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    Allogeneic Hematopoietic Stem Cell Transplantation in Adult Patients with Thalassemia: A Single-Center Experience and Literature Review
    (2023) Uysal, Ayşe; Erkurt, Mehmet Ali; Sarıcı, Ahmet; Kuku, İrfan; Biçim, Soykan; Hidayet, Emine; Kaya, Ahmet
    Objective: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment modality in thalassemia. Its use has been limited by age, transplant-related mortality (TRM), graft rejection, and graft versus host disease (GvHD), especially in adult patients. We aimed to present our allo-HSCT experience in adult patients with thalassemia major. Material and Method: Patients’ demographic and clinical features, donor types, resource of stem cells, conditioning regimens, GvHD prophylaxis, time to neutrophil and platelet engraftments, acute and chronic GvHD, thalassemia -free survival (TFS) and overall survival were examined. Results: The study included six patients. The median age was 21.5 (20-26) years. The median ferritin levels were 1498.4 (347.4-6992.3) pg/ml. The matched sibling donor (MSD) was used in 4 patients while matched unrelated donor (MUD) was used in 2 patients. The median time to neutrophil and platelet engraftments were 17 (15-35) and 18 (15-40) days, respectively. Acute and chronic GvHD were detected in 2 and 1 patients, respectively. The TRM was detected in 2 patients (33.3%), due to infection and acute GVHD. At a median follow-up of 28 months after transplantation, 4 (66.6%) patients were alive and TFS was achieved in 2 (33.3%) patients. Graft failure was detected in 3 (50%) patients. Conclusion: Graft rejection, TRM and GvHD limited the use of allo-HSCT, especially in adult patients. These complications were reduced by re- duced-intensity conditioning regimens and allo-HSCT should be done primarily in patients under the age of 20 years and without organ damage due to iron overload.
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    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.
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    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.
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    Splenic Marginal Zone Lymphoma in Turkey: Association with Hepatitis B Instead of Hepatitis C Virus as an Etiologic and Possible Prognostic Factor - A Multicenter Cohort Study
    (2020) Okay, Müfide; Aslan, Tuncay; Özdemir, Evren; Üner, Ayşegül; Ayhan, Arzu; Güngör, Elif Sena; Uysal, Ayşe; Alayvaz, Nevin; Yıldızhan, Esra; Ağıt, Abdullah; Dal, Mehmet Sinan; Korkmaz, Serdal; Namdaroğlu, Sinem; Sivgin, Serdar; Akgün Çağlıyan, Gülsüm; Demircioğlu, Sinan; Barışta, İbrahim; Özhamam, Esra; Vural, Filiz; Eser, Bülent; Özet, Gülsüm; Yıldırım, Rahşan; Doğu, Mehmet; Berber, İlhami; Erkurt, Mehmet Ali; Malkan, Ümi?T Yavuz; Altuntaş, Fevzi; Büyükaşık, Yahya
    Abstract: Objective: Chronic antigenic stimulation is frequently blamed in the pathogenesis of extranodal marginal zone lymphomas including splenic marginal zone lymphoma (SMZL). Chronic hepatitis C is frequently observed in SMZL patients in some geographical regions. However, these reports are largely from North America and Europe, and data from other countries are insufficient. In this multicenter study we aimed to identify the clinical characteristics of SMZL patients in Turkey, including viral hepatitis status and treatment details. Materials and Methods: Data were gathered from participating centers from different regions of Turkey using IBM SPSS Statistics 23 for Windows. Hepatitis B virus surface antigen (HBsAg), anti-HBs antibody, anti-HB core antigen antibody (anti-HBcAg), HB viral load, anti-hepatitis C virus (HCV) antibody, HCV viral load results were analyzed. Results: One hundred and four patients were reported. Hepatitis C virus positivity was observed in only one patient. However, hepatitis B virus surface antigen (HBsAg) positivity was observed in 11.2% and HBsAg and/or anti-HB core antigen antibody (anti-HBcAg) positivities were seen in 34.2% of the patients. The median age was 60 years (range=35-87). Median follow-up duration was 21.2 months (range=00.2-212; 23.2 months for surviving patients). Median overall survival was not reached. Estimated 3-year and 10-year survival rates were 84.8% and 68.9%, respectively. Older age, no splenectomy during follow-up, platelet count of <90x103/µL, lower albumin, higher lactate dehydrogenase, higher ?2-microglobulin, and HBsAg positivity were associated with increased risk of death. Only albumin remained significant in multivariable analysis. Conclusion: These results indicate that hepatitis B virus may be a possible risk factor for SMZL in our population. It may also be an indirect prognostic factor.