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Yiğit Kaya S, Mutlu YG, Malkan ÜY, Mehtap Ö, Keklik Karadağ F, Korkmaz G, Elverdi T, Saydam G, Özet G, Ar MC, Melek E, Maral S, Kaynar L, Sevindik ÖG. Single agent vemurafenib or rituximab-vemurafenib combination for the treatment of relapsed/refractory hairy cell leukemia, a multicenter experience. Leuk Res 2024; 140:107495. [PMID: 38599153 DOI: 10.1016/j.leukres.2024.107495] [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: 01/26/2024] [Revised: 03/07/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Hairy cell leukemia (HCL) is a rare mature B-cell malignancy that is primarily treated with purine analogues. However, relapse remains a significant challenge, prompting the search for alternative therapies. The BRAF V600E mutation prevalent in HCL patients provides a target for treatment with vemurafenib. PATIENTS AND METHODS This multicenter retrospective study included nine patients with relapsed/refractory (R/R) HCL from six different centers. Patient data included demographics, prior treatments, clinical outcomes, and adverse events. RESULTS Patients received different treatment regimens between centers, including vemurafenib alone or in combination with rituximab. Despite the differences in protocols, all patients achieved at least a partial response, with seven patients achieving a complete response. Adverse events were generally mild with manageable side effects. The absence of myelotoxic effects and manageable side effects make BRAF inhibitors attractive, especially for patients ineligible for purine analogues or those with severe neutropenia. CONCLUSION Single agent vemurafenib or in combination with rituximab appears to be a promising therapeutic option for R/R HCL. Further research is needed to establish standardized treatment protocols and to investigate long-term outcomes.
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Affiliation(s)
- Süreyya Yiğit Kaya
- Department of Hematology, Faculty of Medicine, Istanbul Medipol University, Turkey.
| | - Yaşa Gül Mutlu
- Department of Hematology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ümit Yavuz Malkan
- Department of Hematology, Faculty of Medicine, Hacettepe University, Turkey
| | - Özgür Mehtap
- Department of Hematology, Faculty of Medicine, Kocaeli University, Turkey
| | | | - Gülten Korkmaz
- Department of Hematology, Ankara Bilkent City Hospital, Turkey
| | - Tuğrul Elverdi
- Department of Hematology, Cerrahpaşa Faculty of Medicine, Istanbul University, Turkey
| | - Güray Saydam
- Department of Hematology, Faculty of Medicine, Ege University, Turkey
| | - Gülsüm Özet
- Department of Hematology, Ankara Bilkent City Hospital, Turkey
| | - Muhlis Cem Ar
- Department of Hematology, Cerrahpaşa Faculty of Medicine, Istanbul University, Turkey
| | - Elif Melek
- Department of Hematology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Senem Maral
- Department of Hematology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Leylagül Kaynar
- Department of Hematology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ömür Gökmen Sevindik
- Department of Hematology, Faculty of Medicine, Istanbul Medipol University, 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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Saglam B, Albayrak M, Yıldız A, Tığlıoğlu P, Tığlıoğlu M, Aras MR, Yilmaz F, Maral S, A Öztürk HB. The prognostic impact of comorbidity, nutritional and performance status on patients with diffuse large B cell lymphoma. Niger J Clin Pract 2023; 26:1512-1518. [PMID: 37929528 DOI: 10.4103/njcp.njcp_175_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Background The aim of the study was to investigate the impact of nutritional status, comorbidity, and performance status on patients with diffuse large B-cell lymphoma (DLBCL). Methods A retrospective study was conducted on 112 DLBCL patients who were diagnosed at our center between 2009 and 2018. Demographic and disease characteristics and laboratory test results were recorded. Assessments were made using the age-adjusted Charlson comorbidity index (CCI-A) for comorbidity, albumin level for nutritional status, and Eastern Cooperative Oncology Group (ECOG) score for performance status. Results The mean age of the patients was found to be 62.63 ± 15.16 years. The ECOG score of 65 patients (69.1%) was in the range of 0-1. The mean follow-up time of the patients was determined to be 25.24 ± 25.11 months, and at the end of the follow-up period, 64 patients (57.1%) were survivors. The progression-free survival (PFS), overall survival (OS), and 5-year OS rates of those with CCI-A > 4 were found to be significantly lower than those with CCI-A score ≤4 (P < 0.05). As a result of the Cox-Regression (Backward: LR method) analysis, ECOG and albumin levels were found to be independent risk factors for both OS and PFS (P < 0.05). Conclusion This study demonstrated that CCI-A, ECOG, and nutritional status are independent prognostic markers for DLBCL patients. Initial evaluation of these patients should include all these parameters, which are easily available at the time of diagnosis.
