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Öğe Apheresis in patients with sepsis: A multicenter retrospective study(Pergamon-Elsevier Science Ltd, 2021) Aydin, Kaniye; Korkmaz, Serdal; Erkurt, Mehmet Ali; Sarici, Ahmet; Ekinci, Omer; Baysal, Nuran Ahu; Berber, IlhamiBackground and objectives: To consider the effectiveness of apheresis, which is a supportive treatment method, in sepsis. Materials and methods: A hundred and eleven adults with sepsis or septic shock were included in this retrospective study. The demographic characteristics of the patients, the focus and source of infection causing sepsis or septic shock, characteristics of the pathogen, Acute Physiological and Chronic Health Assessment (APACHE) II score, routine laboratory values, which apheresis method was used, the characteristics of the replacement fluids used during the apheresis procedure, the number of apheresis procedures, complications related to the apheresis procedure, the follow-up time after the procedure, and mortality were recorded. The primary outcome was 28day mortality. Results: Sixty-nine (62.2 %) of the patients were male. The mean age of the patients was 47.7 +/- 18.6 years. The most common source of sepsis was hospital-acquired (79.3 %), the most common pathogen causing sepsis was gram-negative bacteria (41.4 %), and the most common infection site was the respiratory tract (58.7 %). The median APACHE II score was 19 (13-24). 92 (82.9 %) of the patients had septic shock. Theropeutic plasma exchange (TPE) was performed in 11.7 % of the patients and immunoabsorbtion IA in 88.3 %. The median number of sessions was 3 (3-5). No procedure-related fatal complication was observed in the study. While 28day mortality was 61.3 % in all patients, when the mortality according to the apheresis procedures was examined, it was 11.3 % and 88.2 % in the patients who underwent TPE and IA, respectively. The most common cause of mortality was multiorgan failure. Conclusions: Apheresis in sepsis can be considered as a salvage treatment. The indication for apheresis in sepsis is still at the level of patient-based individualized decision in line with the studies done so far, including our study. However, there is a need for a multicenter randomized controlled study with a large number of patients in order to give positive or negative recommendations about its effectiveness.Öğe 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, EminIn 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.Öğe 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, IrfanAim: 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.Öğe Convalescent plasma therapy in COVID-19(2022) Uysal, Ayşe; Erkurt, Mehmet Ali; Kuku, Irfan; Sarici, Ahmet; Bicim, Soykan; Kaya, Emin; Berber, IlhamiThe 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.Öğe 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, SoykanBackground: 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.Öğe 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, IlhamiObjective: 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.Öğe 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, SoykanBackground 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.Öğe The effect of G-CSF used after allogeneic hematopoietic stem cell transplantation on engraftment times and platelet suspension replacement numbers(Pergamon-Elsevier Science Ltd, 2022) Sarici, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Bicim, Soykan; Hidayet, EmineBackground: With the use of granulocyte colony stimulating factor (G-CSF) after allogeneic hematopoietic stem cell transplantation (HSCT), the duration of neutrophil engraftment and hospitalization were shortened. How-ever, there is no consensus on the effect of G-CSF on platelet engraftment time. The primary aim of our study is to determine the effect of G-CSF use on platelet engraftment time after HSCT. Secondary purposes are to determine the number of platelet suspension, number of erythrocyte suspension and incidence of acute graft versus disease after HSCT. Material and methods: Patients who had allogeneic stem cell transplantation at our center between 01.01.2011 and 01.01.2022 were retrospectively analyzed. Patients were divided into 2 groups as those who received and did not receive G-CSF after transplantation. Results: A total