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Öğe Are mesenchymal stem cells still effective in acute GvHD management?(Pergamon-Elsevier Science Ltd, 2025) Ulu, Bahar Uncu; Hindilerden, Ipek Yonal; Yigenoglu, Tugce Nur; Tiryaki, Tarik Onur; Erkurt, Mehmet Ali; Korkmaz, Gulten; Namdaroglu, SinemObjective: Graft-versus-host disease (GvHD) is a common and serious complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), significantly impacting transplant efficacy. In the treatment of GvHD, numerous therapeutic approaches have been explored, with mesenchymal stem cells (MSCs) emerging as a prominent immunomodulatory option. We aimed to evaluate efficacy and outcomes of using MSCs for steroid refractory acute GVHD (SR-aGvHD) management. Materials and Methods: We retrospectively analyzed data from 36 patients' who received MSCs for treatment of SR-aGvHD following allo-HSCT between 2018 and 2024 from nine transplantation centers in T & uuml;rkiye. The product consisted of umbilical cord-derived allogeneic MSCs, which were administered intravenously. Results: Our cohort was at the median age of 39 years (range: 19-61 years), with aGvHD diagnosed at a median of two months after allo-HSCT. More than half of the patients (58.3%) classified as high-grade aGvHD according to the Minnesota risk scoring. Cord blood-derived MSCs were administered at a median dose of 3.45 (range: 0.8-5) million MSCs/kg, with a median of 3th (range: 2-5) line treatment. The rate of responses exceeding partial response (PR) was approximately 20% at the first month, increasing to 24% at the second month. The six-month survival rate was 33%, with 46% of mortality attributed to sepsis and 12.5% related to GvHD. Multivariate analysis indicated that increasing age (>= 35 years) and lower platelet counts (<= 75 x10(9)/L) were associated with higher mortality (p<0.05). Conclusion: MSC therapy has shown promising potential in improving response rates in aGvHD treatment, with efficacy enhanced by younger age and higher platelet counts.Öğe Does body mass index affect stem cell yield in healthy donors?(Pergamon-Elsevier Science Ltd, 2025) Yilmaz, Seda; Okumus, Nazik; Seyhan, Mert; Sahin, Rasim; Korkmaz, Gulten; Erkurt, Mehmet Ali; Namdaroglu, SinemObjectives: Hematopoietic stem cell transplantation is an important treatment for many benign and malignant diseases. Factors affecting the donor response to mobilization and thus hematopoietic progenitor cell yield have been investigated, but studies on donor body mass index are limited and contradictory. Our aim in our study was to investigate this situation. Material and methods: The data of a total of 665 healthy donors were analyzed and divided into 2 groups as body mass index (BMI) < 25 (group 1, n: 247) and >= 25 kg/m(2) (group 2, n: 418). In addition to demographic data, smoking, blood group, agent used for mobilization, number of days of apheresis, volume of blood processed, amount of product collected, complete blood count before mobilization and biochemical parameters were evaluated. Results: Group 1 consisted of 247 and group 2 consisted of 418 participants. Median age was 29 (18-66) years in group 1 and 37 (18-68) years in group 2. Median BMI was 22.49 (16.10-24.98) and 28.06 (25.00-48.27) kg/m(2), respectively. Male donors constituted 62.7 % in group 1 and 73.9 % in group 2. In group 2, the number of apheresis days was lower and the median CD34(+) stem cell count on the first day and in total was statistically significantly higher (7.1 x10(6)/kg and 7.58 x10(6)/kg, respectively). Conclusion: In healthy donors, CD34(+) stem cells were correlated with BMI, whereas no statistically significant difference was found between the groups in terms of smoking habit, blood group, granulocyte stimulating agent type, processed blood volume, non-lymphocyte and biochemical parameters other than LDH.Öğe Does Body Mass Index Affect Stem Cell Yield in Healthy Donors?(Cig Media Group, Lp, 2025) Hatipoglu, Ugur; Yilmaz, Seda; Okumus, Nazik; Seyhan, Mert; Seyhan, Rasim; Korkmaz, Gulten; Erkurt, Mehmet Ali[No abstract available]Öğe Effectiveness of ibrutinib in the management of chronic GVHD(Pergamon-Elsevier Science Ltd, 2025) Erkurt, Mehmet Ali; Sarici, Ahmet; Sahin, Abdulkadir; Berber, Ilhami; Korkmaz, Gulten; Kuku, Irfan; Dal, Mehmet SinanObjectives: Chronic graft-versus-host disease (cGVHD) represents a significant adverse event that may ensue following allogeneic hematopoietic stem cell transplantation (Allo-HSCT). In patients resistant to corticosteroids, which is the first-line treatment for cGVHD, ibrutinib is being evaluated as a potential treatment option. In this study, we aimed to share the findings of our multicenter study regarding the outcomes of ibrutinib treatment in patients with corticosteroid-resistant cGVHD who had previously received multiple systemic therapies. Material and methods: A retrospective analysis was conducted to examine the clinical characteristics and outcomes of patients who received ibrutinib treatment for corticosteroid-resistant cGVHD after Allo-HSCT. Results: A total of 24 patients diagnosed with cGVHD who received ibrutinib treatment were included in the study. The median age of the patients was 34.5 (20-67). The included patients were followed for a median of 6 (1-30) months. All patients had stem cells collected from the peripheral blood. Fifty percent of the patients had multiple organ involvement, while the other 50 % had single organ involvement. The most frequently affected organs were skin and liver. On average, patients received four (3-5) lines of systemic therapy before ibrutinib treatment. At week 24 of ibrutinib treatment, 10 patients (41.7 %) had a complete response, and 10 patients (41.7 %) had a partial response; at week 48, 8 patients (33.3 %) had a complete response, and 10 patients (41.7 %) had a partial response. The most common hematological side effect after ibrutinib treatment was thrombocytopenia in 5 out of 24 patients, while the most common non-hematological side effect was CMV infection in 6 out of 24 patients. Conclusion: In patients with corticosteroid-resistant cGVHD, ibrutinib treatment has been demonstrated to be an efficacious option exhibiting an elevated overall response rate and a tolerable side effect profile.
