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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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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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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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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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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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Tombak A, Pepedil Tanrikulu F, Durusoy SS, Dinçyürek HD, Kaya E, Ümit EG, Yavasoglu İ, Mehtap Ö, Deveci B, Özcan MA, Terzi H, Okay M, Sayinalp N, Yilmaz M, Okan V, Kizikli A, Özcan Ö, Çetin G, Demircioglu S, Aydogdu İ, Saydam G, Davulcu EA, İlhan G, Uçar MA, Özet G, Akpinar S, Turgut B, Berber İ, Kurtoglu E, Sönmez M, Batur DS, Yildirim R, Özkocamaz V, Günes AK, Sahip B, Ertop S, Akay OM, Bastürk A, Dogu MH, Akdeniz A, Ünal A, Seyhanli A, Gürkan E, Çekdemir D, Ferhanoglu B. Efficacy and Safety of Ibrutinib Therapy in Patients with Chronic Lymphocytic Leukemia: Retrospective Analysis of Real-Life Data. Turk J Haematol 2021; 38:273-285. [PMID: 34448556 PMCID: PMC8656120 DOI: 10.4274/tjh.galenos.2021.2021.0007] [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: 12/01/2022] Open
Abstract
Objective: This study aimed to retrospectively evaluate the efficacy, safety, and survival outcome of single-agent ibrutinib therapy in chronic lymphocytic leukemia patients. Materials and Methods: A total of 136 patients (mean age ± standard deviation: 64.6±10.3 years, 66.9% males) who had received at least one dose of ibrutinib were included in this retrospective multicenter, noninterventional hospital-registry study conducted at 33 centers across Turkey. Data on patient demographics, baseline characteristics, laboratory findings, and leukemia-cell cytogenetics were retrieved. Treatment response, survival outcome including overall survival (OS) and progression-free survival (PFS), and safety data were analyzed. Results: Overall, 36.7% of patients were categorized as Eastern Cooperative Oncology Group (ECOG) class 2-3, while 44.9% were in Rai stage 4. Fluorescence in situ hybridization revealed the presence of del(17p) in 39.8% of the patients. Patients received a median of 2.0 (range: 0-7) lines of pre-ibrutinib therapy. Median duration of therapy was 8.8 months (range: 0.4-58.0 months). The 1-year PFS and OS rates were 82.2% and 84.6%, respectively, while median PFS time was 30.0 (standard error, 95% confidence interval: 5.1, 20.0-40.0) months and median OS time was 37.9 (3.2, 31.5-44.2) months. Treatment response (complete or partial response), PFS time, and OS time were better with 0-2 lines versus 3-7 lines of prior therapy (p<0.001, p=0.001, and p<0.001, respectively), with ECOG class 0-1 versus class 2-3 (p=0.006, p=0.011, and p=0.001, respectively), and with Rai stage 0-2 versus 3-4 (p=0.002, p=0.001, and p=0.002, respectively). No significant difference was noted in treatment response rates or survival outcome with respect to the presence of comorbidity, bulky disease, or del(17p). While 176 adverse events (AEs) were reported in 74 (54.4%) patients, 46 of those 176 AEs were grade 3-4, including pneumonia (n=12), neutropenia (n=11), anemia (n=5), thrombocytopenia (n=5), and fever (n=5). Conclusion: This real-life analysis confirms the favorable efficacy and safety profile of long-term ibrutinib treatment while emphasizing the potential adverse impacts of poorer ECOG performance status, heavy treatment prior to ibrutinib, and advanced Rai stage on patient compliance, treatment response, and survival outcomes.
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Affiliation(s)
- Anil Tombak
- Department of Internal Medicine - Hematology, Mersin University Medical Faculty, Mersin, Turkey
| | | | | | | | - Emin Kaya
- Inönü Universitesi, Hematology Inönü Universitesi Turgut Özal Tıp Merkezi Hematoloji BD, Malatya, Turkey
| | | | | | - Özgür Mehtap
- University of Kocaeli, Hematology Kocaeli University, Hematology Department, Kocaeli, Turkey
| | - Burak Deveci
- Medstar Antayla Hospital, Hematology, Medstar Antayla Hospital, Antalya, Turkey
| | | | - Hatice Terzi
- Cumhuriyet University, Hematology Cumhuriyet University, Sivas, Turkey
| | - Müfide Okay
- Hacettepe Universitesi Tip Fakultesi, Internal Medicine, Hematology, Turkey
| | - Nilgün Sayinalp
- Hacettepe Universitesi Tip Fakültesi, Internal Medicine, Hematology, Turkey
| | | | - Vahap Okan
- Gaziantep University School of Medicine, Department of Hematology, Gaziantep, Turkey
| | - Alperen Kizikli
- Gaziantep University School of Medicine, Department of Hematology, Gazıantep, Turkey
| | - Ömer Özcan
- Bezmialem Vakif University, Istanbul, Turkey
| | - Güven Çetin
- Bezmialem Vakif University, İstanbul, Turkey
| | - Sinan Demircioglu
- Necmettin Erbakan University, Meram School of Medicine, Hematology Meram School of Medicine, Konya, Turkey
| | | | - Güray Saydam
- Ege University Hospital Hematology 6th Floor Internal Medicine, Izmir, Turkey
| | - Eren Arslan Davulcu
- Ege University Hospital Hematology 6th. Floor Internal Medicine, Izmir, Turkey
| | - Gül İlhan
- Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Mehmet Ali Uçar
- Ankara Numune Training and Research Hospital, Department of Hematology Ankara, Turkey
| | - Gülsüm Özet
- Ankara Numune, Training and Research Hospital, Department of Hematology Ankara, Turkey
| | - Seval Akpinar
- Namık Kemal University Medical Faculty, Hematology, Tekirdağ, Turkey
| | - Burhan Turgut
- Namık Kemal University Medical Faculty, Hematology, Tekirdag, Turkey
| | - İlhami Berber
- İnönü Üniversity, Hematology İnönü Üniversity Malatya, Turkey
| | - Erdal Kurtoglu
- Antalya Eğitim-Araştırma Hastanesi, Hematology, Antalya, Turkey
