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Kaya AD, Tekin O, Colak Y, Serin I. How complicated can be a case with immune thrombocytopenic purpura?: postsplenectomy arterial thrombosis. Blood Coagul Fibrinolysis 2024; 35:209-213. [PMID: 38407854 DOI: 10.1097/mbc.0000000000001290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Arterial thrombus associated with the surgery can be seen in postsplenectomy cases, but there is no clear data in patients diagnosed with immune thrombocytopenic purpura (ITP). A 52-year-old female patient was admitted to the emergency department due to ecchymotic skin changes. Her initial platelet count was 6000/mm 3 ; after two courses of high dose-dexamethasone, intravenous immunoglobulin and rituximab, splenectomy was planned for the patient whose platelet count was again <40 000/mm 3 . She presented to the emergency department with complaints of pain and pallor in the right arm in the second week of follow-up. There was a mural thrombus that caused approximately 50% stenosis in the lumen at the division site in the aortic arch, proximal of the right subclavian artery. The patient's clinic was found to be associated with the presence of an aberrant right subclavian artery and postoperative thrombocytosis/inflammation after elimination other prothrombotic conditions.
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Affiliation(s)
- Ahmet Deniz Kaya
- Ibrahim Cecen University, Agri Training and Research Hospital, Department of Cardiovascular Surgery
| | - Oguzhan Tekin
- Ibrahim Cecen University, Agri Training and Research Hospital, Department of General Surgery
| | - Yasin Colak
- Ibrahim Cecen University, Agri Training and Research Hospital, Department of Hematology, Agri, Turkey
| | - Istemi Serin
- Ibrahim Cecen University, Agri Training and Research Hospital, Department of Hematology, Agri, Turkey
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2
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Uysalol EP, Uysalol M, Serin I, Pehlivan M, Oyaci Y, Pehlivan S, Karakas Z. The effect of leptin gene polymorphisms ( LEP rs7799039 and LEPR rs1137101) on febrile neutropenia. Heliyon 2024; 10:e28788. [PMID: 38586343 PMCID: PMC10998141 DOI: 10.1016/j.heliyon.2024.e28788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/09/2024] Open
Abstract
Background and aim Leptin is mainly produced in adipose tissue and released into systemic circulation. Leptin and its receptor LEPR activate the Janus kinase/signal transducers and activators of transcription signaling cascade and increase cytokine discharge. In our study, we aimed to examine the role of leptin gene (LEP) rs7799039 and LEPR rs1137101 polymorphisms on the susceptibility for febrile neutropenia (FEN) attacks and their relationship with clinical findings during the course of FEN. Methods This study included pediatric patients with a diagnosis of malignancy who applied to the pediatric emergency department between December 2019 and June 2022 and healthy controls. The genotypes of the LEP rs7799039 and LEPR rs1137101 genes were statistically compared between patients and healthy controls. In addition, the relationship between the genotype distribution of LEP rs7799039 and LEPR rs1137101 polymorphisms and clinical features during the course of FEN was investigated. Results In the statistical analysis in terms of LEP rs7799039 and LEPR rs1137101 genotype distributions between the patient and healthy groups, there was no significant difference. Patients with the AA genotype of LEPR rs1137101 polymorphism had significantly more commonly a body mass index (BMI) value of <25, and all the patients with the AG/GG genotype had a BMI value of 25 and above. LEP rs7799039 and LEPR rs1137101 genotype distributions were not statistically significant with other clinical features. Conclusions It was revealed that leptin gene polymorphisms did not have a significant effect during the course of FEN.
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Affiliation(s)
- Ezgi Paslı Uysalol
- Basaksehir Cam and Sakura City Hospital, Department of Pediatric Hematology- Oncology, Turkey
| | - Metin Uysalol
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Turkey
| | - Istemi Serin
- Agri Training and Research Hospital, Department of Hematology, Turkey
| | - Mustafa Pehlivan
- Basaksehir Cam and Sakura City Hospital, Department of Hematology, Turkey
| | - Yasemin Oyaci
- Istanbul University, Istanbul Faculty of Medicine, Department of Medical Biology and Genetics, Turkey
| | - Sacide Pehlivan
- Istanbul University, Istanbul Faculty of Medicine, Department of Medical Biology and Genetics, Turkey
| | - Zeynep Karakas
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Hematology- Oncology, Turkey
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3
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Goze H, Cinli TA, Baydilli KN, Serin I. Lymphocyte Level at Diagnosis in Hodgkin lymphoma: Could It be an Indicator of the Stage at Initial Diagnosis? Int J Hematol Oncol Stem Cell Res 2024; 18:14-32. [PMID: 38680717 PMCID: PMC11055420 DOI: 10.18502/ijhoscr.v18i1.14741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/16/2023] [Indexed: 05/01/2024] Open
Abstract
Background: Despite the existence of standard risk classification systems and effective treatment approaches, 34% to 37% of advanced-stage Hodgkin lymphomas (HLs) either relapse or progress. Our goal in our study was to show the relationship between initial lymphocyte count and stage while examining their effects on prognosis. The initial lymphocyte count, which is proven in advanced-stage patients, could be an important factor in terms of showing the prognosis in the early stage. Materials and Methods: Our study included 190 patients diagnosed with HL in our hospital between January 2010 and September 2020. HL subtypes, diagnosis stages, presence of bulky or mediastinal masses, lymphadenopathy areas, and demographic data of patients, such as age and sex. The aim was to obtain a cutoff in the statistical analysis performed to explore the relationship between lymphocyte level and stage, which is the main hypothesis of the study. Results: Of the 190 patients evaluated, 77 were female (40.5%) and 113 were male (59.5%). To obtain a cutoff in terms of lymphocyte level and stage relationship, a value of 2380/mm3 and below was found to be associated with stage 3-4 disease with a sensitivity of 86.44% and a specificity of 33.3% (AUC: 0.613 (0.539-0.682), p<0.007). Conclusion: This result can be improved in combination with conventional imaging methods used for staging purposes. Further studies may shed light on staging and especially the diagnosis of advanced-stage disease with high sensitivity.
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Affiliation(s)
- Hasan Goze
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Tahir Alper Cinli
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Kursad Nuri Baydilli
- Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
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4
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Serin I, Sevindik OG, Balik Aydin B, Melek E, Mutlu YG, Bilgen H, Bekoz H, Kaynar L. Plerixafor in autologous stem cell transplantation: Does it affect engraftment kinetics? Transfus Apher Sci 2023; 62:103809. [PMID: 37690861 DOI: 10.1016/j.transci.2023.103809] [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: 05/12/2023] [Revised: 08/18/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023]
Abstract
Plerixafor increases stem cell mobilization by reversibly binding to the chemokine receptor CXCR4. In our study, we examined the results of mobilization with plerixafor and granulocyte colony-stimulating factor (G-CSF) and revealed their effects on autologous stem cell transplantation (ASCT) engraftment kinetics. The study included all cases of ASCT performed in the Adult Bone Marrow Transplantation Unit of xxx University between January 2014 and January 2022. It included a total of 300 patients. The total number of CD34 + cells collected was 7.44 ± 4.19 in patients with plerixafor and 9.53 ± 6.09 in patients without plerixafor. The mean neutrophil and platelet engraftment took longer in plerixafor-mobilized patients (neutrophil: 12 ± 4.1 vs. 10.2 ± 2.7 days; platelet: 21.6 ± 13.9 vs. 14.2 ± 5.9 days; p = 0.008 and p = 0.002). The number of febrile neutropenia attacks was significantly higher in plerixafor-mobilized patients (p = 0.04). In the chemo-mobilized patient subgroup, plerixafor-mobilized patients experienced more febrile neutropenia attacks (p = 0.04). The mean time to both neutrophil and platelet engraftment was longer in patients mobilized with plerixafor. In the subgroup of patients with MM, the mean time to platelet engraftment was longer in patients mobilized with plerixafor. Plerixafor and its effect on engraftment kinetics should be evaluated with further studies in a larger population with survival analysis.
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Affiliation(s)
- Istemi Serin
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey.
| | - Omur Gokmen Sevindik
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Berrin Balik Aydin
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Elif Melek
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Yasa Gul Mutlu
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Hulya Bilgen
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Huseyin Bekoz
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Leylagul Kaynar
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
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5
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Serin I, Colak Y, Oyaci Y, Tuncel FC, Pehlivan M, Pehlivan S. Effect of interleukin-2 (IL-2) polymorphisms on multiple myeloma: IL-2RA rs2104286, IL-2 rs2069762 and rs2069763 polymorphisms. Cytokine 2023; 172:156401. [PMID: 37832160 DOI: 10.1016/j.cyto.2023.156401] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/29/2023] [Revised: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
Interleukin-2 (IL-2) is a cytokine secreted from T helper type 1 cells and released after induction of T helper cells with major histocompatibility complexes or antigens presented by antigen presenting cells. IL-2 activity and gene polymorphisms have been studied in both solid and hematological malignancies. In the present study, it was aimed to examine the effects of IL-2RA rs2104286, IL-2 rs2069762 and rs2069763 polymorphisms on multiple myeloma (MM) susceptibility, progression-free survival (PFS) and overall survival (OS). A total of 300 patients diagnosed with MM in our clinic between January 2010 and January 2021, and 170 healthy individuals were included. In addition to the demographic data of the patients, MM subtypes, initial stages, prognostic index scores, laboratory results, treatment preferences, and survival data were recorded. The genotypes of the IL-2RA rs2104286, IL-2 rs2069762 and rs2069763 polymorphisms were statistically compared between patients and healthy controls to reveal their effects on MM susceptibility and survival. In the statistical analysis performed to examine the effect of IL-2RA rs2104286, IL-2 rs2069762 and rs2069763 polymorphisms on disease susceptibility, no significant difference was found between the patient and healthy control groups. Patients with the TG genotype of IL-2 rs2069762 had a significantly shorter median PFS and OS compared to others. Patients with the GG genotype of IL-2 rs2069763 had a significantly shorter median PFS compared to others. Having the TG genotype of IL-2 rs2069762 has been shown to be protective for short PFS and OS. Our study results will be guiding in terms of IL-2 based therapies, the future for MM and MM epigenetics.
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Affiliation(s)
- Istemi Serin
- Department of Hematology, Agri Training and Research Hospital, Ibrahim Cecen University, Agri, Turkey.
| | - Yasin Colak
- Department of Hematology, Agri Training and Research Hospital, Ibrahim Cecen University, Agri, Turkey
| | - Yasemin Oyaci
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Fatima Ceren Tuncel
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
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6
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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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7
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Erol VB, Mutlu YG, Balik B, Mert A, Mergen S, Mergen M, Serin I, Cakir A, Ozden F, Sevindik OG. Intravascular B-cell lymphoma with generalized telangiectasias. J Dtsch Dermatol Ges 2023; 21:1025-1027. [PMID: 37401140 DOI: 10.1111/ddg.15148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 05/10/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Vedat Bugra Erol
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Yaşa Gul Mutlu
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Berrin Balik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ali Mert
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Sena Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Mahmut Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Aslı Cakir
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ferhat Ozden
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
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8
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Dogu MH, Ozcelik B, Akbulut YE, Kantarci M, Bektas E, Serin I. AAT: does it have a place in acute leukemia? Biomark Med 2023; 17:747-754. [PMID: 38197403 DOI: 10.2217/bmm-2023-0415] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 01/11/2024] Open
Abstract
Aim: In this study, the authors aimed to investigate the change of AAT, its effect on the response to induction and its effects on the treatment process in acute myeloid leukemia and acute lymphoblastic leukemia patients. Materials & methods: This study included 94 patients who were hospitalized and followed up in Istanbul Training and Research Hospital, Hematology Clinic, between October 2019 and December 2021. Results: Patients with a complete response had higher serum AAT levels than those with a non-complete response (p < 0.05). The mean serum AAT level was found to be significantly higher in patients without Gram-positive growth than in patients with Gram-positive growth. Conclusion: It can be thought that AAT can play a role during the course of acute leukemia management.
