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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 Concurrent congenital hemophilia B and acquired hemophilia A: a unique case report(Lippincott Williams & Wilkins, 2024) Cirik, Salih; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Hidayet, Emine; Bicim, SoykanCongenital hemophilia B is a rare X-linked recessive bleeding disorder caused by factor IX deficiency. Acquired hemophilia A is a rare, acquired bleeding disorder that presents with new-onset bleeding, especially in older adults, due to the development of auto-antibodies against factor VIII (FVIII). This case report presents the medical management of a patient with congenital hemophilia B and acquired hemophilia A. We highlight the limitations of maintaining factor levels with factor replacement therapy alone, particularly in hemophilia patients who have developed factor inhibitors. In addition, we draw attention to the need for dose escalation, the cost, and the need for immune-tolerance induction therapy. This case illustrates that when the current diagnosis does not explain the full clinical picture and laboratory data are inadequate, it is important to continue to seek alternative diagnoses and cost-effective treatment.Öğe Convalescent plasma therapy in COVID-19(2022) Uysal, Ayşe; Erkurt, Mehmet Ali; Kuku, Irfan; Sarici, Ahmet; Bicim, Soykan; Kaya, Emin; Berber, IlhamiThe coronavirus disease 2019 (COVID?19) affected many people in a short time and 5-10% of them were severely affected by the disease. A variety of treatment methods have been developed for this rapidly spreading disease and vaccine studies have been initiated. One of these treatment methods is convalescent plasma (CP) therapy which is a passive immunization therapy. CP method is based on the principle of giving the plasma containing the antibodies formed against the pathogen to people who have active disease after they have recovered from the disease which is a very effective but short-term solution until a definitive and permanent treatment (vaccine, drug, etc.) is found in pandemic conditions. Here, we presented the use of CP in the COVID-19 pandemic.Öğe Does ferritin level affect the outcomes of autologous stem cell transplantation equally in all diseases?(Pergamon-Elsevier Science Ltd, 2023) Uysal, Ayse; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Sarici, Ahmet; Berber, Ilhami; Bicim, SoykanBackground: In this retrospective study, we evaluated the effect of ferritin levels on the outcomes of autologous stem cell transplantation in patients with MM or lymphoma.Methods: In this study, 170 patients with measured ferritin levels within one month before transplantation who underwent ASCT with the diagnosis of MM or lymphoma were evaluated. The cut-off value of ferritin was determined as 500 ng/mL to evaluate the transplant outcomes in both groups. The hematological recovery status/duration, febrile neutropenia rate, hospitalization time, transplant-related mortality (TRM) in the first 100 days, and OS were evaluated according to the ferritin levelResults: Of all patients, 105 (61,8%) were diagnosed with MM and 65 (38.2%) with lymphoma. Ferritin levels had no statistically significant effect on the engraftment status/times, the febrile neutropenia rates, and hospitalization times of both lymphoma and myeloma patients (p > .05). Ferritin level was not significantly associated with TRM in MM (p = .224). However, in lymphoma, ferritin level was significantly associated with TRM (33.3% for ferritin level & GE;500 ng/L vs. 5.3% for ferritin level ng/mL, p = .005). There was no statistically significant correlation between ferritin value and OS in MM group [ferritin level & GE; 500 ng/L: 39.9 months (95% CI: 33.7-46.1) and ferritin level 500 ng/mL: 39.4 months (95% CI: 36.5-42.2), p = .446]. Ferritin level was significantly associated with OS in patients with lymphoma [ferritin level & GE; 500 ng/L: 22.1 months 95% CI: 14.7-29.5), ferritin level 500 ng/mL: 27.3 months (95% CI: 22.4-32.2), p = .038]Conclusion: High ferritin level is important prognostic factor on survival after ASCT in patients with lymphoma.