| | - Mehmet Sönmez
- Karadeniz Technical University, School of Medicine, Department of Haematology Trabzon, Turkey
| | - Derya Selim Batur
- Karadeniz Technical University School of Medicine, Department of Haematology Trabzon, Turkey
| | | | - Vildan Özkocamaz
- Uludag University School of Medicine, Division of Hematology, Bursa, Turkey
| | - Ahmet Kürsad Günes
- Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Birsen Sahip
- Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Sehmus Ertop
- Zonguldak Bülent Ecevit University Zonguldak, Turkey
| | | | - Abdülkadir Bastürk
- Istanbul Training and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Istanbul Training and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Aydan Akdeniz
- Mersin University Medical Faculty, Department of Hematology, Mersin, Turkey
| | - Ali Ünal
- Erciyes University, Kayseri, Turkey
| | | | - Emel Gürkan
- Çukurova Universitesi, Hematology Adana Turkey
| | - Demet Çekdemir
- Anadolu Saglik Merkezi, Bone Marrow Transplantation Center, Department of Hematology, Kocaeli, Turkey
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Sinan Dal M, Merdin A, Erkurt MA, Ekinci Ö, Albayrak M, Kabukcu Hacıoglu S, Kaya A, Dogu MH, Hindilerden F, Sarici A, Merter M, Reis Aras M, Akgun Caglıyan G, Kizil Cakar M, Aydogdu I, Kuku I, Korkmaz S, Ulas T, Eser B, Altuntas F. Pralatrexate experience in PTCL: A multicenter retrospective study from Turkey. J BUON 2021; 26:1536-1539. [PMID: 34565016] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Pralatrexate is a new generation antifolate treatment agent used for the treatment of relapsed or refractory peripheral T-cell lymphomas. This study aims to determine the general characteristics of the patients receiving pralatrexate therapy in Turkey, contributing to the literature on the effectiveness of pralatrexate therapy in peripheral T-cell lymphomas by determining the response levels of such patients to the therapy. The study also attempts to clinically examine the major side effects observed in patients during treatment with pralatrexate. METHODS The study included patients with peripheral T-cell lymphoma followed up in the hematology units of several hospitals in Turkey. Overall, 20 patients aged 18 and over were included in the study. RESULTS The median age at the time of diagnosis was 58.5 years. PTCL-NOS (Peripheral T-cell lymphoma, not otherwise specified) subtype was in 40% of patients, making the PTCL-NOS the most common subtype in the study. In general, most patients were diagnosed with disease at an advanced stage. Pralatrexate therapy was given to the patients at a median treatment line of 3.5. Pralatrexate dose reduction was required in only 3 patients (15%). Response to pralatrexate therapy with partial remission (PR) and above was observed in 11 (55%) of the patients. CONCLUSION Pralatrexate seemed to be a promising novel treatment in relapsed refractory PTCL patients. However, patients receiving pralatrexate should be followed up carefully for skin reactions, mucosal side effects, thrombocytopenia and neutropenia.
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Affiliation(s)
- Mehmet Sinan Dal
- University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Hematology Clinic and Bone Marrow Transplantation Unit, Ankara, Turkey
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8
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Akay OM, Ozbalak M, Pehlivan M, Yildiz B, Uzay A, Yigenoglu TN, Elverdi T, Kaynar L, Ayyildiz O, Yonal Hindilerden I, Goksoy HS, Izmir Guner S, Gunes AK, Sonmez M, Kurt Yuksel M, Civriz Bozdag S, Ozkurt ZN, Toptas T, Dogu MH, Salim O, Saydam G, Yavasoglu I, Ayli M, Ozet G, Albayrak M, Birtas Atesoglu E, Toprak SK, Yildirim R, Mehtap O, Kalayoglu Besisik S, Nalcaci M, Altuntas F, Ferhanoglu B. Brentuximab vedotin consolidation therapy after autologous stem-cell transplantation in patients with high-risk Hodgkin lymphoma: Multicenter retrospective study. Hematol Oncol 2021; 39:498-505. [PMID: 34171130 DOI: 10.1002/hon.2897] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/03/2021] [Accepted: 06/17/2021] [Indexed: 11/09/2022]
Abstract
The AETHERA trial reported an increased progression-free survival (PFS) when brentuximab vedotin (BV) was used as maintenance therapy in high-risk Hodgkin lymphoma (HL) after autologous stem cell transplantation (ASCT). Thus, we aimed to determine the impact and safety of BV as maintenance after ASCT in real-world patients. Seventy-five patients with relapsed/refractory HL started on BV consolidation therapy after ASCT due to high risk of relapse, between January 2016 and July 2019, from 25 institutions, were included in the study. The median follow-up time was 26 months. The most common high-risk features were primary refractory or relapsed disease <12 months (n = 61), lack of complete response (CR) to the last salvage regimen (n = 51), and having had at least two salvage regimens (n = 29). At the time of analysis, 42 patients completed consolidation courses, and BV was discontinued in 33 patients. Fifty patients had an ongoing response (CR in 41, PR in 6, and SD in 3 patients), 25 had progressed. Ten died in the follow-up, eight with progressive disease and two due to infection while in CR. The 2-year PFS and OS rates were 67.75% (95% confidence interval [CI]: 0.55-0.77) and 87.61% (95% CI: 0.76-0.94), respectively. Seventeen patients (23%) received BV in the pre-ASCT treatment lines, and there was no survival difference between the BV-naïve and BV-exposed groups. The most common adverse events were neutropenia (27%) and peripheral neuropathy (21%). Sixteen patients (21.3%) experienced grade 3 or 4 toxicity. BV was discontinued due to adverse event in 12 patients. Consolidation with BV after ASCT can achieve a 2-year PFS of 67.75% (95% CI: 0.55-0.75) with an acceptable toxicity profile.