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Affiliation(s)
- B Saglam
- Department of Hematology, Liv Hospital Gaziantep, Gaziantep, Turkey
| | - M Albayrak
- Department of Hematology, Ministry of Health Ankara Etlik City Hospital, Ankara, Turkey
| | - A Yıldız
- Ministry of Health Hitit University, Erol Olçok Training and Research Hospital, Çorum, Turkey
| | - P Tığlıoğlu
- Department of Hematology, University of Health Sciences, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - M Tığlıoğlu
- Department of Hematology, University of Health Sciences, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - M R Aras
- Department of Hematology, Ministry of Health Ankara Etlik City Hospital, Ankara, Turkey
| | - F Yilmaz
- Department of Hematology, Ministry of Health Ankara Etlik City Hospital, Ankara, Turkey
| | - S Maral
- Department of Hematology, Medicine Faculty, Istanbul Medipol University, Istanbul, Turkey
| | - H B A Öztürk
- Department of Hematology, Ministry of Health Ankara Etlik City Hospital, Ankara, Turkey
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Albayrak A, Yıldız A, Albayrak M, Özhamam EU, Maral S. Co-occurence of follicular lymphoma and Langerhans cell histiocytosis with primary parotid gland involvement: a case report. Hematol Transfus Cell Ther 2023; 45:131-133. [PMID: 34593368 PMCID: PMC9938452 DOI: 10.1016/j.htct.2021.06.015] [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: 01/15/2021] [Revised: 05/29/2021] [Accepted: 06/24/2021] [Indexed: 02/06/2023] Open
Affiliation(s)
- Aynur Albayrak
- University of Health Sciences, Numune Training and Research Hospital, Department of Pathology, Ankara, Turkey
| | - Abdulkerim Yıldız
- Hitit University Training and Research Hospital, Department of Hematology, Çorum, Turkey.
| | - Murat Albayrak
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Esra Uçaryılmaz Özhamam
- University of Health Sciences, Numune Training and Research Hospital, Department of Pathology, Ankara, Turkey
| | - Senem Maral
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
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Gündüz E, Kırkızlar HO, Ümit EG, Karaman Gülsaran S, Özkocaman V, Özkalemkaş F, Candar Ö, Elverdi T, Küçükyurt S, Paydaş S, Ceneli Ö, Karakuş S, Maral S, Ekinci Ö, İpek Y, Kis C, Güven ZT, Akdeniz A, Celkan T, Eroğlu Küçükdiler AH, Akgün Çağlıyan G, Özçelik Şengöz C, Karataş A, Bulduk T, Özcan A, Belen Apak FB, Canbolat A, Kartal İ, Ören H, Töret E, Özdemir GN, Bakanay Öztürk ŞM. Castleman Disease: A Multicenter Case Series from Turkey. Turk J Haematol 2022; 39:130-135. [PMID: 35176839 PMCID: PMC9160699 DOI: 10.4274/tjh.galenos.2022.2021.0670] [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: Castleman disease (CD) is a rare disease also known as angiofollicular lymph node hyperplasia. The two main histological subtypes are the hyaline vascular and plasma cell variants. It is further classified as unicentric CD (UCD) or multicentric CD (MCD) according to the anatomical distribution of the disease and the number of lymph nodes involved. The aim of this multicenter study was to evaluate all cases of CD identified to date in Turkey to set up a national registry to improve the early recognition, treatment, and follow-up of CD. Materials and Methods: Both adult (n=130) and pediatric (n=10) patients with lymph node or involved field biopsy results reported as CD were included in the study. Patients’ demographic information, clinical and laboratory characteristics, imaging study results, treatment strategies, and clinical outcomes were evaluated retrospectively. Results: A total of 140 patients (69 male and 71 female) with a diagnosis of UCD (n=73) or MCD (n=67) were included. The mean age was 39 years in the UCD group and 47 years in the MCD group. Female patients were more common in the UCD group. The most common histological subtype was hyaline vascular for both UCD and MCD patients. Asymptomatic patients were more common in the UCD group. Anemia, elevations of acute phase reactants, and hypoalbuminemia were more common in the MCD group. The most commonly used treatment strategies for UCD were surgical excision, rituximab, and radiotherapy, respectively. All UCD patients were alive at a median of 19.5 months of follow-up. The most commonly used treatment strategies for MCD were methyl prednisolone, R-CHOP, R-CVP, and rituximab. Thirteen MCD patients had died at a median of 34 months of follow-up. Conclusion: This study is important in presenting the patient characteristics and treatment strategies for CD from Turkey, with the potential of increasing awareness about CD. Treatment data may help in making decisions, particularly in countries that do not have access to siltuximab. However, larger prospective studies are needed to make definitive conclusions.