Öğe The effect of comorbidity on survival and collected CD34+cell counts in autologous hematopoietic stem cell transplant patients(Pergamon-Elsevier Science Ltd, 2022) Sarici, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Bahcecioglu, Omer Faruk; Bicim, Soykan; Kaya, Emin; Berber, IlhamiObjective: In this study, we aimed to report the effectiveness of hematopoietic cell transplantation-specific comorbidity index (HCT-CI) and GATMO scores in predicting overall survival (OS) who underwent autologous stem cell transplantation (ASCT). Material and methods: The data of 263 MM and 204 lymphoma patients who underwent ASCT in the last 11 years were retrospectively analyzed. Results: Neutrophil engraftment time, thrombocyte engraftment time and collected CD34+ cell counts were similar in MM patients with HCT-CI 2 (all p 2 tended to be higher than those with HCT-CI 2 was 51.5 months, the estimated median OS of patients with HCT-CI 2 was 9.5 months (p=0.012). When lymphoma patients were divided into four groups according to their GATMO scores, the OS of the four groups was found to be different from each other (p<0.001). Conclusion: HCT-CI and GATMO scores predict OS in lymphoma patients but not MM patients.Öğe The effect of cryopreserved and noncryopreserved stem cells on the outcome of autologous stem-cell transplantation in multiple myeloma patients: A single-center experience(Wolters Kluwer Medknow Publications, 2022) Uysal, Ayse; Erkurt, Mehmet A.; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Sarici, Ahmet; Bicim, SoykanBackground The CD34+ stem cells are either noncryopreserved (non-CP) or cryopreserved (CP) in autologous stem-cell transplantation (ASCT). Some retrospective studies have shown that engraftment failure and engraftment rate are similar in CP cells and infusion reactions are lower in CP cells due to the absence of dimethyl sulfoxide. Objective In this study, we presented our clinical experience comparing the outcomes and safety of ASCT with CP and non-CP stem cells. Patients and methods A total of 163 patients were enrolled between January 2019 and June 2021. Duration of neutrophil/platelet engraftment, rates of infusion-related reactions, febrile neutropenia, and duration of hospitalization were compared between the CP and non-CP groups. Results Fifty five (33.7%) received CP cells, 108 (66.3%) received non-CP cells. The median dose of CD34+ cells was similar in both groups (P=0.755). The median duration of neutrophil and platelet engraftment was not statistically significantly different in CP and non-CP groups (P=0.896 and 0.183, respectively). No statistical difference was observed in the median duration of hospitalization between the two groups [CP: 16 (13-26) vs. non-CP: 15 (11-31) days, P=0.124]. The febrile neutropenia rate was higher in the CP group, but there was no statistical difference between the two groups (CP: 56.4% vs. non-CP, 48.1%, P=0.301). The rates of infusion-related reaction such as nausea, vomiting, and rash were higher in the CP group (21.8 vs. 12%), with no statistically significant difference (P=0.159). Conclusion Non-CP cells have similar outcomes to CP cells and lower toxicity than CP cells, which are safe and effective in ASCT.Öğe Effect of extracorporeal photopheresis on survival in acute graft versus host disease(Wiley, 2023) Kaya, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Bicim, Soykan; Hidayet, EmineBackground: Extracorporeal photopheresis (ECP) is the main non-pharmacological approach accompanying systemic medical treatments in steroid-resistant acute or chronic graft versus host disease. The study aimed to examine the effect of ECP on survival in acute graft versus host disease (aGVHD).Methods: A total of 35 patients who were followed up in the adult hematology clinic of Inonu University Turgut ozal Medical Center for aGVHD were included in the study. Stem cell transplantation and ECP application parameters that may affect the survival of the patients were examined.Results: In aGVHD using ECP, the degree of involvement affects survival. Involvements with a clinical and laboratory score (Glucksberg system) of 2 and above significantly reduced survival. The duration of ECP use is associated with survival. Especially, 45 days and longer use increases survival (hazard ratio, P-value <.05). The duration of steroid use was found to be effective in survival in aGVHD (P < .001). ECP administration day (P = .003), duration of steroid use (P < .001), duration of ECP use (P = .001), and grade of aGVHD (P < .001) affect survival.Conclusion: ECP use is effective in survival in patients with aGVHD score =2. In patients with aGVHD, especially the use of 45 days and longer has a positive effect on survival. The duration of steroid use is associated with survival in aGVHD.