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Affiliation(s)
- Olga Meltem Akay
- Department of Internal Medicine, Division of Hematology, Koç University Medical Faculty, Istanbul, Turkey
| | - Murat Ozbalak
- Department of Internal Medicine, Division of Hematology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Internal Medicine, Division of Hematology, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - Birol Yildiz
- Department of Internal Medicine, Division of Medical Oncology, Gulhane Research and Training Hospital, Ankara, Turkey
| | - Ant Uzay
- Depatment of Hematology, Acıbadem University Medical Faculty, Istanbul, Turkey
| | - Tugce Nur Yigenoglu
- Division of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey
| | - Tugrul Elverdi
- Department of Internal Medicine, Division of Hematology, Istanbul University Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Leylagul Kaynar
- Department of Internal Medicine, Division of Hematology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Orhan Ayyildiz
- Department of Internal Medicine, Division of Hematology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Ipek Yonal Hindilerden
- Department of Internal Medicine, Division of Hematology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Hasan Sami Goksoy
- Depatment of Hematology, Yeniyuzyıl University Gaziosmanpaşa Hospital, Istanbul, Turkey
| | | | | | - Mehmet Sonmez
- Department of Internal Medicine, Division of Hematology, Karadeniz Technical University, Trabzon, Turkey
| | - Meltem Kurt Yuksel
- Department of Internal Medicine, Division of Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Sinem Civriz Bozdag
- Department of Internal Medicine, Division of Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Zubeyde Nur Ozkurt
- Department of Internal Medicine, Division of Hematology, Gazi University Medical Faculty, Ankara, Turkey
| | - Tayfur Toptas
- Department of Internal Medicine, Division of Hematology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Division of Hematology, Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Ozan Salim
- Department of Internal Medicine, Division of Hematology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Guray Saydam
- Department of Internal Medicine, Division of Hematology, Ege University Medical Faculty, Izmir, Turkey
| | - Irfan Yavasoglu
- Department of Internal Medicine, Division of Hematology, Adnan Menderes University Medical Faculty, Aydın, Turkey
| | - Meltem Ayli
- Department of Internal Medicine, Division of Medical Oncology, Gulhane Research and Training Hospital, Ankara, Turkey
| | - Gulsum Ozet
- Division of Hematology, Ankara City Hospital, Ankara, Turkey
| | - Murat Albayrak
- Division of Hematology, Dışkapı Research and Training Hospital, Ankara, Turkey
| | | | - Selami K Toprak
- Department of Internal Medicine, Division of Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Rahsan Yildirim
- Department of Internal Medicine, Division of Hematology, Ataturk University Medical Faculty, Erzurum, Turkey
| | - Ozgur Mehtap
- Department of Internal Medicine, Division of Hematology, Kocaeli University Medical Faculty, İzmit, Turkey
| | - Sevgi Kalayoglu Besisik
- Department of Internal Medicine, Division of Hematology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Meliha Nalcaci
- Department of Internal Medicine, Division of Hematology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fevzi Altuntas
- Division of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey
| | - Burhan Ferhanoglu
- Department of Internal Medicine, Division of Hematology, Koç University Medical Faculty, Istanbul, Turkey.,Division of Hematology, V.K.V. American Hospital, İstanbul, 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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Goren Sahin D, Akay OM, Keklik M, Okan V, Karakus A, Demir C, Erkurt MA, Ilkkilic K, Yildirim R, Akgun Cagliyan G, Aksu S, Dogu MH, Dal MS, Karakus V, Gemici AI, Terzi H, Kelkitli E, Sivgin S, Unal A, Yilmaz M, Ayyildiz O, Korkmaz S, Eser B, Altuntas F. Clinical characteristics and therapeutic outcomes of paroxysmal nocturnal hemoglobinuria patients in Turkey: a multicenter experience. Ann Hematol 2021; 100:1667-1675. [PMID: 33988739 DOI: 10.1007/s00277-021-04554-4] [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: 04/23/2020] [Accepted: 05/02/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study is to collect paroxysmal nocturnal hemoglobinuria (PNH) patient data from hematology centers all over Turkey in order to identify clinical features and management of PNH patients. Patients with PNH were evaluated by a retrospective review of medical records from 19 different institutions around Turkey. Patient demographics, medical history, laboratory findings, and PNH-specific information, including symptoms at the diagnosis, complications, erythrocyte, and granulocyte clone size, treatment, and causes of death were recorded. Sixty patients (28 males, 32 females) were identified. The median age was 33 (range; 17-77) years. Forty-six patients were diagnosed as classic PNH and 14 as secondary PNH. Fatigue and abdominal pain were the most frequent presenting symptoms. After eculizumab became available in Turkey, most of the patients (n = 31/46, 67.4%) were switched to eculizumab. Three patients with classic PNH underwent stem cell transplantation. The median survival time was 42 (range; 7-183 months) months. This study is the first and most comprehensive review of PNH cases in Turkey. It provided us useful information to find out the differences between our patients and literature, which may help us understand the disease.
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Affiliation(s)
- Deniz Goren Sahin
- Department of Hematology, Demiroglu Bilim University, Istanbul, Turkey.
| | | | - Muzaffer Keklik
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Vahap Okan
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | | | - Cengiz Demir
- Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | | | - Kadir Ilkkilic
- Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Rahsan Yildirim
- Division of Hematology, Medical Park Antalya Hospital, Antalya, Turkey
| | | | - Salih Aksu
- Department of Hematology, Hacettepe University, Ankara, Turkey
| | - Mehmet Hilmi Dogu
- Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Sinan Dal
- Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Volkan Karakus
- Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey
| | - Ali Ihsan Gemici
- Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Hatice Terzi
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Engin Kelkitli
- Department of Hematology, Ondokuz Mayis University, Samsun, Turkey
| | - Serdar Sivgin
- Division of Hematology, Acibadem Kayseri Hospital, Kayseri, Turkey
| | - Ali Unal
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Mehmet Yilmaz
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | - Orhan Ayyildiz
- Department of Hematology, Dicle University, Diyarbakir, Turkey
| | - Serdal Korkmaz
- Kayseri City Training and Research Hospital, University of Health Sciences, Kayseri, Turkey
| | - Bulent Eser
- Division of Hematology, Medical Park Antalya Hospital, Antalya, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
- Department of Hematology, Yildirim Beyazit University, Ankara, Turkey
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11
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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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13
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Erkurt MA, Hindilerden F, Ekinci O, Yildiz J, Dal MS, Bagci M, Hacibekiroglu T, Dogu MH, Namdaroglu S, Basturk A, Gulturk E, Merter M, Saglam B, Demircioglu S, Ozatli D, Sarici A, Ulas T, Korkmaz S, Eser B, Altuntas F. An Experience on Pomalidomide in Patients within Relapsed/Refractory Multiple Myeloma - A Multicenter Study in Turkey. JPRI 2021. [DOI: 10.9734/jpri/2020/v32i4131047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective: Pomalidomide is a new generation thalidomide analogue. Effectiveness as a single agent or combination with low dose dexamethasone has been in the treatment of relapse/refractory Multiple Myeloma (MM). The aim of the present study was to share the experience of different oncology centres with pomalidomide treatment in patients with relapsed/refractory MM.
Materials and Methods: Seventy-three patients from 16 centres were enrolled into the study. The patients were followed for a median of 6 months. Relapsed/refractory MM patients who received at least one line of treatment before pomalidomide were included into the study. ISS, R-ISS and Eastern Cooperative Oncology Group (ECOG) scores of the patients and treatment-related side effects were evaluated.
Results: As a result of the median follow-up for 6 months, 36% (26/72) of the patients presented progression. The estimated median PFS was found 29 months. The Cox regression analysis revealed that ECOG affected PFS only, myeloma subtype; ISS and R-ISS scores did not affect PFS. The most common side effects with pomalidomide treatment in our population include neutropenia, infections, anaemia and thrombocytopenia.
Conclusion: In our study, it was statistically shown that the ECOG score was effective in survival in relapsed / refractory MM patients treated by pomalidomide. Therefore, we recommend evaluation of the ECOG score for each patient before treatment in eligible cases.
