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Kilic Gunes E, Yigit Kaya S, Yaman F, Yeniay MK, Vural K, Comert M, Sevindik OG, Andic N, Dagdas S, Nizam Ozen I, Kaynar L, Yavasoglu F, Ozet G, Karakus V, Ayli M. Eltrombopag treatment in thrombocytopenia following hematopoietic stem cell transplantation: A multicenter real-world experience. Leuk Res 2024; 140:107484. [PMID: 38520796 DOI: 10.1016/j.leukres.2024.107484] [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: 01/05/2024] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Thrombocytopenia is among the most common complications following hematopoietic stem cell transplantation and is associated with increased mortality and morbidity with no standard treatment yet. In this multicenter and retrospective study, we aim to present our multi-center experience of Eltrombopag treatment in patients with isolated thrombocytopenia following HSCT. MATERIAL-METHOD A total of 73 patients from 5 centers who underwent autologous or allogeneic stem cell transplantation, had no primary disease relapse, all of whom had neutrophil engraftment, complete chimerism, and who were diagnosed with Prolonged Isolated Thrombocytopenia (PIT) or Secondary Failure Of Platelet Recovery (SFPR) were included in the study. The patients were initiated on Eltrombopag at a dose of 50-150 mg. Complete response was defined as a platelet count >50×109/L for 7 consecutive days with no transfusion support. RESULTS A total of 50.3% of the patients underwent Autologous and 49.7% Allogeneic Stem Cell Transplantation, 54.8% were diagnosed with PIT, and 45.2% were diagnosed with SFPR, and the treatment with 50-150 mg/day Eltrombopag was initiated on the median day +42. Complete response was achieved in 71.2% of these patients on the median day 23 of the treatment. No significant effects of the initial dose (50-150 mg/day) were detected in the Complete Response in the multivariate analysis on response. An insufficient number of Megakaryocytes in the bone marrow before Eltrombopag treatment was determined as an independent risk factor in determining the response (OR 3.57, 95% CI 1.21-10.55). The overall survival of the patients who did not respond to Eltrombopag was found to be significantly worse than that of patients who responded (p=0.022, HR:2.74, 95% CI 1.12-6.54). CONCLUSION As a result of the present study, Eltrombopag treatment was found to be effective and safe in thrombocytopenia that develops following hematopoietic stem cell transplantation. It was concluded that its use may be more effective in patients with sufficient bone marrow megakaryocytes before the treatment and an initial dose of 50 mg/day may be appropriate in terms of cost, effectiveness, and toxicity. Large-scale randomized and controlled prospective studies are needed to determine the roles of Eltrombopag treatment in patients with post-transplant PIT and SFPR.
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Affiliation(s)
- Ebru Kilic Gunes
- University of Health and Sciences, Gulhane Training and Research Hospital, Department of Hematology, Ankara, Turkiye.
| | - Sureyya Yigit Kaya
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkiye
| | - Fatih Yaman
- Eskisehir Osmangazi University, Faculty of Medicine, Department of Hematology, Eskisehir, Turkiye
| | - Mustafa Kemal Yeniay
- University of Health and Sciences, Ankara Bilkent City Hospital, Department of Hematology, Ankara, Turkiye
| | - Kurtulus Vural
- University of Health and Sciences, Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkiye
| | - Melda Comert
- University of Health and Sciences, Gulhane Training and Research Hospital, Department of Hematology, Ankara, Turkiye
| | - Omur Gokmen Sevindik
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkiye
| | - Neslihan Andic
- Eskisehir Osmangazi University, Faculty of Medicine, Department of Hematology, Eskisehir, Turkiye
| | - Simten Dagdas
- University of Health and Sciences, Ankara Bilkent City Hospital, Department of Hematology, Ankara, Turkiye
| | - Ilknur Nizam Ozen
- University of Health and Sciences, Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkiye
| | - Leylagul Kaynar
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkiye
| | - Filiz Yavasoglu