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Affiliation(s)
- Mehmet H Dogu
- Department of Hematology, Istinye University, Faculty of Medicine, Liv Hospital Ulus, Ulus-Istanbul, 34340, Turkey
| | - Berfin Ozcelik
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Fatih-Istanbul, 34098, Turkey
| | - Yusuf E Akbulut
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Fatih-Istanbul, 34098, Turkey
| | - Mert Kantarci
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Fatih-Istanbul, 34098, Turkey
| | - Ezgi Bektas
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Fatih-Istanbul, 34098, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Fatih-Istanbul, 34098, Turkey
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9
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Erol VB, Mutlu YG, Balik B, Mert A, Mergen S, Mergen M, Serin I, Cakir A, Ozden F, Sevindik OG. Intravaskuläres B-Zell-Lymphom mit generalisierten Teleangiektasien. J Dtsch Dermatol Ges 2023; 21:1025-1028. [PMID: 37700402 DOI: 10.1111/ddg.15148_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 05/10/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Vedat Bugra Erol
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Yaşa Gul Mutlu
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Berrin Balik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ali Mert
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Sena Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Mahmut Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Aslı Cakir
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ferhat Ozden
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
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10
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Tukek T, Pehlivan S, Medetalibeyoglu A, Serin I, Oyacı Y, Arıcı H, Senkal N, Pehlivan M, Isoglu-Alkac U, Kose M. The suppressor of cytokine signaling-1 ( SOCS1) gene polymorphism and promoter methylation correlate with the course of COVID-19. Pathog Glob Health 2023; 117:392-400. [PMID: 36448222 PMCID: PMC10177741 DOI: 10.1080/20477724.2022.2151861] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 12/05/2022] Open
Abstract
The suppressor of the cytokine signaling-1 (SOCS1) gene is a short sequence located on chromosome 16 that functions to induce an appropriate immune response and is an essential physiological regulator of interferon (IFN) signaling. In addition to comparing the global DNA and SOCS1 gene promoter methylation status between our patients with coronavirus disease 2019 (COVID-19) and healthy controls, this study demonstrates the effect of the SOCS1 rs33989964 polymorphism on patients with COVID-19. The study group included 139 patients diagnosed with COVID-19 in our hospital's clinics between June and December 2020, and the control group included 78 healthy individuals. After comparing the initial gene polymorphisms of the patients with the healthy control group, three separate clinical subgroups were formed. The gene polymorphism distribution and the methylation status of SOCS1 were examined in these clinical subgroups. Hypomethylation of the SOCS1 gene was observed in the COVID-19 patient group compared to the healthy control group (p = 0.001). Between the patients divided into two separate clinical subgroups, those with severe and mild infections, the Del/Del genotype of the SOCS1 gene was more common in patients with severe infection than in patients with mild infection (p = 0.018). Patients with the CA/CA and CA/Del genotypes were 0.201 times more likely to have a severe infection (95% CI: 0.057-0.716, p = 0.007). Having a non-Del/Del genotype was a protective factor against severe infection. The effect of the SOCS1 rs33989964 polymorphism and methylation status of the SOCS1 gene throughout the COVID-19 pandemic could be significant contributions to the literature.
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Affiliation(s)
- Tufan Tukek
- Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Alpay Medetalibeyoglu
- Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Yasemin Oyacı
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Huzeyfe Arıcı
- Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Naci Senkal
- Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ummuhan Isoglu-Alkac
- Department of Physiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Kose
- Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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11
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Serin I, Pehlivan S, Demir I, Oyacı Y, Pehlivan M. A New Clock is Running for Multiple Myeloma: Circadian Clock Protein-Period 3 (PER-3) Polymorphism. Balkan J Med Genet 2023; 25:37-43. [PMID: 37265974 PMCID: PMC10230830 DOI: 10.2478/bjmg-2022-0026] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Circadian Clock Protein PERIOD 3 (PER-3) is situated on chromosome 1p36.23 and has a polymorphic domain that expresses 4 or 5 copies of the 54-bp tandem repeat sequence. PER-3 gene polymorphisms play a role in the dysregulation of the immune system. This study intended to investigate the distributions and clinical effectiveness of the PER-3 gene polymorphism in multiple myeloma (MM) patients. One hundred fifty patients diagnosed between January 2007-2009 and 100 healthy individuals were included in this study. All patients were suitable for autologous stem cell transplantation (ASCT) at first evaluation, and after 4 courses of VCD at least partial remission, ASCT was carried out. Later, LD was used as maintenance. Genotypes of PER-3 gene of patients and healthy controls were statistically compared before treatment. In addition, these genotypes' effects on overall and progression free survival (OS and PFS) were investigated. Median PFS in the 5R/5R genotype was found to be significantly longer, albeit low, at 86% (p = 0.046). In the statistical analysis performed between the 4R/4R genotype and others, the PFS of patients with 4R/4R was found to be significantly shorter at 40.4 months (p = 0.026). Patients with the 4R/4R genotype would have a risk of 2.049 times of a shorter PFS (p=0.009). With this first study investigating the effect of a circadian gene in MM, the net effect of PER-3 gene polymorphism on PFS was revealed, and it will be a guide for future studies.
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Affiliation(s)
- I. Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - S. Pehlivan
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - I. Demir
- Department of Hematology, Gaziantep Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Y. Oyacı
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - M. Pehlivan
- Department of Hematology, Gaziantep Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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12
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Serin I, Cinli TA, Tunc S, Kaynar L, Sevindik OG, Yokus O. Inherited transmission of the CSF3R T618I mutation: a familial report. Ann Hematol 2023; 102:477-479. [PMID: 36376598 DOI: 10.1007/s00277-022-05050-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz Gurman Cad. 34098, Istanbul, Turkey.
| | - Tahir Alper Cinli
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz Gurman Cad. 34098, Istanbul, Turkey
| | - Sertac Tunc
- Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Leylagul Kaynar
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Osman Yokus
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz Gurman Cad. 34098, Istanbul, Turkey
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13
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Isel I, Serin I, Kal Kolik B, Goze H, Cinli TA, Huq GE, Cicek ME, Altindal S, Yokus O. A COVID-19 mystery: multisystem inflammatory syndrome in adults (MIS-A) associated with splenic rupture. New Microbiol 2023; 46:81-85. [PMID: 36853824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/01/2023]
Abstract
Severe inflammation and one or more extrapulmonary organ dysfunctions have been observed in those who had recently developed COVID-19, except for a macrophage activation syndrome-like picture. A 50-year-old female patient was admitted to the emergency department with fever and a history of COVID-19 infection. More than one area of hemophagocytosis was found in the bone marrow aspiration. The HLH-2004 protocol was started with neurological involvement and she underwent splenectomy due to massive intra-abdominal bleeding secondary to splenic laceration on the 3rd day. Multiple microthrombosis and infarcts were observed in the splenectomy specimen. At the 4th week of the treatment, she was discharged with oral agents. Splenic microthrombosis and splenic rupture due to "multisystem inflammatory syndrome in adults" are the most important findings of this report.
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Affiliation(s)
- Isil Isel
- University of Health Science, Istanbul Training and Research Hospital, Department of Internal Medicine, Istanbul
| | - Istemi Serin
- University of Health Science, Istanbul Training and Research Hospital, Department of Hematology, Istanbul
| | - Beyza Kal Kolik
- University of Health Science, Istanbul Training and Research Hospital, Department of Internal Medicine, Istanbul
| | - Hasan Goze
- University of Health Science, Istanbul Training and Research Hospital, Department of Hematology, Istanbul
| | - Tahir Alper Cinli
- University of Health Science, Istanbul Training and Research Hospital, Department of Hematology, Istanbul
| | - Gulben Erdem Huq
- University of Health Science, Istanbul Training and Research Hospital, Department of Pathology, Istanbul
| | - Mahmut Emin Cicek
- University of Health Science, Istanbul Training and Research Hospital, Department of General Surgery, Istanbul
| | - Sermin Altindal
- University of Health Science, Istanbul Training and Research Hospital, Department of Hematology, Istanbul
| | - Osman Yokus
- University of Health Science, Istanbul Training and Research Hospital, Department of Hematology, Istanbul
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14
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Senkal N, Serin I, Pehlivan S, Pehlivan M, Medetalibeyoglu A, Cebeci T, Konyaoglu H, Oyacı Y, Sayın GY, Isoglu-Alkac U, Tukek T, Kose M. The effect of DNA repair gene variants on COVID-19 disease: susceptibility, severity, and clinical course. Nucleosides Nucleotides Nucleic Acids 2023:1-15. [PMID: 36708261 DOI: 10.1080/15257770.2023.2172183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Oxidative stress (OS), which leads to DNA damage, plays a role in the pathogenesis of Coronavirus disease 2019 (COVID-19). We aimed to evaluate the role of DNA repair gene variants [X-ray repair cross complementing 4 (XRCC4) rs28360071, rs6869366, and X-ray cross-complementary gene 1 (XRCC1) rs25487] in susceptibility to COVID-19 in a Turkish population. We also evaluated its effect on the clinical course of the disease. A total of 300 subjects, including 200 COVID-19 patients and 100 healthy controls, were included in this study. These variants were genotyped using polymerase chain reaction (PCR) and/or PCR-restriction fragment length polymorphism (RFLP) methods. The patients were divided into three groups: those with a mild or severe infection; those who died or lived at the 28-day follow-up; those who required inpatient treatment or intensive care. There were 87 women (43.5%) and 113 men (56.5%) in the patient group. Hypertension was the most common comorbidity (26%). In the patient group, XRCC4 rs6869366 G/G genotype and G allele frequency were increased compared to controls, while XRCC4 rs6869366 G/T and T/T genotype frequencies were found to be higher in controls compared to patients. For XRCC1 rs25487, the A/A and A/G genotypes were significantly associated with COVID-19 disease. All of the patients hospitalized in the intensive care unit had the XRCC4 rs6869366 G/G genotype. In this study, we evaluated for the first time the impact of DNA repair gene variants on COVID-19 susceptibility. Results suggested that XRCC4 rs6869366 and XRCC1 rs25487 were associated with COVID-19 suspectibility and clinical course.
