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    Clinical Characteristics and Outcomes of COVID-19 in Turkish Patients with Hematological Malignancies
    (Galenos Yayincilik, 2022) Bozdag, Sinem Civriz; Seval, Guldane Cengiz; Hindilerden, Ipek Yonal; Hindilerden, Fehmi; Andic, Neslihan; Baydar, Mustafa; Kaynar, Lale Aydin
    Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARSCoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixtynine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.
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    Retrospective analysis of autologous stem cell transplantation outcomes in multiple myeloma patients with renal insufficiency
    (2021) Goren Sahin, Deniz; Akay, Olga Meltem; Andic, Neslihan; Uskudar Teke, Hava; Gunduz, Eren
    Aim: The most seen complication of multiple myeloma (MM) is renal insufficiency (RI). Although MM is known as one of the causes of reversible end-stage renal disease, these patients are usually not suitable for autologous stem cell transplantation (ASCT). We aimed in this study to reveal the clinical course of MM patients with renal insufficiency that underwent ASCT. Materials and Methods: We included 25 MM patients with RI who has undergone ASCT in this study. Creatinine levels more than 2 mg/dL was defined as renal insufficiency at the time of diagnosis. For survival analysis, we included patients with a minimum 100 days post-transplantation follow-up. Results: Median age was 56.6±7.9 (42-65) years. Melphalan was given 140 mg/m 2 . Nine patients (36%) required dialysis at the time of diagnosis. Six patients became dialysis-free with induction therapy. After ASCT, none of the patients needed dialysis. Cox regression analysis showed a significant increase in disease-free survival (DFS) and overall survival (OS) times compared to patients with very good partial response in patients with complete response on the 100 th day of ASCT (for DFS; 15.7 months vs 63.7 months, p=0.009 and for OS; 37.9 months vs 97.3 months p=0.01, respectively). Conclusion: There are studies showing that ASCT performed with reduced dose of melphalan is a renal protective and effective method in patients with renal impairment. Our study confirms this thesis, as well as emphasizing the significant effect of CR on DFS and OS on the 100 th day after transplantation in these patients.