- Eskisehir Osmangazi University, Faculty of Medicine, Department of Hematology, Eskisehir, Turkiye
| | - Gulsum Ozet
- University of Health and Sciences, Ankara Bilkent City Hospital, Department of Hematology, Ankara, Turkiye; Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Hematology, Ankara Bilkent City Hospital, Ankara, Turkiye
| | - Volkan Karakus
- University of Health and Sciences, Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkiye
| | - Meltem Ayli
- University of Health and Sciences, Gulhane Training and Research Hospital, Department of Hematology, Ankara, Turkiye
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Serin I, Sevindik OG, Balik Aydin B, Melek E, Mutlu YG, Bilgen H, Bekoz H, Kaynar L. Plerixafor in autologous stem cell transplantation: Does it affect engraftment kinetics? Transfus Apher Sci 2023; 62:103809. [PMID: 37690861 DOI: 10.1016/j.transci.2023.103809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/18/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023]
Abstract
Plerixafor increases stem cell mobilization by reversibly binding to the chemokine receptor CXCR4. In our study, we examined the results of mobilization with plerixafor and granulocyte colony-stimulating factor (G-CSF) and revealed their effects on autologous stem cell transplantation (ASCT) engraftment kinetics. The study included all cases of ASCT performed in the Adult Bone Marrow Transplantation Unit of xxx University between January 2014 and January 2022. It included a total of 300 patients. The total number of CD34 + cells collected was 7.44 ± 4.19 in patients with plerixafor and 9.53 ± 6.09 in patients without plerixafor. The mean neutrophil and platelet engraftment took longer in plerixafor-mobilized patients (neutrophil: 12 ± 4.1 vs. 10.2 ± 2.7 days; platelet: 21.6 ± 13.9 vs. 14.2 ± 5.9 days; p = 0.008 and p = 0.002). The number of febrile neutropenia attacks was significantly higher in plerixafor-mobilized patients (p = 0.04). In the chemo-mobilized patient subgroup, plerixafor-mobilized patients experienced more febrile neutropenia attacks (p = 0.04). The mean time to both neutrophil and platelet engraftment was longer in patients mobilized with plerixafor. In the subgroup of patients with MM, the mean time to platelet engraftment was longer in patients mobilized with plerixafor. Plerixafor and its effect on engraftment kinetics should be evaluated with further studies in a larger population with survival analysis.
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Affiliation(s)
- Istemi Serin
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey.
| | - Omur Gokmen Sevindik
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Berrin Balik Aydin
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Elif Melek
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Yasa Gul Mutlu
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Hulya Bilgen
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Huseyin Bekoz
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
| | - Leylagul Kaynar
- Istanbul Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey
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Mutlu YG, Yıgıt Kaya S, Maral S, Melek E, Baslar Z, Kaynar L, Sevindik OG. Relapsed refractory multiple myeloma with CNS involvement successfully treated with Elranatamab: first reported case. Front Immunol 2023; 14:1276295. [PMID: 37901215 PMCID: PMC10611496 DOI: 10.3389/fimmu.2023.1276295] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/02/2023] [Indexed: 10/31/2023] Open
Abstract
Central nervous system (CNS) involvement in multiple myeloma (MM) is a rare and challenging complication associated with poor prognosis and limited treatment options. Emerging T-cell directing therapies, such as bispecific antibodies (bsAbs) and chimeric antigen receptor T cells (CAR-T), have shown remarkable success in treating MM, but their efficacy in CNS involvement remains unclear. Elranatamab, a humanized bispecific antibody targeting B-cell maturation antigen (BCMA) and CD3-expressing T cells, has demonstrated promising results in relapsed refractory MM. However, its efficacy in treating CNS-MM has not been reported. We present a case of a 37-year-old male MM patient with CNS involvement who has been successfully treated with Elranatamab.