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Affiliation(s)
- Naci Senkal
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Alpay Medetalibeyoglu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Timurhan Cebeci
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hilal Konyaoglu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yasemin Oyacı
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gozde Yesil Sayın
- Department of Medical Genetics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ummuhan Isoglu-Alkac
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tufan Tukek
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Kose
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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15
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Dogu MH, Tekgunduz AIE, Deveci B, Korkmaz G, Comert M, Sevindik OG, Yokus O, Serin I. Gilteritinib (XOSPATA®) in Turkey: Early Access Program Results. Mediterr J Hematol Infect Dis 2023; 15:e2023031. [PMID: 37180209 PMCID: PMC10171205 DOI: 10.4084/mjhid.2023.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023] Open
Abstract
Background And Objectives Gilteritinib (XOSPATA®, Astellas) is a type I oral FLT3 inhibitor, a tyrosine kinase AXL inhibitor, involved in both c-Kit and FMS-like tyrosine kinase 3 (FLT3) resistance. In the phase 3 ADMIRAL trial, gilteritinib was compared with the standard of care in (R/R) acute myeloid leukemia (AML) patients who harbored any FLT3 mutation and showed superior efficacy with regard to response and survival. Objectives This research aimed to investigate the real-life efficacy and safety of gilteritinib in FLT3-positive R/R AML patients who were treated as a part of an early access program held in Turkey in April 2020 (NCT03409081). Results The research included 17 R/R AML patients who had received gilteritinib from seven centers. The overall response rate was 100%. The most common adverse events were anemia and hypokalemia (7 patients, 41.2%). Grade 4 thrombocytopenia was observed in one patient only (5.9%), leading to permanent treatment discontinuation. Patients with peripheral edema had a 10.47 (95% CI: 1.64-66.82) times higher risk of death than those without peripheral edema (p<0.05). Conclusion This research showed that patients with febrile neutropenia and peripheral edema were at a high risk of death when compared to patients without febrile neutropenia and peripheral edema.
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Affiliation(s)
- Mehmet Hilmi Dogu
- Department of Hematology, Istinye University, Faculty of Medicine, Liv Hospital Ulus, Istanbul, Turkey
| | | | - Burak Deveci
- Department of Hematology, Medstar Antalya Hospital, Antalya, Turkey
| | | | - Melda Comert
- Department of Hematology, University of Health Sciences, Gulhane Training and Research Hospital, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Department of Hematology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Osman Yokus
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
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16
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Uysalol M, Serin I, Oyacı Y, Yıldız R, Uysalol E, Pehlivan S. Association of Tumor Necrosis Factor-Alpha (TNF-α) and Suppressor of Cytokine Signaling-1 (SOCS-1) Gene Variants in Children with COVID-19. J PEDIAT INF DIS-GER 2023. [DOI: 10.1055/s-0042-1759801] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Abstract
Objective The suppressor of cytokine signaling-1 (SOCS-1) gene is an essential physiological regulator of cytokine signaling. Tumor necrosis factor-α (TNF-α) is an important component of the immunological response. Herein, we aimed to investigate the effects of SOCS-1 (-1478 CA > Del) and TNF-α (-308) polymorphisms on disease susceptibility and prognosis in pediatric patients with coronavirus disease 2019 (COVID-19).
Methods One-hundred fifty COVID-19 patients in the COVID-19 emergency department between September 2020 and April 2021 and 80 healthy volunteers (control group) without any additional disease were included. Baseline gene polymorphisms were compared between the patient and healthy control groups. Afterward, the gene polymorphism distribution was examined by forming two separate clinical patients' subgroups.
Results While CA/CA and CA/Del gene variants of SOCS-1 were higher in the patient group, Del/Del genotype was more common in the control group (p < 0.05). The GG genotype of the TNF-α was significantly more common in the severe subgroup (p = 0.044). The GA genotype of TNF-α was associated with the risk of hospitalization (2.83-fold), while the GG genotype was found to be protective in terms of hospitalization (2.95-fold).
Conclusions This study will be a guide in terms of the presence of high cytokine release genotypes and COVID-19-related cytokine release syndromes.
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Affiliation(s)
- Metin Uysalol
- Department of Pediatrics, Division of Pediatric Emergency, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Science, Istanbul, Türkiye
| | - Yasemin Oyacı
- Department of Medical Biology and Genetics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Raif Yıldız
- Department of Pediatrics, Division of Pediatric Emergency, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Ezgi Uysalol
- Department of Pediatric Hematology- Oncology, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Sacide Pehlivan
- Department of Medical Biology and Genetics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
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17
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Tuncel FC, Serin I, Pehlivan S, Oyaci Y, Pehlivan M. Epigenetic and genetic investigation of SOCS-1 gene in patients with multiple myeloma. Blood Res 2022; 57:250-255. [PMID: 36289192 PMCID: PMC9812727 DOI: 10.5045/br.2022.2022097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/17/2022] [Accepted: 09/08/2022] [Indexed: 02/01/2023] Open
Abstract
Background The suppressor of cytokine signaling-1 (SOCS-1) functions to induce an appropriate immune response and is an essential physiological regulator of interferon signaling. DNA methylation involves adding a methyl group to the carbon 5 position of cytosine. Besides comparing SOCS-1 gene methylation status between patients with multiple myeloma (MM) and healthy controls, this study also aimed to demonstrate the effect of SOCS-1 gene distribution and the effect of methylation of SOCS-1 on progression-free survival (PFS) and overall survival (OS). Methods This study included 120 patients diagnosed with MM between January 2018 and 2020 and 80 healthy individuals. The distribution of the SOCS-1 genotypes was statistically compared between MM patients and healthy controls. Additionally, the statistically significant effects of these genotypes on survival were examined. Results The CA/CA genotype of SOCS-1 was significantly higher in healthy controls (P=0.001), while the Del/Del genotype was significantly higher in patients with MM (P=0.034). The percent methylated reference (PMR) value of the SOCS-1 gene was significantly higher in the healthy controls (median, 43.48; range, 2.76‒247.75; P=0.001). Patients with a PMR value of ≥43.48 were 3.125 times more likely to develop progression than those with a PMR value of <43.48. Conclusion The effects of SOCS-1 polymorphisms on the pathogenesis of.
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Affiliation(s)
- Fatıma Ceren Tuncel
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey,Correspondence to Istemi Serin, M.D., Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org. Nafiz Gurman Cad. Fatih 34098, Istanbul, Turkey, E-mail:
| | - Sacide Pehlivan
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Yasemin Oyaci
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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18
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Gunes AK, Serin I, Demir I, Sarifakiogullari S, Durusoy SS, Akkurt DM, Ince I, Ozkan G, Cinli TA, Pehlivan M. Comparison of Mitoxantrone-Melphalan and BEAM Conditioning Regimens in Patients with Lymphoma. Hematol Oncol Stem Cell Ther 2022; 15:201-207. [PMID: 33933474 DOI: 10.1016/j.hemonc.2021.03.005] [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] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/20/2021] [Accepted: 03/27/2021] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE/BACKGROUND Lymphoma is seen as a highly treatable and curable malignancy with aggressive treatment methods. Efficacy is often limited by toxicity and many patients need alternative treatment strategies as they cannot tolerate existing high cytotoxic approaches. Our aim is to compare BEAM [carmustine (BCNU), etoposide, cytarabine (ARA-C, cytosine arabinoside), and melphalan] and mitoxantrone-melphalan (Mx-Mel) regimens utilized in our patients with a diagnosis of lymphoma who underwent autologous stem cell transplantation (ASCT), and to demonstrate that the Mx-Mel regimen has similar but less toxic results than the BEAM regimen we have been using frequently as standard conditioning regimen. METHODS A total of 101 patients with lymphoma who underwent ASCT were included in our study. The BEAM regimen included BCNU, etoposide, ARA-C, and melphalan. The Mx-Mel regimen included mitoxantrone and melphalan. RESULTS Of 101 patients included in the study, 60 (59.4%) received BEAM and 41 (40.6%) received Mx-Mel (40.6%) conditioning regimen. The median time to neutrophil engraftment was 10 (range: 9-20) days and 12 (range: 9-12) days in the BEAM and Mx-Mel arms, respectively; it was statistically significantly shorter in the BEAM arm (p = .001). CONCLUSION This study demonstrates that the Mx-Mel regimen has similar efficacy and toxicity compared with the BEAM regimen. Although time to neutrophil engraftment was shorter in the BEAM arm, it did not result as significant transplant-related complications between the two regimens. The Mx-Mel regimen is seen as a good alternative with low toxicity and high efficacy.
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Affiliation(s)
| | - Istemi Serin
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Ilknur Demir
- Gaziantep Abdulkadir Yuksel State Hospital, Gaziantep, Turkey
| | | | | | - Dervis Murad Akkurt
- Gaziantep University, Faculty of Medicine, Department of Hematology, Gaziantep, Turkey
| | - Idris Ince
- Dr. Ersin Aslan Training and Research Hospital, Department of Hematology, Gaziantep, Turkey
| | - Gulkan Ozkan
- Istanbul Hamidiye Sisli Etfal Training and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Tahir Alper Cinli
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Mustafa Pehlivan
- Gaziantep University, Faculty of Medicine, Department of Hematology, Gaziantep, Turkey
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19
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Sari ND, Serin I, Bakir A, Alacam S. Could serum thrombocyte/lymphocyte (TLR), neutrophil/lymphocyte (NLR) and neutrophil/albumin (NAR) ratios be indicators of hospitalization and mortality in COVID-19? Iran J Microbiol 2022; 14:913-920. [PMID: 36721444 PMCID: PMC9867618 DOI: 10.18502/ijm.v14i6.11266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background and Objectives Neutrophil / lymphocyte (NLR) and thrombocyte / lymphocyte ratios (TLR) are also a guiding factors in the prognostic evaluation of infectious diseases. Another parameter to determine inflammation and prognosis is albumin. This study was aimed to determine whether TLR, NLR and neutrophil / albumin ratios (NAR) are effective in predicting the severity and course of Corona Virus Disease-2019 (COVID-19). Materials and Methods In this retrospective and cross-sectional study, a total of 1597 patients who were admitted to our hospital between 15.03.2020-1.06.2020, diagnosed with COVID-19 were evaluated. Results In the estimation of the decision for hospitalization, TLR, NLR and NAR AUROC values were 0.596, 0.634, 0.602 for cutoff values 123.7, 2.3 and 839.5, respectively. In predicting mortality, TLR, NLR and NAR AURO sample size can be specified C values were 0.674, 0.821, 0.787 for cutoff values 168.1, 5.2 and 1303.4, respectively (p <0.001 for all). Conclusion In our study, it was determined that TLR, NLR and NAR are independent predictors in making the decision of hospitalization and in determining the prognosis in patients who are decided to be hospitalized.
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Affiliation(s)
- Nagehan Didem Sari
- Department of Clinical Microbiology and Infectious Diseases, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey,Corresponding author: Istemi Serin, MD, Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. Tel: +90-2124596330 Fax: +90-2124696062
| | - Ayfer Bakir
- Department of Medical Microbiology, Gulhane Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sema Alacam
- Department of Medical Microbiology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Serin I, Baltali S, Cinli TA, Goze H, Demir B, Yokus O. Lateral flow assay (LFA) in the diagnosis of COVID-19-associated pulmonary aspergillosis (CAPA): a single-center experience. BMC Infect Dis 2022; 22:822. [PMCID: PMC9644000 DOI: 10.1186/s12879-022-07828-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
Invasive pulmonary aspergillosis (IPA) is seen during coronavirus-2019 (COVID-19), has been reported in different incidences, and is defined as COVID-19-associated pulmonary aspergillosis (CAPA). Detection of galactomannan antigen is an important diagnostic step in diagnosing IPA. Enzyme-linked immunoassay (ELISA) is the most frequently used method, and lateral flow assay (LFA) is increasingly used with high sensitivity and specificity for rapid diagnosis. The present study aimed to compare the sensitivity of LFA and ELISA in the diagnosis of CAPA in COVID-19 patients followed in our hospital's ICU for pandemic (ICU-P).
