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Öğe Allojenik kök hücre nakli uygulanan hastalarda geç dönem enfeksiyon dışı komplikasyonların retrospektif incelenmesi(İnönü Üniversitesi, 2020) Karaman, Sevtap; Erkurt, Mehmet Alı?Amaç: Bu çalışmanın amacı allojenik hematopoetik kök hücre nakli ( AHKHN) yapılmış hastalarda geç dönem enfeksiyon dışı komplikasyonları incelemektir. Gereç ve yöntem: İnönü Üniversitesi Turgut Özal Tıp Merkezi Hematoloji Bilim Dalı'nda 01.02.2011- 31.12.2018 tarihleri arasında hematopoetik kök hücre nakli yapılan 206 hastanın dosyası retrospektif olarak sistem üzerinden incelendi. Bulgular: Çalışmaya dahil edilen 143 hastada gelişen geç dönem enfeksiyon dışı komplikasyonlar incelendiğinde %68 inde geç dönemde komplikasyon geliştiği gözlendi. Elli yaş altı ve üstü komplikasyon gelişme oranları arasında fark görülmedi. Hastaların %33 ünde kronik Graft Versus Host Disease (GVHD) geliştiği gözlendi. En sık cilt ve karaciğer GVHD' ye rastlanıldı. Hastalarda gelişen endokrin, hepatik, cilt, oküler, oral, nörolojik, pskiatrik, renal komplikasyonlar dosya taramaları ile analiz edildi. Sistem komplikasyonları büyük oranda GVHD ve tedavisi ile bağlantılı görülmekle birlikte verilen hazırlık rejimine, tedavilere, primer hastalığa bağlı komplikasyonlara da rastlanıldı. Hepatik komplikasyonlardan karaciğer fonksiyon testleri (KCFT )yüksekliğine en sık GVHD ve ilaç toksisitesinin neden olduğu görüldü. Endokrin komplikasyonlar içerisinde en çok tip 2 Diyabetes Mellitus (DM) ve tiroid fonksiyon bozukluğu ile tespit edildi. Cilt komplikasyonlarının daha çok Herpes Simplex virüs (HSV) ve Herpes Zoster gibi viral nedenli olduğu saptandı. Oküler ve oral komplikasyonlar daha çok GVHD' nin tutulumu yahut tedavisi ile ilgili olduğu görüldü. Sonuç: AHKHN yapılan hastalarda geç dönem komplikasyonlarla sık karşılaşıldığı, bu komplikasyonların büyük oranda GVHD ve GVHD' nin tedavisi ile ilişkili olduğu görüldü. Anahtar kelimeler: allojenik hematopoetik kök hücre nakli, geç dönem komplikasyonlar, GVHDÖğe 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 Non-Infectious Complications in Patients with Allogeneic Hematopoietic Stem Cell Transplantation- Single Center Experience from Eastern Anatolia(2022) Karaman, Sevtap; Sarıcı, Ahmet; Erkurt, Mehmet Ali; Biçim, Soykan; Hidayet, Emine; Kaya, Ahmet; Kuku, İrfanIntroduction: The aim of this study was to investigate late non-infectious complications in patients with allogeneic hematopoietic stem cell transplantation (HSCT). Materials and Methods: The records of 143 patients who underwent allogeneic HSCT between 01.02.2011 and 31.12.2018 in Inonu University Turgut Özal Medical Center Department of Hematology were retrospectively reviewed. Results: In our study, late non-infectious complications were seen in 68 % of the patients. Graft Versus Host Disease (GVHD) was observed in 43 patients (33%) %. The most common GVHD involvement sites were skin and liver. It was determined that the number of CD 34 (+) cells had a significant effect on the development of chronic GVHD (p=0,01) and late stage complications (p=0,016). Chronic GVHD and late complication rates were found to be lower in the group given high CD 34 (+) cell count. When the patients were grouped according to the preparation regimens, statistically significantly more complications were observed at the rate of 78.8% in the patients in the myeloablative regimen group (p=0.005). It was observed that the rate of recurrence of the primary disease, renal complications and neurological complications was higher in the 90-120th days after transplantation. Ocular and GVHD complications were more likely to develop later. It was observed that endocrine complications were encountered equally in both early and late periods. Discussion: It was seen that, late complications were common in patients who underwent allogeneic HSCT and these complications were mostly related to GVHD and GVHD treatment.
