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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 Daptomycin in combination with rosuvastatin induced blood creatine phosphokinase elevation(Bmj Publishing Group, 2021) Durmus, Mefkure; Bahcecioglu, Omer Faruk; Gok, SelimWe present the case of a 73-year-old male patient who was hospitalised with infective endocarditis, and report an elevation in his blood creatine phosphokinase (CPK) after receiving daptomycin and rosuvastatin therapy concomitantly. His previous home-scheduled medications included apixaban, ivabradine, metformin, rosuvastatin 20 mg, ginkgo biloba and trimetazidine, and he continued to receive these medications at the hospital. After three sets of blood cultures were taken, empirical treatment was started with vancomycin and gentamicin. On the eighth day of treatment, daptomycin and ampicillin-sulbactam were initiated due to ampicillin-resistant Enterococcus faecalis growth in the patient's blood culture. Daptomycin and rosuvastatin were discontinued on the 23rd day of treatment because of blood CPK elevation (2416 U/L) and linezolid was started instead of daptomycin. Six days after discontinuation of daptomycin and rosuvastatin, the CPK concentrations returned to normal range.Öğe Efficacy and safety of ruxolitinib plus extracorporeal photopheresis in acute and chronic graft versus host disease: A single center experience(2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Bahcecioglu, Omer Faruk; Tanriverdi, Lokman Hekim; Berber, İlhami; Kaya, Emin; Biçim, Soykan; Gok, Selim; Özgül, Mustafa; Kuku, İrfanAbstract: Aim: There is no standard treatment for corticosteroid refractory acute and chronic graft versus host disease (GVHD). Ruxolitinib and extracorporeal phopheresis (ECP) are promising treatment options in GVHD. In this study, we aimed to share our clinical experience in steroid refractory GVHD patients treated with ruxolitinib plus ECP. Materials and Methods: The data of patients receiving ruxolitinib plus ECP for corticosteroid refractory acute and chronic GVHD patients were analyzed retrospectively. Results: A total of 11 cases, 6 of which were acute, were included in this retrospective, observational and single-center study. Acute GVHD developed in the 6 patients after allogeneic HSCT (median onset of GVHD=27, between 20 and 60 days ). Chronic GVHD developed in the 5 patients after allogeneic HSCT (median onset of GVHD= 159 between 60 and 380 days. The overall response rate of acute GVHD patients to ruxolitinib ECP combination therapy was 16.7% (complete response: 16.7%, partial response: 0%). The overall response rate of chronic GVHD patients to combination therapy was 60% (complete response: 20%, partial response: 40%). As a result of combination therapy, thrombocytopenia occurred in 36% (4/11) of patients, neutropenia in 27% (3/11) of patients, and CMV reactivation in 9% (1/11) of patients. Conclusion: We observed a low rate of overall response to ruxolitinib plus ECP treatment in acute GVHD patients but a high rate in chronic GVHD patients. According to our trial, ruxolitinib ECP combination may be beneficial in GVHD, especially in chronic GVHD, but prospective trials comparing its efficacy with other agents are needed.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 Is it safe to use remdesivir in combination with a combined p-glycoprotein and CYP3A4 inhibitor?(Bmj Publishing Group, 2021) Bahcecioglu, Omer Faruk; Gok, Selim; Durmus, Mefkure[Abstract Not Available]Öğe Is sitagliptin effective for the treatment of COVID-19?(Bmj Publishing Group, 2022) Memis, Hasan; Cakir, Ahmet; Durmus, Mefkure; Gok, Selim; Bahcecioglu, Omer Faruk[Abstract Not Available]Öğe Is there any difference between busulfan-cyclophosphamide and cyclophosphamide-busulfan in patients underwent allogeneic transplantation?