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Affiliation(s)
- Eren Gündüz
- Eskişehir Osmangazi University Faculty of Medicine Department of Hematology, Eskişehir, Turkey
| | | | - Elif Gülsüm Ümit
- Trakya University Faculty of Medicine Department of Hematology, Edirne, Turkey
| | | | - Vildan Özkocaman
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Fahir Özkalemkaş
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Ömer Candar
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Tuğrul Elverdi
- İstanbul University Cerrahpaşa Faculty of Medicine Department of Hematology, İstanbul, Turkey
| | - Selin Küçükyurt
- İstanbul University Cerrahpaşa Faculty of Medicine Department of Hematology, İstanbul, Turkey
| | - Semra Paydaş
- Çukurova University Faculty of Medicine Department of Hematology, Adana, Turkey
| | - Özcan Ceneli
- Necmettin Erbakan University Meram Faculty of Medicine Department of Hematology, Konya, Turkey
| | - Sema Karakuş
- Ankara Başkent University Faculty of Medicine Department of Hematology, Ankara, Turkey
| | - Senem Maral
- Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Ömer Ekinci
- Fırat University Faculty of Medicine Department of Hematology, Elazığ, Turkey
| | - Yıldız İpek
- Kartal Dr Lutfi Kirdar City Hospital Department of Hematology, İstanbul, Turkey
| | - Cem Kis
- Adana Baskent University Faculty of Medicine Department of Hematology, Adana, Turkey
| | - Zeynep Tuğba Güven
- Erciyes University Faculty of Medicine Department of Hematology, Kayseri, Turkey
| | - Aydan Akdeniz
- Mersin University Faculty of Medicine Department of Hematology, Mersin, Turkey
| | - Tiraje Celkan
- İstinye University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
| | | | | | - Ceyda Özçelik Şengöz
- Karadeniz Technical University Faculty of Medicine Department of Hematology, Trabzon, Turkey
| | - Ayse Karataş
- Hacettepe University Faculty of Medicine Department of Hematology, Ankara, Turkey
| | - Tuba Bulduk
- Health Sciences University Gulhane Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Alper Özcan
- Erciyes University Faculty of Medicine Department of Pediatric Hematology, Kayseri, Turkey
| | - Fatma Burcu Belen Apak
- Ankara Başkent University Faculty of Medicine Department of Pediatric Hematology, Ankara, Turkey
| | - Aylin Canbolat
- İstanbul Medeniyet University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
| | - İbrahim Kartal
- Ondokuz Mayıs University Faculty of Medicine Department of Pediatric Hematology, Samsun, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine Department of Pediatric Hematology, İzmir, Turkey
| | - Ersin Töret
- Eskişehir Osmangazi University Faculty of Medicine Department of Pediatric Hematology, Eskişehir, Turkey
| | - Gül Nihal Özdemir
- İstinye University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
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Tığlıoğlu P, Albayrak M, Tığlıoğlu M, Öztürk HBA, Aras MR, Sağlam B, Maral S. The outcome of COVID-19 in patients with hematological malignancy. Memo 2022; 15:83-89. [PMID: 34904019 PMCID: PMC8655323 DOI: 10.1007/s12254-021-00775-5] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/08/2021] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The aim of this study was to examine the effect of coronavirus disease 2019 (COVID-19) on the malignancy-related clinical course and overall survival, and to determine the factors affecting mortality. METHODS This retrospective study included 77 patients with hematological cancer and COVID-19. Patients were sub-grouped for analysis as survivors and non-survivors. RESULTS COVID-19 was seen more frequently in myeloproliferative neoplasms (MPN), non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) patients. Mortality rate due to COVID-19 was 20.8%. No statistically significant difference was determined between the survivor and non-survivor groups with respect to age and gender, presence of any comorbidity, leukocyte, neutrophil, lymphocyte, and monocyte values. Platelet count and hemoglobin count were significantly lower in the group with mortality than in the group with recovery. CONCLUSION It should be kept in mind that low hemoglobin and platelet levels contribute to mortality. In addition, it is important to protect patients with hematological cancer from COVID-19 and undertake effective vaccination due to its mortal course.
