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Öğe Addition of Thalidomide (T) to Oral Melphalan/Prednisone (MP) in Patients with Multiple Myeloma: Initial Results of a Randomized Trial From the Turkish Myeloma Study Group.(Amer Soc Hematology, 2009) Beksac, Meral; Haznedar, Rauf; Firatli-Tuglular, Tulin; Ozdogu, Hakan; Aydogdu, Ismet; Konuk, Nahide; Sucak, Gulsan[Abstract Not Available]Öğe Addition of thalidomide to oral melphalan/prednisone in patients with multiple myeloma not eligible for transplantation: results of a randomized trial from the Turkish Myeloma Study Group(Wiley, 2011) Beksac, Meral; Haznedar, Rauf; Firatli-Tuglular, Tulin; Ozdogu, Hakan; Aydogdu, Ismet; Konuk, Nahide; Sucak, GulsanThe combination of melphalan-prednisone-thalidomide (MPT) has been investigated in several clinical studies that differed significantly with regard to patient characteristics and treatment schedules. This prospective trial differs from previous melphalan-prednisone (MP) vs. MPT trials by treatment dosing, duration, routine anticoagulation, and permission for a crossover. Newly diagnosed patients with multiple myeloma (MM) (n = 122) aged greater than 55 yr, not eligible for transplantation were randomized to receive 8 cycles of M (9 mg/m2/d) and P (60 mg/m2/d) for 4 d every 6 wk (n = 62) or MP and thalidomide (100 mg/d) continuously (n = 60). Primary endpoint was treatment response and toxicities following 4 and 8 cycles of therapy. Secondary endpoints were disease-free (DFS) and overall survival (OS). Overall, MPT-treated patients were younger (median 69 yr vs. 72 yr; P = 0.016) and had a higher incidence of renal impairment (RI, 19% vs. 7%, respectively; P = 0.057). After 4 cycles of treatment (n = 115), there were more partial responses or better in the MPT arm than in the MP arm (57.9% vs. 37.5%; P = 0.030). However, DFS and OS were not significantly different between the arms after a median of 23 months follow-up (median OS 26.0 vs. 28.0 months, P = 0.655; DFS 21.0 vs. 14.0 months, P = 0.342, respectively). Crossover to MPT was required in 11 patients, 57% of whom responded to treatment. A higher rate of grade 3-4 infections was observed in the MPT arm compared with the MP arm (22.4% vs. 7.0%; P = 0.033). However, none of these infections were associated with febrile neutropenia. Death within the first 3 months was observed more frequently in the MP arm (n = 8, 14.0%) than in the MPT arm (n = 2, 3.4%; P = 0.053). Long-term discontinuation and dose reduction rates were also analyzed (MPT: 15.5% vs. MP: 5.3%; P = 0.072). Although patients treated with MPT were relatively younger and had more frequent RI, better responses and less early mortality were observed in all age groups despite more frequent discontinuation. This study is registered at http://www.clinicaltrials.gov as #NCT00934154.Öğe Clinicopathologic Characteristics and Therapeutic Outcomes of Primary Gastrointestinal Non-Hodgkin's Lymphomas: 10 Years of Experience from a Single Center in Eastern Anatolia(Karger, 2009) Erkurt, Mehmet Ali; Aydogdu, Ismet; Kuku, Irfan; Kaya, Emin; Basaran, YalcinObjective: The objective of this retrospective study was to report the clinicopathological data and the treatment outcomes in patients with primary gastrointestinal non-Hodgkin's lymphoma. Patients and Methods: We carried out a retrospective analysis of 41 patients (22 females, 18 males, median age 58 and range 18-90 years) who presented to our department with histopathological diagnosis of primary gastrointestinal non-Hodgkin's lymphoma between 1995 and 2004. Results: The stomach was the most common extranodal site and was seen in 25 of 41 (61%) patients. At presentation 28 (68.3%) patients had gastrointestinal symptoms while 27 (65.9%) had B symptoms. The range of follow-up was 2-84 months with a median of 9 months. The overall survival rate was 3 years for 25 (61.2%) patients. The 3-year overall survival rate was better in patients with early-stage disease (stages I and II1) who were treated with surgery plus chemotherapy and/or radiation therapy than in those treated with chemotherapy alone (91.6 vs. 50%, p < 0.05). The disease had a significant impact on both the progression-free survival and overall survival rates. Conclusion: Our data showed that surgical resection prior to postoperative chemotherapy was a better option for patients with early-stage disease with better patient survival. Copyright (C) 2009 S. Karger AG, BaselÖğe Current practice of autologous hematopoietic