Öğe The effect of G-CSF used after allogeneic hematopoietic stem cell transplantation on engraftment times and platelet suspension replacement numbers(Pergamon-Elsevier Science Ltd, 2022) Sarici, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Bicim, Soykan; Hidayet, EmineBackground: With the use of granulocyte colony stimulating factor (G-CSF) after allogeneic hematopoietic stem cell transplantation (HSCT), the duration of neutrophil engraftment and hospitalization were shortened. How-ever, there is no consensus on the effect of G-CSF on platelet engraftment time. The primary aim of our study is to determine the effect of G-CSF use on platelet engraftment time after HSCT. Secondary purposes are to determine the number of platelet suspension, number of erythrocyte suspension and incidence of acute graft versus disease after HSCT. Material and methods: Patients who had allogeneic stem cell transplantation at our center between 01.01.2011 and 01.01.2022 were retrospectively analyzed. Patients were divided into 2 groups as those who received and did not receive G-CSF after transplantation. Results: A total of 64 patients were included. While 32 patients were given post-HSCT G-CSF support, the other 32 patients were not given. Neutrophil engraftment time and length of hospital stay were shorter in the group receiving G-CSF (p < 0.05). Platelet engraftment time was shorter in the group that did not receive G-CSF (p < 0.05). The incidence of acute GVHD of the patients in group 1 tended to be higher than the patients in group 2 (40.6 % vs 15.6 %, p = 0.052). Post-HSCT platelet suspension was less in the group that did not receive G-CSF, but this difference was not statistically significant (p = 0.173). Conclusion: While the positive effect of post HSCT G-CSF use on duration of neutrophil engraftment and hospi-talization is evident, its effects on platelet engraftment need to be investigated.Öğe The effect of preemptive use of plerixafor on stem cell mobilization in patients with lymphoma and multiple myeloma(Marmara Univ, Fac Medicine, 2023) Uysal, Ayse; Erkurt, Mehmet Ali; Kuru, Irfan; Kaya, Emin; Berber, Ilhami; Sarici, Ahmet; Bicim, SoykanObjective: The aim of this study is to investigate the effect of the preemptive use of plerixafor in patients with lymphoma and multiple myeloma which was administered as a preemptive single dose to the patients who were determined to have a CD34+ cell count of <15/ mu L in the peripheral blood (PB) on the 4th day of mobilization.Patients and Methods: Thirty-five patients who were administered plerixafor on the 4th day after granulocyte colony-stimulating factor (G-CSF) alone for stem cell mobilization between January 2020 and November 2021 were included. CD34+ stem cell counts in PB before and after plerixafor, the amount of CD34+ stem cells collected, and the outcome of transplantation was examined.Results: The median CD34+ cell count in PB on the 4th day was 5.2/mu L (0.1-13.4), which was determined to increase 206.6-fold (31.5749347) to 924.80 /mu L (295.00-5056) following the administration of plerixafor on the 5th day (Z=-5.160; r= - 872.2; p<0.0001). The number of apheresis sessions was 1 in all patients. The median collected CD34+ cell count was 5.90x106/kg (2.70x106-14.4x106).Conclusion: The use of preemptive plerixafor shows that it is an effective mobilization method by increasing the rate of stem cell collection at an effective dose and reducing the mobilization time/apheresis sessions.Öğe The effect of therapeutic plasma exchange on management of HELLP Syndrome: The report of 47 patients(Pergamon-Elsevier Science Ltd, 2021) Erkurt, Mehmet Ali; Sarici, Ahmet; Kuku, Irfan; Berber, Ilhami; Kaya, Emin; Bicim, Soykan; Karaman, SevtapBackground and objectives: HELLP syndrome is a life-threatening condition that may potentially cause complications during pregnancy. If not diagnosed and treated quickly, HELLP syndrome may lead to serious complications both for the mother and the baby. The aim of this study was to determin the effectiveness of therapeutic plasma exchange (TPE) for treatment of Class-I HELLP syndrome. Materials and Methods: Laboratory results from 47 patients with Class-I HELLP syndrome patients who underwent TPE between 2011 and 2020 were recorded before and after the procedure. A central venous catheter was inserted, and TPE was performed in patients who had not responded to delivery, steroid, and supportive therapy (blood products, anti-hypertensive therapy, intravenous fluid administration, and antibiotics) within 24 hours after the diagnosis of Class I HELLP syndrome according to the Mississippi Criteria. Results: The average age of patients was 33 +/- 4.7 years (range; 21-39 years). A mean of 5 (range; 4 to 6) TPE sessions were performed. There was a statistically significant decrease in total bilirubin, lactic dehydrogenase, aspartate aminotransferase, and alanine aminotransferase levels in all patients, whereas a significant increase in platelet count was observed (p < 0.05). Furthermore, clinical and laboratory improvement was achieved. Conclusion: In all patients with HELLP syndrome, a dramatically clinical and laboratory improvement occurred after TPE. Our study suggests that postpartum use of TPE within 24 hours is an efficient treatment option for Class-I HELLP syndrome.