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Agresif seyreden double-hit lenfoma: bir olgu sunumu
(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Kaya, Emin; Erkurt, Mehmet Ali; Berber, İlhami; Köroğlu, Mustafa; Kuku, İrfan
Double-Hit lenfoma acil tedavi edilmez ise aylar içinde ölümcül olabilen kötü seyirli B hücreli lenfomadır. Biz burada kötü seyirli giden fatal seyreden Double-Hit Lenfomalı erişkin bir olguyu sunduk. 18 yaşındaki erkek hasta Kulak Burun Boğaz polikliniğine çene altındaki şişlik nedeni ile başvurdu ve eksizyonel biopsi yapıldı. Hastanın biyopsisi CD20(+) Burkitt-like lenfoma olarak rapor edildi. Ann-Arbor evreleme sistemine göre evre IIIB kabul edilen hasta tedavi protokolündeki kemoterapotiklere ve yüksek doz kemoterapi eşliğinde otolog kemik iliği nakline cevap vermedi. Hastamız tanı konulmasından yaklaşık 12 ay sonra kaybedildi. Double-Hit lenfoma agresif gidişli olabilir ve fatal seyirli seyredebilir. Bu yüzden tanıdan sonra zaman kaybetmeden tedavi başlanmalıdır.
Akut lösemili hastalarda kemoterapi sonrası gelişen nötropenide, ateşli ve ateşsiz dönemlerde serum crp, Il-6 ve Il-8 düzeyleri
(İnönü Üniversitesi, 2002) Kaya, Emin
Akut lösemilerde, kemoterapi sonrası gelişen nötropeni sonucu ortaya çıkan infeksiyonlar en önemli ölüm nedenidir. Febril nötropeni atakları esnasında ölçülen serum CRP, IL-6 ve IL-8 düzeylerinin yüksek bulunması infeksiyonun erken bir göstergesi olabileceği bir çok çalışmada gösterilmiştir. Bu çalışmanın amacı; kemoterapi alan akut lösemili hastalarda gelişen nötropenide ateş ortaya çıkmadan önce ve sonrası dönemde serum CRP, IL-6 ve IL-8 düzeylerini tespit ederek ateşin infeksiyona mı yoksa başka bir nedene mi bağlı olduğunu araştırmaktır. Çalışmamızda, nötropenik febril ve afebril dönemlerde alman serum CRP, IL-6 ve IL-8 düzeyleri nötropeni öncesine göre yüksek bulunmuştur. Ancak afebril dönemdeki serum CRP, IL-6 ve IL-8 düzeylerindeki artış febril dönem ile karşılaştırıldığında istatistiksel olarak farklı olmadığı görüldü. Çalışmaya alman tüm hastalarda febril nötropeni atağı gelişti ve bu hastaların hepsi antibiyotik tedavisine iyi cevap verdi. Antibiyotik tedavisi sonrası ölçülen serum CRP, IL-6 ve IL-8 düzeylerinin başlangıç değerlerine döndüğü görüldü. Bu bulgular hastaların nötropenik dönemde, ateşleri olmasa bile serum CRP, IL-6 ve IL-8 düzeylerindeki artışın infeksiyonun erken bir habercisi olabileceğini göstermektedir.
Assessing Safety of Pneumatic Tube System (PTS) for Patients with Very Low Hematologic Parameters
(Int Scientific Information, Inc, 2016) Koroglu, Mustafa; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Nizam, Ilknur; Yagar, Yavuz
Background: Preventive interventions save lives during the process of chemotherapy for hematologic malignancies, when a hematology laboratory can ensure accurate results. The use of a pneumatic tube system (PTS) is associated with measurement errors and unnecessary transfusions. The aim of this study was to evaluate pre-analytical errors associated with transportation method (PTS versus hand-delivered) and to investigate whether there are unnecessary transfusion events in pancytopenia leukemia patients with very low hematological parameters. Material/Methods: A total of 140 paired blood collections were performed for hemogram and biochemistry assays. Paired EDTA and serum gel blood samples were collected from 58 cases with acute leukemia on different days. For each pair, one sample was hand-delivered by a courier (Group 1) while the other sample was transported through a PTS (Group 2). Results: The hand-delivered method showed that some platelet transfusions were unnecessary for different thrombocyte cut-off values. Calculated unnecessary platelet (PLT) transfusion ratios when using PTS (PLT <30x10(3)/mu L, 16.3%; PLT <25x10(3)/mu L, 16.4%; PLT <20x10(3)/mu L, 80.3%; PLT <15x10(3)/mu L, 48.6%; and PLT <10x10(3)/mu L, 150.0%) were found to be statistically significant (p=0.002, p=0.046, p<0.000, p=0.028, and p<0.000, respectively). In contrast, for RBC transfusion ratios, although the ratios were high in Group 2, we found no significant difference between the two groups; (HGB <8.0 g/dL, 23.3%; HGB <9.0 g/dL, 25.0%, HGB<10.0 g/dL, 19.3%) and (p=0.002, p=0.085, p<0.160, and p=0.235, respectively). Conclusions: Although our results cannot be universally applied, physicians should be careful, skeptical, and suspicious of transfusion decisions in hematology clinics and consider potential analytical and pre-analytical errors in cases of severe cytopenia when using PTS.