progenitor cell mobilization in adult patients with multiple myeloma and lymphoma: The results of a survey from Turkish hematology research and education group (ThREG)(Pergamon-Elsevier Science Ltd, 2017) Tekgunduz, Emre; Demirkan, Fatih; Vural, Filiz; Goker, Hakan; Ozdogu, Hakan; Kiki, Ilhami; Aydogdu, IsmetAutologous hematopoietic cell transplantation (AHCT) is an established treatment option for adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and/or relapsed/refractory disease settings. Although there are recently published consensus guidelines addressing critical issues regarding autologous hematopoietic progenitor cell mobilization (HPCM), mobilization strategies of transplant centers show high variability in terms of routine practice. In order to understand the current institutional policies regarding HPCM in Turkey and to obtain the required basic data for preparation of a national positional statement on this issue, Turkish Hematology Research and Education Group (ThREG) conducted a web-based HPCM survey. The survey was designed to include multiple-choice questions regarding institutional practice of HPCM in adults presenting MM, HL, and NHL. The representatives of 27 adult HCT centers participated to the study. Here we report the results of this survey shedding light on the real world experience in Turkey in terms of autologous HPCM mobilization strategies in patients presenting with MM and lymphoma. (C) 2017 Elsevier Ltd. All rights reserved.Öğe Effects of cyanocobalamin on immunity in patients with pernicious anemia(Karger, 2008) Erkurt, Mehmet Ali; Aydogdu, Ismet; Dikilitas, Mustafa; Kuku, Irfan; Kaya, Emin; Bayraktar, Nihayet; Ozhan, OnurObjective: The aim of the study was to evaluate the role of vitamin B-12 in patients with pernicious anemia. Materials and Methods: This study was conducted prospectively at the Turgut Ozal Medical Center, Department of Hematology, between April and November 2002. Absolute numbers and ratio of the surface antigens of T and B lymphocyte subgroups, CD4/CD8 ratio were calculated in order to evaluate changes in leukocyte and lymphocyte numbers; natural killer (NK) cell count, serum C3, C4, and levels of immunoglobulins G, A, and M were also measured to evaluate vitamin B-12 effect on immunity. Values obtained before treatment with cyanocobalamin were compared with those found during peak reticulocyte count. Results: In vitamin B-12-deficient patients, absolute numbers of CD4+ and especially CD8+ lymphocytes were found to be decreased; CD4/CD8 ratio increased, and NK cell activity was depressed. After cyanocobalamin treatment, absolute numbers and percentage of lymphocyte subgroups were elevated. Increased CD4/CD8 ratio and depressed NK cell activity were restored and levels of C3, C4, and immunoglobulins were elevated. Conclusion: These findings suggest that vitamin B-12 has important immunomodulatory effects on cellular immunity, and abnormalities in the immune system in pernicious anemia are restored by vitamin B-12 replacement therapy. Copyright (C) 2008 S. Karger AG, Basel.Öğe Efficacy and safety of ruxolitinib in patients with myelofibrosis: a retrospective and multicenter experience in Turkey(Tubitak Scientific & Technological Research Council Turkey, 2021) Soyer, Nur; Ali, Ridvan; Turgut, Mehmet; Haznedaroglu, Ibrahim C.; Yilmaz, Fergun; Aydogdu, Ismet; Pir, AliBackground/aim: The aim of this study is to assess the efficacy and safety of ruxolitinib in patients with myelofibrosis. Materials and methods: From 15 centers, 176 patients (53.4% male, 46.6% female) were retrospectively evaluated. Results: The median age at ruxolitinib initiation was 62 (28-87) and 100 (56.8%) of all were diagnosed as PMF. Constitutional symptoms were observed in 84.7%. The median initiation dose of ruxolitinib was 30 mg (10-40). Dose change was made in 69 (39.2%) patients. Forty seven (35.6%) and 20 (15.2%) of 132 patients had hematological and nonhematological adverse events, respectively. The mean spleen sizes before and after ruxolitinib treatment were 219.67 +/- 46.79 mm versus 199.49 +/- 40.95 mm, respectively (p < 0.001). There was no correlation between baseline features and subsequent spleen response. Overall survival at 1-year was 89.5% and the median follow up was 10 (1-55) months. We could not show any relationship between survival and reduction in spleen size (p = 0.73). Conclusion: We found ruxolitinib to be safe, well tolerated, and effective in real-life clinical practice in Turkey. Ruxolitinib dose titration can provide better responses in terms of not only clinical benefit but also for long term of ruxolitinib treatment.