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    Diagnostic value of ultrasonograpy and 99mTc-MIBI scintigraphy for preoperative localization of parathyroid adenomas
    (2021) Sahin, Abdulkadir; Sakat, Muhammed Sedat; Sengoz, Furkan; Kilic, Korhan; Bilen, Arzu; Aktan, Bulent; Bilen, Habib
    Aim: The primary treatment of primary hyperparathyroidism (PHPT) is parathyroidectomy. With its shorter operative time and healing period, lesser general anesthesia duration, lesser hypoparathyroidism risk and better cosmetic results minimally invasive parathyroidectomy is the most commonly performed contemporary surgical procedure. However, in order for this procedure to be successful, it is important to know the location of the parathyroid adenoma. The purpose of this study was to determine the diagnostic value of Ultrasonography (USG) and technetium methoxyisobutylisonitrile scintigraphy ( 99m Tc-MIBI) in the preoperative localization of parathyroid adenoma. Materials and Methods: Fifty-two patients diagnosed with parathyroid adenoma were included in the study. Preoperative parathyroid USG and 99m Tc-MIBI were performed on all patients. All patients’ preoperative serum calcium, phosphorus, parathormone and Vitamin D levels, parathyroid USG and 99m Tc-MIBI, intraoperative parathyroid lesion location and histopathological examination results were recorded. Results: Patients aged between 22 and 81 (51.7±15.6) were eventually enrolled. When USG was used alone, the site of the adenoma was correctly determined in 26 of the 52 patients with a sensitivity of 52% and a positive predictive value of 92.8%. When scintigraphy was performed alone, the site of the adenoma was correctly identified in 39 of the 52 patients. Sensitivity was thus 76.4% and positive predictive value 97.5%. When USG and scintigraphy were assessed together, adenoma location was correctly identified in 45 of the 52 patients. Sensitivity for the two tests employed together was 88.2% and positive predictive value was 97.8%. Conclusions: Due to the high sensitivity of combined use of USG and 99m Tc-MIBI, we recommend the two tests to be assessed together before parathyroid surgery.
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    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 Sinan
    Objectives: 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.
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    Is there a relationship between stem cell yield obtained from healthy donors and healthy donors' blood type?
    (Pergamon-Elsevier Science Ltd, 2025) Katircilar, Yavuz; Sahin, Abdulkadir; Aydin, Muruvvet Seda; Erer, Kerim; Erkurt, Mehmet Ali; Namdaroglu, Sinem; Yilmaz, Seda
    Background and objectives: Factors affecting adequate mobilization and apheresis are critical for a good yield of hematopoietic stem cells (HSCs) in the final product. A female donor, advanced age, smoking, high lactate dehydrogenase levels, high absolute lymphocyte count at baseline were found to be inversely correlated to the number of harvested CD34+ cells. However, the data on whether there is a correlation between blood types A, B, AB, O and the number of harvested CD34+ cells is insufficient. The aim of this study is to investigate the effect of blood types on the stem cell yield in healthy donors. Material and methods: A total of 807 healthy donors from 10 centers in T & uuml;rkiye were included in this retrospective study. Donors were subdivided into four groups as A, B, AB, O by their blood types. These four groups were compared in terms of age, sex, ECOG performance score, smoking status, and the amount of harvested CD34+ stem cells. Results: The median age of the 807 healthy donors included in the study was 35 years (11-70). 256 (31.7 %) donors were female and 551 (68.2 %) donors were male. There were 349 donors in type A blood group, 134 in type B blood group, 53 in type AB blood group and 271 donors in type O blood group. The median amount of CD34+ cells in the total apheresis product was 7.67 x 106 per kg in type O blood group, 7.52 x 106 per kg in type A blood group, 7.2 x 106 per kg in type B blood group, and 7.45 x 106 per kg in type AB blood group. There was no statistically significant difference among the groups (p:0.673). Smoking was lower in the type B blood group with 29.1 % compared to the other groups. However, there was no statistically significant difference in total amount of CD34+ stem cells in the type B blood group who smoked less (p = 0.949). Conclusion: In our study in which we have retrospectively analyzed the effect of donor blood types on the efficiency of HSCs harvested from peripheral blood in healthy donors, no correlation was found between the blood types and the mobilization and amount of harvested CD34+ cells.