Atypical presentation of herpes zoster infection following fludarabine treatment for chronic lymphocytic leukemia: a case report
(2011) Demircioğlu, Sinan; Aydoğdu, İsmet; Kaya, Emin; Kuku, İrfan
Abstract: Herpes 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.
BK virus incidence, risk factors and its effect on mortality in hematopoietic stem cell transplant patients-single center experience
(2021) Deviren, Mehmet Veysi; Sarıcı, Ahmet; Erkurt, Mehmet Ali; Bahçecioğlu, Ömer Faruk; Biçim, Soykan; Berber, İlhami; Kaya, Emin
The aim of this trial is to investigate the risk factors of BK viruria and the effect of BK viruria on mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). The data of 247 patients who underwent HSCT between 01.01.2011-01.12.2017 in Inonu University Faculty of Medicine Department of Hematology were retrospectively analyzed. BK viruria was defined as positive at any copy level in the urine. Of 247 patients, 97 patients (39.2%) were detected to have BK virus-posi- tive. Patients with positive BK virus in urine were younger than BK virus negative patients, and patients with multiple myeloma had a lower rate of BK virus positivity than other patients (p<0.05). The rate of BK viruria was found to be higher in patients who received busulfan and cyclophosphamide-containing conditioning regimens compared to patients who received other conditioning regimens (46% vs 28.9%, p=0.007). In addition, BK virus positivity was found to be lower in those receiving mel- phalan-based conditioning regimens than those receiving other conditioning regimes (28.6% vs 47.2%, p=0.008). BK virus positivity in urine was detected median 20 days after HSCT. BK virus positivity was detected in 80.4% (78/97) of the patients within the first 30 days. Patients with BK viruria had a higher first 100-day mortality than patients without BK viruria (17.5% vs 8%, p=0.023). In this series, BK viruria is a factor associated with mortality in the early period after HSCT and should be closely monitored in these patients.
Can BuCyE conditioning regimen be an alternative treatment to BEAM at autologous transplantation in malignant lymphoma patients?: a single center experience
(E-Century Publishing Corp, 2015) Berber, Ilhami; Erkurt, Mehmet Ali; Nizam, Ilknur; Koroglu, Mustafa; Kaya, Emin; Kuku, Irfan; Bag, Harika Gozukara
High-dose chemotherapy (HDC) applied together with autologous stem cell transplantation (ASCT) is a commonly used treatment modality in patients with malignant lymphoma. At present, there is a limited number of studies which compare toxicity and efficacy of various high-dose regimens applied in the treatment of malignant lymphoma. For this reason, the aim of this study was to investigate the efficacy and toxicity of BuCyE (busulfan, cyclophosphamide and etoposide) and BEAM (carmustine, etoposide, cytarabine and melphalan) preparative regimens in the patients with malignant lymphoma scheduled for autologous stem cell transplantation. Between November, 2010 and April, 2015, 42 patients with relapsed or refractory malignant lymphoma who underwent autologous stem cell transplantation following BEAM (n=11) and BuCyE (n=31) preparative regimens were analyzed at Bone Marrow Transplantation Unit of TurgutOzal Medicine Center in Turkey. The groups were compared in terms of patient characteristics, hematopoietic engraftment time, toxicity profiles and survival. No significant differences were detected between the groups with regard to age, gender distribution, international prognostic index, ASCT indications, disease status at the time of ASCT and type of lymphoma (P>0.05). Median number of infused CD34+ cells/kg, neutrophil and platelet engraftment statuses of BuCyE and BEAM groups were found to be similar (P>0.05). More patients in BuCyE group developed mucositis and nausea, but this difference was not statistically significant (P>0.05). A similar statistically insignificant difference was seen in that infectious complications occurred more commonly in BEAM group (P>0.05). Overall survival and event-free survival rates were not significantly different between the groups (P>0.05). BuCyE is a conditioning regimen which can be effectively used as an alternative to BEAM in the patients with malignant lymphoma undergoing ASCT. Moreover, toxicity rates of both regimens are similar. In order to comprehend the effect of each HDC regimen, further evidence-based data obtained from the studies involving larger sample sizes are required.