(Elsevier, 2021) Bahcecioglu, Omer Faruk; Gok, Selim; Durmus, Mefkure; Sarici, Ahmet[Abstract Not Available]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 Monoamine Oxidase-B (MAO-B) Inhibitors in the Treatment of Alzheimer's and Parkinson's Disease(Bentham Science Publ Ltd, 2021) Ozdemir, Zeynep; Alagoz, Mehmet Abdullah; Bahcecioglu, Omer Faruk; Gok, SelimBackground: The MAO enzyme is presented in the brain and peripheral tissues and is a significant enzyme that is responsible for the deamination of biogenic amines and thus the regulation of neurotransmitter levels. The reaction of these neurotransmitters with the MAO enzyme produces aldehyde and free amine. MAO enzyme consists of two isoforms, MAO-A and MAO-B, which are characterized by amino acid sequence, three-dimensional structure, substrate preference, and inhibitor selectivity. Dopamine, tyramine, and tryptamine are substrates of both MAO isoforms and MAO inhibitors such as clorgiline and selegiline, which are used as medications in neurodegenerative and neurological diseases. In particular, MAO-A inhibitors are used in the treatment of depression, while MAO-B inhibitors are used in the treatment of Parkinson's disease. It is also investigated whether MAO-B inhibitors are effective in the treatment of Alzheimer's disease. Nowadays, life expectancy has increased, as a result, neurodegenerative diseases such as Parkinson's and Alzheimer's disease have started to occur more frequently. The elderly population is increasing day by day. As a result of these common diseases in elderly people, these people are unable to do their jobs and need care. Therefore, these diseases have become a significant health problem in society. Methods: In this study, review, inclusion, and exclusion criteria were used. Peer -reviewed research articles were searched. The quality of the examined articles was evaluated with standard tools. The information obtained was analyzed conceptually by using qualitative content analysis methodology. Results: One hundred and five papers were included in the review. The current MAO-B inhibitors and their usage areas are discussed together with the structures of the drugs; also, their possible effects in Alzheimer's and Parkinson's treatment are evaluated. In addition, different articles have been compiled in which structures such as arylalkylamines, chalcones, benzoquinone, benzoxazinone, and chromen are substituted with various functional groups and aromatic rings, along with thestructures of 44 different compounds that have recently been developed and their inhibitory effects on MAO-B enzyme. As a result, the structure required for MAO-B inhibition and SAR studies is discussed. Conclusion: Many studies demonstrate that MAO-B activity increases with age in brain tissue, cerebrospinal fluid (CSF), and platelets in Alzheimer's patients. This suggests that MAO-B inhibitor drugs, which may be effective in the treatment of Parkinson's disease, may also be effective in the treatment of Alzheimer's disease. This article was written to explain the multifaceted MAO-B inhibitor molecules.Öğe The safety profile of favipiravir in COVID-19 patients with severe renal impairment(Wiley-Hindawi, 2021) Gok, Selim; Bahcecioglu, Omer Faruk; Durmus, Mefkure; Gun, Zeynep Ulku; Ersoy, Yasemin; Aytemur, Zeynep Ayfer; Ulutas, OzkanObjective The safety profile of favipiravir in patients with severe renal impairment has not been investigated and available data are insufficient. The study aimed to compare the incidence of favipiravir-associated adverse events amongst patients with varying renal function statuses. Methods Records of 921 patients who were hospitalised for COVID-19 and had received at least 5 days of favipiravir treatment were retrospectively evaluated and 228 patients were included in the study. Patients' age, sex, comorbidities, estimated glomerular filtration rate (eGFR) and haematological and biochemical values were recorded. The incidence of adverse events was compared with the age, sex, comorbidities and eGFR of the patients. Results The mean age of the patients was 59.3 +/- 15.6 years, and 38.2% of the patients were women. One hundred and thirty-one (57.5%) patients had experienced adverse events. These adverse effects consisted of ALT elevation (35.5%), AST elevation (21.5%), anaemia (16.2%), hyperuricaemia (10.5%), hepatocellular injury (9.2%), neutropenia (3.5%) and thrombocytopenia (2.6%). The incidence of adverse events was not significantly different when patients had eGFR >60 mL/min/1.73 m(2) or eGFR 30-60 mL/min/1.73 m(2) (P > .05), but significantly increased when the eGFR dropped to <30 (P < .05). The differences seen with hyperuricaemia and anaemia were significant (P < .05). Conclusion Even though favipiravir appeared to be well tolerated in the individuals with renal failure in this study, its use in this population remains a challenge that requires more research and analysis.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.
