuksek 127 ay) olup olgularin 8'i kadin (%44,4), 10'u erkek (%55,6)’tir. Ortanca yas 38,5 idi. Hastalarin tani anindaki laboratuvar degerleri incelendiginde tani aninda Hb ortalama 9g/dL, WBC ortalama 3,89 10^3/µL, plt ortalama 87,6 10^3/µL,LDH ortalama 609 U/L, Retikulosit ortalama 3,38 oldugu gozlendi. Olgulardan 5 tanesi eculizumab tedavisi almis, 2’si tam yanitli, digerleri kismi yanitlidir. Ortalama 41 aylik izlem suresi sonunda %5,6 olgunun ex oldugu, %94,4’un yasadigi izlendi. Sonuc: PNH hematolojik nadir hastaliklardan birisidir. Klasik tedavi yontemleri disinda patogenezinin anlasilmasindan sonra bulunan populer tedavi modalitesi eculizumabdir. Olgularimizdan eculizumab tedavi gereksinimi olan 5 hastamizda tedavi sonrasinda hastalarin hemolizinin, kan transfuzyon sikligini azalmis oldugu, yasam kalitesinin artirmis oldugu gozlenmistir.
BACKGROUND: Recent reports showed neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ra... more BACKGROUND: Recent reports showed neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as a predictor of progression-free survival (PFS) and overall survival (OS) in various malignancies. MATERIALS AND METHODS: We retrospectively examined the PLR, NLR, and MLR in a cohort of 186 newly diagnosed multiple myeloma (MM) patients. This study investigated the prognostic relevance of NLR, PLR, and MLR in MM patients. NLR, PLR, and MLR were calculated from whole blood counts before therapy. The Kaplan–Meier curves and multivariate Cox models were used for the evaluation of survival. RESULTS: Applying cutoff of 1.9 (NLR), 120.00 (PLR), and 0.27 (MLR), decreased PLR showed a negative impact on the outcome. Decreased PLR is an independent predictor for PFS and OS. There were no significant differences in median survival between the high and low NLR (P = 0.80) and MLR (P = 0.87) groups. CONCLUSIONS: In this study, thrombocytopenia and...
Turkish journal of haematology : official journal of Turkish Society of Haematology, Jan 20, 2018
High dose melphalan chemotherapy and autologous stem cell transplantation in multiple myeloma ( M... more High dose melphalan chemotherapy and autologous stem cell transplantation in multiple myeloma ( MM ) is still important treatment modality in transplant eligible patients. At least 2 x 106 /kg CD 34+ cell dose is preferred for sufficient engraftment. Some patients need multiple leukapheresis procedures to reach a required number of the CD34+ cell but this can cause high volume of stem cell product that can not be given in a single day. Whether the number of infusion days affect engraftment or not, isn't studied before. We want to evaluate the effect of reinfusion of stem cell in multiple day on engraftment results. Demographic features, CD 34+ cell doses, neutrophil and platelet engraftment days, hospitalization days, number of infusion days of 149 autologous transplantation of 143 multiple myeloma patients were evaluated retrospectively. The data of 143 multiple myeloma patients who were transplanted were analyzed retrospectively. Median age was 55 ± 8,5 (26-70) with 91/58 Male...
The serum albumin (SA) level has been reported to be an independent prognostic biomarker that may... more The serum albumin (SA) level has been reported to be an independent prognostic biomarker that may serve as a surrogate representative of disease biology in patients diagnosed with myelodysplastic syndrome (MDS). However, its prognostic ability has not been tested in a model adjusting for comorbidities. We analyzed 200 patients who were diagnosed as having de novo MDS. Median overall survival (OS) of all patients was 25 months and median leukemia-free survival (LFS) was 24 months. Median OS according to the SA level groups of ≤ 3.5, 3.6-4.0 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 4.0 mg/dL were 24, 39 and 77 months, respectively. SA level remained an independent predictor of both LFS and OS even when adjusting for the hematopoietic cell transplant comorbidity index (HCT-CI) and the International Prognostic Scoring System (IPSS) or World Health Organization classification-based Prognostic Scoring System (WPSS). Our findings indicate that SA level at the time of diagnosis is a significant and independent predictor of LFS and OS even when adjusting for commonly used prognostic systems and comorbidities.
Essential thrombocythemia (ET) is the most common of the myeloproliferative neoplasms. For better... more Essential thrombocythemia (ET) is the most common of the myeloproliferative neoplasms. For better predicting the occurrence of thrombotic events, an International Prognostic Score of Thrombosis for ET (IPSET-Thrombosis) was recently developed. We aimed to investigate the validity of IPSET-Thrombosis in a Turkish patient cohort and to compare the efficacy of IPSET-Thrombosis and conventional risk scoring systems in predicting thrombosis-free survival. We retrospectively evaluated the clinical characteristics and risk factors for thrombosis in 112 Turkish patients. Median thrombosis-free survival and Harrell C concordance indexes were calculated for both conventional and IPSET-Thrombosis. Median age of 112 patients included in the study was 61 (range, 27-90) years at the time of diagnosis. When patients were stratified according to the conventional risk stratification system, 43.8% of patients were in the low-risk group and 56.2% in the high-risk group. A total of 22.4% of low-risk and 42.9% of high-risk patients had at least one thromboembolic event. When patients were stratified according to the IPSET-Thrombosis, 33% were in the low-risk group, 26.8% in the intermediate-risk group, and 40.2% in the high-risk group. Considering IPSET-Thrombosis risk groups, 5.4% of low-risk, 26.7% of intermediate-risk, and 66.2% of high-risk patients had at least one thromboembolic event. Regarding IPSET-Thrombosis risk groups, 10-year thrombosis-free survival was 86.8% for low-risk, 39.4% for intermediate-risk, and 32.9% for high-risk groups (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Harrell C concordance indexes of conventional and IPSET-Thrombosis were 0.60 and 0.77, respectively. By validating the reproducibility of IPSET-Thrombosis in Turkish ET patients, we found that IPSET-Thrombosis identifies thrombosis-free survival better than the conventional risk stratification system.
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