Cardiac autonomic control during platelet apheresis
(2022) Cakan, Pinar; Ozgul, Mustafa; Erkut, Mehmet Ali; Kaya, Emin; Yıldız, Sedat; Kuku, İrfan
Aim: The aim of the current study was to assess the effects of platelet apheresis (PA) on cardiac autonomic control by the means of short-term heart-rate variability (HRV) technique. Materials and Methods: A total of 100 platelet donors (age: 29.0±0.9 years, body mass index: 25.8±0.7) were evaluated for heart rate (HR), HRV and blood pressure through a full cycle of PA. HR and HRV were assessed by 5-min continuous electrocardiographic recordings at four occasions, i.e., 5 min before (-5 min), and at 10th min (10 min), 45th min (45 min) and at post 5th min of PA. Time- and frequency-domain parameters of HRV were calculated using specific software. Low-frequency (LF)/high-frequency (HF) ratio was also determined. Blood pressure (BP) was also recorded 5 min before and 5 min after PA. Results: HR increased towards 45th min and declined towards the end of the PA (P < 0.05). Both time- and frequency-domain parameters decreased towards the 45th min and increased towards the last 5th mins (P < 0.05). LF/HF was increased towards 45th min and declined towards the end of the PA. Systolic BP decreased from 111 (106-120) mm Hg to 107 (99-115) mm Hg (P=0.003). Conclusions: HR, HRV and blood pressure were dynamically changed throughout the process of PA. These changes appeared to be caused by increased cardiac sympathovagal balance, resembling the pattern observed during whole blood donation.
The Clinical Characteristics and Therapeutic Outcomes of Elderly Patients with Chronic Lymphocytic Leukemia: A Retrospective Multicenter Study
(Amer Soc Hematology, 2014) Tombak, Anil; Tiftik, Naci; Dogu, Mehmet Hilmi; Sari, Ismail; Akay, Meltem Olga; Karagulle, Mustafa; Kaya, Emin
[Abstract Not Available]
Clinical characteristics and treatments outcomes in elderly patients with multiple myeloma: A multicenter retrospective study
(2017) Terzi, Hatice; Korkmaz, Serdal; Berber, İlhami; Keklik, Muzaffer; Doğu, Mehmet Hilmi; Şencan, Mehmet; Kaya, Emin; Eser, Bülent; Sarı, İsmail; İlhan, Osman
Abstract: Amaç: Mutipl Myeloma, tüm kanser tiplerinin %1' ini, hematolojik malignitelerin ise %10' unu oluşturan tamamen kürün sağlanamadığı fatal bir hastalıktır. Genellikle yaşlı populasyonda izlenir. Bu çalışmanın amacı, son 5 yılda farklı rejimlerle tedavi edilen 65 yaş ve üzerindeki 105 Mutipl Myeloma' lı hastadaki klinik deneyimimizi sunmaktır. Yöntem: 65 yaş üzerindeki Mutipl Myeloma'lı hastaların klinik karakterleri ve terapötik sonuçlarını analize etmek için, Türkiye'deki 5 farklı merkezden retrospektif olarak veriler toplandı.Bulgular: 51 erkek ve 54 kadından oluşan toplam 105 yaşlı Multipl Myeloma hastası (65 yaş ve üzeri) retrospektif olarak değerlendirildi. Hastalara ilk basamak olarak, VAD( vinkrsitin, adriamisin, deksametazon), VCD ( Bortezomib, siklofosfamid, deksametazon), MP( melphalan, prednizolon), MPT (Melphalan, prednizolon, thalidomid) rejimleri verildi. 29 hastada tam yanıt elde edildi ve bu hastaların 18 'ine otolog kök hücre nakli yapıldı. Tam yanıt elde edilemeyen 46 hastaya, ikinci basamak tedavi olarak bortezomib, lenalidomid ve talidomid bazlı rejimler verildi. İkinci basamak tedavi ile tedavi edilenlerin 29'unda tam yanıt elde edildi ve bu hastalardan 20'sine otolog kök hücre nakli yapıldı. 16 hastaya ise birinci ve ikinci basamak rejimlere yanıt vermediğinden lenalidomid bazlı rejimler (n: 10), talidomid bazlı rejimler (n: 6) verildi. Bu tedavilerle remisyona giren 5 hastaya Otolog kök hücre nakli yapıldı. Sonuç: Optimal tedavi yaklaşımı, verimli, güvenli, kaliteli yaşam sağlamalı ve amaç tam yanıtın yanı sıra hastalıksız sağ kalımı ve genel sağ kalımı uzatmak olmalıdır