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Affiliation(s)
- Pınar Tığlıoğlu
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | - Murat Albayrak
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | - Mesut Tığlıoğlu
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | - Hacer Berna Afacan Öztürk
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | - Merih Reis Aras
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | - Buğra Sağlam
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | - Senem Maral
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
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Aras MR, Albayrak M, Yildiz A, Maral S, A Ozturk HB, Tiglioglu P, Tiglioglu M, Saglam B, Yilmaz F. The prognostıc significance of blood counts in patients with hodgkin lymphoma. Niger J Clin Pract 2022; 25:1332-1337. [DOI: 10.4103/njcp.njcp_175_22] [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: 11/04/2022]
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Yılmaz F, Albayrak M, Tığlıoğlu P, Tığlıoğlu M, Sağlam B, Reis Aras M, Maral S, Afacan Öztürk HB. Vitreous hemorrhage: A rare ophthalmic adverse effect due to imatinib treatment. J Oncol Pharm Pract 2021; 28:725-728. [PMID: 34775854 DOI: 10.1177/10781552211060730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Imatinib is generally well tolerated by patients. The most common ophthalmic side effects are eyelid edema and periorbital edema. Other side effects which occur at rates of <1% include blepharitis, blurred vision, conjunctival hemorrhage, conjunctivitis, retinal hemorrhage, etc. An uncommon case is here reported of a 51-year-old male with chronic myeloid leukemia who developed vitreous hemorrhage due to imatinib after 9 months of treatment. CASE REPORT A 51-year-old male with leukocytosis detected in the blood test examination was referred to the Hematology Department. The bone marrow biopsy result was compatible with chronic myeloid leukemia. Imatinib treatment (400 mg/day) was started. In the ninth month of imatinib treatment, the patient complained of a sudden decrease in vision. Vitreous hemorrhage was detected in the left eye and the patient underwent surgery. Vitreous hemorrhage recurred 1 month after the operation. On the fourth day after the discontinuation of imatinib treatment, the patient's ophthalmic complaints improved significantly. The Naranjo algorithm was applied and a score of 9 was detected. The vitreous hemorrhage of the patient was attributed to imatinib, and so the treatment of the patient was switched to bosutinib. DISCUSSION Imatinib is an oral signal inhibitor that targets tyrosine kinase for BCR/ABL, platelet-derived growth factor, stem cell factor, and c-kit (CD117). The conjunctiva and sclera have a large amount of c-kit positive mast cells which are inhibited by imatinib. The inhibition of c-kit positive mast cells by imatinib may be responsible for further exposure of the conjunctival mucosa to injuries.
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Affiliation(s)
- Fatma Yılmaz
- University of Health Sciences, 146992Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Murat Albayrak
- University of Health Sciences, 146992Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Pınar Tığlıoğlu
- University of Health Sciences, 146992Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Mesut Tığlıoğlu
- University of Health Sciences, 146992Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Buğra Sağlam
- University of Health Sciences, 146992Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Merih Reis Aras
- University of Health Sciences, 146992Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Senem Maral
- University of Health Sciences, 146992Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Hacer Berna Afacan Öztürk
- University of Health Sciences, 146992Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
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Sağlam B, Albayrak M, Afacan Öztürk HB, Aras MR, Tığlıoğlu P, Tığlıoğlu M, Yılmaz F, Maral S. A RARE CAUSE OF ANEMIA IN ADULTHOOD CONGENITAL DYSERYTHROPETIC ANEMIA. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.1064] [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: 10/19/2022] Open
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Aras MR, Tiglioglu P, Tiglioglu M, Saglam B, Yilmaz F, Olgun N, Maral S, Ozturk HBA, Albayrak M. T-ACUTE MYELOID LEUKEMIA CASE THOUGHT TO BE ASSOCIATED WITH RADIOIODINE (I¹³¹) TREATMENT. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.1019] [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: 11/15/2022] Open
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Maral S, Albayrak M, Korkmaz G, Dagdas S, Öztürk BA, Albayrak A, Han Ü, Aras MR, Özet G. IMPACT OF BONE MARROW FIBROSIS IN MYELOMA PATIENTS UNDERGONE AUTOLOGOUS STEM CELL TRANSPLANTATION. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.973] [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: 10/19/2022] Open
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Tığlıoğlu M, Tığlıoğlu P, Aras MR, Sağlam B, Yılmaz F, Maral S, Afacan Öztürk HB, Albayrak M. CASE REPORT OF MARGINAL ZONE LYMPHOMA DETECTED WHILE INVESTIGATING ETIOLOGY FOR HEMOSTASIS DISORDER. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.1030] [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: 11/27/2022] Open
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Tığlıoğlu P, Tığlıoğlu M, Aras MR, Sağlam B, Yılmaz F, Maral S, Afacan Öztürk HB, Albayrak M. A RARE CASE: POSTTRANSPLANT NK/T CELL LYMPHOMA. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.1033] [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: 11/16/2022] Open
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Aras MR, Maral S, Ozturk HBA, Tiglioglu P, Tiglioglu M, Saglam B, Yilmaz F, Onder M, Albayrak M. INAPPROPRIATE ADH SYNDROME OCCURING DURING B-ALL TREATMENT. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.1018] [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: 10/19/2022] Open
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Civriz Bozdağ S, Cengiz Seval G, Yönal Hindilerden İ, Hindilerden F, Andıç N, Baydar M, Aydın Kaynar L, Koçak Toprak S, Göksoy HS, Balık Aydın B, Demirci U, Can F, Özkocaman V, Gündüz E, Güven ZT, Özkurt ZN, Demircioğlu S, Beksaç M, İnce İ, Yılmaz U, Eroğlu Küçükdiler H, Abishov E, Yavuz B, Ataş Ü, Mutlu YG, Baş V, Özkalemkaş F, Üsküdar Teke H, Gürsoy V, Çelik S, Çiftçiler R, Yağcı M, Topçuoğlu P, Çeneli Ö, Abbasov H, Selim C, Ar MC, Yücel OK, Sadri S, Albayrak C, Demir AM, Güler N, Keklik M, Terzi H, Doğan A, Yegin ZA, Kurt Yüksel M, Sadri S, Yavaşoğlu İ, Beköz HS, Aksu T, Maral S, Erol V, Kaynar L, İlhan O, Bolaman AZ, Sevindik ÖG, Akyay A, Özcan M, Gürman G, Ünal Ş, Yavuz Y, Diz Küçükkaya R, Özsan GH. Clinical Characteristics and Outcome of COVID-19 in Turkish Hematological Malignancy Patients. Turk J Haematol 2021; 39:43-54. [PMID: 34521187 PMCID: PMC8886271 DOI: 10.4274/tjh.galenos.2021.2021.0287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARS-CoV- 2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixty-nine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.