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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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Altuntas F, Ata N, Yigenoglu TN, Bascı S, Dal MS, Korkmaz S, Namdaroglu S, Basturk A, Hacıbekiroglu T, Dogu MH, Berber İ, Dal K, Kınık K, Haznedaroglu İ, Yılmaz FM, Kılıç İ, Demircioğlu S, Yosunkaya A, Erkurt MA, Turgut B, Caglayan M, Celik O. Convalescent plasma therapy in patients with COVID-19. Transfus Apher Sci 2020; 60:102955. [PMID: 33011076 PMCID: PMC7501849 DOI: 10.1016/j.transci.2020.102955] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 08/29/2020] [Revised: 09/01/2020] [Accepted: 09/06/2020] [Indexed: 12/28/2022]
Abstract
Introduction Passive antibody therapy has been used to immunize vulnerable people against infectious agents. In this study, we aim to investigate the efficacy of convalescent plasma (CP) in the treatment of severe and critically ill patients diagnosed with COVID-19. Method The data of severe or critically ill COVID-19 patients who received anti-SARS-CoV-2 antibody-containing CP along with the antiviral treatment (n = 888) and an age-gender, comorbidity, and other COVID-19 treatments matched severe or critically ill COVID-19 patients at 1:1 ratio (n = 888) were analyzed retrospectively. Results Duration in the intensive care unit (ICU), the rate of mechanical ventilation (MV) support and vasopressor support were lower in CP group compared with the control group (p = 0.001, p = 0.02, p = 0.001, respectively). The case fatality rate (CFR) was 24.7 % in the CP group, and it was 27.7 % in the control group. Administration of CP 20 days after the COVID-19 diagnosis or COVID-19 related symptoms were associated with a higher rate of MV support compared with the first 3 interval groups (≤5 days, 6−10 days, 11−15 days) (p=0.001). Conclusion CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients.
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Affiliation(s)
- Fevzi Altuntas
- University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology and Bone Marrow Transplantation Center, Ankara, Turkey; Ankara Yıldırım Beyazıt University, School of Medicine, Department of Hematology, Ankara, Turkey.
| | - Naim Ata
- Republic of Turkey, Ministry of Health, Department of Strategy Development, Ankara, Turkey.
| | - Tugce Nur Yigenoglu
- University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology and Bone Marrow Transplantation Center, Ankara, Turkey.
| | - Semih Bascı
- University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology and Bone Marrow Transplantation Center, Ankara, Turkey.
| | - Mehmet Sinan Dal
- University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology and Bone Marrow Transplantation Center, Ankara, Turkey.
| | - Serdal Korkmaz
- University of Health Sciences, Kayseri Training and Research Hospital, Department of Hematology, Kayseri, Turkey.
| | - Sinem Namdaroglu
- University of Health Sciences, Bozyaka Training and Research Hospital, Department of Hematology, Izmir, Turkey.
| | - Abdulkadir Basturk
- Selcuk University, School of Medicine, Department of Internal Medicine, Division of Hematology, Konya, Turkey.
| | - Tuba Hacıbekiroglu
- Sakarya University, School of Medicine, Department of Internal Medicine, Division of Hematology, Sakarya, Turkey.
| | - Mehmet Hilmi Dogu
- İstanbul Training and Research Hospital, Department of Hematology, İstanbul, Turkey.
| | - İlhami Berber
- Inonu University, School of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey.
| | - Kursat Dal
- Kecioren Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey.
| | | | - İbrahim Haznedaroglu
- Hacettepe University, School of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
| | | | - İsa Kılıç
- Bursa City Hospital, Department of Anesthesiology, Bursa, Turkey.
| | - Sinan Demircioğlu
- Necmettin Erbakan University, School of Medicine, Department of Internal Medicine, Division of Hematology, Konya, Turkey.
| | - Alper Yosunkaya
- Necmettin Erbakan University, School of Medicine, Department of Anesthesiology, Konya, Turkey.
| | - Mehmet Ali Erkurt
- Inonu University, School of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey.
| | - Burhan Turgut
- Namık Kemal University, School of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey.
| | | | - Osman Celik
- Republic of Turkey, Ministry of Health, Public Hospitals General Directorate, Ankara, Turkey.
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19
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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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20
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Korkmaz S, Solmaz Medeni S, Demirkan F, Kalayoglu Besisik S, Altay Dadin S, Akgun Cagliyan G, Kabukcu Hacioglu S, Sari I, Goren Sahin D, Arat M, Dagdas S, Ozet G, Kutlu N, Karaagac Akyol T, Ozcebe OI, Uskudar Teke H, Kiper Unal D, Guner N, Tombak A, Celik H, Bay I, Kiki I, Ozgur G, Erkurt MA, Ozatli D, Meletli O, Demircioglu S, Demir C, Kurtoglu E, Vural F, Tobu M, Karakus A, Ayyildiz O, Dal MS, Afacan Ozturk B, Albayrak M, Ocakci S, Bolaman Z, Sonmez M, Karakus V, Gokmen Sevindik O, Berber I, Dogu MH, Gulturk E, Ulas T, Payzin B, Kuku I, Cagirgan S, Altuntas F. The Turkish experience with therapeutic plasma exchange: A national survey. Transfus Apher Sci 2019; 58:287-292. [DOI: 10.1016/j.transci.2019.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Karismaz A, Dogu MH, Huq G, Altindal S, Yokus O, Suyani E. A diffuse large B cell lymphoma emerging with breast cancer relapse. Pan Afr Med J 2019; 31:125. [PMID: 31037185 PMCID: PMC6462376 DOI: 10.11604/pamj.2018.31.125.15057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/25/2018] [Indexed: 11/11/2022] Open
Abstract
The prevalence of secondary cancers associated with the breast cancer treatment has increased, which is due to the administration of cytotoxic/hormonal drugs as well as radiotherapy. A 54-year-old female patient with a history of breast cancer for 4 years and receiving tamoxifen the hematology clinic with fatigue and nosebleed. Laboratory parameters were revealed pancytopenia. The bone marrow biopsy finding was compatible with CD20 positive high-grade B cell lymphoma resembling diffuse large B cell lymphoma. The patient started to receive a chemotherapy. Her hemogram values displayed an improvement after the second cycle. However, interim PET-BT, performed after the fourth cycle, showed an incomplete response in cervical lymphatic nodes. Then, a tru-cut biopsy was performed resulting in breast cancer metastasis. This is an unusual case of secondary-DLBCL presenting with pancytopenia and occuring 4 years after the diagnosis of breast cancer. In conclusion, clinicians should carefully set the dosage of chemotherapy drugs to avoid the long-term side effects associated with such drugs.