Clinicopathologic Characteristics and Therapeutic Outcomes of Primary Gastrointestinal Non-Hodgkin's Lymphomas: 10 Years of Experience from a Single Center in Eastern Anatolia
(Karger, 2009) Erkurt, Mehmet Ali; Aydogdu, Ismet; Kuku, Irfan; Kaya, Emin; Basaran, Yalcin
Objective: The objective of this retrospective study was to report the clinicopathological data and the treatment outcomes in patients with primary gastrointestinal non-Hodgkin's lymphoma. Patients and Methods: We carried out a retrospective analysis of 41 patients (22 females, 18 males, median age 58 and range 18-90 years) who presented to our department with histopathological diagnosis of primary gastrointestinal non-Hodgkin's lymphoma between 1995 and 2004. Results: The stomach was the most common extranodal site and was seen in 25 of 41 (61%) patients. At presentation 28 (68.3%) patients had gastrointestinal symptoms while 27 (65.9%) had B symptoms. The range of follow-up was 2-84 months with a median of 9 months. The overall survival rate was 3 years for 25 (61.2%) patients. The 3-year overall survival rate was better in patients with early-stage disease (stages I and II1) who were treated with surgery plus chemotherapy and/or radiation therapy than in those treated with chemotherapy alone (91.6 vs. 50%, p < 0.05). The disease had a significant impact on both the progression-free survival and overall survival rates. Conclusion: Our data showed that surgical resection prior to postoperative chemotherapy was a better option for patients with early-stage disease with better patient survival. Copyright (C) 2009 S. Karger AG, Basel
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, Emin
In 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.
Comparison of the renal response of bortezomib-based induction and conventional regimen in multiple myeloma patients with renal failure
(2021) Sarici, Ahmet; Kaya, Emin; Erkurt, Mehmet Ali; Berber, Ilhami; Tanrıverdi, Lokman Hekim; Bahçecioğlu, Ömer Faruk; Gök, Selim; Kuku, Irfan
Aim: Vincristine-doxorubicin-dexamethasone (VAD) was the commonly used first-line treatment for multiple myeloma (MM) patients with renal failure before bortezomib entered clinical practice. In this trial, we aimed to compare the effect of VAD and bortezomibcyclophosphamide-dexamethasone (VCD) chemotherapy regimens on improving kidney function in MM patients with renal failure. Materials and Methods: The records of MM patients in our center between January 2010 and February 2020 were retrospectively analyzed. Patients who received VAD or VCD as a first treatment chemotherapy protocol and whose initially estimated glomerular filtration rate (eGFR) was 50 mL/min/1.73 m2and below were included in the study. Patients were divided into two groups according to the chemotherapy regimens they received. Results: Sixty one MM patients (VAD: 26, VCD: 35) were included in the study. No significant difference was found between the VAD and VCD groups when the baseline, 1st and 2nd month eGFRs were compared (p>0.05). Overall renal response rate (at least minor response) in the VCD group at the end of the 1st month were higher than in the VAD group (p=0.002). Also, renal response rate in the VCD group at the end of the 2nd month were higher than in the VAD group (p=0.033). Conclusion: In MM patients with renal insufficiency, overall renal response rates have increased with the use of VCD instead of VAD as a standard induction regimen.
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.
Convalescent plasma therapy in COVID-19
(2022) Uysal, Ayşe; Erkurt, Mehmet Ali; Kuku, Irfan; Sarici, Ahmet; Bicim, Soykan; Kaya, Emin; Berber, Ilhami
The 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.
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, Soykan
Background: 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.