Öğe The effect of thrombocytapheresis on hemogram and biochemistry parameters in patients with essential thrombocytemia(Elsevier France-Editions Scientifiques Medicales Elsevier, 2023) Kaya, Ahmet; Kuku, Irfan; Erkurt, Mehmet Ali; Kaya, Emin; Berbera, Ilhami; Bicim, Soykan; Hidayet, EmineBackground: Essential thrombocythemia is one of the chronic myeloproliferative neoplasms characterized by clonal proliferation of myeloid cells with variable morphological maturation and hematopoietic activity. It is characterized by excessive clonal platelet production with a tendency to thrombosis and bleeding. Thrombocytapherests is the removal of platelets by apheresis techniques. Thrombocytapherests is generally recommended in patients with essential thrombocythemia with acute, severe thrombotic or hemorrhagic events.Methods: The study included 39 patients who were diagnosed with essential thrombocythemia, started cytoreductive and aspirin therapy, and underwent thrombocytapherests due to the development of acute severe thrombotic or hemorrhagic events, diagnosed in the adult hematology clinic of I_nonu University Turgut Ozal Medical Center. Hemogram and biochemistry values of the patients were scanned retrospectively.Results: After thrombocytapherests, a statistically significant difference was found between the first and last measurements of hemoglobin, mean platelet volume, White blood cell, neutrophil, platelet, platelet distribution width, creatine, lactate dehydrogenase, fibronogen and calcium levels of the patients. Conclusion: The use of thrombocytapherests in patients with essential thrombocytosis causes a rapid decrease in platelet values as well as an effect on hemogram and biochemistry parameters. Other hemogram and biochemistry parameters such as platelet value should be monitored in patients.(c) 2023 Societe francaise de transfusion sanguine (SFTS). Published by Elsevier Masson SAS. All rights reserved.Öğe Etiological evaluation and the role of plasma exchange treatment in trombotic microangiopathies: A retrospective analysis from Eastern Anatolia(2022) Hidayet, Emine; Erkurt, Mehmet Ali; Sarici, Ahmet; Bicim, Soykan; Berber, Ilhami; Kuku, Irfan; Kaya, Emin; Kaya, Ahmet; Özgül, MustafaThe aim is this study was to make the etiological classification of patients diagnosed with TMA in our region and to statistically evaluate the effect of therapeutic plasma exchange, which we use in treatment, on laboratory recovery and mortality. In our study, between 2009-2017, 85 patients diagnosed with TMA in our center evaluated retrospectively. Thirty- one (36.5%) of our patients were followed up with HELLP, 23 with thrombotic thrombocytopenic purpura (TTP) (27.1%), 20 (23.5%) snake bites, and 11 (12.9%) with atypical hemolytic uremic syndrome (aHUS). TPE treatment was performed in all patients. TPE treatment was found effective in patients with HELLP syndrome, TTP and snake bite and statistically significant improvement was obtained in laboratory parameters (p<0.05). However, TPE treatment was not found to be effective in the treatment of atipical HUS (p>0.05). Mortality rates were found 9.7%, 21.7%, 27.3%, and 0% in patients with HELLP Syndrome, TTP, aHUS, and snake bite, respectively. The primary treatment in HELLP syndrome was termination of pregnancy, it was observed in our study that TPE was effective in TTP, HELLP syndrome and snake bites and treatment should be started without delayÖğe Evaluation of busulfan, cyclophosphamide, and etoposide as a preparation regimen for autologous stem cell transplantation in Hodgkin's lymphoma patients(Wolters Kluwer Medknow Publications, 2024) Bicim, Soykan; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Kaya, Ahmet; Hidayet, EmineBACKGROUND: Hodgkin's lymphoma (HL) exhibits a cure rate of 90% in patients diagnosed at an early stage and a cure rate ranging from 70% to 90% in patients diagnosed at an