Öğe A hundred years after the first article, a recollection: Cabot ring(Korean Assoc Internal Medicine, 2016) Erdem, Neslihan; Berber, Ilhami; Aydogdu, Ismet; Sevinc, Alper[Abstract Not Available]Öğe Measuring holotranscobalamin II, an early indicator of negative vitamin B12 balance, by radioimmunoassay in patients with ischemic cerebrovascular disease(Springer, 2008) Serefhanoglu, Songul; Aydogdu, Ismet; Kekilli, Ersoy; Ilhan, Atilla; Kuku, IrfanCirculating homocysteine is a risk factor of cardiovascular and cerebrovascular events. Hyperhomocysteinemia may be an early indicator for vitamin B-12 disorders because cobalamin is a cofactor in the remethylation process of homocysteine. Serum holotranscobalamin (holoTC II) becomes decreased before the development of metabolic dysfunction. In this study, we assessed circulating holoTC II to estimate the diagnosis of vitamin B-12 deficiency in the first ischemic cerebrovascular attack. We also compared the efficacy of the measurement of plasma holoTC II with the other standard biochemical and hematological markers used to reach the diagnosis of cobalamin deficiency. Forty-five patients (age 71 years (range 35-90), 16 men/29 women) within the first ischemic cerebrovascular event were included in this prospective study. All the enrolled patients have been administered vitamin B-12 1 mg intramuscular injection once a day for 10 days. At the baseline and on the tenth day of treatment, plasma levels of holoTC II and the proper biochemical and hematological markers in diagnosing cobalamin deficiency were measured. After admission, anemia and diminished serum vitamin B-12 levels were determined to be only 20% (9/45) and 44% (20/45), respectively; 78% (35/45) of the patients had low serum holoTC II (< 37 pmol/l). Serum homocysteine was higher in patients (49% of them) who had previously suffered a stroke. Thrombocytopenia, hypersegmentated neutrophils, and indirect hyperbilirubinemia were observed in 20% of the patients. Leukopenia and macrocytosis were not evident in any of them. In 18 of 27 patients (67%) that had low holoTC II levels after joining the study and who remained in the study until the end of cobalamin treatment, serum holoTC II levels returned to normal values. Cobalamin deficiency should be considered in patients with cerebrovascular diseases, even if anemia, elevated mean cell volume, depression of the serum cobalamin, or other classic hematological and/or biochemical abnormalities are lacking. Furthermore, measurement of serum holoTC II looks promising as a first-line of tests for diagnosing early vitamin B-12 deficiency.Öğe Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: twenty-four year Turkish experience in cladribine therapy(Wiley, 2015) Hacioglu, Sibel; Bilen, Yusuf; Eser, Ali; Sivgin, Serdar; Gurkan, Emel; Yildirim, Rahsan; Aydogdu, IsmetIn this multicenter retrospective analysis, we aimed to present clinical, laboratory and treatment results of 94 patients with Hairy cell leukemia diagnosed in 13 centers between 1990 and 2014. Sixty-six of the patients were males and 28 were females, with a median age of 55. Splenomegaly was present in 93.5% of cases at diagnosis. The laboratory findings that came into prominence were pancytopenia with grade 3 bone marrow fibrosis. Most of the patients with an indication for treatment were treated with cladribine as first-line treatment. Total and complete response of cladribine was 97.3% and 80.7%. The relapse rate after cladribine was 16.6%, and treatment related mortality was 2.5%. Most preferred therapy ( 95%) was again cladribine at second-line, and third line with CR rate of 68.4% and 66.6%, respectively. The 28-month median OS was 91.7% in all patients and 25-month median OS 96% for patients who were given cladribine as first-line therapy. In conclusion, the first multicenter retrospective Turkish study where patients with HCL were followed up for a long period has revealed demographic characteristics of patients with HCL, and confirmed that cladribine treatment might be safe and effective in a relatively large series of the Turkish study population. Copyright (C) 2014 John Wiley & Sons, Ltd.