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Affiliation(s)
- Yasa Gul Mutlu
- Department of Hematology, Istanbul Medipol University, Istanbul, Türkiye
| | - Sureyya Yıgıt Kaya
- Department of Hematology, Istanbul Medipol University, Istanbul, Türkiye
| | - Senem Maral
- Department of Hematology, Istanbul Medipol University, Istanbul, Türkiye
| | - Elif Melek
- Department of Hematology, Istanbul Medipol University, Istanbul, Türkiye
| | - Zafer Baslar
- Department of Hematology, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Leylagul Kaynar
- Department of Hematology, Istanbul Medipol University, Istanbul, Türkiye
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Birtas Atesoglu E, Gulbas Z, Uzay A, Ozcan M, Ozkalemkas F, Dal MS, Kalyon H, Akay OM, Deveci B, Bekoz H, Sevindik OG, Toptas T, Yilmaz F, Koyun D, Alkis N, Alacacioglu I, Sonmez M, Yavasoglu I, Tombak A, Mehtap O, Kurnaz F, Yuce OK, Karakus V, Turgut M, Kurekci DD, Ayer M, Keklik M, Buyuktas D, Ozbalak M, Ferhanoglu B. Glofitamab in relapsed/refractory diffuse large B-cell lymphoma: Real-world data. Hematol Oncol 2023; 41:663-673. [PMID: 37211991 DOI: 10.1002/hon.3174] [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: 10/25/2022] [Revised: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 05/23/2023]
Abstract
Glofitamab is a CD3xCD20 bi-specific antibody with two fragments directed to the CD20 antigen and a single CD3-binding fragment. Encouraging response and survival rates were recently reported in a pivotal phase II expansion trial conducted in patients with relapsed/refractory (R/R) B-cell lymphoma. However, the real-world data of patients of all ages with no strict selection criteria are still lacking. Herein, this retrospective study aimed to evaluate the outcomes of diffuse large B-cell lymphoma (DLBCL) patients who received glofitamab via compassionate use in Turkey. Forty-three patients from 20 centers who received at least one dose of the treatment were included in this study. The median age was 54 years. The median number of previous therapies was 4, and 23 patients were refractory to first-line treatment. Twenty patients had previously undergone autologous stem cell transplantation. The median follow-up time was 5.7 months. In efficacy-evaluable patients, 21% and 16% of them achieved complete response and partial response, respectively. The median response duration was 6.3 months. The median progression-free survival (PFS) and overall survival (OS) was 3.3 and 8.8 months, respectively. None of the treatment-responsive patients progressed during the study period, and their estimated 1-year PFS and OS rate was 83%. The most frequently reported toxicity was hematological toxicity. Sixteen patients survived, while 27 died at the time of the analysis. The most common cause of death was disease progression. One patient died of cytokine release syndrome during the first cycle after receiving the first dose of glofitamab. Meanwhile, two patients died due to glofitamab-related febrile neutropenia. This is the largest real-world study on the effectiveness and toxicity of glofitamab treatment in R/R DLBCL patients. The median OS of 9 months seems promising in this heavily pretreated group. The toxicity related mortality rates were the primary concerns in this study.
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Affiliation(s)
- Elif Birtas Atesoglu
- Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey
| | - Zafer Gulbas
- Division of Hematology, Anadolu Medical Center, Kocaeli, Turkey
| | - Ant Uzay
- Division of Hematology, Acibadem Atakent Hospital, Istanbul, Turkey
| | - Muhit Ozcan
- Department of Internal Medicine, Division of Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Fahir Ozkalemkas
- Department of Internal Medicine, Division of Hematology, Uludag University Medical Faculty, Bursa, Turkey
| | - Mehmet Sinan Dal
- Division of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital, Ankara, Turkey
| | - Hakan Kalyon
- Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey
| | - Olga Meltem Akay
- Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey
| | - Burak Deveci
- Division of Hematology, Medstar Hospital, Antalya, Turkey
| | - Huseyin Bekoz
- Department of Internal Medicine, Division of Hematology, Medipol University Medical Faculty, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Department of Internal Medicine, Division of Hematology, Medipol University Medical Faculty, Istanbul, Turkey
| | - Tayfur Toptas
- Department of Internal Medicine, Division of Hematology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Fergun Yilmaz
- Department of Internal Medicine, Division of Hematology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Derya Koyun
- Department of Internal Medicine, Division of Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Nihan Alkis
- Division of Hematology, Bursa City Hospital, Bursa, Turkey
| | - Inci Alacacioglu
- Department of Internal Medicine, Division of Hematology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| | - Mehmet Sonmez
- Department of Internal Medicine, Division of Hematology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Irfan Yavasoglu
- Department of Internal Medicine, Division of Hematology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Anil Tombak
- Department of Internal Medicine, Division of Hematology, Mersin University Medical Faculty, Mersin, Turkey
| | - Ozgur Mehtap
- Department of Internal Medicine, Division of Hematology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Fatih Kurnaz
- Division of Hematology, Kocaeli Medicalpark Hospital, Kocaeli, Turkey
| | - Orhan Kemal Yuce
