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    Carfilzomib experience in relapsed/refractory multiple myeloma: a single-center experience
    (Tubitak Scientific & Technological Research Council Turkey, 2018) Uysal, Ayse; Akad Soyer, Nur; Ozkan, Melda; Sahin, Fahri; Vural, Filiz; Tobu, Mahmut; Tombuloglu, Murat
    Background/aim: Carfilzomib (CFZ) is a new-generation proteasome inhibitor with significant activity in relapsed or refractory multiple myeloma (R/R-MM). We have retrospectively evaluated R/R-MM patients who were treated with CFZ plus dexamethasone. Materials and methods: Twenty-one R/R-MM patients who were treated with CFZ plus dexamethasone between October 2013 and January 2016 were screened. The patients were followed until March 2016 after CFZ treatment. Results: Ten (47.6%) of the patients were female and 11 (52.4%) of them were male. The median age was 62 (47-76) years. The median number of prior treatment lines was 3 (2-7). The median number of administered cycles of treatment for CFZ was 4 (1-10). The median overall response rate was 26.3%. The most common hematological adverse events were anemia and thrombocytopenia (38%). The most common nonhematological adverse event was fatigue (71.4%). One patient died because of a cerebrovascular event and 1 patient died because of pneumonia during the treatment period. The median duration of response rate and time to next therapy were 8 (7-9) and 3 (2-16) months, respectively. The median overall survival was 8 (0.5-33) months. Conclusion: Despite the small number of patients, our results suggest that CFZ provides acceptable responses in heavily pretreated R/R-MM patients.
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    Carfilzomib experience in relapsed/refractory multiple myeloma: a single-center experience
    (Tubıtak scıentıfıc & technıcal research councıl turkey, ataturk bulvarı no 221, kavaklıdere, ankara, 00000, turkey, 2018) Uysal, Ayse; Akad Soyer, Nur; Ozkan, Melda; Sahin, Fahri; Vural, Filiz; Tobu, Mahmut; Tombuloglu, Murat; Saydam, Guray
    Background/aim: Carfilzomib (CFZ) is a new-generation proteasome inhibitor with significant activity in relapsed or refractory multiple myeloma (R/R-MM). We have retrospectively evaluated R/R-MM patients who were treated with CFZ plus dexamethasone. Materials and methods: Twenty-one R/R-MM patients who were treated with CFZ plus dexamethasone between October 2013 and January 2016 were screened. The patients were followed until March 2016 after CFZ treatment. Results: Ten (47.6%) of the patients were female and 11 (52.4%) of them were male. The median age was 62 (47-76) years. The median number of prior treatment lines was 3 (2-7). The median number of administered cycles of treatment for CFZ was 4 (1-10). The median overall response rate was 26.3%. The most common hematological adverse events were anemia and thrombocytopenia (38%). The most common nonhematological adverse event was fatigue (71.4%). One patient died because of a cerebrovascular event and 1 patient died because of pneumonia during the treatment period. The median duration of response rate and time to next therapy were 8 (7-9) and 3 (2-16) months, respectively. The median overall survival was 8 (0.5-33) months. Conclusion: Despite the small number of patients, our results suggest that CFZ provides acceptable responses in heavily pretreated R/R-MM patients.