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Affiliation(s)
- Sinem Civriz Bozdağ
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | | | - İpek Yönal Hindilerden
- İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Fehmi Hindilerden
- İstanbul Bakırköy Sadi Konuk Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Neslihan Andıç
- Eskişehir Osmangazi University Faculty of Medicine, Department of Hematology, Eskisehir, Turkey
| | - Mustafa Baydar
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Lale Aydın Kaynar
- Gazi University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Selami Koçak Toprak
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Hasan Sami Göksoy
- Yeni yüzyıl University, Özel Gaziosmanpaşa Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Berrin Balık Aydın
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Ufuk Demirci
- Trakya University Faculty of Medicine, Department of Hematology, Edirne, Turkey
| | - Ferda Can
- Ankara City Hospital, Clinic of Internal Medicine, Ankara, Turkey
| | - Vildan Özkocaman
- Bursa Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Eren Gündüz
- Eskişehir Osmangazi University Faculty of Medicine, Department of Hematology, Eskisehir, Turkey
| | - Zeynep Tuğba Güven
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Zübeyde Nur Özkurt
- Gazi University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Sinan Demircioğlu
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Hematology, Konya, Turkey
| | - Meral Beksaç
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - İdris İnce
- Dr. Ersin Arslan Training and Research Hospital, Clinic of Hematology, Gaziantep, Turkey
| | - Umut Yılmaz
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | | | - Elgün Abishov
- Yeni yüzyıl University, Özel Gaziosmanpaşa Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Boran Yavuz
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Ünal Ataş
- Akdeniz University Faculty of Medicine, Department of Hematology, Antalya, Turkey
| | - Yaşa Gül Mutlu
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Volkan Baş
- Trakya University Faculty of Medicine, Department of Hematology, Edirne, Turkey
| | - Fahir Özkalemkaş
- Bursa Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Hava Üsküdar Teke
- Eskişehir Osmangazi University Faculty of Medicine, Department of Hematology, Eskisehir, Turkey
| | - Vildan Gürsoy
- Bursa City Hospital, Clinic of Hematology, Bursa, Turkey
| | - Serhat Çelik
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Rafiye Çiftçiler
- Aksaray Training and Research Hospital, Clinic of Hematology, Aksaray, Turkey
| | - Münci Yağcı
- Gazi University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Pervin Topçuoğlu
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Özcan Çeneli
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Hematology, Konya, Turkey
| | - Hamza Abbasov
- Yeni yüzyıl University, Özel Gaziosmanpaşa Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Cem Selim
- Adnan Menderes University Faculty of Medicine, Department of Hematology, Aydın, Turkey
| | - Muhlis Cem Ar
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Orhan Kemal Yücel
- Akdeniz University Faculty of Medicine, Department of Hematology, Antalya, Turkey
| | - Sevil Sadri
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Canan Albayrak
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Hematology, Samsun, Turkey
| | | | - Nil Güler
- Pamukkale University Faculty of Medicine, Department of Internal Medicine, Denizli, Turkey
| | - Muzaffer Keklik
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Hatice Terzi
- Cumhuriyet University Faculty of Medicine, Department of Hematology, Sivas, Turkey
| | - Ali Doğan
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Hematology, Van, Turkey
| | - Zeynep Arzu Yegin
- Gazi University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Meltem Kurt Yüksel
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Soğol Sadri
- Yeni yüzyıl University, Özel Gaziosmanpaşa Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - İrfan Yavaşoğlu
- Adnan Menderes University Faculty of Medicine, Department of Hematology, Aydın, Turkey
| | - Hüseyin Saffet Beköz
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Tekin Aksu
- University of Health Sciences Turkey, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Department of Pediatric Hematology and Oncology, Ankara, Turkey
| | - Senem Maral
- University of Health Sciences Turkey, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Veysel Erol
- Pamukkale University Faculty of Medicine, Department of Internal Medicine, Denizli, Turkey
| | - Leylagül Kaynar
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Osman İlhan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Ali Zahit Bolaman
- Adnan Menderes University Faculty of Medicine, Department of Hematology, Aydın, Turkey
| | - Ömür Gökmen Sevindik
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Arzu Akyay