Methods
This study included patients with a diagnosis of COVID-19 cases confirmed by polymerase chain reaction and were followed up in ICU-P between August 2021 and February 2022 with acute respiratory failure. The diagnosis of CAPA was based on the European Confederation of Medical Mycology (ECMM) and the International Society for Human and Animal Mycology 2020 (ECMM/ ISHAM) guideline. Galactomannan levels were determined using LFA and ELISA in serum samples taken simultaneously from the patients.
Results
Out of the 174 patients followed in the ICU-P, 56 did not meet any criteria for CAPA and were excluded from the analysis. The rate of patients diagnosed with proven CAPA was 5.7% (10 patients). A statistically significant result was obtained with LFA for the cut-off value of 0.5 ODI in the diagnosis of CAPA (p < 0.001). The same significant statistical relationship was found for the cut-off value of 1.0 ODI for the ELISA (p < 0.01). The sensitivity of LFA was 80% (95% CI: 0.55–1.05, p < 0.05), specificity 94% (95% CI: 0.89–0.98, p < 0.05); PPV 53% (95% CI: 0.28–0.79, p > 0.05) and NPV was 98% (95% CI: 0.95–1.01, p < 0.05). The risk of death was 1.66 (HR: 1.66, 95% CI: 1.02–2.86, p < 0.05) times higher in patients with an LFA result of ≥ 0.5 ODI than those with < 0.5 (p < 0.05).
Conclusions
It is reckoned that LFA can be used in future clinical practice, particularly given its effectiveness in patients with hematological malignancies and accuracy in diagnosing CAPA.
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21
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Dogu SY, Serin I, Dogu MH, Guleroglu FY, Dane C. Efficacy of the lactate dehydrogenase (LDH)/lymphocyte ratio (LLR) to reduce the need for X-ray in pregnant patients with COVID-19. J Perinat Med 2022; 50:887-895. [PMID: 35488442 DOI: 10.1515/jpm-2021-0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 03/23/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Pregnancy carries a significant risk for coronavirus disease-2019 (COVID-19) due to natural immunosuppression. A previous study from our center has shown that the lactate dehydrogenase (LDH)/lymphocyte ratio (LLR) can be used in the early diagnosis of COVID-19 and predicting mortality. Based on this, we aimed to determine the effect of LLR on early detection of critical pregnant women and mortality in COVID-19. METHODS The data of 145 patients who were admitted to our hospital between March and December 2020; diagnosed with COVID-19 and hospitalized, were retrospectively analyzed. RESULTS The median gestation period was 31 weeks (range: 5-41), 30.3% (n: 44) gave birth and 68.3% (n: 99) were pregnant. Median LLR was 0.13 (range: 0.04-0.70). The rate of cough (47% vs. 22.8%; p=0.003) was found to be high in patients with LLR>0.13. The patients were divided into subgroups. The proportion of patients without active complaints was higher in the Q1, followed by the Q4. The proportion of patients with an initial complaint of cough increased as LLR from Q1 to Q4, the distribution of other complaints did not differ between the quartiles. CONCLUSIONS The higher rate of cough in the group with high LLR indicates that it may be an important indicator of lung involvement during pregnancy. The highest rate of non-treatment follow-up in the lowest LLR group proved that the LLR value at the time of diagnosis can be used as an important clinical marker in pregnant women.
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Affiliation(s)
- Sevilay Yavuz Dogu
- Haseki Training and Research Hospital, Department of Obstetrics and Gynecology, University of Health Science, Istanbul, Turkey
| | - Istemi Serin
- Istanbul Training and Research Hospital, Department of Internal Medicine and Hematology, University of Health Science, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Faculty of Medicine, Liv Hospital, Department of Internal Medicine and Liv Hospital Hematology, Istinye University, Istanbul, Turkey
| | - Filiz Yarsilikal Guleroglu
- Haseki Training and Research Hospital, Department of Obstetrics and Gynecology, University of Health Science, Istanbul, Turkey
| | - Cem Dane
- Faculty of Medicine, Department of Gynocology and Obstetrics, Istinye University, Istanbul, Turkey
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22
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Yokus O, Sunger E, Cinli TA, Goze H, Serin I. Serum albumin and ferritin levels: a practical indicator of prognosis in acute myeloid leukemia over 50 years of age? Am J Blood Res 2022; 12:97-104. [PMID: 35873101 PMCID: PMC9301019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 05/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Low albumin and high ferritin levels have negative effects on survival in acute myeloid leukemia (AML). In this study, the aim is to determine the role of these factors on survival in patients over 50 years of age with AML. METHODS Eighty patients followed up between January 2014 and July 2019 were included in the study. Patients were categorised into three subgroups: The favorable, intermediate and high-risk groups. RESULTS The overall survival of the favorable group was found to be longer in a statistically significant way. CONCLUSION In this study, it has been shown that serum albumin and ferritin values are useful and simple laboratory values to show prognosis in AML over 50 years of age.
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Affiliation(s)
- Osman Yokus
- University of Health Sciences, Istanbul Training and Research Hospital, Department of HematologyIstanbul, Turkey
| | - Erdem Sunger
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Internal MedicineIstanbul, Turkey
| | - Tahir Alper Cinli
- University of Health Sciences, Istanbul Training and Research Hospital, Department of HematologyIstanbul, Turkey
| | - Hasan Goze
- University of Health Sciences, Istanbul Training and Research Hospital, Department of HematologyIstanbul, Turkey
| | - Istemi Serin
- University of Health Sciences, Istanbul Training and Research Hospital, Department of HematologyIstanbul, Turkey
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Serin I, OYACI Y, PEHLIVAN M, PEHLIVAN S. PB1967: ROLE OF CYTOKINES IN MULTIPLE MYELOMA: IL-1RN AND IL-4 VNTR POLYMORPHISMS. Hemasphere 2022. [PMCID: PMC9429308 DOI: 10.1097/01.hs9.0000850704.22267.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Serin I, Sari ND, Gunaltili M, Karakilic A, Gulesir B, Kal Kolik B, Cevik G, Sungurlu H, Keskin M, Baltik M, Cakmak O, Cinli TA. Enigma of COVID-19: is “multisystem inflammatory syndrome in adults” (MIS-A) predictable? BMC Infect Dis 2022; 22:300. [PMID: 35346086 PMCID: PMC8960085 DOI: 10.1186/s12879-022-07303-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 03/23/2022] [Indexed: 12/11/2022] Open
Abstract
Background Severe inflammation and one or more extrapulmonary organ dysfunctions have been reported and this clinical picture is defined as "multisystem inflammatory syndrome in adults" (MIS-A) in severe coronavirus disease-2019 (COVID-19). We aimed to determine the effect of LDH/lymphocyte ratio (LLR) on the development of MIS-A. Methods The data of 2333 patients were retrospectively analyzed. Results MIS-A rate was found to be 9.9% and MIS-A related mortality was 35.3%. LRR level above 0.24 was found to predict MIS-A development with 70% sensitivity and 65.2% specificity. The risk of MIS-A development was found to be 3.64 times higher in those with LRR levels above 0.24 compared to those with 0.24 and below. In patients with MIS-A, LRR level above 0.32 predicts mortality with 78% sensitivity and 70% specificity. Conclusions Early detection of MIS-A with high sensitivity and specificity in a practical ratio is very important in terms new studies.
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Serin I, Oyaci Y, Pehlivan M, Pehlivan S. Role of cytokines in multiple myeloma: IL-1RN and IL-4 VNTR polymorphisms. Cytokine 2022; 153:155851. [PMID: 35272075 DOI: 10.1016/j.cyto.2022.155851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/06/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The IL-1 receptor antagonist (IL-1Ra or IL-1RN) is a member of the IL-1 superfamily that functions as a competitive antagonist of the cell surface IL-1 receptor, thereby regulating various immune and inflammatory responses related to IL-1. IL-1 induces tumor growth and metastasis, while IL-1RN inhibits the secretion of IL-1α and IL-6 in cancer cells. Interleukin-4 (IL-4) is a potent anti-inflammatory cytokine, can be secreted by many types of immune cells. In this study, it was aimed to reveal the effects of IL-1RN and IL-4 VNTR polymorphisms on disease development and survival in patients with multiple myeloma (MM). MATERIAL AND METHODS In this study, 244 patients diagnosed with MM in hematology clinic between January 2010 and January 2021, and 179 healthy individuals were included. The genotypes of the IL-1RN VNTR polymorphism were statistically compared before treatment between patients having undergone stem cell transplantation and healthy controls, as were the genotypes of IL-4 VNTR polymorphism. Additionally, the statistically significant effects of these genotypes on survival were examined. RESULTS In the statistical analysis of the distribution of IL-1RN VNTR gene variants, 1/3 and 1/4 genotypes were found to be significantly higher in patients with MM compared to the healthy controls (p = 0.035). There was no significant difference between the MM patient group and the healthy controls in terms of IL-4 VNTR genotype distribution. PFS of patients with IL-1RN VNTR non-2-allele carrier genotypes was significantly shorter, but no significant effect was found on OS (p = 0.03, p = 0.786, respectively). Patients with IL-1RN VNTR non-2-allele carrier genotypes had 1.718-fold increased risk of shorter PFS. CONCLUSIONS In conclusion, with this study, the effects of IL-1RN VNTR and IL-4 VNTR polymorphisms on MM were evaluated for the first time in the literature. This study will shed light on ones on cytokine-MM relationship and epigenetic mechanisms.
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Affiliation(s)
- Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Yasemin Oyaci
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Faculty of Medicine, Institute of Health Sciences, Istanbul University, Istanbul, Turkey
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Serin I, Orhan B, Sonmez D, Cinli TA, Goze H, Serin H, Gulesir B, Yokus O. A new approach in acute myeloid leukemia (AML): Samatya-predicting score. Leuk Res Rep 2022; 17:100293. [PMID: 35242525 PMCID: PMC8866886 DOI: 10.1016/j.lrr.2022.100293] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/07/2022] [Accepted: 02/14/2022] [Indexed: 11/28/2022] Open
Abstract
We aimed to examine the efficiency of our new scoring system in non-APL AML cases,. The AUC for the median risk score of 2,5 in ROC analysis was 0,635 (p = 0,006) for exitus; 0,605 (p = 0,024) for being responder,. The sensitivity for mortality was 88%, the specificity 42%, the PPV 90,1%, and the NPV was 24,7%,. In terms of being non-responder to induction therapy, the sensitivity was 90,1%, the specificity 25,3%, the PPV 89,8%, and the NPV was 32%.
We aimed to examine the efficiency for prediction of prognosis and response in non-APL AML cases of the “Samatya-predicting score”. A total of 213 patients diagnosed between January 2010-December 2020 were examined. Of the 158 patients included in the study, the median value of risk score was determined as 2,5. The sensitivity for mortality was 88% and the specificity was 42%. In terms of being non-responder to induction therapy, the sensitivity was 90,1%, the specificity was 25,3%. OS was shorter in those with high risk scores. This study makes an important contribution to the literature in terms of creating a different perspective to predict prognosis in AML.