Öğe Myelodysplastic Syndrome in an Acromegaly Patient: A Case Report(Galenos Yayincilik, 2005) Sari, Ramazan; Demirel, Ulvi; Sahin, Ibrahim; Aydogdu, Ismet; Mizrak, Bulent; Taskapan, HulyaAcromegaly patients have higher incidence of neoplasia than the general population, especially for colonic carcinoma. Recently, various hematological malignancies have been reported in patients with acromegaly. However, myelodysplastic syndrome has not been reported in acromegaly previously. In this paper, we reported a unique patient with acromegaly and concomitant pancytopenia and myelodysplastic syndrome.Öğe Peripheral Blood Smear Findings of COVID-19 Patients Provide Information about the Severity of the Disease and the Duration of Hospital Stay(Mattioli 1885, 2021) Berber, Ilhami; Cagasar, Ozlem; Sarici, Ahmet; Berber, Nurcan Kirici; Aydogdu, Ismet; Ulutas, Ozkan; Yildirim, AsliBackground: Data about the morphological changes in peripheral blood smears during COVID-19 infection and their clinical severity association are limited. We aimed to examine the characteristics of the cells detected in the pathological rate and/or appearance and whether these findings are related to the clinical course by evaluating the peripheral blood smear at the time of diagnosis in COVID-19 patients. Methods: Clinical features, laboratory data, peripheral blood smear of fifty patients diagnosed with COVID-19 by PCR was evaluated at diagnosis. Peripheral smear samples of the patients were compared with the age and sex-matched 30 healthy controls. Pictures were taken from the patient's peripheral blood smear. Patients were divided into two groups. Mild and severe stage patient groups were compared in terms of laboratory data and peripheral smear findings. The relationship between the laboratory values of all patients and the duration of hospitalization was analyzed. Results: The number of segmented neutrophils and eosinophils were low, pseudo-Pelger-Huet, pseudo-Pelger-Huet/mature lymphocyte ratio, atypical lymphocytes, monocytes with vacuoles, bands, and pyknotic neutrophils rates were higher in the peripheral blood smear of the patient group (p<0.05). Increased pseudo-Pelger-Huet anomaly, pseudo-Pelger Huet/mature lymphocyte ratio, a decreased number of mature lymphocytes, and eosinophils in peripheral blood smear were observed in the severe stage patients (p<0.05). A negative correlation was observed between hospitalization duration and mature lymphocyte and monocytes with vacuoles rates (p<0.05). Conclusion: A peripheral blood smear is an inexpensive, easily performed, and rapid test. Increased Pseudo-Pelger-Huet anomaly/mature lymphocyte rate suggests a severe stage disease, while high initial mature lymphocyte and monocytes with vacuoles rates at the time of diagnosis may be an indicator of shortened duration of hospitalization.Öğe Prevalence of Gallstones in Patients with Chronic Myelocytic Leukemia(Karger, 2009) Ates, Fehmi; Erkurt, Mehmet Ali; Karincaoglu, Melih; Aladag, Murat; Aydogdu, IsmetObjective: The aim of the present case-control study was to determine whether or not the prevalence of gallbladder stones (GBS) was increased in patients with chronic myelocytic leukemia (CML) and to investigate clinical and laboratory characteristics of CML patients with GBS. Subjects and Methods: This study included 56 patients with CML and 55 sex- and age-matched healthy controls. All participants underwent abdominal ultrasonography and the main clinical and laboratory characteristics were recorded. Results: Gallbladder stones were detected in 13 (23.6%) patients with CML and in 3 (5.4%) control individuals (p < 0.05). The mean follow-up period of CML patients after diagnosis was 54.6 months, range 3-120 months. Hemoglobin levels were higher in the control group than in CML patients. However, total bilirubin, unconjugated bilirubin, lactate dehydrogenase levels, leukocyte and thrombocyte counts, frequency of splenomegaly and hepatomegaly were higher in the CML than in the control group (p < 0.05). Other clinical and laboratory values were not significantly different between the groups. CML patients with and without GBS were also compared for clinical and laboratory values. Age and follow-up period of CML patients after diagnosis were higher in the CML patients with GBS (p < 0.05). Conclusions: Higher prevalence of GBS in CML patients than in healthy controls was detected. We suggest that CML may increase the frequency of GBS, apart from other well-known risk factors. This risk is probably related to increased unconjugated bilirubin, which determines hemolysis, older age and long follow-up period of CML patients after diagnosis. Copyright (C) 2009 S. Karger AG, BaselÖğe Prevention