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Öğe BK virus incidence, risk factors and its effect on mortality in hematopoietic stem cell transplant patients-single center experience(2021) Deviren, Mehmet Veysi; Sarıcı, Ahmet; Erkurt, Mehmet Ali; Bahçecioğlu, Ömer Faruk; Biçim, Soykan; Berber, İlhami; Kaya, EminThe aim of this trial is to investigate the risk factors of BK viruria and the effect of BK viruria on mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). The data of 247 patients who underwent HSCT between 01.01.2011-01.12.2017 in Inonu University Faculty of Medicine Department of Hematology were retrospectively analyzed. BK viruria was defined as positive at any copy level in the urine. Of 247 patients, 97 patients (39.2%) were detected to have BK virus-posi- tive. Patients with positive BK virus in urine were younger than BK virus negative patients, and patients with multiple myeloma had a lower rate of BK virus positivity than other patients (p<0.05). The rate of BK viruria was found to be higher in patients who received busulfan and cyclophosphamide-containing conditioning regimens compared to patients who received other conditioning regimens (46% vs 28.9%, p=0.007). In addition, BK virus positivity was found to be lower in those receiving mel- phalan-based conditioning regimens than those receiving other conditioning regimes (28.6% vs 47.2%, p=0.008). BK virus positivity in urine was detected median 20 days after HSCT. BK virus positivity was detected in 80.4% (78/97) of the patients within the first 30 days. Patients with BK viruria had a higher first 100-day mortality than patients without BK viruria (17.5% vs 8%, p=0.023). In this series, BK viruria is a factor associated with mortality in the early period after HSCT and should be closely monitored in these patients.Öğe Comparison of efficacy and toxicity of treosulfan-fludarabine and busulfancyclophosphamide conditioning regimens in patients undergoing allogeneic stem cell transplantation(2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Bahçecioğlu, Ömer Faruk; Gok, Selim; Bicim, Soykan; Kaya, EminIn hematologic malignancy patients undergoing allogeneic HSCT, the optimal conditioning regimen is uncertain and comparative studies of conditioning regimens with each other are needed. In the current study, it was intended to compare the toxicity profile of two myeloablative conditioning regimens (treosulfan-fludarabine vs busulfan-cyclophosphamide) and their effects on clinical outcomes. The data of patients who underwent allogeneic HSCT between 2015 and 2020 in Inonu University Turgut Ozal Medical Center were retrospectively analyzed. Patients receiving treosulfan-fludarabine (treosulfan group) or busulfan-cyclophosphamide (busulfan group) as a conditioning regimen prior to allogeneic HSCT were matched 1: 1 according to their disease and age. A total of 42 patients were included in this trial (busulfan: 21, treosulfan: 21). The mean age of the patients was 45.2±14 years, and regimen-related toxicities and clinical outcomes of both groups were similar (all p>0.05). The median follow-up time of the patients in the treosulfan regimen groups was 9 months, while it was 15 months in the busulfan regimen group (p=0.82). 54.8% of the patients (12 treosulfan, 11 busulfan) died after a median follow-up of 9.5 months. When the effects of the two conditioning regimens on were compared in 28 acute myeloid leukemia (AML) patients, the engraftment times, acute and chronic graft versus host disease incidences, and sinusoidal obstruction syndrome incidence were found to be similar in busulfan and treosulfan groups (all p>0.05). In addition, the estimated median progression-free survival (p=0.938) and overall survival (p=0.672) of the groups were similar. Treosulfan-fludarabine appears to be a conditioning regimen that can be used as an alternative to busulfan-cyclophosphamide. Prospective randomized studies are needed to confirm the data in our study.