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Affiliation(s)
- Abdulkadir Karismaz
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Gülben Huq
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Pathology, Istanbul, Turkey
| | - Sermin Altindal
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Osman Yokus
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Elif Suyani
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey
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22
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Eren R, Unaldi M, Karismaz A, Dogu MH, Tan Koker H, Altindal S, Yokus O, Suyani E. Neutrophil Lymphocyte Ratio in Estimating Response to Corticosteroid Treatment in İmmune Thrombocytopenia Patients. Istanbul Med J 2018. [DOI: 10.5152/imj.2018.76158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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23
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Dogu MH, Batgi H, Erkurt MA, Hacioglu S, Tekgunduz E, Kaya E, Iskender D, Eren R, Kuku I, Altuntas F. Stem cell mobilization kinetics in elderly patients with multiple myeloma. Transfus Apher Sci 2018; 57:204-207. [PMID: 29439920 DOI: 10.1016/j.transci.2018.01.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/17/2017] [Accepted: 01/23/2018] [Indexed: 11/15/2022]
Abstract
In this study, we aimed to investigate whether the procedure and product kinetics differ according to age groups in advanced-age MM patients who underwent autologous HSCT. 59 patients who underwent autologous HSCT were retrospectively analyzed. Then, the patients were divided into two groups as 60-65 years and ≥65 years. It was significantly lower in ≥65 years group (p = 0.008) and proportionally, the procedure duration was also significantly shortened in this group (p = 0.013). Total number of collected CD34 positive stem cells was 6.20 × 106 (±3.83) in 60-65 years group while it was 5.51 × 106 (±2.48) in ≥65 years group with no statistically significant difference (p = 0.825). In conclusion, there was no significant difference in terms of the number of collected CD34-positive stem cells in this study that investigates the mobilization data, procedure and product kinetics, we think that successful stem cell mobilization can be performed in appropriately selected patients regardless of age.
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Affiliation(s)
- Mehmet Hilmi Dogu
- Istanbul Education and Research Hospital, Hematology Clinic, Istanbul, Turkey.
| | - Hikmetullah Batgi
- Ankara Oncology Education and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Mehmet Ali Erkurt
- Department of Hematology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Sibel Hacioglu
- Department of Hematology, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Emre Tekgunduz
- Ankara Oncology Education and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Emin Kaya
- Department of Hematology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Dicle Iskender
- Ankara Oncology Education and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Rafet Eren
- Istanbul Education and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Irfan Kuku
- Department of Hematology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Education and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
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24
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Dogu MH, Çagirgan S, Ocakci S, Kaya AH, Ilkkilic K, Sanli NM, Kahraman S, Eren R, Tekgunduz E, Hacioglu S, Kaynar L, Erkurt MA, Altuntas F. Autologous stem cell transplantation and stem cell mobilization kinetics in elderly patients with B cell non-Hodgkin lymphoma. Transfus Apher Sci 2017; 56:814-818. [PMID: 29153347 DOI: 10.1016/j.transci.2017.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
As known, the world population is aging and as the life span increases the number of advanced-age lymphomas also shows an upward trend. Autologous hematopoietic stem cell transplantation (HSCT) is the standard treatment modality in chemotherapy-sensitive relapsed or refractory aggressive lymphomas. Increased morbidity and mortality related to both the transplant itself and comorbid diseases can be observed in elderly lymphoma patients. Patients who are 65 years or older and underwent autologous HSCT with B-cell non-Hodgkin lymphoma were retrospectively included in our study. In terms of survival analysis, median follow-up was 34.5 months (8-159) while the overall survival (OS) was 58%. In the univariate analysis of prognostic data in OS, patients who were referred to transplantation with complete response had a statistically significant survival advantage (p=0.043). In terms of the effect of pre-transplant conditioning regimens on survival, BEAM regimen yielded better results, though not statistically significant. Age, number of chemotherapy cycles received before mobilization and radiation therapy had no significant effect on the CD34 (+) cell count in the final product (p=0.492, 0.746 and 0.078 respectively). In conclusion, autologous HSCT is a practicable treatment modality that provides survival advantage in suitable advanced-age patients with a diagnosis of B-cell non-Hodgkin lymphoma.
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Affiliation(s)
- Mehmet Hilmi Dogu
- Istanbul Training and Research Hospital, Hematology Clinic, Istanbul, Turkey.
| | - Seçkin Çagirgan
- Medical Park Izmir Hospital, Department of Hematology, Izmir, Turkey
| | - Serkan Ocakci
- Medical Park Izmir Hospital, Department of Hematology, Izmir, Turkey
| | - Ali Hakan Kaya
- Ankara Oncology Training and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Kadir Ilkkilic
- Pamukkale University Faculty of Medicine, Department of Hematology, Denizli, Turkey
| | | | - Selda Kahraman
- Medical Park Izmir Hospital, Department of Hematology, Izmir, Turkey
| | - Rafet Eren
- Istanbul Training and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Emre Tekgunduz
- Ankara Oncology Training and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Sibel Hacioglu
- Pamukkale University Faculty of Medicine, Department of Hematology, Denizli, Turkey
| | - Leylagul Kaynar
- Erciyes University Faculty of Medicine, Department of Hematology, Kayseri, Turkey
| | - Mehmet Ali Erkurt
- Inonu University Faculty of Medicine, Department of Hematology, Malatya, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Training and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey; Yildirim Beyazit University Faculty of Medicine, Department of Hematology, Ankara, Turkey
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25
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Kaya AH, Tekgündüz E, Ilkkiliç K, Dal MS, Merdin A, Karakus A, Hacioglu SK, Bekdemir F, Çakar MK, Dogu MH, Ayyildiz MO, Korkmaz S, Altuntaş F. Efficacy of CLARA in recurrent/refractory acute myeloid leukaemia patients unresponsive to FLAG chemotherapy. J Chemother 2017; 30:44-48. [PMID: 29098953 DOI: 10.1080/1120009x.2017.1396017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We hereby report our multicentre, retrospective experience with CLARA in patients with fludarabine/cytarabine/G-CSF (FLAG) refractory AML. The study included all consecutive R/R AML patients, who received CLARA salvage during October 2010-October 2015 period. All patients were unresponsive to FLAG salvage chemotherapy regimen and did not undergo previous allo-HCT. A total of 40 patients were included. Following CLARA 5 (12.5%) patients experienced induction mortality and 10 (25%) patients achieved CR. 25 (62.5%) patients were unresponsive to CLARA. 7 (17.5%) out of 10 patients in CR received allo-HCT. Median overall survival of patients who achieved CR after CLARA was 24.5 months (8.5-54.5) and 3 months (2.5-5), in patients who underwent and didn't allo-HCT, respectively. Our results indicate that CLARA may be good alternative even in FLAG refractory AML patients and can be used as a bridge to allo-HCT, who have a suitable donor and able to tolerate the procedure.
