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Bakırtaş M, Dal MS, Yiğenoğlu TN, Giden AO, Serin I, Başcı S, Kalpakci Y, Korkmaz S, Ekinci O, Albayrak M, Basturk A, Ozatli D, Dogu MH, Hacıbekiroglu T, Çakar MK, Ulas T, Miskioglu M, Gulturk E, Eser B, Altuntas F. Real-world data on the effectiveness and safety of Ixazomib-Lenalidomide-Dexamethasone therapy in relapsed/refractory multiple myeloma patients: a multicenter experience in Turkey. J Chemother 2023; 35:563-569. [PMID: 37211906 DOI: 10.1080/1120009x.2023.2208439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 04/03/2023] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Abstract
A multicenter, retrospective, observational study was conducted to explore effectiveness and safety of ixazomib plus lenalidomide with dexamethasone (IRd) in relapsed/refractory multiple myeloma (RRMM) patients following at least ≥ two lines of therapy. Patients' treatment responses, overall response rate, progression-free survival rate, and adverse events were recorded. Mean age of 54 patients was 66.5 ± 9.1 years. There were 20 patients (37.0%) with progression. Median progression-free survival was 13 months in patients who received a median of three therapy lines in a 7.5-month follow-up period. Overall response rate was 38.5%. Of 54 patients, 19 (40.4%) had at least one adverse event, and nine (19.1%) had an adverse event of at least grade 3 or more. Of 72 adverse events observed in 47 patients, 68% were grade 1 or 2. Treatment was not stopped in any patient due to adverse events. IRd combination therapy was effective and safe in heavily treated RRMM patients.
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Affiliation(s)
- Mehmet Bakırtaş
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Mehmet Sinan Dal
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Tuğçe Nur Yiğenoğlu
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | | | - Istemi Serin
- Istanbul Training and Research Hospital, Department of Hematology, University of Health Sciences, Istanbul, Turkey
| | - Semih Başcı
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Yasin Kalpakci
- Department of Hematology, Sakarya University, Sakarya, Turkey
| | - Serdal Korkmaz
- Kayseri City Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Kayseri, Turkey
| | - Omer Ekinci
- Gazi Yasargil Training and Research Hospital, Department of Hematology, University of Health Sciences, Diyarbakir, Turkey
| | - Murat Albayrak
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | | | - Duzgun Ozatli
- Department of Hematology, Ondokuz Mayis University, Samsun, Turkey
| | - Mehmet Hilmi Dogu
- Liv Hospital Ulus, Department of Hematology, Istinye University, Istanbul, Turkey
| | | | - Merih Kızıl Çakar
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Turgay Ulas
- School of Medicine, Department of Internal Medicine, Division of Hematology, Near East University, Nicosia, Cyprus
| | - Mine Miskioglu
- Department of Hematology, Celal Bayar University, Manisa, Turkey
| | - Emine Gulturk
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Hematology, University of Health Sciences, Istanbul, Turkey
| | - Bulent Eser
- Department of Hematology, Medical Park Antalya Hospital, Antalya, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
- School of Medicine, Department of Internal Medicine, Division of Hematology, Ankara Yildirim Beyazit University, Ankara, Turkey
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Gulturk E, Yilmaz D, Sonmezoz GB, Yildirim ES. Contribution of lowered hemoglobin threshold value in the diagnosis of polycythemia vera: Comparison of 2016 and 2008 WHO criteria. Medicine (Baltimore) 2023; 102:e34462. [PMID: 37543796 PMCID: PMC10403029 DOI: 10.1097/md.0000000000034462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
Polycythemia vera (PV) diagnosis remains a difficult task despite various updates in the 2016 World Health Organization (WHO) diagnostic criteria compared to 2008 criteria. This study aimed to examine the biochemical and clinical features of patients diagnosed with PV using the WHO 2016 criteria but would have been missed by the WHO 2008 criteria, and to ascertain the impact of the lowered thresholds on PV diagnosis. A total of 229 patients with suspected myeloproliferative neoplasms were included in this cross sectional study. The study group was divided with regard to hemoglobin values. Group A consisted of 126 patients with hemoglobin values of ≤ 18.5 g/dL in males and ≤ 16.5 g/dL in females. Group B comprised 103 patients with hemoglobin values of > 18.5 g/dL in males and > 16.5 g/dL in females. The number of PV diagnoses increased to 145 from 87 (increased by 66.67%) when the 2016 diagnostic criteria were employed rather that the 2008 criteria. Mean age and the frequency of female subjects were lower in Group A compared to Group B. The groups were similar in terms of chronic obstructive pulmonary disease/obstructive sleep apnea syndrome, spleen status, smoking status, and mean corpuscular volume, white blood count, neutrophil, eosinophil and platelet values. red blood cells and lactate dehydrogenase values were significantly higher, while lymphocyte counts were significantly lower in Group B. With the introduction of WHO 2016 criteria, we found a significant increase in the number of patients who were candidates for PV testing and were ultimately diagnosed with PV. These findings support the diagnostic value of the 2016 WHO criteria, and by extension, the lowered thresholds for detection of patients requiring further analysis.