- İnönü University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Malatya, Turkey
| | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Günhan Gürman
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Şule Ünal
- Hacettepe University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Yasemin Yavuz
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Reyhan Diz Küçükkaya
- İstanbul University Faculty of Science, Department of Molecular Biology and Genetic, İstanbul, Turkey
| | - Güner Hayri Özsan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, 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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Afacan Ozturk HB, Albayrak M, Maral S, Reis Aras M, Yilmaz F, Akyol P, Tiglioglu M, Malkan UY. Hypercalcemia associated with the interaction between all trans retinoic acid and posaconazole in an acute promyelocytic leukemia case. J Oncol Pharm Pract 2021; 27:2027-2029. [PMID: 33847196 DOI: 10.1177/10781552211007889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION All-trans retinoic acid (ATRA) is a physiological metabolite of vitamin A and it is used for the treatment of acute promyelocytic leukemia (APL). Hypercalcemia is a rare side effect of ATRA and it may be potentiated after interaction of ATRA with azole group antifungals. Herein, we have reported an APL case with hypercalcemia that is caused by the interaction of ATRA and posaconazole. CASE REPORT A 49-year-old female patient was diagnosed as APL after the examinations performed upon the detection of pancytopenia when she had presented with the complaints of widespread bruising and fever. After the initiation of posaconazole and ATRA, her serum calcium levels begin to increase (10.3 to 11.1mg/dl). Her vitamin D level was 21.9 ng/ml and PTH 17.8 pg/ml, both were in the normal ranges. The Drug Interaction Probability Scale score of our case was calculated as 6, indicating that the probable adverse drug reaction. Therefore, the high level of serum calcium was attributed to the interaction between ATRA and posaconazole. MANAGEMENT & OUTCOME Although hypercalcemia with ATRA and other antifungal agents have been previously reported in the literature, this is the first report of hypercalcemia with the concomitant use of ATRA and posaconazole. DISCUSSION This case highlights the importance of monitoring ATRA's side effects when it is used in combination with drugs inhibiting the cytochrome P450 enzymes. In conclusion, the concomitant use of posaconazole and ATRA may lead to hypercalcemia and serum calcium levels return to normal ranges with the discontinuation of these drugs.
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Affiliation(s)
- Hacer Berna Afacan Ozturk
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Murat Albayrak
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Senem Maral
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Merih Reis Aras
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Fatma Yilmaz
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Pınar Akyol
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mesut Tiglioglu
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Umit Yavuz Malkan
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Maral S, Albayrak M, Pala C, Yıldız A, Ozturk HB, Sahin O. R-IDARAM treatment in central nervous system lymphomas: A single-center experience and review of the literature. Avicenna J Med 2021; 10:227-231. [PMID: 33437695 PMCID: PMC7791280 DOI: 10.4103/ajm.ajm_59_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Central nervous system lymphomas (CNSLs) require effective treatment strategies due to aggressive nature of disease. Despite therapeutic approaches having improved in the last decades, there is no standard treatment for these patients. As a CNSL targeted-therapy IDARAM protocol was developed, the outcomes were reported with a few studies. We observed the R-IDARAM protocol in our CNSL cases, and we discuss the effectiveness, tolerability, and toxicity with a review of the literature in this article. Subjects and Methods: We retrospectively analyzed response rates, progression-free survival, adverse events, and long-term side effects in patients who were treated by modified R-IDARAM as standard clinical care of CNSL in our hematology department. Results: Response was achieved in five of nine patients. Three patients (two primary CNSL and one secondary CNSL) are still being followed up without disease progression with a median duration of follow-up of 79 months (88, 79, and 17 months, respectively). Manageable hematological side effects including thrombocytopenia and neutropenia were experienced by all patients. Conclusion: R-IDARAM protocol may be an option with high early response rates and manageable toxicity. Hematological side effects are the main problem, and long-term neurological toxicity is not common. Eligible patients must continue with autologous stem cell transplantation due to poor long-term survival outcomes.