advanced stage. In the case of patients with relapsed/refractory HL (r/rHL), it is recommended to provide salvage chemotherapy initially, followed by autologous stem cell transplantation (ASCT). The ideal conditioning regimen for the transplantation process is still being investigated.OBJECTIVES: For individuals with r/rHL, high-dose chemotherapy combined with ASCT (HD-ASCT) is thought to be the most effective method of treatment. The purpose of this research was to evaluate the effectiveness and safety of the busulfan, cyclophosphamide, and etoposide (BuCyE) preparation regimen in r/rHL patients.MATERIALS AND METHODS: Retrospective analysis was conducted on the data of 67 lymphoma patients older than 18 years who had HD-ASCT with the BuCyE conditioning regimen between September 2014 and November 2021 (86 months). The research consisted of 34 r/r HL patients among them. A parenteral regimen of 0.8 mg/kg of busulfan every 6 h from day -7 to day -5, 50 mg/kg of cyclophosphamide on days -3 and -2, and 400 mg/m2 of etoposide on days -5 and -4 comprised the patient preparation regimen before ASCT. All data were collected from inpatient files and the Inonu University Turgut Ozal Medical Center Hospital Information System.RESULTS: The median age of the patients was 43 years, and 67.6% were males. The most common type of HL was nodular sclerosis, which was followed by mixed cellularity. The median time for platelet and neutrophil engraftment was 14 and 11 days, respectively. 5.0 x 106/kg was the median transplanted dose of CD34+ cells (2.1-13.55). Liver toxicity was observed in 6 (17.6%) patients. Eight patients suffered from pulmonary side effects. The median number of previous chemotherapies was 2 (2-4). In all lymphoma patients, the complete response rate was 61.8% (n = 21), whereas the disease progression rate was 32.3% (n = 11). Transplantation-related mortality on the 100th day was 8.8% (n = 3). Three-year overall survival was 57.17%.CONCLUSION: When the literature was reviewed, the studies with the BuCyE preparation regimen in patients with r/rHL were limited. This conditioning regimen was found to have fewer side effects and a lower cost. It can be preferable when compared to carmustine (BCNU), etoposide, cytarabine (ARA-C), and melphalan (known as BEAM) in r/rHL.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 Experience of Ibrutinib in Chronic Graft-Versus-Host Disease in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: Single Center Experience(Galenos Publ House, 2023) Sarici, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Bicim, Soykan; Hidayet, EmineIntroduction: Chronic graft-versus host disease (GVHD) is a serious complication that develops in 35-50% of patients in the late period after allogeneic hematopoetic stem cell transplantation. About half of the patients are resistant to corticosteroids, which is the first-line treatment of chronic GVHD, and therefore new treatment options that can be effective in chronic GVHD are needed. In the present study, we aimed to share our experience with the use of ibrutinib therapy in patients with steroid-resistant chronic GVHD who have previously received multiple lines of systemic therapy. Methods: The characteristics and clinical outcomes of steroid-resistant chronic patients with GVHD receiving ibrutinib were retrospectively reviewed. Results: A total of 10 steroid resi-stant chronic patients with GVHD who received ibrutinib was included. While 50% of the patients had more than one organ involvement, 50% had a single organ involvement. The most commonly affected organs were the skin and liver. The patients received a median of three lines of systemic therapy before ibrutinib. After a median of 210 days of ibrutinib usage, the complete response rate of patients was 40% and the partial response rate was 40%. Corticosteroids were completely discontinued in 30% of patients after ibrutinib were initiated. Before ibrutinib, patients were given a median of 0.3 mg/kg methylprednisolone. The median methylprednisolone dose after ibrutinib was 0.03 mg/kg. Conclusion: Ibrutinib therapy causes a quite high overall response in steroid resistant chronic patients with GVHD and appears to be a good option in these patients.