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Affiliation(s)
- Ali Hakan Kaya
- a Hematology Clinic and Bone Marrow Transplantation Unit , University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital , Ankara , Turkey
| | - Emre Tekgündüz
- a Hematology Clinic and Bone Marrow Transplantation Unit , University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital , Ankara , Turkey
| | - Kadir Ilkkiliç
- b Department of Hematology, Faculty of Medicine , Pamukkale University , Denizli , Turkey
| | - Mehmet Sinan Dal
- c Department of Hematology, Faculty of Medicine , Dicle University , Diyarbakır , Turkey
| | - Alparslan Merdin
- a Hematology Clinic and Bone Marrow Transplantation Unit , University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital , Ankara , Turkey
| | - Abdullah Karakus
- c Department of Hematology, Faculty of Medicine , Dicle University , Diyarbakır , Turkey
| | - Sibel Kabukcu Hacioglu
- b Department of Hematology, Faculty of Medicine , Pamukkale University , Denizli , Turkey
| | - Filiz Bekdemir
- a Hematology Clinic and Bone Marrow Transplantation Unit , University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital , Ankara , Turkey
| | - Merih Kızıl Çakar
- a Hematology Clinic and Bone Marrow Transplantation Unit , University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital , Ankara , Turkey
| | - Mehmet Hilmi Dogu
- b Department of Hematology, Faculty of Medicine , Pamukkale University , Denizli , Turkey
| | - Mehmet Orhan Ayyildiz
- c Department of Hematology, Faculty of Medicine , Dicle University , Diyarbakır , Turkey
| | - Serdal Korkmaz
- a Hematology Clinic and Bone Marrow Transplantation Unit , University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital , Ankara , Turkey
| | - Fevzi Altuntaş
- a Hematology Clinic and Bone Marrow Transplantation Unit , University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital , Ankara , Turkey
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26
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Gemici A, Aydogdu I, Terzi H, Sencan M, Aslan A, Kaya AH, Dal MS, Akay MO, Dogu MH, Ayyildiz O, Sahin F, Cagliyan GA, Yilmaz M, Gokgoz Z, Bilen Y, Demir C, Sevindik OG, Korkmaz S, Eser B, Altuntas F. Nodular lymphocyte predominant Hodgkin's lymphoma in daily practice: A multicenter experience. Hematol Oncol 2017; 36:116-120. [PMID: 28707314 DOI: 10.1002/hon.2460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 01/16/2017] [Revised: 04/01/2017] [Accepted: 06/19/2017] [Indexed: 01/01/2023]
Abstract
Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is a rare subtype of Hodgkin's lymphoma. In this study, we aimed to investigate the clinical features and therapeutic outcomes of patients with NLPHL who were diagnosed at different institutes in Turkey. We retrospectively reviewed the records of the patients diagnosed with NLPHL. Adult patients who were diagnosed after 2005 with histological confirmation were selected for the study. Forty-three patients were included in the study. Median age of patients was 37.5 years (18-70) at the time of diagnosis. About 60.5% patients were diagnosed as stage I and II NLPHL, and remaining 39.5% had stage III and IV disease. Median follow-up was 46 months. During follow-up, none of the patients died. Seven patients relapsed or progressed after initial therapy at a median of 12 months. Five of 7 relapsed/refractory patients (71.4%) were salvaged with chemotherapy only (DHAP, ICE), and the remaining 2 (28.6%) were salvaged with chemoimmunotherapy. All of relapsed/refractory patients were able to achieve complete remission after salvage therapy. Lactate dehydrogenase levels were significantly higher in patients with progressive disease compared with nonprogressive disease. Our study showed an excellent outcome with all patients alive at last contact with a median follow up of 46 months despite a wide range of different therapeutic approaches. All relapsed and refractory patients were successfully salvaged despite a low frequency of patients received immunotherapy in conjunction with chemotherapy. Our results suggest that immunotherapy may be reserved for further relapses.
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Affiliation(s)
- Aliihsan Gemici
- Division of Hematology, Sanliurfa Mehmet AkifInan Training and Research Hospital, Sanliurfa, Turkey
| | - Ismet Aydogdu
- Department of Hematology, Celal Bayar University, Manisa, Turkey
| | - Hatice Terzi
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Mehmet Sencan
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Alma Aslan
- Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| | - Ali Hakan Kaya
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Sinan Dal
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Meltem Olga Akay
- Department of Hematology, Osmangazi University, Eskisehir, Turkey
| | - Mehmet Hilmi Dogu
- Division of Hematology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Orhan Ayyildiz
- Department of Hematology, Dicle University, Diyarbakir, Turkey
| | - Fahri Sahin
- Department of Hematology, Ege University, Izmir, Turkey
| | | | - Mehmet Yilmaz
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | - Zafer Gokgoz
- Ordu State Hospital, Division of Hematology, Ordu, Turkey
| | - Yusuf Bilen
- Department of Hematology, Ataturk University, Erzurum, Turkey
| | - Cengiz Demir
- Department of Hematology, YuzuncuYil University, Van, Turkey
| | | | - Serdal Korkmaz
- Division of Hematology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Bulent Eser
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Fevzi Altuntas
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
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27
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Dogu MH, Hacioglu S. Are We Aware of Blood and Blood Products Need? Four Year Single Center Experience. Istanbul Med J 2017. [DOI: 10.5152/imj.2017.57614] [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: 11/22/2022] Open
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28
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Aslan C, Eren R, Dogu MH, Yokus O, Suyani E. Relationship between Neutrophil-Lymphocyte Ratio and Clinicopathological Parameters in Follicular Lymphoma. Istanbul Med J 2016. [DOI: 10.5152/imj.2016.93546] [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: 11/22/2022] Open
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29
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Dogu MH, Kaya AH, Berber I, Sari İ, Tekgündüz E, Erkurt MA, Iskender D, Kayıkçı Ö, Kuku I, Kaya E, Keskin A, Altuntaş F. Does the preference of peripheral versus central venous access in peripheral blood stem cell collection/yield change stem cell kinetics in autologous stem cell transplantation? Transfus Apher Sci 2016; 54:76-9. [DOI: 10.1016/j.transci.2016.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Caner V, Sen Turk N, Baris IC, Cetin GO, Tepeli E, Hacioglu S, Sari I, Zencir S, Dogu MH, Bagci G, Keskin A. MYD88 expression and L265P mutation in mature B-cell non-Hodgkin lymphomas. Genet Test Mol Biomarkers 2015; 19:372-8. [PMID: 25978699 DOI: 10.1089/gtmb.2015.0041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Myeloid differentiation primary response 88 (MYD88) is a common adaptor protein that is responsible for signaling from several receptors; mutations in this gene may play a role in the pathogenesis of lymphoma. AIM We aimed to determine the MYD88 L265P mutation frequency, the level of MYD88 expression, and their associations with clinicopathological parameters in mature B-cell non-Hodgkin lymphomas (NHLs). METHODS A total of 68 patients were included in the study. The presence of the MYD88 L265P mutation was analyzed by real-time polymerase chain reaction and direct sequencing. MYD88 protein expression was evaluated by immunohistochemistry (IHC) using two different scoring systems. RESULTS MYD88 L265P mutation was present in eight (18.6%) diffuse large B-cell lymphoma (DLBCL) patients. We also observed a significant association between the loss of MYD88 expression and advanced stage in both mature B-cell NHL and DLBCL according to the first IHC scoring systems (p=0.015 and p=0.024, respectively). An association was also seen between MYD88 overexpression and low clinical risk in both mature B-cell NHL and DLBCL according to the second IHC scoring system (p=0.027 and p=0.024, respectively). CONCLUSIONS The L265P mutation may be helpful for understanding the pathogenesis of immune-privileged site-associated DLBCLs. The presence of the mutation, together with its protein overexpression, could also be used as a prognostic marker in advanced stage DLBCLs.