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Affiliation(s)
- Senem Maral
- Department of Hematology, Dıskapı Research and Training Hospital, Ankara, Turkey
| | - Murat Albayrak
- Department of Hematology, Dıskapı Research and Training Hospital, Ankara, Turkey
| | - Cigdem Pala
- Department of Hematology, Dıskapı Research and Training Hospital, Ankara, Turkey
| | - Abdulkerim Yıldız
- Department of Hematology, Dıskapı Research and Training Hospital, Ankara, Turkey
| | - Hacer B Ozturk
- Department of Hematology, Dıskapı Research and Training Hospital, Ankara, Turkey
| | - Osman Sahin
- Department of Hematology, Dıskapı Research and Training Hospital, Ankara, Turkey
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Maral S, Albayrak M, Ozturk HBA, Incekara F, Yıldız A, Comert P, Albayrak A, Aras MR, Kaya S. A rare case of pulmonary lymphomatoid granulomatosis complicated with venous thrombosis. Sarcoidosis Vasc Diffuse Lung Dis 2021; 38:e2021038. [PMID: 35115745 PMCID: PMC8787372 DOI: 10.36141/svdld.v38i4.10140] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/24/2021] [Indexed: 11/29/2022]
Abstract
Lymphomatoid granulomatosis (LG) is Epstein-Barr virus associated and aggressive B cell lymphoproliferative disease. The most common sites of involvement are lungs, skin, kidneys, liver and central nervous system. The clinical presentation of pulmonary LG may mimic infectious diseases, malignancies or vasculitis. While treatment approach of low grade disease is watch and wait, patients with advanced stage require aggressive treatment with chemotherapy. Patients with hematological malignancy as well as solid tumors are at increased risk of venous thromboembolic events (VTE). We reported here in a case of pulmonary LG who was complicated with VTE during treatment with chemo-immunotherapy After 4 cycles of R-CHOP, she achieved complete remission for LG and was followed up without relapse for 2 years. She was anticoagulated with Low-Molecular-Weight Heparin (LMWH) during chemotherapy period, and the thrombus improved over the next several weeks. While on this paper written, patient completed her pregnancy successfully under anticoagulation prophylaxis.
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Affiliation(s)
- Senem Maral
- Alanya Alaaddin Keykubat University, Department of Hematology, Antalya, Turkey
| | | | | | - Funda Incekara
- Ankara Ataturk Chest Disease and Chest Surgery Research and Training Hospital, Department of Chest Disease, Ankara, Turkey
| | | | - Pınar Comert
- Ankara Ataturk Chest Disease and Chest Surgery Research and Training Hospital, Department of Chest Disease, Ankara, Turkey
| | - Aynur Albayrak
- Ankara City Training Hospital, Department of Pathology, Ankara, Turkey
| | | | - Sadi Kaya
- Ankara Ataturk Chest Disease and Chest Surgery Research and Training Hospital, Department of Chest Disease, Ankara, Turkey
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Öztürk HA, Albayrak M, Maral S, Aras MR, YıLmaz F, Akyol P, Tiglioglu M. Hypercalcemia due to the interaction between all trans retinoic acid and posaconazole used for acute promyelocytic leukemia treatment. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.09.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Yilmaz F, Albayrak M, Tiglioglu M, Aras M, Maral S, Yildiz A, Malkan U. Alk (−) anaplastic large cell lymphoma diagnosed by tongue root biopsy: case report. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.09.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Maral S, Albayrak M, Dagdas S, Yıldız A, Yıldırım R, Oz M, Pala C, Afacan Ozturk HB, Bay I, Ozet G, Dilek I. Prognostic Value of Baseline Serum Lactate Dehydrogenase Level in Patients With Hairy Cell Leukemia. Clinical Lymphoma Myeloma and Leukemia 2020; 20:e616-e621. [DOI: 10.1016/j.clml.2020.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/04/2020] [Accepted: 04/11/2020] [Indexed: 10/24/2022]
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Maral S, Albayrak M, Sahin O, Ozturk HBA, Han U, Falay M. Synchronous detection of multiple myeloma and acute myeloid leukemia: A diagnostic and therapeutic challenge. J Oncol Pharm Pract 2020; 27:464-469. [PMID: 33620259 DOI: 10.1177/1078155220932352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Synchronous detection of multiple myeloma and acute myeloid leukemia in a single patient is a rare coincidence. Treatment of these patients is still unclear, mostly based on acute myeloid leukemia strategies combined with bortezomib. CASE REPORT A 72-year-old male with no medical history was investigated for pancytopenia. On medical examination, he was complicated with a wide and severe skin infection on arm. On examination of bone marrow aspirate, 25% myeloblasts infiltration and additional 10% plasma cells were seen. Acute myeloid leukemia was diagnosed and plasma cell proliferation was attributed to reactive plasmacytosis due to skin infection. However, flowcytometric studies and immunohistochemical examination revealed two different cell populations with 30-40% atypical plasma cells and >20% myeloblasts. Serum M-protein detected by serum electrophoresis test and immunofixation test revealed a monoclonal IgG lambda band. He was diagnosed with concurrent acute myeloid leukemia and multiple myeloma without history of chemotherapy.Management and outcome: The patient was initially treated with bortezomib and dexamethasone for the myeloma. Subsequently, azacitidine was administered subcutaneously for the acute myeloid leukemia treatment. The tru-cut biopsy of the lesion on his arm revealed suppurative inflammatory findings and no malign cells detected. Antibiotherapy was started according to susceptibility. He expired after three months of survival. DISCUSSION The synchronous occurrence of these two different clonal hematological malignancies is rare in hematology practice. Patient-based prospective studies and case series are needed to guide diagnosis and treatment strategies. Furthermore, this report highlights the importance of ruling out reactive plasmacytosis in patients with hematological malignancy who developed severe infections.