of 64 patients were included. While 32 patients were given post-HSCT G-CSF support, the other 32 patients were not given. Neutrophil engraftment time and length of hospital stay were shorter in the group receiving G-CSF (p < 0.05). Platelet engraftment time was shorter in the group that did not receive G-CSF (p < 0.05). The incidence of acute GVHD of the patients in group 1 tended to be higher than the patients in group 2 (40.6 % vs 15.6 %, p = 0.052). Post-HSCT platelet suspension was less in the group that did not receive G-CSF, but this difference was not statistically significant (p = 0.173). Conclusion: While the positive effect of post HSCT G-CSF use on duration of neutrophil engraftment and hospi-talization is evident, its effects on platelet engraftment need to be investigated.Öğe The effect of preemptive use of plerixafor on stem cell mobilization in patients with lymphoma and multiple myeloma(Marmara Univ, Fac Medicine, 2023) Uysal, Ayse; Erkurt, Mehmet Ali; Kuru, Irfan; Kaya, Emin; Berber, Ilhami; Sarici, Ahmet; Bicim, SoykanObjective: The aim of this study is to investigate the effect of the preemptive use of plerixafor in patients with lymphoma and multiple myeloma which was administered as a preemptive single dose to the patients who were determined to have a CD34+ cell count of <15/ mu L in the peripheral blood (PB) on the 4th day of mobilization.Patients and Methods: Thirty-five patients who were administered plerixafor on the 4th day after granulocyte colony-stimulating factor (G-CSF) alone for stem cell mobilization between January 2020 and November 2021 were included. CD34+ stem cell counts in PB before and after plerixafor, the amount of CD34+ stem cells collected, and the outcome of transplantation was examined.Results: The median CD34+ cell count in PB on the 4th day was 5.2/mu L (0.1-13.4), which was determined to increase 206.6-fold (31.5749347) to 924.80 /mu L (295.00-5056) following the administration of plerixafor on the 5th day (Z=-5.160; r= - 872.2; p<0.0001). The number of apheresis sessions was 1 in all patients. The median collected CD34+ cell count was 5.90x106/kg (2.70x106-14.4x106).Conclusion: The use of preemptive plerixafor shows that it is an effective mobilization method by increasing the rate of stem cell collection at an effective dose and reducing the mobilization time/apheresis sessions.Öğe 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 Efficacy and safety of ruxolitinib plus extracorporeal photopheresis in acute and chronic graft versus host disease: A single center experience(2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Bahcecioglu, Omer Faruk; Tanriverdi, Lokman Hekim; Berber, İlhami; Kaya, Emin; Biçim, Soykan; Gok, Selim; Özgül, Mustafa; Kuku, İrfanAbstract: Aim: There is no standard treatment for corticosteroid refractory acute and chronic graft versus host disease (GVHD). Ruxolitinib and extracorporeal phopheresis (ECP) are promising treatment options in GVHD. In this study, we aimed to share our clinical experience in steroid refractory GVHD patients treated with ruxolitinib plus ECP. Materials and Methods: The data of patients receiving ruxolitinib plus ECP for corticosteroid refractory acute and chronic GVHD patients were analyzed retrospectively. Results: A total of 11 cases, 6 of which were acute, were included in this retrospective, observational and single-center study. Acute GVHD developed in the 6 patients after allogeneic HSCT (median onset of GVHD=27, between 20 and 60 days ). Chronic GVHD developed in the 5 patients after allogeneic HSCT (median onset of GVHD= 159 between 60 and 380 days. The overall response rate of acute GVHD patients to ruxolitinib ECP combination therapy was 16.7% (complete response: 16.7%, partial response: 0%). The overall response rate of chronic GVHD patients to combination therapy was 60% (complete response: 20%, partial response: 40%). As a result of combination therapy, thrombocytopenia occurred in 36% (4/11) of patients, neutropenia in 27% (3/11) of patients, and CMV reactivation in 9% (1/11) of patients. Conclusion: We observed a low rate of overall response to ruxolitinib plus ECP treatment in acute GVHD patients but a high rate in chronic GVHD patients. According to our trial, ruxolitinib ECP combination may be beneficial in GVHD, especially in chronic GVHD, but prospective trials comparing its efficacy with other agents are needed.