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Affiliation(s)
- Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Org. Nafiz GURMAN Cad., Samatya, Fatih, Istanbul, Istanbul, 34098 Turkey
- Corresponding author.
| | - Bagnu Orhan
- Department of Medical Biochemistry, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Derya Sonmez
- Department of Medical Biochemistry, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Tahir Alper Cinli
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Org. Nafiz GURMAN Cad., Samatya, Fatih, Istanbul, Istanbul, 34098 Turkey
| | - Hasan Goze
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Org. Nafiz GURMAN Cad., Samatya, Fatih, Istanbul, Istanbul, 34098 Turkey
| | - Huriye Serin
- Department of Medical Biochemistry, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Begum Gulesir
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Osman Yokus
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Org. Nafiz GURMAN Cad., Samatya, Fatih, Istanbul, Istanbul, 34098 Turkey
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Uysalol EP, Uysalol M, Pehlivan M, Oyaci Y, Pehlivan S, Serin I. Association of mannose-binding lectin 2 (MBL2) and suppressor of cytokine signaling-1 (SOCS1) gene variants in children with febrile neutropenia. J Infect Chemother 2022; 28:657-662. [PMID: 35115241 DOI: 10.1016/j.jiac.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/25/2021] [Revised: 12/15/2021] [Accepted: 01/17/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Febrile neutropenia (FEN) was reported in patients with solid malignancies at a rate of 5-10% and in patients with hematological malignancies at a rate of 20-25%. In our study, we aimed to investigate the effects of mannose-binding lectin 2 (MBL2) (rs1800450) and suppressor of cytokine signaling-1 (SOCS1) (rs33989964) gene variants on patients with FEN. METHODS A total of 123 patients who applied to pediatric emergency department between December 2019-12/2020 included in the study. Thirteen patients were excluded from the study due to the inability to obtain DNA. Demographic-clinical features at initial diagnosis and genotype distributions were recorded. The control group consisted of volunteers with the same ethnicity, age and gender, no active infection, and no consanguinity. RESULTS CA/CA genotype of SOCS1 was found to be significantly higher in the healthy control group (p = 0.028). AB/BB genotype of MBL2 was significantly higher in FEN patients with a MASCC score of high risk, AA genotype was found to be higher in patients with low risk (p = 0.001). While the rate of microbiologically documented infection (MDI) was significantly lower in patients with the AA genotype of MBL2, it was significantly higher in patients with AA/BB genotypes (p = 0.025). MDI rate in patients with the del/del genotype of SOCS1 was found to be significantly lower than in patients with CA/CA + CA/del genotypes (p = 0.026). CONCLUSIONS In this study, it was revealed that low expression-related MBL2 genotypes were riskier for FEN and also, gene variants associated with high SOCS1 transcription were both protective against FEN and increased the rate of culture-negativity.
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Affiliation(s)
- Ezgi Pasli Uysalol
- Basaksehir Cam and Sakura City Hospital, Department of Pediatric Hematology- Oncology, Turkey
| | - Metin Uysalol
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Turkey
| | - Mustafa Pehlivan
- Gaziantep University, Faculty of Medicine, Department of Hematology, Turkey
| | - Yasemin Oyaci
- Istanbul University, Istanbul Faculty of Medicine, Department of Medical Biology and Genetics, Turkey
| | - Sacide Pehlivan
- Istanbul University, Istanbul Faculty of Medicine, Department of Medical Biology and Genetics, Turkey
| | - Istemi Serin
- University of Health Science, Istanbul Training and Research Hospital, Department of Department of Hematology, Turkey.
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Yokus O, Jafarli K, Sametoglu F, Goze H, Serin I. Secondary Immunodeficiency Frequency in Patients with Chronic Lymphocytic Leukemia: The Relationship with Stage and Treatment. Int J Hematol Oncol Stem Cell Res 2022; 16:14-21. [PMID: 35975119 PMCID: PMC9339121 DOI: 10.18502/ijhoscr.v16i1.8437] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Chronic lymphocytic leukemia (CLL) is one of the most common hematological malignancies. In patients with CLL, serum immunoglobulin levels decrease over time due to both the disease itself and the chemo-immunotherapeutic agents used. It was aimed to reveal the relationship between hypogammaglobulinemia and disease stage, and chemo-immunotherapies.
Materials and Methods: Data were obtained by retrospectively examining 74 patients who were followed-up between 2008-2019. The relationship between all parameters (demographic characteristics, RAI stages or therapy subtypes) and serum IgG levels was analyzed.
Results: Thirty-two of 74 patients received a therapy. Twenty-two patients were on combined therapy with rituximab or only rituximab and 10 were treated with chemotherapeutic agents only. The frequency of hypogammaglobulinemia was 5.4% at the diagnosis, this rate was 55% in patients receiving a therapy. Hypogammaglobulinemia was higher in advanced stages. In patients with rituximab, higher levels of IgG decrease were observed.
Conclusion: Serum IgG level was significantly lower in patients with advanced-stage, received chemotherapy, especially rituximab. In addition to basal IgG, immunoglobulin levels should be checked during treatment, and follow-up period. Early replacement intravenous immunoglobulins will be important to reduce severe infection attacks due to secondary immunodeficiency.
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Affiliation(s)
- Osman Yokus
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Konul Jafarli
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Fettah Sametoglu
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Hasan Goze
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
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Sevindik OG, Mergen M, Mergen S, Mutlu YG, Aydın BB, Serin I. To rechallenge or not to rechallenge, that is the question? An unsuccessful attempt of hypomethylating agent plus venetoclax in an elderly FLT3-positive relapsed acute myeloid leukemia patient after a yearlong period of remission. Ann Hematol 2022; 101:2545-2547. [PMID: 35906348 PMCID: PMC9361949 DOI: 10.1007/s00277-022-04938-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 07/23/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Omur Gokmen Sevindik
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Mahmut Mergen
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Sena Mergen
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Yasa Gul Mutlu
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Berrin Balık Aydın
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz GURMAN Cad., 34098 Fatih Istanbul, Turkey
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Serin I, Dogu MH. The use of hypomethylating agents in hematologic malignancies: treatment preferences and results. Int J Hematol Oncol 2021; 10:IJH37. [PMID: 35295753 PMCID: PMC8922247 DOI: 10.2217/ijh-2020-0019] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 09/06/2021] [Indexed: 11/21/2022] Open
Abstract
Aim: The objective of this article was to compare the efficiency of azacitidine (AZA) and decitabine (DAC) in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) who are not suitable for high-dose chemotherapy. Materials and methods: MDS and AML patients who were treated with hypomethylating agents (HMAs) between January 2005 and 2020 were evaluated retrospectively. Results: No statistically significant difference was found between the patients who received AZA or DAC in AML patients. In MDS group, the rate of patients who achieved remission was statistically significantly higher in patients who received DAC (p = 0.032). Conclusion: The advantage in terms of response for MDS and no survival difference between AZA and DAC for AML and MDS patients will be an important contribution to the literature.
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Affiliation(s)
- Istemi Serin
- University of Health Science, Istanbul Training & Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Istinye University, Department of Internal Medicine and Hematology, Liv Hospital Ulus, Beşiktaş, Turkey
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Uysalol M, Gumus S, Yildiz R, Pasli Uysalol E, Pehlivan S, Pehlivan M, Serin I. Importance of mannose-binding lectin2 polymorphism ( rs1800450) in infections in children. Biomarkers 2021; 27:44-49. [PMID: 34747274 DOI: 10.1080/1354750x.2021.2003432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/19/2022]
Abstract
PURPOSE Mannose-binding lectin (MBL) is a serine protease belonging to the collectins and an important factor in the inherited immune system. We aimed to reveal the distribution of different MBL2 genotypes in patients diagnosed with acute bronchiolitis and pneumonia. MATERIAL AND METHODS A total of 147 patients who applied to Paediatric Emergency between 01.12.2019 and 31.12.2020 were included in the study. Patients were divided into two subgroups: Bronchiolitis and pneumonia. RESULTS AA genotype was found to be significantly higher in healthy controls (p = 0.039). In the pneumonia group, both AB/BB genotype was significantly higher compared to healthy controls (p = 0.001). While the AA genotype was more common in patients with acute bronchiolitis, AB/BB genotypes were more common in the pneumonia group (p = 0.001). The presence of fever, crepitation, tachypnoea, pathological x-ray finding, and high leukocyte count are significantly more common in patients with AA genotype, while more than 3 days of follow-up duration and severe clinical picture were more common in patients with AB/BB genotypes (p < 0.05, for all). CONCLUSIONS Genotypes with low MBL expression were significantly more common in patients with pneumonia and severe infection. All these results reveal the importance of MBL polymorphisms and their expression in infections.
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Affiliation(s)
- Metin Uysalol
- Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul University, Istanbul, Turkey
| | - Suheyla Gumus
- Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul University, Istanbul, Turkey
| | - Raif Yildiz
- Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul University, Istanbul, Turkey
| | - Ezgi Pasli Uysalol
- Department of Pediatric Hematology-Oncology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Sacide Pehlivan
- Istanbul Faculty of Medicine, Department of Medical Biology and Genetics, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Faculty of Medicine, Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | - Istemi Serin
- Department of Department of Hematology, University of Health Science, Istanbul Training and Research Hospital, Istanbul, Turkey
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Sarı ND, Serin I, Kırgezen T, Doğu MH. Mucormycosis in Hematologic Malignancies: Clinical Follow-Up and Treatment Results. Istanbul Med J 2021. [DOI: 10.4274/imj.galenos.2021.65872] [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: 12/01/2022] Open
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Pehlivan S, Köse M, Mese S, Serin I, Senkal N, Oyacı Y, Medetalibeyoglu A, Pehlivan M, Sayın GY, Isoglu-Alkac U, Tukek T. Investigation of MBL2 and NOS3 functional gene variants in suspected COVID-19 PCR (-) patients. Pathog Glob Health 2021; 116:178-184. [PMID: 34570692 PMCID: PMC8477587 DOI: 10.1080/20477724.2021.1984726] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
For COVID-19 (Coronavirus Disease-2019) cases, detecting host-based factors that predispose to infection is a very important research area. In this study, the aim is to investigate the MBL2 and NOS3 gene polymorphisms in COVID-19 patients with lung involvement, whose first nasopharyngeal PCR results were negative. Seventy-nine patients diagnosed with COVID-19 between April-June 2020 who were admitted to a university hospital, and 100 healthy controls were included. In the first statistical analysis performed between PCR-positive, CT-negative and PCR-negative, CT-positive patients; the AB of MBL2 genotype was significantly higher in the first group (p = 0.049). The B allele was also significantly higher in the same subgroup (p = 0.001). The absence of the AB genotype was found to increase the risk of CT positivity by 6.9 times. The AB genotype of MBL2 was higher in healthy controls (p = 0.006). The absence of the AB genotype was found to increase the risk of CT positivity; also, it can be used for early detection and isolation of patients with typical lung involvement who had enough viral loads, but whose initial PCR results were negative.
