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Öğe 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, MustafaObjective: 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.Öğe Kronik Lenfositik Lösemide Kullanılan Fludarabin Tedavisinden Sonra Gelişen Atipik Herpes Zoster (Zona) Enfeksiyonu: Olgu Sunumu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2011) Demircioglu, Sinan; Aydogdu, İsmet; Kaya, Emin; Kuku, İrfan; Erkurt, Mehmet AliHerpes zoster (zona), varisella zoster virüsünün neden olduğu akut veziküler erüpsiyon ile seyreden bir infeksiyondur. Dermatomal dağılımla sınırlı, tek taraflı ve ağrılı döküntülerle karakterizedir. 49 yaşında, Kafkasyalı, erkek hastada kronik lenfositik lösemi nedeni ile fludarabin tedavisi alırken karının sağ tarafında ağrılı veziküller oluştu. Nötropenik olan hastaya anamnez ve izik muayene ile zona tanısı kondu ve asiklovir tedavisi başlandı. Tedavinin 3. gününde hastanın yüz ve kafa derisi dahil tüm vücüdunda yaygın eritematöz veziküller gelişti. Tzanck testi ile varisella zoster olduğu gösterildi. Asiklovir tedavisine rağmen hastanın akciğerinde diffüz infiltrasyon izlendi, hipertermi ve dispne meydana geldi. Toraks tomoğrafisi pnömoni ile uyumlu idi. Hastanın hipertermisi teikoplanin, meronepem ve intravenöz immünglobuline cevap vermedi. Hasta öldü.Öğe A Real-Life Turkish Experience of Ruxolitinib in Polycythemia Vera(Galenos Publ House, 2023) Serin, Istemi; Dogu, Mehmet Hilmi; Ekinci, Omer; Cagliyan, Gulsum Akgun; Basturk, Abdulkadir; Aras, Merih Reis; Demircioglu, SinanIntroduction: Ruxolitinib is a small -molecule inhibitor of the JAK1/2 pathway. This study aimed to reveal the results and side-effect profile of the use of ruxolitinib as a treatment option in polycythemia vera (PV). Methods: A total of 34 patients with PV from 18 different centers were included in the study. The evaluation of the response under treatment with ruxolitinib was determined as a reduction in spleen volume (splenomegaly size: >= 35%) by imaging and control of hematocrit levels (<= 45%) compared to baseline. Results: While the number of patients in which a reduction in spleen volume and hematocrit control was achieved was 19 (55.9%) at 3 months of treatment, it was 21 (61.8%) at 6 months. Additionally, while the number of side effects was negatively correlated with the reduction in spleen volume (Spearman's rho: -0.365, p=0.034), a decrease in the hematocrit level was positively correlated (Spearman's rho: 0.75, p=0.029). Those without a reduction in spleen volume experienced more constipation (chi-square: 5.988, Fisher's exact test: p=0.033). Conclusion: This study shed light on the use of ruxolitinib in PV and the importance of splenomegaly on studies planned with larger patient groups.Öğe The role of heparin in autologous stem cell mobilization in patients with multiple myeloma(Pergamon-Elsevier Science Ltd, 2025) Sarici, Ahmet; Erkurt, Mehmet Ali; Yilmaz, Seda; Demircioglu, Sinan; Berber, Ilhami; Basturk, Abdulkadir; Merter, MustafaBackground : Autologous hematopoietic stem cell transplantation (aHSCT) has become the standard treatment modality for eligible multiple myeloma (MM) patients. One of the most important parameters affecting the success of transplantation is the number of CD34(+) stem cells collected. The most commonly used agents to facilitate the release of CD34(+) stem cells into peripheral blood are granulocyte colony-stimulating factor and plerixafor. Heparin has also been shown to enhance the release of CD34(+) stem cells into peripheral blood. We aimed to report the effect of heparin on the number of CD34(+) stem cells in peripheral blood in MM patients who underwent aHSCT. Materials and methods : This multicenter retrospective study analyzed 138 adult patients diagnosed with MM who underwent aHSCT. Patients were divided into two groups: those who received heparin (n = 108) and those who did not receive heparin before aHSCT (n = 30). Results : The complete response, partial response, and very good partial response rates in the heparin group were 17 % (n = 18), 24 % (n = 26), and 59 % (n = 64), respectively. In the non-heparin group, 20 % of patients (n = 6) achieved complete response, while partial response and very good partial response rates were 33 % (n = 10) and 47 % (n = 14), respectively. There was no statistically significant difference between the groups regarding obesity, ECOG performance scores, and smoking status (p = 0.399, 0.578, and 0.602, respectively). The number of collected CD34(+) stem cells and the peak CD34(+) stem cell count in peripheral blood were significantly higher in the heparin group compared to the control group (both p < 0.001). Conclusion : Heparin has been shown to enhance the migration of CD34(+) stem cells into peripheral blood and facilitate the peripheral stem cell collection process.