- Department of Internal Medicine, Division of Hematology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Volkan Karakus
- Division of Hematology, Antalya Research and Training Hospital, Antalya, Turkey
| | - Mehmet Turgut
- Department of Internal Medicine, Division of Hematology, Ondokuzmayıs University Medical Faculty, Samsun, Turkey
| | - Derya Deniz Kurekci
- Department of Internal Medicine, Division of Hematology, Ondokuzmayıs University Medical Faculty, Samsun, Turkey
| | - Mesut Ayer
- Division of Hematology, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey
| | - Muzaffer Keklik
- Department of Internal Medicine, Division of Hematology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Deram Buyuktas
- Division of Hematology, V.K.V. American Hospital, Istanbul, Turkey
| | - Murat Ozbalak
- Division of Hematology, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey
| | - Burhan Ferhanoglu
- Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey
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5
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Erol VB, Mutlu YG, Balik B, Mert A, Mergen S, Mergen M, Serin I, Cakir A, Ozden F, Sevindik OG. Intravascular B-cell lymphoma with generalized telangiectasias. J Dtsch Dermatol Ges 2023; 21:1025-1027. [PMID: 37401140 DOI: 10.1111/ddg.15148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 05/10/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Vedat Bugra Erol
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Yaşa Gul Mutlu
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Berrin Balik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ali Mert
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Sena Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Mahmut Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Aslı Cakir
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ferhat Ozden
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
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Erol VB, Mutlu YG, Balik B, Mert A, Mergen S, Mergen M, Serin I, Cakir A, Ozden F, Sevindik OG. Intravaskuläres B-Zell-Lymphom mit generalisierten Teleangiektasien. J Dtsch Dermatol Ges 2023; 21:1025-1028. [PMID: 37700402 DOI: 10.1111/ddg.15148_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 05/10/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Vedat Bugra Erol
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Yaşa Gul Mutlu
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Berrin Balik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ali Mert
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Sena Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Mahmut Mergen
- Department of Internal Medicine, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Aslı Cakir
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Ferhat Ozden
- Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Department of Hematology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey
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Serin I, Cinli TA, Tunc S, Kaynar L, Sevindik OG, Yokus O. Inherited transmission of the CSF3R T618I mutation: a familial report. Ann Hematol 2023; 102:477-479. [PMID: 36376598 DOI: 10.1007/s00277-022-05050-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz Gurman Cad. 34098, Istanbul, Turkey.
| | - Tahir Alper Cinli
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz Gurman Cad. 34098, Istanbul, Turkey
| | - Sertac Tunc
- Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Leylagul Kaynar
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Osman Yokus
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz Gurman Cad. 34098, Istanbul, Turkey
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Solmaz S, Uzun O, Sevindik OG, Demirkan F, Ozcan MA, Ozsan GH, Alacacıoglu I. The effect of haemoglobin, albumin, lymphocyte and platelet score on the prognosis in patients with multiple myeloma. Int J Lab Hematol 2023; 45:13-19. [PMID: 36053932 DOI: 10.1111/ijlh.13958] [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: 03/30/2022] [Accepted: 08/09/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION In multiple myeloma cases, a variety of prognostic parameters have been identified, which contain the Durie-Salmon classification and the international staging system (ISS) that takes the serum ß2 microglobulin and albumin levels, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR). This study investigates the effect of haemoglobin, albumin, lymphocyte and platelet (HALP) score which is a marker of inflammation status and nutrition, at the time of diagnosis for the patients with multiple myeloma on prognosis. METHODS A total of 200 multiple myeloma patients with HALP scores calculated from serum haemoglobin, albumin, lymphocyte count and platelet levels at the time of diagnosis were retrospectively examined. The effect of HALP score on overall survival (OS) and progression-free survival and its relationship between the previously evaluated prognostic parameters were investigated. RESULTS The optimal cut-off value with the ROC curves for the HALP score was 28.8. The patients were divided into two groups according to the optimal value of the HALP score (low-score group: HALP ≤28.8 [n: 134] and high-score group HALP >28.8 [n: 66]). In the group with the high HALP score, the OS was statistically longer than the low HALP score group (84 months and 53 months; p = 0.0001). In addition, when the effects of NLR, PLR, HALP score and ISS stage on OS were examined by multivariate analysis, all these markers were found to be statistically significant predictors. CONCLUSIONS HALP score may be a valuable prognostic marker for patients with multiple myeloma.
