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    Assessing Safety of Pneumatic Tube System (PTS) for Patients with Very Low Hematologic Parameters
    (Int Scientific Information, Inc, 2016) Koroglu, Mustafa; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Berber, Ilhami; Nizam, Ilknur; Yagar, Yavuz
    Background: Preventive interventions save lives during the process of chemotherapy for hematologic malignancies, when a hematology laboratory can ensure accurate results. The use of a pneumatic tube system (PTS) is associated with measurement errors and unnecessary transfusions. The aim of this study was to evaluate pre-analytical errors associated with transportation method (PTS versus hand-delivered) and to investigate whether there are unnecessary transfusion events in pancytopenia leukemia patients with very low hematological parameters. Material/Methods: A total of 140 paired blood collections were performed for hemogram and biochemistry assays. Paired EDTA and serum gel blood samples were collected from 58 cases with acute leukemia on different days. For each pair, one sample was hand-delivered by a courier (Group 1) while the other sample was transported through a PTS (Group 2). Results: The hand-delivered method showed that some platelet transfusions were unnecessary for different thrombocyte cut-off values. Calculated unnecessary platelet (PLT) transfusion ratios when using PTS (PLT <30x10(3)/mu L, 16.3%; PLT <25x10(3)/mu L, 16.4%; PLT <20x10(3)/mu L, 80.3%; PLT <15x10(3)/mu L, 48.6%; and PLT <10x10(3)/mu L, 150.0%) were found to be statistically significant (p=0.002, p=0.046, p<0.000, p=0.028, and p<0.000, respectively). In contrast, for RBC transfusion ratios, although the ratios were high in Group 2, we found no significant difference between the two groups; (HGB <8.0 g/dL, 23.3%; HGB <9.0 g/dL, 25.0%, HGB<10.0 g/dL, 19.3%) and (p=0.002, p=0.085, p<0.160, and p=0.235, respectively). Conclusions: Although our results cannot be universally applied, physicians should be careful, skeptical, and suspicious of transfusion decisions in hematology clinics and consider potential analytical and pre-analytical errors in cases of severe cytopenia when using PTS.
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    Factors Affecting Survival in Non-Small Cell Lung Cancer Patients with Brain Metastasis
    (Akad Doktorlar Yayinevi, 2016) Harputluoglu, Hakan; Kaplan, Nihal; Dikilitas, Mustafa; Yagar, Yavuz
    In this study, prognostic factors in non small cell lung cancer (NSCLC) patients with brain metastasis, and relation between brain metastasis location and survival were investigated. 103 NSCLC patients with brain metastasis were enrolled in this study. Demographic, clinical characteristics and treatment modalities of the patients who were followed up in medical oncology department between May 2009 and February 2015 were assessed retrospectively using the hospital database. Brain metastasis location, treatment of brain metastasis, systemic treatment after brain metastasis and survival of the patients were recorded. The relation between these factors and survival was assessed. Follow-up period of the patients was between one and 42 months. Mean survival of the patients after brain metastasis diagnosis was 7.2 months. In the single variant analyses; patient age below 65, good performance status, detection of brain metastasis during initial diagnosis and receiving systemic treatment after brain metastasis were found to be positive prognostic factors. In the multivariant analyses; while combined treatment of brain metastasis with surgery and radiotherapy and systemic therapy after brain metastasis were found to be independent prognostic factors, no relation between location of brain metastasis and survival was found. In this study, systemic therapy including surgery, radiotherapy and chemotherapy was found as independent prognostic factors in selected patients who had NSCLC with brain metastasis. We think that defining prognostic factors in lung cancer patients with brain metastasis is important for both estimating prognosis and selecting optimal therapy for the patient.