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    Determining expression of miRNAs that potentially regulate STAT5A and 5B in dasatinib-sensitive K562 cells
    (Tubitak Scientific & Technological Research Council Turkey, 2017) Yilmaz, Asu Fergun; Kaymaz, Burcin; Aktan, Cagdas; Soyer, Nur; Kosova, Buket; Gunes, Ajda; Sahin, Fahri
    In the era of tyrosine kinase inhibitors, resistance still constitutes a problem in chronic myeloid leukemia (CML) patients; thus, new pathway-specific inhibitors like miRNAs have become important in the treatment of refractory patients. There are no satisfying data regarding the miRNAs and anti-miRNA treatment targeting STAT5A and 5B. In this study, we first researched the effect of dasatinib on apoptosis in the CML cell line K562. The expressions of miRNAs possibly targeting both STAT5A and 5B were then determined. The down-and upregulation of the miRNAs were compared using the Delta Delta CT method. At the last stage of the study, we used a new primer probe in order to validate the results. The level of hsa-miR-940 was decreased 4.4 times and the levels of hsa-miR-527 and hsa-miR-518a-5p were increased 12.1 and 8 times, respectively, in the dasatinib-treated group when compared to the control group. We detected similar results in the validation step. As a conclusion, we determined the expression profiles of miRNAs targeting STAT5A and 5B that had an important role in the pathogenesis of CML. The data obtained could lead to determining new therapeutic targets for CML patients.
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    Extramedullary Relapse in a CML Patient after Allogeneic Stem Cell Transplantation
    (Hindawi Ltd, 2017) Yilmaz, Asu Fergun; Soyer, Nur; Ozsan, Nazan; Cagirgan, Seckin; Gunes, Ajda; Comert, Melda; Sahin, Fahri
    Myeloid or granulocytic sarcoma (GS) is a tumoral lesion consisting of immature granulocytic cells. It is a rare entity during the course of CML patients especially after allogeneic stem cell transplantation (SCT). Relapse without bone marrow involvement is much rarer. We report a case of CML patient who relapsed with isolated granulocytic sarcoma after allogeneic SCT during cytogenetic and molecular remission. 28-year-old male was diagnosed as CML and allogeneic SCT was performed because of refractory disease to tyrosine kinase inhibitors. Complete cytogenetic and molecular response was achieved after allogeneic SCT followed by dasatinib treatment. Approximately 5 years after the transplantation, very rapidly progressive lesion was documented and diagnosed as GS although he was at molecular and cytogenetic remission. The patient died during chemotherapy due to sepsis. GS relapse after allogeneic SCT is a very rare type of relapse in CML patients with molecular and cytogenetic remission. Since it is a very aggressive disease with a poor prognosis, combined chemoradiotherapies with other possible options like DLI or second allogeneic SCT should be considered as soon as the diagnosis is confirmed.
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    Relationship between fear of movement and physical activity levels in adult hemophilic individuals
    (2020) Can, Filiz; Aykar, Sercan; Sahin, Fahri
    Aim: Regular physical activity is important to prevent damage and protect joint health in hemophilic individuals. However, hemophilia patients tend to limit their physical activity due to frequent bleeding. There may be some factors, such as fear of movement or kinesiophobia under these attitudes. For this reason, this study aimed to research the relationship between kinesiophobia and physical activity levels in adult hemophilic individuals.Material and Methods: This study was performed with a retrospective study design. A total of 44 patients included in this study; 33 were hemophilia A, 11 were hemophilia B. All hemophilic individuals were male and between the ages of 18-60 (mean=35.30±12.04). Tampa Scale for Kinesiophobia (TSK) was used to determine fear of movement. To determine the physical activity levels of individuals, the “International Physical Activity Questionnaire-Short Form” was used. The results were analyzed using Spearman correlation analysis and Mann-Whitney U test.Results: There was no statistical correlation between kinesiophobia degree and physical activity level (p=0.616, r=−0.081). There was also no significant difference in kinesiophobia scores between hemophilia A and hemophilia B (z=-0.707, p=0.479). High kinesiophobia levels (TSK score of ≥37) were present in 90.9% of patients. According to physical activity levels, 36.4 % of patients had low, 34.1 % had moderate and 29.5 % had high physical activity levels. Hemophilia A patients had higher physical activity levels than hemophilia B (z=-2.400, p=0.016). Conclusion: These results showed no correlation between physical activity level and kinesiophobia, but high kinesiophobia rates in adult hemophilic individuals. Hemophilia patients should be educated and encouraged about safe and fearless physical activity.