Öğe The efficacy of voxelotor, 900 mg in patients with sickle cell anaemia: A meta-analysis of the randomised controlled trials(Wiley-Hindawi, 2021) Tanriverdi, Lokman Hekim; Sarici, Ahmet; Erkurt, Mehmet Ali; Parlakpinar, HakanObjective Sickle cell anaemia (SCA), an inherited chronic hematological disease affecting hundreds of thousand people worldwide, causes significant morbidity and reduced life expectancy about two or three decades. This study aimed to conduct a meta-analysis of the efficacy of voxelotor, 900 mg in patients with SCA. Methods The research protocol was registered at the International Register of Prospective Systematic Reviews (PROSPERO), under the registration number: CRD42020147796. ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, Conference s, Google Scholar, Ovid Medline, Scopus, Web of Science, and Wiley Online Library from 2015 through July 25, 2019, and bibliographies of review articles and eligible studies. Eleven eligible studies that evaluated the effectiveness of voxelotor, 900 mg in SCA. Based on pre-specified inclusion and exclusion criteria, 2 randomized, placebo-controlled studies were included in the meta-analysis. Results The primary outcome measured was hemoglobin elevation, assessed in a highly similar fashion in both trials. There was a significant difference between voxelotor and placebo in haemoglobin change from baseline (mean difference [MD]: 0.87, 95% confidence interval [CI]: 0.67-1.06). Voxelotor also reduced markers of haemolysis, MD: -36.79, 95% CI: (-75.05) to 1.48 for unconjugated bilirubin that changes from baseline; MD: -19.09, 95% CI: (-44.06) to 5.88 for the percentage of reticulocytes that change from baseline and MD: -23.29, 95% CI: (-65.14) to 18.55 for LDH that change from baseline) but the difference was not statistically significant. Conclusions As a conclusion, voxelotor, 900 mg use significantly increased hemoglobin levels which of 1 g/dL elevation predicts a reduced risk of stroke (41%), albuminuria (53%), pulmonary arterial hypertension (57%), and mortality (64%) in recent studies. Voxelotor also reduced markers of hemolysis but failed to reach statistically significance in current evidence. Multicenter, randomized, placebo-controlled studies are on the way and will provide more evidence to see the potential of disease-modifying effects of voxelotor.Öğe Etiological evaluation and the role of plasma exchange treatment in trombotic microangiopathies: A retrospective analysis from Eastern Anatolia(2022) Hidayet, Emine; Erkurt, Mehmet Ali; Sarici, Ahmet; Bicim, Soykan; Berber, Ilhami; Kuku, Irfan; Kaya, Emin; Kaya, Ahmet; Özgül, MustafaThe aim is this study was to make the etiological classification of patients diagnosed with TMA in our region and to statistically evaluate the effect of therapeutic plasma exchange, which we use in treatment, on laboratory recovery and mortality. In our study, between 2009-2017, 85 patients diagnosed with TMA in our center evaluated retrospectively. Thirty- one (36.5%) of our patients were followed up with HELLP, 23 with thrombotic thrombocytopenic purpura (TTP) (27.1%), 20 (23.5%) snake bites, and 11 (12.9%) with atypical hemolytic uremic syndrome (aHUS). TPE treatment was performed in all patients. TPE treatment was found effective in patients with HELLP syndrome, TTP and snake bite and statistically significant improvement was obtained in laboratory parameters (p<0.05). However, TPE treatment was not found to be effective in the treatment of atipical HUS (p>0.05). Mortality rates were found 9.7%, 21.7%, 27.3%, and 0% in patients with HELLP Syndrome, TTP, aHUS, and snake bite, respectively. The primary treatment in HELLP syndrome was termination of pregnancy, it was observed in our study that TPE was effective in TTP, HELLP syndrome and snake bites and treatment should be started without delayÖğe Experience of ibrutinib in a patient with recurrent mantle cell lymphoma with orbital involvement(2021) Sarici, Ahmet; Kuku, Irfan; Kaya, Emin; Erkurt, Mehmet Ali; Berber, Ilhami; Bicim, Soykan; Bahçecioğlu, Ömer Faruk; Er Ulubaba, HilalMantle cell lymphoma is a subtype of B cell non-Hodgkin's lymphoma with different clinical and molecular features. Extranodal involvement is common in MCL. Bone marrow, liver, spleen, waldeyer ring and gastrointestinal involvement are most common. Lymphomatosis polyposis can be seen in some patients. Central nervous system involvement is rare. Here, we aimed to present a blastoid variant MCL patient who developed orbital recurrence after four lines of systemic therapy and responded to ibrutinib (560 mg/day) monotherapy. The mass disappeared completely in the bilateral orbital MRI taken after the 5th month of the ibrutinib treatment.