of oral mucositis due to 5-fluorouracil treatment with oral cryotherapy(Natl Med Assoc, 2005) Baydar, Mustafa; Dikilitas, Mustafa; Sevinc, Alper; Aydogdu, IsmetIntroduction: One of the most common and important side effects of 5-fluorouracil (5-FU) is mucositis with ulcerations in the oral cavity. We investigated the effects of local cryotherapy on mucositis incidence administrated during 5-FU treatment. Methods: In a total of 99 courses, 5-FU and folinic acid combination chemotherapy was given to 40 patients. In our study, we considered every course as a single case, and cryotherapy was given to the some patient in one course but not given in the next. Results: While mucositis developed in 6.7% of the courses given with cryotherapy, this ratio was 38.9% in courses given without cryotherapy, In the logistic regression analysis, development of mucositis had been found to correlate only with cryotherapy. Odds ratio (OR)=11.5; in the 95% confidence interval (CI)=3.2-41.9; (p=0.001). Discussion: Results of initial studies evaluating the effects of cryotherapy in preventing mucositis due to 5-FU based chemotherapy regimens were promising. We concluded that oral cooling prevents 5-FU induced mucositis. This effective prophylactic treatment should be used in patients who are at increased risk for developing 5-FU induced mucositis.Öğe Serum Zinc Levels in Iron Deficient Women: A Case-Control Study(Galenos Yayincilik, 2016) Ozhan, Onur; Erdem, Neslihan; Aydogdu, Ismet; Erkurt, Ali; Kuku, IrfanSince similar symptoms and findings can be seen in the deficiencies of both iron and zinc, we aimed to evaluate the serum zinc levels of women with iron deficiency anemia (IDA). This study was conducted with women with iron deficiency and a healthy control group. When serum zinc levels were compared, they were found to be lower in the IDA group, which was statistically significant. With the help of these studies, iron and zinc treatment instead of only iron replacement may be considered in cases of iron deficiency.Öğe Therapeutic plasma exchange in patients with neurologic diseases: Retrospective multicenter study(Pergamon-Elsevier Science Ltd, 2008) Kaynar, Leylagul; Altuntas, Fevzi; Aydogdu, Ismet; Turgut, Burhan; Kocyigit, Ismail; Hacioglu, Sibel Kabukcu; Ismailogullari, SevdaTherapeutic plasma exchange (TPE) is commonly used in many neurological disorders where an immune etiology was known or suspected. We report our experience with TPE performed for neuroimmunologic disorders at four university hospitals. The study was a retrospective review of the medical records of neurological patients (n = 57) consecutively treated with TPE between April 2006 and May 2007. TPE indications in neurological diseases included Guillain-Barre Syndrome (GBS) (n = 41), myasthenia gravis (MG) (n = 11), acute disseminated encephalomyelitis (ADEM) (n = 3), chronic inflammatory demyelinating polyneuropathy (CIDP) (n = 1) and multiple sclerosis (MS) (n 1). Patient median age was 49; there was a predominance of males. Twenty-two patients had a history of other therapy including intravenous immunoglobulin (IVIG), steroid, azothioprin, and pridostigmine prior to TPE. Another 35 patients had not received any treatment prior to TPE. All patients were classified according to the Hughes functional grading scores pre- and first day post-TPE for early clinical evaluation of patients. The TPE was carried out 1-1.5 times at the predicted plasma volume every other day. Two hundred and ninety-four procedures were performed on 57 patients. The median number of TPE sessions per patient was five, and the median processed plasma volume was 3075 mL for each cycle. Although the pre-TPE median Hughes score of all patients was 4, it had decreased to grade I after TPE. While the pre-TPE median Hughes score for GBS and MG patients was 4, post-TPE scores were decreased to grade 1. Additionally, there was a statistically significant difference between post-TPE Hughes score for GBS patients with TPE as front line therapy and patients receiving IVIG as front line therapy (1 vs. 3.5; p = 0.034). Although there was no post-TPE improvement in Hughes scores in patients with ADEM and CIDP, patients with MS had an improved Hughes score from 4 to 1. Mild and manageable complications such as hypotension and hypocalcemia were also observed. TPE may be preferable for controlling symptoms of neuroimmunological disorders in early stage of the disease, especially with GBS. (C) 2008 Elsevier Ltd. All rights reserved.