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Affiliation(s)
- Vildan Caner
- 1 Tibbi Genetik AD, Pamukkale Universitesi Hastanesi , Denizli, Turkey
| | - Nilay Sen Turk
- 2 Tibbi Patoloji AD, Pamukkale Universitesi Hastanesi , Denizli, Turkey
| | | | - Gokhan Ozan Cetin
- 1 Tibbi Genetik AD, Pamukkale Universitesi Hastanesi , Denizli, Turkey
| | - Emre Tepeli
- 1 Tibbi Genetik AD, Pamukkale Universitesi Hastanesi , Denizli, Turkey
| | - Sibel Hacioglu
- 4 Hematoloji BD, Pamukkale Universitesi Hastanesi , Denizli, Turkey
| | - Ismail Sari
- 4 Hematoloji BD, Pamukkale Universitesi Hastanesi , Denizli, Turkey
| | - Sevil Zencir
- 3 Tibbi Biyoloji AD, Pamukkale Universitesi , Denizli, Turkey
| | | | - Gulseren Bagci
- 1 Tibbi Genetik AD, Pamukkale Universitesi Hastanesi , Denizli, Turkey
| | - Ali Keskin
- 4 Hematoloji BD, Pamukkale Universitesi Hastanesi , Denizli, Turkey
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Hacioglu S, Bilen Y, Eser A, Sivgin S, Gurkan E, Yildirim R, Aydogdu I, Dogu MH, Yilmaz M, Kayikci O, Tombak A, Kuku I, Celebi H, Akay MO, Esen R, Korkmaz S, Keskin A. Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: twenty-four year Turkish experience in cladribine therapy. Hematol Oncol 2014; 33:192-8. [PMID: 25393847 DOI: 10.1002/hon.2177] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 10/02/2014] [Accepted: 10/03/2014] [Indexed: 11/09/2022]
Abstract
In this multicenter retrospective analysis, we aimed to present clinical, laboratory and treatment results of 94 patients with Hairy cell leukemia diagnosed in 13 centers between 1990 and 2014. Sixty-six of the patients were males and 28 were females, with a median age of 55. Splenomegaly was present in 93.5% of cases at diagnosis. The laboratory findings that came into prominence were pancytopenia with grade 3 bone marrow fibrosis. Most of the patients with an indication for treatment were treated with cladribine as first-line treatment. Total and complete response of cladribine was 97.3% and 80.7%. The relapse rate after cladribine was 16.6%, and treatment related mortality was 2.5%. Most preferred therapy (95%) was again cladribine at second-line, and third line with CR rate of 68.4% and 66.6%, respectively. The 28-month median OS was 91.7% in all patients and 25-month median OS 96% for patients who were given cladribine as first-line therapy. In conclusion, the first multicenter retrospective Turkish study where patients with HCL were followed up for a long period has revealed demographic characteristics of patients with HCL, and confirmed that cladribine treatment might be safe and effective in a relatively large series of the Turkish study population.
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Affiliation(s)
- Sibel Hacioglu
- Pamukkale University, Department of Hematology, Denizli, Turkey
| | - Yusuf Bilen
- Ataturk University, Department of Hematology, Erzurum, Turkey
| | - Ali Eser
- Marmara University, Department of Hematology, Istanbul, Turkey
| | - Serdar Sivgin
- Erciyes University, Department of Hematology, Kayseri, Turkey
| | - Emel Gurkan
- Cukurova University, Department of Hematology, Adana, Turkey
| | - Rahsan Yildirim
- Ataturk University, Department of Hematology, Erzurum, Turkey
| | - Ismet Aydogdu
- Celal Bayar University, Department of Hematology, Manisa, Turkey
| | | | - Mehmet Yilmaz
- Gaziantep University, Department of Hematology, Gaziantep, Turkey
| | - Omur Kayikci
- Ankara Oncology Education and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Anil Tombak
- Mersin University, Department of Hematology, Mersin, Turkey
| | - Irfan Kuku
- Inonu University, Department of Hematology, Malatya, Turkey
| | - Harika Celebi
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Meltem Olga Akay
- Osmangazi University, Department of Hematology, Eskisehir, Turkey
| | - Ramazan Esen
- Yuzuncu Yil University, Department of Hematology, Van, Turkey
| | - Serdal Korkmaz
- Cumhuriyet University, Department of Hematology, Sivas, Turkey
| | - Ali Keskin
- Pamukkale University, Department of Hematology, Denizli, Turkey
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Korkmaz S, Dal MS, Berber I, Sahin DG, Dogu MH, Ayyildiz O, Nizam I, Albayrak M, Esen R, Namdaroglu S, Sencan M, Akay OM, Hacioglu S, Yildirim R, Eser A, Tombak A, Pala C, Ilhan O. Clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study. Geriatr Gerontol Int 2014; 15:729-35. [PMID: 25257190 DOI: 10.1111/ggi.12341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 11/28/2022]
Abstract
AIMS We aimed to investigate whether older age leads to limitations in the starting dose of imatinib in daily treatment of chronic myeloid leukemia, and to determine the compliance of elderly patients with tyrosine kinase inhibitors (TKI) therapy. METHODS Data including the clinical characteristics, therapeutic outcomes and compliance with TKI therapy of elderly patients with chronic myeloid leukemia aged >65 years were collected from 13 institutions in Turkey, retrospectively. RESULTS A total of 69 patients (27 [39%] men, 42 [61%] women) were evaluated retrospectively. The median age of the patients was 71 years (range 66-85 years). Of the patients, 66 (96%) were in the chronic phase and three (4.3%) were in the accelerated phase when diagnosed. A total of 63 (91.3%) patients were receiving imatinib as the first-line therapy. The initial dose of imatinib was 400 mg/day in 59 patients (93.6%). Imatinib treatment induced 57 (90.5%) complete hematological responses at 3 months, 29 (46%) complete cytogenetic responses at 6 months and 49 (77.7%) major molecular responses at 12 months. As a result, nilotinib and dasatinib were used in 14 patients as second-line therapy. Second-line TKI induced nine complete hematological responses (64.3%) at 3 months, four complete cytogenetic responses (28.6%) at 12 months and seven major molecular responses (50%) at 18 months. A total of 56 of the patients (81.2%) are still alive. The median overall survival and progression-free survival rates were 35 months (range 1-95 months) and 17 months (range 0.8-95 months), respectively. CONCLUSION Elderly patients should receive TKI according to the same guidelines that apply to younger patients.