Öğe The Experience of Ibrutinib in Chronic Graft-Versus-Host Disease in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: Single Center Experience(Galenos Publ House, 2023) Sarici, Ahmet; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Bicim, Soykan; Hidayet, EmineIntroduction: Chronic graft-versus host disease (GVHD) is a serious complication that develops in 35-50% of patients in the late period after allogeneic hematopoetic stem cell transplantation. About half of the patients are resistant to corticosteroids, which is the first-line treatment of chronic GVHD, and therefore new treatment options that can be effective in chronic GVHD are needed. In the present study, we aimed to share our experience with the use of ibrutinib therapy in patients with steroid-resistant chronic GVHD who have previously received multiple lines of systemic therapy. Methods: The characteristics and clinical outcomes of steroid-resistant chronic patients with GVHD receiving ibrutinib were retrospectively reviewed. Results: A total of 10 steroid resi-stant chronic patients with GVHD who received ibrutinib was included. While 50% of the patients had more than one organ involvement, 50% had a single organ involvement. The most commonly affected organs were the skin and liver. The patients received a median of three lines of systemic therapy before ibrutinib. After a median of 210 days of ibrutinib usage, the complete response rate of patients was 40% and the partial response rate was 40%. Corticosteroids were completely discontinued in 30% of patients after ibrutinib were initiated. Before ibrutinib, patients were given a median of 0.3 mg/kg methylprednisolone. The median methylprednisolone dose after ibrutinib was 0.03 mg/kg. Conclusion: Ibrutinib therapy causes a quite high overall response in steroid resistant chronic patients with GVHD and appears to be a good option in these patients.Öğe Filgrastim alone versus cyclophosphamide and filgrastim for mobilization in multiple myeloma patients(Pergamon-Elsevier Science Ltd, 2021) Sarici, Ahmet; Erkurt, Mehmet Ali; Bahcecioglu, Omer Faruk; Gok, Selim; Kuku, Irfan; Bicim, Soykan; Berber, IlhamiBackground and objective: High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is standard treatment approach in most multiple myeloma (MM) patients. Before ASCT, chemomobilization or only granulocyte-colony stimulating factor (G-CSF) mobilization can be preferred in stem cell mobilization. The primary aim of the study is to compare the effect of the two mobilization regimens on hematopoietic engraftment times, CD34+cell counts and number of apheresis required to harvest stem cells. Materials and methods: The records of MM patients who applied to our hospital between 2010 and 2020 were analysed retrospectively. Patients were divided into two groups (Group A: Cyclophosphamide plus filgrastim, Group B: Filgrastim alone) according to the mobilization regimen. Results: A total of 223 MM patients were included in this study (Group A:153, Group B:70 patients). When the patients in Group A and Group B were compared, the number of collected CD34+ cells were higher in Group A (p < 0.001). However, there was no significant difference between the two groups in terms of median times to neutrophil and platelet engraftment, and number of apheresis required to harvest stem cells (p > 0.05). The rate of infection development during mobilization in the patients in group A and the duration of hospitalization of these patients were higher than the patients in group B (p < 0.001). Patients receiving >6 cycles of chemotherapy and immunomodulatory treatment had lower collected CD34+ cells than other patients (p = 0.012 and p = 0.054). Conclusion: Based on our findings, filgrastim alone seems to provide a sufficient amount of stem cells in MM patients.