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Affiliation(s)
- Serife Solmaz
- Department of Hematology, Izmir Katip Celebi Training and Research Hospital, IZMIR, Turkey
| | - Ozcan Uzun
- Department of Nephrology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
| | | | - Fatih Demirkan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
| | - Mehmet Ali Ozcan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
| | - Guner Hayri Ozsan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul University, IZMIR, Turkey
| | - Inci Alacacıoglu
- Department of Hematology, Faculty of Medicine, Dokuz Eylul University, IZMIR, 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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Sevindik OG, Mergen M, Mergen S, Mutlu YG, Aydın BB, Serin I. To rechallenge or not to rechallenge, that is the question? An unsuccessful attempt of hypomethylating agent plus venetoclax in an elderly FLT3-positive relapsed acute myeloid leukemia patient after a yearlong period of remission. Ann Hematol 2022; 101:2545-2547. [PMID: 35906348 PMCID: PMC9361949 DOI: 10.1007/s00277-022-04938-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 07/23/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Omur Gokmen Sevindik
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Mahmut Mergen
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Sena Mergen
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Yasa Gul Mutlu
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Berrin Balık Aydın
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Istemi Serin
- Department of Hematology, Istanbul Training and Research Hospital, University of Health Sciences, Org.Nafiz GURMAN Cad., 34098 Fatih Istanbul, Turkey
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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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Ilhan O, Seval GC, Uzay A, Kaya E, Ozturk ZN, Deveci B, Yavasoglu I, Ural AU, Bekoz HS, Ayli M, Sevindik OG, Bozdag SC, Yuksel MK, Gulbas Z. Ibrutinib As a Promising Treatment for Pulmonary Complications Due to Refractory Chronic Graft Versus Host Disease. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Solmaz S, Uzun O, Acar C, Sevindik OG, Piskin O, Ozsan HG, Demirkan F, Undar B, Alacacioglu A, Ozcan MA, Alacacioglu I. Is the platelet-to-lymphocyte ratio a new prognostic marker in multiple myeloma? J Lab Physicians 2020; 10:363-369. [PMID: 30498304 PMCID: PMC6210833 DOI: 10.4103/jlp.jlp_36_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Recent reports showed neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as a predictor of progression-free survival (PFS) and overall survival (OS) in various malignancies. MATERIALS AND METHODS We retrospectively examined the PLR, NLR, and MLR in a cohort of 186 newly diagnosed multiple myeloma (MM) patients. This study investigated the prognostic relevance of NLR, PLR, and MLR in MM patients. NLR, PLR, and MLR were calculated from whole blood counts before therapy. The Kaplan-Meier curves and multivariate Cox models were used for the evaluation of survival. RESULTS Applying cutoff of 1.9 (NLR), 120.00 (PLR), and 0.27 (MLR), decreased PLR showed a negative impact on the outcome. Decreased PLR is an independent predictor for PFS and OS. There were no significant differences in median survival between the high and low NLR (P = 0.80) and MLR (P = 0.87) groups. CONCLUSIONS In this study, thrombocytopenia and low PLR are associated with poor survival in MM patients does this P value apply to thrombocytopenia or low PLR and may serve as the cost-effective prognostic biomarker.