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Affiliation(s)
- Serdal Korkmaz
- Division of Hematology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | | | - Ilhami Berber
- Department of Hematology, Inonu University, Malatya, Turkey
| | | | | | - Orhan Ayyildiz
- Department of Hematology, Dicle University, Diyarbakir, Turkey
| | - Ilknur Nizam
- Department of Hematology, Inonu University, Malatya, Turkey
| | - Murat Albayrak
- Department of Hematology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Ramazan Esen
- Department of Hematology, Yuzuncu Yil University, Van, Turkey
| | - Sinem Namdaroglu
- Department of Hematology, Ankara Oncology Education and Research Hospital, Ankara, Turkey
| | - Mehmet Sencan
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Olga Meltem Akay
- Department of Hematology, Osmangazi University, Eskisehir, Turkey
| | - Sibel Hacioglu
- Department of Hematology, Pamukkale University, Denizli, Turkey
| | - Rahsan Yildirim
- Department of Hematology, Ataturk University, Erzurum, Turkey
| | - Ali Eser
- Department of Hematology, Marmara University, Istanbul, Turkey
| | - Anil Tombak
- Department of Hematology, Mersin University, Mersin, Turkey
| | - Cigdem Pala
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Osman Ilhan
- Department of Hematology, Ibni Sina Hospital, Ankara University, Ankara, Turkey
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Korkmaz S, Dal MS, Berber I, Sahin DG, Dogu MH, Ayyildiz O, Nizam I, Albayrak M, Esen R, Namdaroglu S, Sencan M, Akay OM, Hacioglu SK, Yildirim R, Eser A, Tombak A, Pala C, Ilhan O. The clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.7108] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
- Serdal Korkmaz
- Cumhuriyet University, Department of Hematology, Sivas, Turkey
| | | | - Ilhami Berber
- Inonu University, Department of Hematology, Malatya, Turkey
| | | | | | - Orhan Ayyildiz
- Dicle University, Department of Hematology, Diyarbakir, Turkey
| | - Ilknur Nizam
- Inonu University, Department of Hematology, Malatya, Turkey
| | - Murat Albayrak
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Ramazan Esen
- Department of Hematology, Yuzuncu Yil University, Van, Turkey
| | - Sinem Namdaroglu
- Ankara Oncology Education and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Mehmet Sencan
- Cumhuriyet University, Department of Hematology, Sivas, Turkey
| | - Olga Meltem Akay
- Osmangazi University, Department of Hematology, Eskisehir, Turkey
| | | | - Rahsan Yildirim
- Atatürk University, Department of Hematology, Erzurum, Turkey
| | - Ali Eser
- Marmara University, Department of Hematology, Istanbul, Turkey
| | - Anil Tombak
- Mersin University, Department of Hematology, Mersin, Turkey
| | - Cigdem Pala
- Erciyes University, Department of Hematology, Kayseri, Turkey
| | - Osman Ilhan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
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Goker H, Tekgunduz E, Sari I, Pala C, Dogu MH, Ozturk E, Turgut B, Korkmaz S, Sirinoglu Demiriz I, Buyukasik Y, Kabukcu Hacioglu S, Kaynar L, Civriz Bozdag S, Altuntas F. Philadelphia-positive acute lymphoblastic leukemia in daily practice: A multicenter experience. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e18014] [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: 11/20/2022] Open
Abstract
e18014 Background: The prognosis of Philadelphia-positive acute lymphoblastic leukemia (Ph+ALL) is generally poor. Currently, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only accepted therapy with curative potential. Herein, we report our experience with Ph+ALL patients treated off-study. Methods: Data were collected from medical records of Ph+ALL patients diagnosed between 2005 and 2012. Survival rates were calculated using the Kaplan-Meier method and the log-rank test was used for comparison between groups. Results: This retrospective study included 41 patients (21 females and 20 males) from 7 centers in Turkey. The median age of the patients was 42 years (range, 19-70 years). Thirty (73%) patients received TKI and concurrent chemotherapy, 10 (24%) patients received chemotherapy alone and 1 (3%) patient received TKI alone. Of the patients receiving TKI, 24 (77%) received imatinib and 7 (23%) received dasatinib as induction therapy. Following induction therapy, 77% and 10% of the patients achieved complete hematologic remission and complete response with incomplete hematologic recovery, respectively. Eight (20%) patients had relapsed/resistant disease and received rescue therapy. The most common complication during therapy was febrile neutropenia (n=7, 17%). The induction mortality rate was 5% (n=2). Allo-HSCT was performed in 16 (39%) patients, 12 (75%) of whom underwent HSCT in first complete remission. Donor sources were matched siblings in 14 (88%) and unrelated donors in 2 (12%) patients. Fifteen (37%) patients died during follow-up. The Kaplan-Meier analysis revealed a median overall survival (OS) period of 12 months (range, 1-86 months) for all patients. The median OS period was 17 months (range, 5-86 months) and 2 months (range, 1-24 months) for patients who did or did not undergo HSCT, respectively (p=0.014). The Kaplan-Meier estimate of OS was 69.3% at 12 months and 49.1% at 24 months, for all patients. Conclusions: Allo-HSCT is the most important denominator of survival and the only curative therapy for Ph+ALL patients. For patients without a suitable donor or who are unable to undergo HSCT, TKI with concurrent chemotherapy is a reasonable alternative.
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Affiliation(s)
- Hakan Goker
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Emre Tekgunduz
- Ankara Oncology Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Ismail Sari
- Pamukkale University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Denizli, Turkey
| | - Cigdem Pala
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Mehmet Hilmi Dogu
- Pamukkale University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Denizli, Turkey
| | - Erman Ozturk
- Medeniyet University Faculty of Medicine, Goztepe Training and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Burhan Turgut
- Namik Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdag, Turkey
| | - Serdal Korkmaz
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Itir Sirinoglu Demiriz
- Ankara Oncology Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Yahya Buyukasik
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Sibel Kabukcu Hacioglu
- Pamukkale University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Denizli, Turkey
| | - Leylagul Kaynar
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Sinem Civriz Bozdag
- Ankara Oncology Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
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