Öğe Filgrastim alone versus cyclophosphamide and filgrastim for mobilization in multiple myeloma patients(Pergamon-Elsevier Science Ltd, 2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Bahcecioglu, Omer Faruk; Gok, Selim; Kuku, Irfan; Bicim, Soykan; Berber, IlhamiBackground and objective: High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is standard treatment approach in most multiple myeloma (MM) patients. Before ASCT, chemomobilization or only granulocyte-colony stimulating factor (G-CSF) mobilization can be preferred in stem cell mobilization. The primary aim of the study is to compare the effect of the two mobilization regimens on hematopoietic engraftment times, CD34+cell counts and number of apheresis required to harvest stem cells. Materials and methods: The records of MM patients who applied to our hospital between 2010 and 2020 were analysed retrospectively. Patients were divided into two groups (Group A: Cyclophosphamide plus filgrastim, Group B: Filgrastim alone) according to the mobilization regimen. Results: A total of 223 MM patients were included in this study (Group A:153, Group B:70 patients). When the patients in Group A and Group B were compared, the number of collected CD34+ cells were higher in Group A (p < 0.001). However, there was no significant difference between the two groups in terms of median times to neutrophil and platelet engraftment, and number of apheresis required to harvest stem cells (p > 0.05). The rate of infection development during mobilization in the patients in group A and the duration of hospitalization of these patients were higher than the patients in group B (p < 0.001). Patients receiving >6 cycles of chemotherapy and immunomodulatory treatment had lower collected CD34+ cells than other patients (p = 0.012 and p = 0.054). Conclusion: Based on our findings, filgrastim alone seems to provide a sufficient amount of stem cells in MM patients.Öğe The frequency of HLA A, B, C, DP, DQ, DR allele in patients of Turkish and Syrian nationals with allogeneic stem cell transplantation(Wolters Kluwer Medknow Publications, 2022) Kaya, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Bicim, Soykan; Hidayet, EmineBACKGROUND: In allogeneic stem cell transplantation, donor and recipient HLA tissue compatibility is essential for the success of stem cell transplantation. HLA tissue compatibility percentage is the most important parameter that increases the success of transplantation in donor selection. Pretransplant HLA tissue typing can be looked at in low and high resolution according to the facilities of the center and the urgency of transplantation. Many centers evaluate HLA HLA-A, B, C, DP, DQ, DR tissue types before allogeneic bone marrow transplantation. HLA tissue types differ in many races and even between unrelated individuals of the same race. AIMS: This study aimed to show the common human leukocyte antigen (HLA) rates and differences in Syrian and Turkish ethnicity patients who underwent allogeneic stem cell transplantation in our center. MATERIALS AND METHODS: HLA tissue similarities between Turkish and Syrian patients were revealed by examining the HLA tissue records of Turkish and Syrian patients who applied to the bone marrow transplant unit of Inonu University Turgut Ozal Medical Center between December 2009 and November 2021 for allogeneic stem cell transplantation. RESULTS: As a result of our study, it has been observed that there are similarities in terms of HLA A*02, HLA B*35, HLA C 04,07,12, HLA DP*02,04,11 HLA DQ*02,03,05,06, HLA DR*01,03,11,13 in Turkish and Syrian patients. High resolution HLA subgroups of the patients are shown in Tables three and four. CONCLUSION: In allogeneic stem cell transplantation, there may be similar HLA tissue types among ethnic groups.Öğe Lenograstim versus filgrastim in mobilization before autologous hematopoietic stem cell transplantation in patients with multiple myeloma and lymphoma-Single center experience(Pergamon-Elsevier Science Ltd, 2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Bahcecioglu, Omer Faruk; Bicim, Soykan; Berber, Ilhami; Gok, Selim; Kaya, EminObjective Peripheral blood stem cell transplantation is frequently used in the treatment of various hematological malignancies after intensive chemotherapy. The primary aim of our study is to compare the amount of collected CD34+ cells and engraftment times in patients mobilized with filgrastim or lenograstim. Material and Methods Demographic and clinical data of multiple myeloma (MM) and lymphoma patients who underwent autologous transplantation and mobilized with G-CSF (filgrastim or lenograstim) without chemotherapy were collected retrospectively. Results One hundred eleven MM and 58 lymphoma patients were included in the study. When mobilization with filgrastim and lenograstim was compared in MM patients, there