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Affiliation(s)
- Serife Solmaz
- Department of Hematology, Bozyaka Education and Research Hospital, Batman, Turkey
| | - Ozcan Uzun
- Department of Internal Medicine, Batman Education and Research Hospital, Batman, Turkey
| | - Celal Acar
- Department of Hematology, Bozyaka Education and Research Hospital, Batman, Turkey
| | - Omur Gokmen Sevindik
- Department of Hematology, Faculty of Medicine, Medipol Universıty, Istanbul, Turkey
| | - Ozden Piskin
- Department of Hematology, Faculty of Medicine, Dokuz Eylul Universıty, Izmir, Turkey
| | - Hayri Guner Ozsan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul Universıty, Izmir, Turkey
| | - Fatih Demirkan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul Universıty, Izmir, Turkey
| | - Bulent Undar
- Department of Hematology, Faculty of Medicine, Dokuz Eylul Universıty, Izmir, Turkey
| | | | - Mehmet Ali Ozcan
- Department of Hematology, Faculty of Medicine, Dokuz Eylul Universıty, Izmir, Turkey
| | - Inci Alacacioglu
- Department of Hematology, Faculty of Medicine, Dokuz Eylul Universıty, Izmir, Turkey
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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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15
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Solmaz S, Kahraman S, Sevindik OG, Acar C, Turkyilmaz M, Alacacioglu I, Piskin O, Ozcan MA, Ozsan HG, Undar B, Demirkan F. A Comparison of Fresenius Com.Tec Cell and Spectra Optia Cell Separators for Autologous and Allogeneic Stem Cell Collections: Single Center Experience. Indian J Hematol Blood Transfus 2018; 34:677-683. [PMID: 30369740 DOI: 10.1007/s12288-018-0922-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 11/15/2017] [Accepted: 01/10/2018] [Indexed: 11/25/2022] Open
Abstract
Peripheral blood is the prefered source for hematopoietic stem cells for hematopoietic stem cell transplantation. The efficiency of peripheral blood stem cell (PBSC) collection can vary among devices. In this study we aimed to compare feasibility and effectivity of apheresis procedures of the different systems. Two apheresis systems [Com.Tec (Fresenius Healthcare) and Spectra Optia (Caridian BCT)] were used in our center for the collection of PBSCs for autologous and allogeneic transplantation. We retrospectively analysed 190 apheresis procedures performed in healthy donors and patients between June 2012 and November 2014 in Department of Hematology, Dokuz Eylul University. PBSCS were collected by Fresenius cell separator (64 procedure) or Spectra Optia cell separator (126 procedure). Mobilization treatments were G-CSF (26.8%), cyclophosphamide plus G-CSF (48.4%), prelixafor plus G-CSF (14.7%), ESHAP (10%) and others. Patient and donor characteristics (age, weight, volume processed, disease, mobilization regimes) were similar in Fresenius and Spectra Optia apheresis groups. Altough both collected PBSCs efficiently, the amount of CD34+ cell in product collected by Spectra Optia device was significantly higher (p < 0.05) and product volume was lower than Fresenius Com.Tec significantly (p < 0.05). "CD34+ collection efficiency" with Spectra Optia was significantly higher than Fresenius Com.Tec (CE2: 87%, 70%, p = 0.033) regarding all procedures. High collection efficiency and low product volume may be a significant characteristic of Spectra Optia device (mean 187 mL, product CD34+ cell: 1576 µL).
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Affiliation(s)
- Serife Solmaz
- Department of Hematology, Bozyaka Teaching and Research Hospital, Izmir, Turkey
| | - Selda Kahraman
- Department of Hematology, Medical Park Hospital, Izmir, Turkey
| | | | - Celal Acar
- Department of Hematology, Bozyaka Teaching and Research Hospital, Izmir, Turkey
| | - Munire Turkyilmaz
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Inci Alacacioglu
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ozden Piskin
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Mehmet Ali Ozcan
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Hayri Guner Ozsan
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Bulent Undar
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Fatih Demirkan
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Solmaz Medeni S, Acar C, Olgun A, Acar A, Seyhanlı A, Taskıran E, Sevindik OG, Alacacıoglu I, Piskin O, Ozcan MA, Demirkan F, Undar B, Ozsan GH. Can Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, and Platelet-to-Lymphocyte Ratio at Day +100 be used as a prognostic marker in Multiple Myeloma patients with autologous transplantation? Clin Transplant 2018; 32:e13359. [PMID: 30053318 DOI: 10.1111/ctr.13359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/11/2018] [Accepted: 07/22/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent reports have showed that neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) are predictors of progression-free survival (PFS) and overall survival (OS) in many types of cancer. This study evaluates the predictive value of NLR, MLR, and PLR for survival in MM patients treated with to ASCT. METHODS A set of data consisting of 150 patients who underwent autologous stem cell transplantation (ASCT) for MM was collected retrospectively. The prognostic value of NLR, MLR, and PLR was investigated with Kaplan-Meier method. RESULTS The prognostic value of NLR, MLR, and PLR was analyzed by a receiver operating characteristic (ROC) curve established to determine the cutoff. These cutoff values of NLR, PLR, and MLR were found 1.46, 86, and 0.27, respectively, on the 100th day of post-transplantation period. The overall survival (OS) and the post-transplantation OS of the patients with high NLR, MLR, and PLR levels on the 100th day of post-transplantation were shorter than the other group (P = 0.05, P = 0.018 [NLR], P = 0.05, P = 0.002 [MLR], P = 0.000, P = 0.001 [PLR]). The post-transplantation progression-free survival (PFS) of the patients with high NLR, MLR, and PLR levels on the 100th day of post-transplantation was shorter as well (P = 0.036, P = 0.001, P = 0.001, respectively). CONCLUSION As increased NLR, MLR, and PLR predicted poor clinical outcome in MM patients with autologous transplantation in this study, they may serve as cost-effective and rapidly available prognostic biomarkers for these patients.