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Affiliation(s)
- Sacide Pehlivan
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Köse
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevim Mese
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Naci Senkal
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yasemin Oyacı
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alpay Medetalibeyoglu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Gaziantep University, Faculty of Medicine, Istanbul, Gaziantep, Turkey
| | - Gözde Yesil Sayın
- Department of Medical Genetics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ummihan Isoglu-Alkac
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tufan Tukek
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Akpinar S, Dogu MH, Celik S, Ekinci O, Hindilerden IY, Dal MS, Davulcu EA, Tekinalp A, Hindilerden F, Ozcan BG, Hacibekiroglu T, Erkurt MA, Bagci M, Namdaroglu S, Korkmaz G, Bilgir O, Cagliyan GA, Ozturk HBA, Serin I, Tiryaki TO, Ozatli D, Korkmaz S, Ulas T, Eser B, Turgut B, Altuntas F. The Real-World Experience With Single Agent Ibrutinib in Relapsed/Refractory CLL. Clin Lymphoma Myeloma Leuk 2021; 22:169-173. [PMID: 34629286 DOI: 10.1016/j.clml.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION/BACKGROUND The emergence of novel agents targeting the B-cell receptor pathway and BCL-2 has significantly changed the therapeutic landscape of CLL. We evaluated the safety and efficacy of single-agent ibrutinib in relapsed/refractory CLL in real-world settings. PATIENTS/METHODS A total of 200 relapsed/refractory CLL patients with a median age of 68 were included in this retrospective, multicenter, non-interventional study. Data of the study were captured from the patient charts of the participating centers. RESULTS The median for lines of previous chemotherapy was 2 (1-6); 62 (31.8%) patients had del17p and/or p53 mutations (del17p+/p53mut). Of the study group, 146 (75%) patients achieved at least PR, while 16 (8.7%) patients discontinued ibrutinib due to TEA. The most common drug-related adverse events were neutropenia (n: 31; 17.4%) and thrombocytopenia (n: 40; 22.3%), which were ≥ grade 3 in 9 (5%) and 5 (3.9%) patients, respectively. Pneumonia (n: 42; 23.7%) was the most common nonhematologic TEA. Atrial fibrillation (n: 5; 2.8%) and bleeding (n: 11; 6.3%) were relatively rare during the study period. Within a median follow-up period of 17 (1-74) months, 42 (21%) patients died. The estimated median OS of the study cohort was 52 months. Only the response to ibrutinib (CR/PR vs. SD/PD) was significantly associated with OS. CONCLUSION Our results indicate good safety and efficacy for single-agent ibrutinib in R/R CLL in daily practice.
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Affiliation(s)
- Seval Akpinar
- Department of Internal Medicine, Division of Hematology, Tekirdağ Namık Kemal University Medical School, Tekirdağ, Turkey.
| | - Mehmet Hilmi Dogu
- Liv Hospital Ulus, Department of Hematology, Istinye University, Istanbul, Turkey
| | - Serhat Celik
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Omer Ekinci
- Department of Hematology, University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Ipek Yonal Hindilerden
- Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul University, Istanbul, Turkey
| | - Mehmet Sinan Dal
- Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Eren Arslan Davulcu
- Department of Hematology, University of Health Sciences, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Atakan Tekinalp
- Meram Faculty of Medicine, Department of Hematology, Necmettin Erbakan University, Konya, Turkey
| | - Fehmi Hindilerden
- Department of Hematology, University of Health Sciences, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Busra Gokce Ozcan
- Department of Internal Medicine, Celal Bayar University, Manisa, Turkey
| | | | | | - Metin Bagci
- Department of Hematology, Selcuk University, Konya, Turkey
| | - Sinem Namdaroglu
- Department of Hematology, University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Gulten Korkmaz
- Department of Hematology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Oktay Bilgir
- Department of Hematology, University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | | | - Hacer Berna Afacan Ozturk
- Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Tarık Onur Tiryaki
- Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul University, Istanbul, Turkey
| | - Duzgun Ozatli
- Department of Hematology, Ondokuz Mayis University, Samsun, Turkey
| | - Serdal Korkmaz
- Department of Hematology & Apheresis Unit, University of Health Sciences, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Turgay Ulas
- School of Medicine, Department of Internal Medicine, Division of Hematology, Near East University, Nicosia, Cyprus
| | - Bulent Eser
- Department of Hematology, Medical Park Antalya Hospital, Antalya, Turkey
| | - Burhan Turgut
- Department of Internal Medicine, Division of Hematology, Tekirdağ Namık Kemal University Medical School, Tekirdağ, Turkey
| | - Fevzi Altuntas
- Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara Oncology Training and Research Hospital, Ankara, Turkey; School of Medicine, Department of Internal Medicine, Division of Hematology, Ankara Yildirim Beyazit University, Ankara, Turkey
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Demir I, Pehlivan S, Okan V, Sahin HH, Durusoy SS, Serin I, Oyaci Y, Pehlivan M. Effect of the uncoupling protein-2 (UCP-2) and nuclear receptor subfamily 3 group C member 1 (NR3C1) genes on treatment efficacy and survival in patients with multiple myeloma: a single-center study. BMC Res Notes 2021; 14:346. [PMID: 34481515 PMCID: PMC8418283 DOI: 10.1186/s13104-021-05758-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Studies on the genetic background of patients with multiple myeloma (MM) have been increasing; two important factors considered in such works are uncoupling protein-2 (UCP-2) and nuclear receptor subfamily 3 group C member 1 (NR3C1). We aim to reveal the association of MM with NR3C1 and UCP-2 gene polymorphisms. In this prospective study, 200 patients diagnosed between January 2009 and 2018 and 200 healthy individuals were included. For patients who had undergone autologous stem cell transplantation and control subjects, we statistically compared the CC, GC, and GG genotypes and the C and G alleles of the NR3C1 gene, as well as the AA, AG, and GG genotypes and the A and G alleles of the UCP-2 gene. RESULTS While the AA genotype was significantly more common in the MM group (p = 0.001), the GG genotype was significantly more common in the control group (p = 0.016). Overall survival was found to be significantly shorter in patients with the UCP-2 GG genotype (p = 0.034). It was also found that having the GG genotype of the UCP-2 gene was a 2.48-fold risk factor for mortality. The fact that overall survival is significantly shorter in MM patients with the UCP-2 GG genotype and its definition as a risk factor for mortality have been put forward for the first time in the literature.
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Affiliation(s)
- Ilknur Demir
- Department of Internal Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Vahap Okan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | | | - Salih Sertaç Durusoy
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Org. Nafiz Gurman Cad., Fatih, 34098, Istanbul, Turkey.
| | - Yasemin Oyaci
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.,Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Org. Nafiz Gurman Cad., Fatih, 34098, Istanbul, Turkey
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Yokus O, Herek C, Cinli TA, Goze H, Serin I. Iron overload during the treatment of acute leukemia: pretransplant transfusion experience. Int J Hematol Oncol 2021; 10:IJH36. [PMID: 34840721 PMCID: PMC8609998 DOI: 10.2217/ijh-2021-0005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/06/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Recent studies have shown the increased risk of mortality in cases with acute leukemia and iron overload. We aimed to determine the status of iron overload in patients with acute leukemia. MATERIALS & METHODS Patients diagnosed with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) between January 2015 and December 2019 were included in the study. RESULTS At 6 months, there were statistically more patients with serum ferritin >1000 in the AML group compared to the ALL group (p = 0,011). CONCLUSION Iron overload occurs earlier in patients with AML; the difference disappears after 6 months of treatment. It is the correct point to emphasize that iron overload is an important factor of pretransplant morbidity, especially in AML cases.
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Affiliation(s)
- Osman Yokus
- Department of Hematology, University of Health Sciences, Istanbul Training & Research Hospital, Bagcilar, Istanbul, 34200, Turkey
| | - Celalettin Herek
- Department of Internal Medicine, University of Health Sciences, Bagcilar Training & Research Hospital, Bagcilar, Istanbul, 34200, Turkey
| | - Tahir Alper Cinli
- Department of Hematology, University of Health Sciences, Istanbul Training & Research Hospital, Bagcilar, Istanbul, 34200, Turkey
| | - Hasan Goze
- Department of Hematology, University of Health Sciences, Istanbul Training & Research Hospital, Bagcilar, Istanbul, 34200, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training & Research Hospital, Bagcilar, Istanbul, 34200, Turkey
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Serin I, Dogu MH, Huq GE, Yokus O. A new FLT3 inhibitor with two cases: the gilteritinib experience. Am J Blood Res 2021; 11:271-278. [PMID: 34322291 PMCID: PMC8303015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION In acute myeloid leukemia (AML), a heterogeneous group of leukemias, there are various factors to determine prognosis. Among these prognostic factors, cytogenetic results are increasing in importance day by day. FLT3 mutations are among the most common molecular abnormalities in AML, patients with recurrent or refractory (R/R) AML with this mutation have a low response rate to salvage therapy. Gilteritinib has activity against FLT3, ALK and AXL. This article shall present two cases, for which Gilteritinib was used, a new FLT3 inhibitor, and the results of the treatment. Case 1: A 52-year-old female patient presented to the emergency clinic with weakness and fever. In initial biochemical analysis, leukocyte was 104000/mm3. Peripheral smear contained diffuse myeloid blastoid cells, peripheral blood flow cytometry also supported the AML M0-1 phenotype. The bone marrow biopsy aspiration performed on the 14th day of induction "3+7" treatment, contained diffuse blastic infiltrate and supported refractory disease. In addition to the FLAG-IDA salvage regimen, 120 mg/day Gilteritinib was also started. Bone marrow aspiration performed on the 28th day of salvage therapy was compatible with remission. Case 2: 53 years old male patient with also no comorbidity other than known hypertension. In the initial biochemical analysis of the patient, leukocyte was 156000/mm3, platelet 58000/mm3 and hemoglobin 7.6 g/dl. Peripheral blood flow cytometry supported the AML M5 phenotype, whose peripheral smear showed diffuse monoblastoid cells. On the 14th day of the patient's 3+7 induction treatment, the control bone marrow aspiration showed diffuse blast infiltration and was considered refractory, FLAG-IDA salvage therapy with again 120 mg/day Gilteritinib per oral were started. On the 28th day, control bone marrow aspiration was evaluated as remission. DISCUSSION AND CONCLUSION Unlike other FLT 3 inhibitors, Gilteritinib has been shown to be a highly effective agent in R/R AML with FLT3 mutations. Being the first data to be reported from Turkey, we think it would be quite guiding the titular.
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Affiliation(s)
- Istemi Serin
- Department of Hematology Istanbul, Istanbul Training and Research Hospital, University of Health ScienceIstanbul, Turkey
| | - Mehmet Hilmi Dogu
- Department of Internal Medicine and Hematology, Liv Hospital Ulus, Istinye UniversityIstanbul, Turkey
| | - Gulben Erdem Huq
- Department of Pathology Istanbul, Istanbul Training and Research Hospital, University of Health ScienceIstanbul, Turkey
| | - Osman Yokus
- Department of Hematology Istanbul, Istanbul Training and Research Hospital, University of Health ScienceIstanbul, Turkey
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Taş Ozyurtseven B, Serin I, Nursal AF, Pehlivan S, Pehlivan M. Medication-related osteonecrosis of the jaw (MRONJ) and eNOS Polymorphisms in multiple myeloma patients: a single center experience. BMC Oral Health 2021; 21:272. [PMID: 34006261 PMCID: PMC8130567 DOI: 10.1186/s12903-021-01634-9] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background Multiple myeloma (MM) constitutes approximately 10% of hematological malignancies. Bisphosphonates have established themselves in solid organ metastasis and multiple myeloma lytic bone lesions by inhibiting osteoclast activation. Medication-related osteonecrosis of the jaw (MRONJ) emerges as an important complication. Investigating host-based factors, and developing personal risk factors gain importance in the development mechanism of MRONJ. We aimed to reveal the different genotype polymorphisms, and clinical effects of eNOS in patients with a diagnosis of MRONJ in MM patients. Methods Medical records and blood samples were collected from 60 MRONJ patients with MM and 60 healthy controls. Inclusion criteria was having an exposed maxillofacial bone for more than eight weeks, a history of bisphosphonates, and no history of radiation therapy for the jaws. eNOS G894T and intron 4 VNTR were calculated by polymerase chain reaction and/or restriction fragment length polymorphism. Results eNOS G894T and VNTR genotypes and alleles were compared statistically with the healthy control group. There was no significant difference between the two groups. In comparison between G894T and clinical parameters, aphthous stomatitis was more common in TT genotype, while DMFT > 3 was more common in TG-GG genotype (p = 0.035, 0.023). Conclusions eNOS induces osteogenesis in bone metabolism, with its regulatory effects on bone remodeling and also NO induced angiogenesis takes place indirectly with its protective effect on endothelial functions. We see that these polymorphisms affecting the entire process of bone remodeling and angiogenesis, especially mucosal damage, which is the triggering factor of MRONJ pathology, have been revealed in the MM patient group. Considering the MRONJ initiating factors, it is necessary to emphasize the importance of our study results. It should be seen as an important step for new studies towards MRONJ and its treatment.