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Affiliation(s)
- Emine Gulturk
- Department of Hematology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Deniz Yilmaz
- Department of Internal Medicine, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gulru Birce Sonmezoz
- Department of Hematology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ezgi Simge Yildirim
- Department of Hematology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Gulturk E, Yılmaz D, Bırce Sonmezoz G, Dırıl M. Temporal relationship between thromboembolic events and myeloproliferative neoplasm diagnosis: is it associated with mortality risk? Eur Rev Med Pharmacol Sci 2023; 27:4942-4950. [PMID: 37318468 DOI: 10.26355/eurrev_202306_32611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aim of this study is to investigate the temporal relationship between the first occurrence of thromboembolic events (TEE) and the timing of myeloproliferative neoplasm (MPN) diagnosis and to determine risk factors for TEE-related mortality in MPN. PATIENTS AND METHODS A total of 138 BCR-ABL-negative MPN patients with TEE, diagnosed from January 2010 to December 2019, were included in this retrospective cohort. Patients were compared according to mortality and subjects were classified into three groups with respect to having suffered index TEE before, during, or after MPN diagnosis. RESULTS The mean age of surviving patients was 57.5±13.8, while those who had died had a mean age of 72.0±9.0 (p<0.001). Males represented 56.5% of patients with mortality and 60.9% of those without mortality (p=0.876). TEE was detected in 26.0% of MPN patients, and TEE-related mortality rate was 16.7%. There was no relationship between mortality and the classification of patients according to index TEE (p =0.884). High age (p<0.001) and danazol use (p=0.014) were independently associated with TEE-related mortality. CONCLUSIONS The temporal relationship between TEE and MPN diagnosis was not found to influence mortality. Older patients and danazol recipients should be considered to have a higher risk of TEE-related mortality.
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Affiliation(s)
- E Gulturk
- Department of Hematology, University of Health Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
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Erkurt MA, Hindilerden F, Ekinci O, Yildiz J, Dal MS, Bagci M, Hacibekiroglu T, Dogu MH, Namdaroglu S, Basturk A, Gulturk E, Merter M, Saglam B, Demircioglu S, Ozatli D, Sarici A, Ulas T, Korkmaz S, Eser B, Altuntas F. An Experience on Pomalidomide in Patients within Relapsed/Refractory Multiple Myeloma - A Multicenter Study in Turkey. JPRI 2021. [DOI: 10.9734/jpri/2020/v32i4131047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective: Pomalidomide is a new generation thalidomide analogue. Effectiveness as a single agent or combination with low dose dexamethasone has been in the treatment of relapse/refractory Multiple Myeloma (MM). The aim of the present study was to share the experience of different oncology centres with pomalidomide treatment in patients with relapsed/refractory MM.
Materials and Methods: Seventy-three patients from 16 centres were enrolled into the study. The patients were followed for a median of 6 months. Relapsed/refractory MM patients who received at least one line of treatment before pomalidomide were included into the study. ISS, R-ISS and Eastern Cooperative Oncology Group (ECOG) scores of the patients and treatment-related side effects were evaluated.
Results: As a result of the median follow-up for 6 months, 36% (26/72) of the patients presented progression. The estimated median PFS was found 29 months. The Cox regression analysis revealed that ECOG affected PFS only, myeloma subtype; ISS and R-ISS scores did not affect PFS. The most common side effects with pomalidomide treatment in our population include neutropenia, infections, anaemia and thrombocytopenia.
Conclusion: In our study, it was statistically shown that the ECOG score was effective in survival in relapsed / refractory MM patients treated by pomalidomide. Therefore, we recommend evaluation of the ECOG score for each patient before treatment in eligible cases.
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Hindilerden F, Yonal-Hindilerden I, Gulturk E, Yuksel M, Ozturkmen AY, Sakız D. IgG4 producing POEMS syndrome: A rarely recognized subtype. INDIAN J PATHOL MICR 2021; 64:584-586. [PMID: 34341279 DOI: 10.4103/ijpm.ijpm_995_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Serum IgG4 is typically measured for Immunoglobulin G4-related Disease (IgG4-RD), a fibroinflammatory condition associated with polyclonal increase in serum IgG4. Yet, increased IgG4 may still be monoclonal, and little is known about IgG4 POEMS syndrome. We present a case of 40-year-old male with a mass lesion in the left sacral ala. The mass was composed of non-neoplastic fibrous tissue and dense infiltrate of mature plasmacytes with dense eosinophilic cytoplasm and eccentrically placed nuclei that express monoclonal Lambda free light chains and show diffuse positivity for IgG and IgG4. We discuss clinical manifestations and challenges encountered in the diagnosis and treatment of this rare coexistence.