Double-Hit Lymphoma Presenting with Aggressive Progression: A Case Report
(Turgut Özal Tıp Merkezi Dergisi, 2013) Kaya, Emin; Erkurt, Mehmet Ali; Berber, İlhami; Köroğlu, Mustafa; Kuku, İrfan
Öz: Double-Hit lenfoma acil tedavi edilmez ise aylar içinde ölümcül olabilen kötü seyirli B hücreli lenfomadır. Biz burada kötü seyirli giden fatal seyreden Double-Hit Lenfomalı erişkin bir olguyu sunduk. 18 yaşındaki erkek hasta Kulak Burun Boğaz polikliniğine çene altındaki şişlik nedeni ile başvurdu ve eksizyonel biopsi yapıldı. Hastanın biyopsisi CD20(+) Burkitt-like lenfoma olarak rapor edildi. Ann-Arbor evreleme sistemine göre evre IIIB kabul edilen hasta tedavi protokolündeki kemoterapotiklere ve yüksek doz kemoterapi eşliğinde otolog kemik iliği nakline cevap vermedi. Hastamız tanı konulmasından yaklaşık 12 ay sonra kaybedildi. Double-Hit lenfoma agresif gidişli olabilir ve fatal seyirli seyredebilir. Bu yüzden tanıdan sonra zaman kaybetmeden tedavi başlanmalıdır.
The effect of CD 34+ stem cell dose on both short-term and long-term outcomes of autologous stem cell transplantation in multiple myeloma
(2023) Uysal, Ayşe; Erkurt, Mehmet Ali; Kuku, İrfan; Kaya, Emin; Berber, İlhami; Sarıcı, Ahmet; Biçim, Soykan
Aim: In this single-center, retrospective study, we aimed to evaluate the effect of CD34+ stem cell dose on hematologic recovery and long-term outcomes such as progression-free survival and overall survival after autologous stem cell transplantation (ASCT). Materials and Methods: In this study, 282 patients with MM, who underwent ASCT between January 2014 and October 2021 were evaluated. The patients were divided into 2 groups according to the infused cell dose. Patients who received ?5x106/kg CD34+ cells were defined as group A. Patients who received >5x106/kg CD34+ cells were group B. The outcome of ASCT including the time of neutrophil/platelet engraftment, febrile neutropenia status, transplant-related mortality (TRM) at 100 days, duration of hospital- ization and survival status were examined in both groups. Results: There were 118 (41.8%) patients in group A and 164 patients (58.2%) in group B. The median neutrophil engraftment was 12 (7-26) days in A group, 11 (6-28) days in B group. The median platelet engraftment was 12 (6-40) and 11 (6-29) days in group B. There were statically significant different in both group for neutrophil and platelet engraftment time (p=.001 and .002, respectively). The median hospitalization time was 16 (10-53) days and 15 (6-83) days in group A and B, respectively. The hospitalization time was statistically significantly different in two groups (p<.012). The mean OS was 53.1±4.2 months in group A and 58.2±3.5 in group B which was not statistically significant difference (p=.841). The mean PFS was 11.8±1.3 months in group A and 19.1±1.4 months in group B which was statistically significant difference in 2 groups (p<0.001). Conclusion: Infusion of >5x106/kg CD34+ stem cells (median dose 9,6 x106/kg) may have a favorable effect on short-term outcomes of transplantation, including short-term neutrophil engraftment, short-term platelet engraftment, and short-term hospitalization. Additionally, progression-free survival may be positively affected by high dose, but upper limit should be defined by new study.
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, Ilhami
Objective: 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.
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, Soykan
Background 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.
Effect of endogen-exogenous melatonin and erythropoietin on dinitrobenzene sulfonic acidinduced colitis
(Wiley, 2013) Tasdemir, Seda; Parlakpinar, Hakan; Vardi, Nigar; Kaya, Emin; Acet, Ahmet
Inflammatory bowel disease has been linked to elevated T cells. Excessive production of reactive oxygen species and apoptosis are known to be accompanied by intestinal inflammation. This study was designed to investigate the effects of melatonin (MEL) and erythropoietin (EPO), which is a known anti-inflammatory and antiapoptotic agent, in dinitrobenzene sulfonic acid (DNBS)induced colitis in pinealectomized (Px) rats. In microscopically results, epithelial and goblet cell loss, absence of crypts, and increased colonic caspase-3 activity were observed in the DNBS group. Also, in flow cytometric analysis, the percentage of CD4+ T cells was highest in the DNBS group. Treatment with MEL or EPO had a curative effect on DNBS-induced colitis. The MEL+EPO groups showed significantly greater improvement when compared with the other treatment groups. Our results indicate that the combination of EPO and MEL may exert more beneficial effects than either agent used alone.

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