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Affiliation(s)
- Betul Taş Ozyurtseven
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org. Nafiz GURMAN Cad. 34098 Fatih, Istanbul, Turkey.
| | - Ayse Feyda Nursal
- Department of Medical Genetics, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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Gemici A, Ozkalemkas F, Dogu MH, Tekinalp A, Alacacioglu I, Guney T, Ince I, Geduk A, Cagliyan GA, Maral S, Serin I, Gunduz E, Karakus V, Bekoz HS, Eren R, Pinar IE, Gunes AK, Sargın FD, Sevindik OG. A Real-life Turkish Experience of Venetoclax Treatment in High-risk Myelodysplastic Syndrome and Acute Myeloid Leukemia. Clin Lymphoma Myeloma Leuk 2021; 21:e686-e692. [PMID: 34059487 DOI: 10.1016/j.clml.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Venetoclax is a selective B-cell lymphoma 2 (BCL2) inhibitor, which is approved to treat elderly patients with newly diagnosed acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) in combination with either low-dose cytarabine (ARA-C) or hypomethylating agents. We aimed to collect and share data among the efficacy and safety of venetoclax both as a monotherapy or in combination with other drugs used to treat high-risk MDS or AML. MATERIALS AND METHODS A total of 60 patients with a median age of 67 (30-83) years from 14 different centers were included in the final analysis. Thirty (50%) of the patients were women; 6 (10%) of the 60 patients were diagnosed with high-risk MDS and the remaining were diagnosed with AML. RESULTS The best objective response rate (complete remission [CR], complete remission with incomplete hematological recovery (CRi), morphological leukemia-free state [MLFS], partial response [PR]) was 35% in the entire cohort. Best responses achieved during venetoclax per patient number were as follows: 7 CR, 1 CRi, 8 MLFS, 5 PR, and stable disease. Median overall survival achieved with venetoclax was 5 months in patients who relapsed and not achieved in patients who were initially treated with venetoclax. Nearly all patients (86.7%) had experienced a grade 2 or more hematologic toxicity. Some 36.7% of these patients had received granulocyte colony stimulating factor (GCSF) support. Infection, mainly pneumonia (26.7%), was the leading nonhematologic toxicity, and fatigue, diarrhea, and skin reactions were the others reported. CONCLUSION Our real-life data support the use of venetoclax in patients with both newly diagnosed and relapsed high-risk MDS and AML.
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Affiliation(s)
- Aliihsan Gemici
- Department of Hematology, Medipol University, Istanbul, Turkey.
| | | | | | - Atakan Tekinalp
- Department of Hematology, Necmettin Erbakan University, Konya, Turkey
| | | | - Tekin Guney
- Department of Hematology, University of Medical Sciences, Ankara City Hospital, Ankara, Turkey
| | - Idris Ince
- Division of Hematology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Ayfer Geduk
- Department of Hematology, Kocaeli University, Kocaeli, Turkey
| | | | - Senem Maral
- Division of Hematology, Diskapi Training and Research Hospital, Ankara, Turkey
| | - Istemi Serin
- Division of Hematology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Eren Gunduz
- Department of Hematology, Osman Gazi University, Eskisehir, Turkey
| | - Volkan Karakus
- Department of Hematology, Alaaddin Keykubat University, Alanya, Turkey
| | | | - Rafet Eren
- Division of Hematology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | | | - Ahmet Kursad Gunes
- Department of Hematology, University of Medical Sciences, Ankara City Hospital, Ankara, Turkey
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Serin I, Dogu MH. Serum Aspergillus galactomannan lateral flow assay for the diagnosis of invasive aspergillosis: A single-centre study. Mycoses 2021; 64:678-683. [PMID: 33683715 DOI: 10.1111/myc.13265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/21/2021] [Revised: 02/27/2021] [Accepted: 03/03/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Aspergillus species meet the most important group of invasive fungal diseases (IFD) in immunosuppressed patients. Galactomannan is a polysaccharide antigen located in the wall structure of Aspergillus. The most commonly used method for antigen detection is enzyme-linked immunoassay (ELISA). Aspergillus galactomannan lateral flow assay (LFA) constitutes one of the new methods in the diagnosis of invasive aspergillosis (IA). The goal of this study was to demonstrate efficacy of LFA in our patients and to compare it to synchronous ELISA results. METHODS Galactomannan antigen was examined using both LFA and ELISA in serum samples taken from patients who were followed up in our haematology clinic. All patients are classified in subgroups as 'proven', 'probable' and 'possible' patients according to the last EORTC / MSG guideline. Patients who met the 'proven' IA criteria were included in the study as the gold standard. RESULTS A total of 87 patients were included in the study. Majority of patients had acute myeloid leukaemia (AML) (56.3%). Eleven (12.6%) were in 'proven' IA group. LFA test showed a superior diagnostic performance compared with ELISA (LFAAUC = 0.934 vs ELISAAUC = 0.545; p < .001). The LFA had a sensitivity of 90.9% and a specificity of 90.8% for '0.5 ODI' in predicting IA (PPV = 55.8%; NPV = 98.6%; p < .001). CONCLUSION The most important finding of this study is that the specificity of LFA was found to be higher for cut-off value of 0.5. It is recommended to combine the methods in many studies to provide a better early diagnosis for IA.
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Affiliation(s)
- Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Department of Internal Medicine and Hematology, Istinye University, Liv Hospital ULUS, Istanbul, Turkey
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Yokus O, Yigit B, Goze H, Serin I. The relationship between serum ferritin level and fibrosis and splenomegaly in myelofibrosis. Am J Blood Res 2020; 10:345-350. [PMID: 33489443 PMCID: PMC7811910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/27/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Myelofibrosis (MF) is a disease in which the grade of bone marrow fibrosis increases in proportion to the degree of extramedullary hematopoiesis and splenomegaly. Associated with increased cytokines and inflammation, anemia deepens and an increase in serum ferritin levels is also expected. There are no studies addressing the relationship between ferritin and splenomegaly or fibrosis. In this study, the relationship between serum ferritin level and splenomegaly and bone marrow fibrosis was examined. MATERIAL AND METHOD The study was performed retrospectively in 46 MF cases diagnosed between 2012 and 2020. MF was divided into 3 separate subgroups: Primary myelofibrosis, secondary myelofibrosis and myeloproliferative neoplasms (MDS/MPN) with myelodsplastic syndrome. RESULTS Thirty (28.3%) of cases were PMF, 26 (56.5%) were SMF and 7 (15.2%) were MDS/MPN. There was no relation found between serum ferritin and splenomegaly in none of the cases or subgroup analysis (for PMF p: 0.564, for SMF p: 0.192, for MDS/MPN p: 0.364). There was a statistically significant relationship between serum ferritin and marrow fibrosis within the group of ages 60 years and older (p: 0.016). DISCUSSION AND CONCLUSION Disruption of hematopoiesis and progressive splenomegaly causes an increase in iron stores associated with an increased need for transfusion. This causes iron-related organ toxicity and bone marrow hematopoiesis disruption, leading to an increase in morbidity. We see that a significant relationship between ferritin and fibrosis has been revealed in the group aged 60 years and older. It is an unprecedented study in the literature in terms of both examining the relationship ferritin and fibrosis or splenomegaly and its results.
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Affiliation(s)
- Osman Yokus
- Department of Hematology, University of Health Sciences, Istanbul Training and Research HospitalIstanbul, Turkey
| | - Betul Yigit
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research HospitalIstanbul, Turkey
| | - Hasan Goze
- Department of Hematology, University of Health Sciences, Istanbul Training and Research HospitalIstanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research HospitalIstanbul, Turkey
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Yokus O, Saglam EN, Goze H, Sametoglu F, Serin I. Prognostic Role of Lymphocyte/Monocyte Ratio in Chronic Lymphocytic Leukemia. J Hematol 2020; 9:116-122. [PMID: 33224391 PMCID: PMC7665864 DOI: 10.14740/jh730] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/18/2020] [Indexed: 11/23/2022] Open
Abstract
Background Chronic lymphocytic leukemia (CLL) is a B-lymphoproliferative disease with varying clinical characteristics, which occurs mostly in older ages. In studies from literature, we see that different parameters are examined to determine the prognosis of CLL. The main purpose of our study is to determine the relationship of lymphocyte/monocyte ratio (LMR) value in CLL, which has been previously shown to be a prognostic factor in various solid organ tumors and some hematological malignancies. Methods A total of 173 patients who were followed up between 2005 and 2019 were retrospectively analyzed. The diagnostic age, gender, laboratory, absolute lymphocyte and monocyte count, LMR and overall survival (OS), treatment and responses, recurrence, cytogenetic subtype and mortality rates were examined. Results The median LMR was 26.7 and it was considered as cut-off value of 26. A positive correlation was found between LMR and Rai Stage. LMR was significantly higher in patients who have an indication for treatment or who died. Conclusions In our study, in CLL, LMR has been shown to be over 26 in advanced stages, in relapse or with indication of a treatment. With the increase of LMR, it was found that survival and disease-free gap decreased.
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Affiliation(s)
- Osman Yokus
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Fatih, Istanbul, Turkey
| | - Esma Nur Saglam
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Fatih, Istanbul, Turkey
| | - Hasan Goze
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Fatih, Istanbul, Turkey
| | - Fettah Sametoglu
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Fatih, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Fatih, Istanbul, Turkey
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Kirik MP, Pehlivan M, Nursal AF, Oyaci Y, Pehlivan S, Serin I. The miRNA 196a2 rs11614913 variant has prognostic impact on Turkish patients with multiple myeloma. BMC Res Notes 2020; 13:545. [PMID: 33228759 PMCID: PMC7682760 DOI: 10.1186/s13104-020-05392-9] [Citation(s) in RCA: 2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/17/2020] [Indexed: 01/05/2023] Open
Abstract
Objective Multiple myeloma (MM) arises from malignant plasma cells as a single clone in the bone marrow. Accumulating evidences have reported that there is an association between miR-196a2 (rs11614913) variant and various cancers while there were unverified and inconsistent results in MM. The goal of this study is to investigate the impact of the miR-196a2 variant on clinical findings and susceptibility in MM. Two hundred MM patients (156 patients under transplantation of autologous stem cell) and 200 healthy controls included in this study. Results The statistical analysis showed no significant relationship for allele and frequencies of miR-196a2 genotype between patients and controls (p > 0.05). Log-rank test showed that gender has highly significant impact on both OS and PFS (p = 0.027, p = 0.045). In the univariate analysis, TT genotype (p = 0.022), and CT/TT (p = 0.008) had better OS. In the multivariate analysis, CC/CT-TT were associated with positively OS (p = 0.041). Currently, the most valuable prognostic markers in MM that has clinical implication are genetic abnormalities. It can be concluded from the results that miR-1962a variant is effective in prognosis of the MM. It is believed that these findings will help us understand the molecular basis of disease.