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Affiliation(s)
- Fehmi Hindilerden
- University of Health Sciences Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Ipek Yonal-Hindilerden
- Istanbul University Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul, Turkey
| | - Emine Gulturk
- University of Health Sciences Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Mahmut Yuksel
- Altınbas University Faculty of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Asli Yuksel Ozturkmen
- University of Health Sciences Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Damlanur Sakız
- University of Health Sciences Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Pathology Clinic, Istanbul, Turkey
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Ozturkmen A, Gulturk E, Yildiz O, Hindilerden F. Postdural puncture superior sagittal sinus thrombosis during remission induction therapy for acute lymphoblastic leukemia. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.09.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Korkmaz S, Solmaz Medeni S, Demirkan F, Kalayoglu Besisik S, Altay Dadin S, Akgun Cagliyan G, Kabukcu Hacioglu S, Sari I, Goren Sahin D, Arat M, Dagdas S, Ozet G, Kutlu N, Karaagac Akyol T, Ozcebe OI, Uskudar Teke H, Kiper Unal D, Guner N, Tombak A, Celik H, Bay I, Kiki I, Ozgur G, Erkurt MA, Ozatli D, Meletli O, Demircioglu S, Demir C, Kurtoglu E, Vural F, Tobu M, Karakus A, Ayyildiz O, Dal MS, Afacan Ozturk B, Albayrak M, Ocakci S, Bolaman Z, Sonmez M, Karakus V, Gokmen Sevindik O, Berber I, Dogu MH, Gulturk E, Ulas T, Payzin B, Kuku I, Cagirgan S, Altuntas F. The Turkish experience with therapeutic plasma exchange: A national survey. Transfus Apher Sci 2019; 58:287-292. [DOI: 10.1016/j.transci.2019.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tanrikulu Simsek E, Eskazan AE, Cengiz M, Ar MC, Ekizoglu S, Salihoglu A, Gulturk E, Elverdi T, Ongoren Aydin S, Senem Demiroz A, Buyru AN, Baslar Z, Ozbek U, Ferhanoglu B, Aydin Y, Tuzuner N, Soysal T. Imatinib reduces bone marrow fibrosis and overwhelms the adverse prognostic impact of reticulin formation in patients with chronic myeloid leukaemia. J Clin Pathol 2016; 69:810-6. [PMID: 26811428 DOI: 10.1136/jclinpath-2015-203320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/23/2015] [Indexed: 11/03/2022]
Abstract
AIMS Before the era of tyrosine kinase inhibitors (TKIs), the presence of bone marrow fibrosis (MF) in patients with chronic myeloid leukaemia (CML) has been established as a poor prognostic factor. The aim of the present study was to evaluate the effects of imatinib treatment on MF and the prognostic significance of MF at this new era of CML therapy. METHODS The study cohort consisted of 135 patients with CML who were exposed to imatinib. The grades of MF pre and post imatinib together with cytogenetic and molecular responses were evaluated. RESULTS Severe MF (grade II-III) was observed in 44 (33%) patients prior to imatinib therapy, and in 8 (8%) after 12 months of imatinib treatment (p=0.001). The complete cytogenetic response (CCyR) rates at 12 months did not differ according to the pre-imatinib MF grades, and CCyR rates in patients with grades 0, I, II and III MF were 36/47 (76.5%), 26/33 (78.7%), 12/23 (52.1%) and 7/10 (70%), respectively (p=0.127). There was no significant difference between patients with or without CCyR at 12 months of imatinib regarding grades of MF (p=0.785). The distribution of the major molecular response rates at 18 months according to pre-treatment grades of MF were determined as grade 0 in 38/45 (84.4%), grade I in 21/28 (75%), grade II in 14/21 (66.6%) and grade III in 7/10 (70%) (p=0.112). There was no significant difference in overall survival rates between initial MF mild (grade 0-I) and severe (grade II-III) groups (p=0.278). CONCLUSIONS According to our findings, MF regresses with imatinib therapy over time, and the MF grades at diagnosis do not have a negative impact on the responses to imatinib treatment. Therefore, the adverse prognostic impact of the MF among patients with CML seems to disappear in the era of the TKIs.