Öğe Comparison of the renal response of bortezomib-based induction and conventional regimen in multiple myeloma patients with renal failure(2021) Sarici, Ahmet; Kaya, Emin; Erkurt, Mehmet Ali; Berber, Ilhami; Tanrıverdi, Lokman Hekim; Bahçecioğlu, Ömer Faruk; Gök, Selim; Kuku, IrfanAim: Vincristine-doxorubicin-dexamethasone (VAD) was the commonly used first-line treatment for multiple myeloma (MM) patients with renal failure before bortezomib entered clinical practice. In this trial, we aimed to compare the effect of VAD and bortezomibcyclophosphamide-dexamethasone (VCD) chemotherapy regimens on improving kidney function in MM patients with renal failure. Materials and Methods: The records of MM patients in our center between January 2010 and February 2020 were retrospectively analyzed. Patients who received VAD or VCD as a first treatment chemotherapy protocol and whose initially estimated glomerular filtration rate (eGFR) was 50 mL/min/1.73 m2and below were included in the study. Patients were divided into two groups according to the chemotherapy regimens they received. Results: Sixty one MM patients (VAD: 26, VCD: 35) were included in the study. No significant difference was found between the VAD and VCD groups when the baseline, 1st and 2nd month eGFRs were compared (p>0.05). Overall renal response rate (at least minor response) in the VCD group at the end of the 1st month were higher than in the VAD group (p=0.002). Also, renal response rate in the VCD group at the end of the 2nd month were higher than in the VAD group (p=0.033). Conclusion: In MM patients with renal insufficiency, overall renal response rates have increased with the use of VCD instead of VAD as a standard induction regimen.Öğe Experience of ibrutinib in a patient with recurrent mantle cell lymphoma with orbital involvement(2021) Sarici, Ahmet; Kuku, Irfan; Kaya, Emin; Erkurt, Mehmet Ali; Berber, Ilhami; Bicim, Soykan; Bahçecioğlu, Ömer Faruk; Er Ulubaba, HilalMantle cell lymphoma is a subtype of B cell non-Hodgkin's lymphoma with different clinical and molecular features. Extranodal involvement is common in MCL. Bone marrow, liver, spleen, waldeyer ring and gastrointestinal involvement are most common. Lymphomatosis polyposis can be seen in some patients. Central nervous system involvement is rare. Here, we aimed to present a blastoid variant MCL patient who developed orbital recurrence after four lines of systemic therapy and responded to ibrutinib (560 mg/day) monotherapy. The mass disappeared completely in the bilateral orbital MRI taken after the 5th month of the ibrutinib treatment.Öğe The frequency of hepatitis B virus reactivation in patients receiving anti-TNF treatment: A single center, retrospective study(2024) Keser, Muhammed Furkan; Erdogan, Mehmet Ali; Bahçecioğlu, Ömer Faruk; Seçkin, Yüksel; Yolbaş, Servet; Yıldırım, Tülay; Yıldırım, OğuzhanAim: The equilibrium between the host immune response counter the hepatitis B virus (HBV) and the amount of viral replication is a crucial factor in the pathogenesis of HBVassociated liver disease. Tumor necrosis factor-alpha (TNF-?) is a considerable proinflammatory and immune regulatory cytokine in the pathogenesis of various inflammatory and autoimmune conditions. There is no consensus on using antiviral prophylaxis treatments in cases who have been exposed to hepatitis B but have not become chronically ill, and are thus planned to receive anti-TNF-? treatment. The aim of this study is to determine the frequency of reactivation after anti-TNF treatment in cases with isolated anti-HBc total positivity who have been exposed to hepatitis B virus. Materials and Methods: Serological HBV infection markers (HBsAg, anti-HBc IgG and anti-HBs) of 1467 adult cases who received anti-TNF therapy for the indications of various rheumatological diseases in the rheumatology and physical therapy clinics between the years 2010-2021 were retrospectively screened using the hospital’s electronic information system. Results: 140 rheumatologic disease cases who took a TNF-? inhibitor (infliximab, adalimumab, etanercept, golimumab, certolizumab) treatment were included in