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Affiliation(s)
- Melya Pelin Kirik
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ayse Feyda Nursal
- Department of Medical Genetics, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Yasemin Oyaci
- Department of Medical Biology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz GURMAN CAD. 34098, Istanbul, Turkey.
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Serin I, Bayir A, Goze H, Yokus O. A case report: paroxysmal nocturnal hemoglobinuria and systemic lupus erythematosus association. Int J Hematol Oncol 2020; 10:IJH30. [PMID: 34136122 PMCID: PMC8191648 DOI: 10.2217/ijh-2020-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is defined by acquired intravascular hemolytic anemia, thrombosis and bone marrow failure with pancytopenia. Systemic lupus erythematosus (SLE) also appears as an autoimmune disease. The coexistence of both is rarely reported. Here we report the case of a 30-year-old female presenting with pancytopenia and diagnosed as SLE, who also had a PNH clone. Bone marrow biopsy did not support hypoplastic anemia. The patient was then followed up with the consideration of the existence of a PNH clone with SLE. She was treated by the rheumatology department and complete blood count improved under immunosuppressive treatment. The coexistence of CD59–CD55 deficiency with autoimmune diseases has been reported. It is an important example in terms of receiving clinical response with SLE-specific treatment.
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Affiliation(s)
- Istemi Serin
- Department of Hematology, University of Health Science, Istanbul Training & Research Hospital, Istanbul, Turkey
| | - Aslıhan Bayir
- Department of Internal Medicine, University of Health Science, Bagcilar Training & Research Hospital, Istanbul, Turkey
| | - Hasan Goze
- Department of Hematology, University of Health Science, Istanbul Training & Research Hospital, Istanbul, Turkey
| | - Osman Yokus
- Department of Hematology, University of Health Science, Istanbul Training & Research Hospital, Istanbul, Turkey
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Serin I, Hilmi Dogu M. An unexpected situation in isolated nasopharyngeal mass differential diagnosis: Solitary extramedullary plasmacytoma. Otolaryngology Case Reports 2020. [DOI: 10.1016/j.xocr.2020.100246] [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: 10/22/2022] Open
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Serin I, Ulusoy A, Onar MI, Dogu MH. COVID-19 Pneumonia or Hypereosinophilic Syndrome? J Med Cases 2020; 11:400-402. [PMID: 33984086 PMCID: PMC8040447 DOI: 10.14740/jmc3587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/26/2020] [Indexed: 11/11/2022] Open
Abstract
Hypereosinophilic syndromes (HESs) are a group of disorders characterized by pathological proliferation of eosinophils. Diagnostic criteria include eosinophil count of 1,500/mm3 or higher, presence of organ involvement and exclusion of other causes of eosinophilia for at least 6 months. A 69-year-old male patient was referred to the pandemic clinic with a preliminary diagnosis of coronavirus disease 2019 (COVID-19) with fever and dyspnea. Computed tomography (CT) was compatible with COVID-19, nasopharyngeal swab polymerase chain reaction (PCR) was negative for two times. He had 20,000/mm3 eosinophilia and retrospective examinations showed that he have had eosinophilia for more than 1 year. Platelet-derived growth factor receptor alpha (PDGFRα) resulted positively. After starting parenteral methylprednisolone with a dose of 1 mg/kg, he was discharged with oral maintenance therapy. In outpatient follow-up, it was observed that eosinophilic pneumonia completely regressed. HES may occur with multiple system and organ involvement and findings. In the differential diagnosis of patients presenting with heart failure, pulmonary involvement and eosinophilia, HES must definitely be considered.
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Affiliation(s)
- Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Avni Ulusoy
- Department of Internal Medicine, University of Health Sciences, Bagcilar Training and Research Hospital, Bagcilar, Istanbul, Turkey
| | - Mediha Irem Onar
- Department of Internal Medicine, University of Health Sciences, Bagcilar Training and Research Hospital, Bagcilar, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Deparment of Internal Medicine and Hematology, Liv Hospital ULUS, Istanbul, Turkey
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Abstract
Background Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma and may occur with lymph node and/or extranodal involvement. Recurrence in patients with diffuse large B-cell lymphoma usually occurs within the first few years after treatment and may occur in a different area outside the initial localization. Case presentation A female Turkish patient who was diagnosed with nodular sclerosing Hodgkin lymphoma through lymphadenopathy examination reached remission after chemotherapy and radiotherapy. In the 11th year of follow-up and at the age of 45, newly developed multiple lymphadenopathies were diagnosed with a pathological result of diffuse large B-cell lymphoma in her advanced examination. Due to massive splenomegaly and cystic necrotic splenic residues, splenectomy was performed after eight cycles of a first-line chemotherapy regimen and two cycles of high-dose methotrexate treatment for central nervous system prophylaxis. A pericardial mass (maximum standardized uptake value 34.8), which was not present at the time of diagnosis and interim evaluation of positron emission tomography/computed tomography, was detected through chest pain in the third month after the last screening, although a complete response had been obtained. Pathological examination of the pericardial area revealed the pathological result was a recurrence. Conclusions Patients with diffuse large B-cell lymphoma have an aggressive clinical course, but cardiac involvement is very rare. In our patient’s case, pericardial involvement was observed after treatment and scanning revealed that recurrence took place in an area different from the pericardium. Cooperation of clinicians and pathologists and rapid evaluation are very important in cases of diffuse large B-cell lymphoma relapse. Although a tumoral invasion of the pericardium mostly suggests secondary malignancies, it should be kept in mind that recurrence of lymphoma is also possible.
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Affiliation(s)
- Istemi Serin
- Department of Hematology Istanbul, University of Health Sciences, Istanbul Training and Research Hospital, 34098, Istanbul, Turkey.
| | - Avni Ulusoy
- Department of Internal Medicine, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Mediha Irem Onar
- Department of Internal Medicine, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Department of Hematology Istanbul, University of Health Sciences, Istanbul Training and Research Hospital, 34098, Istanbul, Turkey
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Serin I, Sari ND, Dogu MH, Acikel SD, Babur G, Ulusoy A, Onar MI, Gokce EC, Altunok O, Yaylaci Mert F, Karakilic A, Baltik M, Gulesir B. A new parameter in COVID-19 pandemic: initial lactate dehydrogenase (LDH)/Lymphocyte ratio for diagnosis and mortality. J Infect Public Health 2020; 13:1664-1670. [PMID: 33071210 PMCID: PMC7526632 DOI: 10.1016/j.jiph.2020.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/07/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023] Open
Abstract
Background COVID-19 (Coronavirus Disease-2019) is a pandemic disease, infecting more than 26.5 million people. Since there is no specific and effective treatment; early diagnosis and optimal isolation of the patient are of vital importance. Real-time polymerase chain reaction-based (RT-PCR) analyses do not achieve sufficient sensitivity in the diagnosis of the disease. Methods The data from 2217 patients diagnosed as COVID-19 between March 2020 and June 2020 and hospitalized or discharged with home isolation were retrospectively analyzed. Demographic data, comorbidities, PCR results, initial computed tomography (CT), laboratory values, Lactate Dehydrogenase (LDH)/Lymphocyte ratio, initial treatments and last status were recorded. The diagnostic sensitivity of LDH/Lymphocyte ratio, which is the main purpose of the study, was analyzed statistically. Results In order to test the effectiveness of LDH/Lymphocyte ratio for COVID-19 for diagnostic purposes, CT results were considered as gold standard. The area under the curve (AUC) was found to be 0.706 (p < 0.001; cut-off > 0.06) (Sensitivity: 76.4, specificity: 59.60). For the evaluation of LDH/Lymphocyte ratio in terms of survival, AUC was found to be 0.749 (p < 0.001; cut-off > 0.21) (Sensitivity: 70.59, specificity: 73.88). Conclusion Studies based on radiological findings have demonstrated that CT involvement has higher sensitivity. LDH/Lymphocyte ratio was analyzed in terms of diagnosis and mortality with using specific CT involvement as gold standard method which was found to be a more sensitive due to PCR false negativity; 0.06 and 0.21 were obtained as cut off values for diagnosis and mortality.
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Affiliation(s)
- Istemi Serin
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Fatih, Turkey.
| | - Nagehan Didem Sari
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Mehmet Hilmi Dogu
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Fatih, Turkey
| | - Sakine Damla Acikel
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Gulnıhal Babur
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Avni Ulusoy
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Mediha Irem Onar
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Emre Cem Gokce
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Oguz Altunok
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Feyza Yaylaci Mert
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Ayse Karakilic
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Muhammed Baltik
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Turkey
| | - Begum Gulesir
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Internal Medicine, Turkey
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49
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Serin I, Eren R, Dogu MH. Lenalidomide Plus Decitabine Treatment in a Myelodysplastic Syndrome Patient With Deletion 5q and Excess Blasts. J Hematol 2020; 9:33-36. [PMID: 32362984 PMCID: PMC7188382 DOI: 10.14740/jh618] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 03/23/2020] [Indexed: 12/19/2022] Open
Abstract
This is the first case of decitabine plus lenalidomide treatment for a myelodysplastic syndrome (MDS) patient with 5q deletion (del(5q)) and elevated number of blasts. Upon bone marrow aspiration and biopsy with conventional cytogenetical studies she was diagnosed with MDS with del(5q) and refractory anemia with excess blasts (RAEB-1). Decitabine was started at a daily dose of 20 mg/m2 1 - 5 days and lenalidomide was started at daily doses of 10 mg 6 - 20 days a month. After two cycles, her hemoglobin level increased and transfusion dependency ceased. After four cycles, bone marrow aspiration showed blast ratio of < 5%. Decitabine and lenalidomide were applied for three more cycles. Decitabine was terminated after seven cycles and lenalidomide has been continued for 12 months. Latest blood values (February 2020) were as follows: white blood cells (WBCs) of 8,670/mm3, neutrophil count of 3,470/mm3, hemoglobin (Hb) level of 11.7 g/dL and platelet count of 203,000/mm3, and the patient continues to follow-up without treatment. In conclusion, combination of lenalidomide and decitabine seems to be an effective treatment modality without notable side effects in MDS patients with del(5q) and excess blasts. The efficacy of this combination should be validated with studies including large patient groups and with longer follow-up periods.
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Affiliation(s)
- Istemi Serin
- Department of Hematology, University of Health Science, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Rafet Eren
- Department of Hematology, University of Health Science, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Department of Hematology, University of Health Science, Istanbul Training and Research Hospital, Istanbul, Turkey
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Soysal T, Eskazan AE, Serin I, Sadri S, Keskin D, Ozgur Yurttas N, Berk S, Erdogan Ozunal I, Salihoglu A, Ar MC, Ongoren S, Baslar Z, Ozbek U, Aydin Y. The Outcomes of Chronic Myeloid Leukemia Patients With Molecular Warning Responses During Imatinib Treatment According to the European LeukemiaNet 2013 Recommendations. Clinical Lymphoma Myeloma and Leukemia 2019; 19:e377-e384. [DOI: 10.1016/j.clml.2019.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 03/13/2019] [Accepted: 03/25/2019] [Indexed: 11/27/2022]
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