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Affiliation(s)
- Eda Tanrikulu Simsek
- Division of Medical Oncology, Department of Internal Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Ahmet Emre Eskazan
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mahir Cengiz
- Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Muhlis Cem Ar
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Seda Ekizoglu
- Department of Medical Biology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayse Salihoglu
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emine Gulturk
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugrul Elverdi
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Seniz Ongoren Aydin
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahu Senem Demiroz
- Department of Pathology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayse Nur Buyru
- Department of Medical Biology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zafer Baslar
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ugur Ozbek
- Department of Genetics, Institute of Experimental Medicine (DETAE), Istanbul University, Istanbul, Turkey
| | - Burhan Ferhanoglu
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Yildiz Aydin
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nukhet Tuzuner
- Department of Pathology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Teoman Soysal
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Ulas T, Apucu HG, Gulturk E, Karakas EY, Borlu F. Hodgkin's Disease Presenting with Chronic Pruritis and Cutaneous Involvement. J Clin Diagn Res 2015; 9:OL01. [PMID: 25738023 DOI: 10.7860/jcdr/2015/11075.5382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/14/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Turgay Ulas
- Associate Professor, Department of Internal Medicine, Harran University, School of Medicine , Sanliurfa
| | - Haci Gokhan Apucu
- Faculty, Department of Internal Medicine, Necip Fazil Metropolitan Training and Research Hospital , Kahramanmaras
| | - Emine Gulturk
- Faculty, Department of Internal Medicine, Sisli Etfal Training and Research Hospital , Istanbul
| | - Emel Yigit Karakas
- Faculty, Department of Internal Medicine, Harran University, School of Medicine , Sanliurfa
| | - Fatih Borlu
- Faculty, Department of Internal Medicine, Sisli Etfal Training and Research Hospital , Istanbul
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Eskazan AE, Salihoglu A, Gulturk E, Aydin SO, Tuzuner N, Aydin Y. Successful management of chronic refractory immune thrombocytopenia with laparoscopic splenectomy in a patient with acute promyelocytic leukemia. Indian J Hematol Blood Transfus 2012; 29:173-7. [PMID: 24426368 DOI: 10.1007/s12288-012-0173-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 06/11/2012] [Indexed: 11/25/2022] Open
Abstract
Acute promyelocytic leukemia (APL) is a particular type of acute myeloid leukemia with characteristic biological and clinical features, the frequent association at diagnosis of a severe hemorrhagic diathesis. Immune thrombocytopenia (ITP) is a common autoimmune disease characterized by low platelet counts and an increased risk of bleeding. Here we present a patient with the diagnosis of APL who achieved and maintained a remission with an induction consisting of idarubicin and ATRA, and then developed corticosteroid refractory ITP which is successfully treated with laparoscopic splenectomy.
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Affiliation(s)
- Ahmet Emre Eskazan
- Department of Hematology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Ayse Salihoglu
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emine Gulturk
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Seniz Ongoren Aydin
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nukhet Tuzuner
- Department of Pathology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yildiz Aydin
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Eskazan AE, Salihoglu A, Gulturk E, Ongoren S, Soysal T. Thrombotic thrombocytopenic purpura after prophylactic cefuroxime axetil administered in relation to a liposuction procedure. Aesthetic Plast Surg 2012; 36:464-7. [PMID: 21853406 DOI: 10.1007/s00266-011-9794-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 07/07/2011] [Indexed: 11/29/2022]
Abstract
Thrombotic thrombocytopenic purpura (TTP) or Moschcowitz's syndrome is characterized by platelet and von Willebrand factor (vWF) deposition in arterioles and capillaries throughout the body, which results in organ ischemia. The diagnostic pentad characterizing TTP consists of thrombocytopenia, microangiopathic hemolytic anemia (MAHA), fever, neurologic manifestations, and renal insufficiency. In terms of type, TTP can be either idiopathic or secondary. The causes of secondary TTP include pregnancy, infections, pancreatitis, collagen vascular disease, cancer, bone marrow transplantation, and drugs (including cephalosporins). Postoperative TTP has been reported after vascular surgery, renal and liver transplantations, and orthopedic, urologic, and abdominal surgical procedures. Therapeutic plasma exchange (TPE) therapy has reduced the mortality rates, but sometimes patients may have to receive immunosuppressive drugs including vincristine (VCR). This report describes a 42-year-old woman with TTP after prophylactic usage of cefuroxime axetil in relation to a liposuction procedure who was treated successfully with plasma exchange and VCR. The patient fully recovered after 17 TPEs and three doses of VCR. At this writing, her TTP still is in remission after 6 months of follow-up evaluation. To the authors' knowledge, this is the first report in the literature describing a patient with TTP after cefuroxime axetil administered in relation to a surgical procedure who was treated successfully with TPE and VCR.
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Affiliation(s)
- Ahmet Emre Eskazan
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Kocamustafapasa, Fatih, Istanbul, Turkey.
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Eskazan AE, Soysal T, Ongoren S, Gulturk E, Ferhanoglu B, Aydin Y. Pleural and pericardial effusions in chronic myeloid leukemia patients receiving low-dose dasatinib therapy. Haematologica 2011; 96:e15; author reply e16-7. [PMID: 21357709 DOI: 10.3324/haematol.2011.040048] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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