was no significant difference in neutrophil and thrombocyte engraftment times of lenograstim and filgrastim groups (p = 0.931 p = 0.135, respectively). Similarly, the median number of CD34+ cells collected in patients receiving filgrastim and lenograstim was very similar (4.2 x 10(6)/kg vs 4.3 x 10(6)/kg, p = 0.977). When compared with patients who received lenalidomide before transplantation and patients who did not receive lenalidomide, the CD34+ counts of the two groups were similar. However, neutrophil and platelet engraftment times in the group not receiving lenalidomide tended to be shorter (p = 0.095 and p = 0.12, respectively). When lymphoma patients mobilized with filgrastim and lenograstim were compared, neutrophil engraftment time (p = 0.498), thrombocyte engraftment time (p = 0.184), collected CD34+ cell counts (p = 0.179) and mobilization success (p = 0.161) of the groups mobilized with filgrastim and lenograstim were similar. Conclusion The superiority of the two agents to each other could not be demonstrated. Multi-center prospective studies with larger numbers of patients are needed.Öğe Life saving effect of early use of convalescent plasma in Covid-19 treatment(2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Bicim, Soykan; Berber, Ilhami; Kaya, Emin; Ozgul, MustafaAcute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus, which is detected by the transmission from bat to person in Wuhan Province of China, has shown its effect all over the world in a very short time. There is no treatment method proven effective in Coronavirus disease 2019 (COVID-19) pandemics. The whole world is still working on it. Convalescent Plasma (CP) treatment is a passive antibody treatment that has been shown to be effective during periods of epidemic disease in history. CP treatment is interesting in the treatment of virus infection without vaccine or specific treatment, such as SARS-CoV-2, which causes COVID-19. The mechanisms of action of CP include neutralizing the virus by direct binding, initiating virus elimination by complement activation, antibody-dependent cellular cytotoxicity and / or phagocytosis. Neutralizing antibodies are the most important mechanisms of action. The most important point in recovery is the inactivation of the virus and the prevention of viral replication. It was demonstrated for the first time that CP significantly reduced mortality in COVID-19 disease. Our results of CP treatment in COVID-19 patients have been published. We have shown that CP is effective and safe in COVID-19 disease. We aimed to gather CP experiences up to date in COVID-19.Öğe Selection of the mobilization regimen in lymphoma patients: A retrospective cohort study(Pergamon-Elsevier Science Ltd, 2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Gok, Selim; Bahcecioglu, Omer Faruk; Bicim, Soykan; Berber, IlhamiBackground and objectives: Consolidation with autologous stem cell transplantation (ASCT) is recommended for patients with recurrent or refractory lymphoma after salvage chemotherapy. Stem cells which will be used in ASCT are provided by mobilization using granulocyte colony stimulation factor (G-CSF) or chemotherapy plus GCSF. The aim of this study was to compare the effect of various mobilization regimens on the clinical parameters of lymphoma patients. Materials and methods: Mobilization interventions of lymphoma patients were analysed retrospectively. The patients were divided into 3 groups according to the mobilization method implemented to collect stem cells before ASCT, (Group 1: Salvage chemotherapy plus G-CSF, Group 2: Cyclophosphamide plus G-CSF, Group 3: GCSF alone). Results: Analysis of CD34+ cell counts of the 3 groups revealed a significant difference (p 0.001). Although the number of CD34+ cells collected were different, the neutrophil and platelet engraftment of the 3 groups were similar (p 0.05). Furthermore, the results were similar in the separate analysis of NHL and HL patients. While the mobilization success rate in group 1 was 97.8 %, it was 90.2 % in group 3. This difference showed a certain trend towards statistical significance (p = 0.074). Patients who received DHAP plus G-CSF had a higher CD34+ count, while neutrophil engraftment was shorter than with ESHAP plus G-CSF (p < 0.05). Conclusion: Although the success rate of mobilization and number of CD34+ cell collected were higher in the salvage chemotherapy plus G-CSF than G-CSF alone, G-CSF alone group provided similar neutrophil and thrombocyte engraftment in most lymphoma patients.