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Affiliation(s)
| | - Celal Acar
- Hematology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Aybuke Olgun
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Alev Acar
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Ahmet Seyhanlı
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Emin Taskıran
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | | | - Inci Alacacıoglu
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Ozden Piskin
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Mehmet Ali Ozcan
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Fatih Demirkan
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Bulent Undar
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Guner Hayri Ozsan
- Faculty of Medicine Hematology, Dokuz Eylul University, Izmir, Turkey
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18
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Ersan S, Sevindik OG, Cavdar C, Ada S, Sifil A, Celik A, Sarioglu S, Camsari T. Evaluation of Clinical and Pathological Characteristics of Patients with IgA Nephropathy Based on Oxford Classification System: Should Crescents be Included? BANTAO Journal 2017. [DOI: 10.1515/bj-2017-0003] [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: 11/15/2022] Open
Abstract
Abstract
Introduction. None of the classification systems in immunoglobulin A (IgA) nephropathy has been widely agreed or implemented by clinicians or pathologists. In order to meet this need, "Oxford Classification System", which is highly reproducible and predictive for clinical course, was developed in 2009. In the present study, we investigated clinical and pathological characteristics of patients with IgA nephropathy based on current classification and the predictivity of crescent presence on prognosis. Methods. The study comprised 40 patients with diagnosis of primary IgA nephropathy on renal biopsy. The biopsy findings and follow-up parameters of patients were retrospectively re-evaluated. Pathological findings were examined based on the Oxford classification system. The presence of crescent formation in the specimens was noted. Results. The presence of crescent formation was predictive of poor prognosis regarding the glomerular filtration rate (eGFR), the level of proteinuria, and mean arterial pressure (MAP). Conclusion: Considering the importance of crescent formation in prediction of the clinical course and need for immunosuppressive therapy, it is suggested that crescent presence can be included in this classification system.