this study. Before the cases were started on TNF-? treatment, all cases were anti-HBc total positive, 110 were anti-HBs positive, 30 were anti-HBs negative, and 4 were HbsAg positive and HBV-DNA negative. The median pre-treatment anti-HBc total and anti-HBs values of the cases were 5.6 IU/L and 79.29 IU/L, respectively. No HBV reactivation was observed in any of the 140 cases after a median follow-up duration of 71.5 (min. 8, max. 185) months. Conclusion: In conclusion, HBV reactivation was not detected in any of the anti-HBc positive cases included in this study, which suggest that anti-HBc positive cases can be followed up with close follow-up without starting them on anti-TNF therapies and antiviral prophylaxis.Öğe Linezolid drug interactions: A retrospective study(2020) Gün , Zeynep Ülkü; Bahçecioğlu, Ömer Faruk; Gök, SelimAbstract: Linezolid is an antimicrobial drug which has good activity against clinically important gram-positive methicillin and vancomycin resistant microorganisms. However, linezolid is a lifesaving medicine for resistant infections, it can be responsible for severe drug interactions. Linezolid is a nonselective, weak, reversible inhibitor of monoamine oxidase A and B. That is why it can lead to increase activity of concomitant administrated monoamine oxidase inhibitors, serotonergic and adrenergic agents. This study is a one-month retrospective chart review of inpatients at a university hospital. All charts in a 1368 bed university hospital were reviewed via electronic records. Charts, which include linezolid have evaluated by clinical pharmacists and were assessed for prevalence and severity of potential drug-drug interactions using the Up- ToDate drug reference database. Fifty-four patients included in this study. Total number of interactions with linezolid was 86, which was 28.2 percent of all interactions. Eight of these interactions were in X category (avoid combination), 59 were in D category (consider therapy modification) and 19 were in C category (monitor therapy). There wasn’t any interaction classified as category B (no action needed). In our study, it was predicted that serotonergic toxicity and hypertension may develop in many patients due to concurrent administration of linezolid with serotonergic and/or adrenergic drugs. If the coadministration of these drugs is unavoidable, physicians should be alert to the symptoms and management of serotonergic toxicity and hypertension. The number of patients and its retrospective nature were limiting factors of our study. More comprehensive prospective studies are needed.Öğe Mevcut COVID-19 Tedavisine Alternatif Olabilecek İlaçlar ve Kök Hücre Tedavisi(2020) Bahçecioğlu, Ömer Faruk; Gök, Selim; Arısoy, SemaAralık 2019’da Çin’in Wuhan şehrinde tanımlanan ve hızla ya-yılan SARS-CoV-2 virüsü, küresel bir pandemiye yol açmıştır. T.C. Sağlık Bakanlığının önerdiği mevcut tedavi protokolündekiilaçlar (hid-roksiklorokin, azitromisin, lopinavir/ritonavir, favipiravir, tocilizumab) da dâhil olmak üzere, COVID-19 hastalığının tedavisiiçin henüz ka-nıtlanmış bir ilaç yoktur. Bununla birlikte, pek çok molekülün in vitro veya klinik çalışmalarla etkinliği araştırılmaktadır. Arbidol, ribavirin, niklozamit, nitazoksanid, ivermektin gibi antiviral aktivitesi olan ilaç-ların, COVID-19 hastalarındaki etkinliğini değerlendirecek klinik ça-lışmalar başlamıştır. Ayrıca immünomodülatör ve antiinflamatuar etkileri nedeniyle Tip 1 interferonlar, kortikosteroidler, ekulizumab, si-rolimus, bevacizumab, Janus kinaz inhibitörleri, statinler ve kolşisin gibi pek çok ilacın, sitokin fırtınasına bağlı olarak özellikle kritik COVID-19 hastalarında gelişen akut akciğer hasarı ve akut respiratuar distres sendromundaki etkinliği araştırılmaktadır. Bu derlemede, yuka-rıda bahsedilen ilaçlar ve mezenkimal kök hücre tedavisinin etkinliği-nin değerlendirildiğiin vitro ve klinik çalışmalar ele alınmıştır. Klinisyenler, bu çalışmaları yakından takip etmeli ve çalışmaların so-nuçlarına göre mevcut tedavilerin güncellenebileceğini göz önünde bu-lundurmalıdırlar.
