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    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, Soykan
    Congenital 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.
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    Fingolimod induced fulminant liver failure requiring liver transplantation: A case report
    (Kare Publ, 2023) Caliskan, Ali Riza; Harputluoglu, Muhsin Murat Muhip; Samdanci, Emine; Cirik, Salih; Yilmaz, Sezai
    Fingolimod has been used for about ten years to treat multiple recurrent sclerosis. It has been reported that Fingolimod causes an elevation in liver enzymes. In this case report, the clinical and laboratory parameters improved after discontinuation of the drug. However, there is no publication in the literature regarding acute liver failure and liver transplantation following Fingolimod treatment. In this article, we presented a 33 - year - old female patient who developed acute liver failure and underwent liver transplantation after Fingolimod treatment for recurrent multiple sclerosis.
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    Fresh and cryopreserved stem cell transplantation in myeloma patients: Does it make a difference on transplant outcomes?
    (Pergamon-Elsevier Science Ltd, 2025) Erkurt, Mehmet Ali; Yilmaz, Seda; Namdaroglu, Sinem; Demircioglu, Sinan; Sarici, Ahmet; Cirik, Salih; Koroglu, Mustafa
    Objective: The standard approach for multiple myeloma patients eligible for transplantation includes 4-6 cycles of induction therapy, followed by autologous stem cell transplantation (aHSCT). The aHSCT process starts with stem cell mobilization and collection, followed by high-dose chemotherapy and reinfusion of the harvested stem cells. These cells can be infused fresh within 24-48 h post-collection or cryopreserved for future use. Herein we analyzed the outcomes of aHSCT patients receiving infusions of fresh versus cryopreserved hematopoietic stem cells. Materials and methods: This multicenter retrospective study analyzed 88 adult patients diagnosed with multiple myeloma who underwent aHSCT (n = 43 for cryopreserved; n = 45 for fresh infused group). Results: A total of 88 patients were included in the study. 39.7 % of patients were female and 60.3 % of patients were male. No correlation was observed between pre-mobilization disease status, mobilization regimen, and disease risk status as defined by the R-ISS system (p = 0.1, p = 0.8). The median neutrophil engraftment time was 10 days in the fresh group and 12 days in the cryopreserved group (p < 0.01). In contrast, the median platelet engraftment time was 12 days in the fresh group and 11 days in the cryopreserved group (p < 0.01). Engraftment was achieved in all patients included in the study. Conclusion: The shorter neutrophil engraftment time in the fresh group and the shorter platelet engraftment time in the cryopreserved group, along with successful engraftment in all patients, suggest that both options are reasonable within the MM aHSCT protocol.