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Affiliation(s)
- Sibel Ersan
- Dokuz Eylul University Hospital, Department of Internal Medicine, Division of Nephrology, Izmir , Turkey
| | | | - Caner Cavdar
- Dokuz Eylul University Hospital, Department of Internal Medicine, Division of Nephrology, Izmir , Turkey
| | - Sibel Ada
- Dokuz Eylul University Hospital, Department of Internal Medicine, Division of Nephrology, Izmir , Turkey
| | - Aykut Sifil
- Dokuz Eylul University Hospital, Department of Internal Medicine, Division of Nephrology, Izmir , Turkey
| | - Ali Celik
- Dokuz Eylul University Hospital, Department of Internal Medicine, Division of Nephrology, Izmir , Turkey
| | - Sulen Sarioglu
- Dokuz Eylul University Hospital, Department of Pathology, Izmir , Turkey
| | - Taner Camsari
- Dokuz Eylul University Hospital, Department of Internal Medicine, Division of Nephrology, Izmir , Turkey
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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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Aksoy A, Artas G, Sevindik OG. Predictive value of stathmin-1 and osteopontin expression for taxan resistance in metastatic castrate-resistant prostate cancer. Pak J Med Sci 2017; 33:560-565. [PMID: 28811771 PMCID: PMC5510103 DOI: 10.12669/pjms.333.12559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective: Several pathways are known to be activated during metastasis and treatment of cancer. We investigated the role of osteopontin (OPN) and stathmin-1 (STHMN1) in metastatic castrate-resistant (mCRPC). Methods: We included 30 patients who received at least 6 cycles of taxane regimen for metastatic mPC in the present study. For this study retrospective data was taken from Firat University, Faculty of Medicine, Medical Oncology Department between 2009 and 2015. OPN expression and STHMN1 expression were retrospectively evaluated by immunohistochemical staining in biopsy specimens. The relationship between the expression levels of OPN and STMN1 and the response to taxane based regimen and survival was analyzed. Results: There was mild or strong overexpression of OPN and STHMN1 in all the patients. STHMN1 expression was mildly positive (+2) in four of the cases (13.2%) while it was strongly positive (+3) in 25 (83.4%) cases. Similarly, OPN expression was mildly positive (+2) and strongly positive (+3) in five (16.6%) and 25 (87.4%) patients, respectively. There was no significant correlation between the expression levels of STHMN1 and OPN, survival, and response to taxane based regimen (p>0.05); however, OPN overexpression showed a significant correlation with lower Gleason scores (GS) (p:0.032). Conclusions: STHMN1 and OPN may be prognostic markers although they are not predictive markers of response to treatment in mCRPC. The overexpression of OPN may help identifying patients with lower GS.
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Affiliation(s)
- Asude Aksoy
- Asude Aksoy, Department of Medical Oncology, Medical Faculty, Firat University, Elazig, Turkey
| | - Gokhan Artas
- Gokhan Artas, Department of Pathology, Medical Faculty, Firat University, Elazig, Turkey
| | - Omur Gokmen Sevindik
- Omur Gokmen Sevindik, Department of Hematology, Medical Faculty, Firat University, Elazig, Turkey
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Sevindik OG, Mersin S, Katgi A, Tunali S, Solmaz SM, Acar C, Alacacioglu I, Piskin O, Ozcan MA, Demirkan F, Undar B, Ozsan GH. IPSET-Thrombosis Better Identifies Thrombosis-Free Survival: A Turkish Cohort. Clinical Lymphoma Myeloma and Leukemia 2015; 15:e101-4. [DOI: 10.1016/j.clml.2015.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/09/2015] [Accepted: 02/03/2015] [Indexed: 11/27/2022]
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Ersan S, Sevindik OG, Cavdar C, Sarıoglu S, Camsari T. FP156ASSESSMENT OF THE CLINICOPATHOLOGIC FEATURES OF PATIENTS WITH IGA NEPHROPATHY ON THE BASIS OF OXFORD CLASSIFICATION: SHOULD CRESCENTS BE INCLUDED? Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv171.45] [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: 11/13/2022] Open
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23
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Sevindik OG, Guc Z, Kahraman S, Medeni Solmaz S, Katgi A, Acar C, Alacacioglu I, Piskin O, Ozsan GH, Demirkan F, Undar B, Ozcan MA. Hypoalbuminemia is a surrogate biomarker of poor prognosis in myelodysplastic syndrome even when adjusting for comorbidities. Leuk Lymphoma 2015; 56:2552-5. [DOI: 10.3109/10428194.2015.1014362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Borazan A, Sevindik OG, Solmaz D, Gulcu A, Cavdar C, Sifil A, Celik A, Akar S, Goktay Y, Camsari T. A rare cause of renovascular hypertension: Takayasu arteritis with only renal artery involvement. Ren Fail 2009; 31:327-31. [PMID: 19462284 DOI: 10.1080/08860220902780093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Takayasu arteritis is a chronic inflammatory disease that affects mainly the aorta, main branches of aorta, and pulmonary arteries with unknown etiology. Disease affecting solely the renal arteries is rare. We will present a case that had hypertension, hypokalemia, and metabolic alkalosis where the etiology was type 2 Takayasu arteritis, affecting renal arteries.
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Affiliation(s)
- Ali Borazan
- Mustafa Kemal University Faculty of Medicine, Department of Nephrology, Hatay, Turkey.
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