Öğe The impact of transfusion burden and comorbidities on the prognosis of patients with myelodysplastic syndromes(Pergamon-Elsevier Science Ltd, 2020) Sarici, Ahmet; Ar, Muhlis Cem; Yokus, Osman; Ongoren, Seniz; Ayer, Mesut; Altindal, Sermin; Koker, Hilal TanPurpose: Early comorbidity detection has been reported to be associated with treatment-related outcomes in several diseases. Two main goals of the present study were to investigate both the impact of comorbidities and transfusion frequencies on the survival and quality of life of patients with myelodysplastic syndromes (MDS). Methods: One hundred and four MDS patients with a median International Prognostic Scoring System (IPSS) score of 0.5 (range: 0-3) were included in the study. Almost half of the patients had more than one comorbidity. Results: Median short form health surveys (SF)-36 mental and physical scores were 42.1 (range: 20.6-66.1) and 38.7 (range: 18-59.7), respectively. Mean scores of the Eastern Cooperative Oncology Group (ECOG) performance scales at diagnosis and during recruitment were 1.0 (1.4 +/- 1.0) and 2.0 (1.8 +/- 1.1), respectively. The mean Charlson Comorbidity Index (CCI) score was 1.0 (1.4 +/- 1.5). In the model that was constructed using variables with a p value < 0.100 in the univariate analysis, factors that predicted death were refractory anemia with excess blasts (RAEB) and ECOG scores at recruitment. When ECOG was removed from the model, RAEB and CCI at diagnosis moved to the forefront as mortality predictors. Conclusion: This study demonstrated that both CCI and ECOG performance status had an impact on survival in MDS patients who had low IPSS scores. ECOG stood out as a better and more practical predictor of survival than CCI, especially after considering its (ECOG) ease of use.Öğe An innovation in stem cell harvesting: Heparin use(Pergamon-Elsevier Science Ltd, 2021) Gul, Hacer Gozde; Erkurt, Mehmet Ali; Sarici, Ahmet; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Merter, MustafaBackground and Objectives: Stem cell transplantation is a growing treatment strategy for most malignant and nonmalignant hematological diseases. Plerixafor and granulocyte colony stimulating factor (G-CSF) are usually used in mobilization regimens to increase the CD34+ cell count in the harvest. Heparin is a sulphated glycosaminoglycated polymer with 12-15 kDa mass. Heparin inhibits the CXCR4/SDF1 axis, as does plerixafor. In this study, our aim was to investigate the effect of using heparin on stem cell mobilization and harvesting. Materials and Methods: We administered 5000 units of unfractioned heparin intravenously in 150 mL (mL) of isotonic sodium chloride solution, 15 min before the stem cell harvesting procedure to 141 patients who underwent bone marrow transplantation between the years of 2018 and 2019 at our Stem Cell Transplantation Unit. Thirty patients were included as a control group, and they were not given heparin. The study population included patients with multiple myeloma and lymphoma equally in each group. Results: In all patients hematopoeitic stem cells were successfully harvested in a single cycle of apheresis. In multiple myeloma patients who received heparin, the mean collected CD34+ cell number was 8 x 10(6)/kg, and the mean CD34+ cell number yield was 12,555/mu l. In the control group, the mean collected CD34+ cell number was 4,2 x 10(6)/kg, and mean CD34+ cell number in yield was 492/mu l. In lymphoma patients who received heparin, the mean collected CD34+ cell number was 6,8 x 10(6)/kg, and the mean CD34+ cell number was 1421/ mu l. In the control group the mean collected CD34+ cell number was 4,3 x 10(6)/kg, and the mean CD34+ cell number was 358/mu l. The effect of heparin on the collected stem cell number in both myeloma and lymphoma patients was statistically significant (p < 0.01) Conclusions: Our results have shown that heparin increases harvested stem cell numbers significantly. Heparin may be a promising agent for stem cell harvesting.Öğe Is Ferric Carboxymaltose a Safer Option Compared to Iron Sucrose?(Cig Media Group, Lp, 2023) Sarici, Ahmet; Tanriverdi, Lokman Hekim[Abstract Not Available]Öğe Is there any difference between busulfan-cyclophosphamide and cyclophosphamide-busulfan in patients underwent allogeneic transplantation?(Elsevier, 2021) Bahcecioglu, Omer Faruk; Gok, Selim; Durmus, Mefkure; Sarici, Ahmet[Abstract Not Available]