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Affiliation(s)
- Senem Maral
- Department of Hematology, Ankara Dıskapı Research and Training Hospital, Ankara, Turkey
| | - Murat Albayrak
- Department of Hematology, Ankara Dıskapı Research and Training Hospital, Ankara, Turkey
| | - Osman Sahin
- Department of Hematology, Ankara Dıskapı Research and Training Hospital, Ankara, Turkey
| | | | - Unsal Han
- Department of Pathology and Cytology, Ankara Dıskapı Research and Training Hospital, Ankara, Turkey
| | - Mesude Falay
- Department of Hematology, Ankara Numune Research and Training Hospital, Ankara, Turkey
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Malkan UY, Albayrak M, Yildiz A, Maral S, Afacan Ozturk HB, Comert P. A rare case of diffuse large B-cell lymphoma-associated hemophagocytic lymphohistiocytosis. J Oncol Pharm Pract 2020; 27:250-252. [PMID: 32507098 DOI: 10.1177/1078155220929750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive immune activation. Herein, we aimed to report a diffuse large B-cell lymphoma (DLBCL) case that was presented as HLH. CASE REPORT A 32-year-old man presented to a hospital with complaints of vomiting, nausea and diarrhea in October 2019. Fever and hepatosplenomegaly was detected in physical investigation. Bone marrow aspiration investigation revealed the hemaphagocytosis. HLH-2004 protocol was started for hemophagocytosis. Whole body magnetic resonance imaging (MR) revealed no lymphadenopathy. Bone marrow biopsy revealed high-grade B-cell lymphoma, favoring DLBCL. There were no pathologic cells in lumber puncture investigation. MANAGEMENT AND OUTCOME He was diagnosed with secondary hemaphagocytic syndrome due to DLBCL, and chemotherapy was switched to rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (R-EPOCH) regimen. After three cycles of R-EPOCH chemotherapy regimen, complete remission was confirmed with positron emission tomography-computerised tomography (PET-CT) scan. DISCUSSION Our patients' findings are suitable for six out of eight criteria of hemaphagocytic syndrome. The H-score of our patient was more than 250, reflecting the >99% probability of HLH syndrome. Compatible with literature knowledge, our patient had responded very well to etoposide-containing regimens. In our patient, no lymphadenopathy was detected by physical examination or MR scan, and the diagnosis of DLBCL was only made by the result of bone marrow investigation. In conclusion, herein, we have reported a DLBCL case that had presented with HLH, and clinicians should be aware that B-cell lymphomas may be the underlying cause of HLH.
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Affiliation(s)
- Umit Yavuz Malkan
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Murat Albayrak
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Abdulkerim Yildiz
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Senem Maral
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Hacer Berna Afacan Ozturk
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Pinar Comert
- Department of Hematology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Yıldız A, Maral S, Albayrak M, Pala Ç, Cömert P, Afacan Öztürk HB, Şahin O. Are the conventional risk factors still valid for acute myeloid leukemia patients? Konuralp Tıp Dergisi 2020. [DOI: 10.18521/ktd.549666] [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: 11/04/2022]
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Sağlam B, Albayrak M, Yıldız A, Tığlıoğlu M, Cömert P, Öztürk ÇP, Maral S, Öztürk HA, Şahin O. Localized skin edema associated with ATRA in a patient with acute promyelocytic leukemia: a case report. Leuk Res 2019. [DOI: 10.1016/s0145-2126(19)30342-x] [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: 11/26/2022]
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Cömert P, Yıldız A, Albayrak M, Yıldırım M, Tığlıoğlu M, Sağlam B, Maral S, Öztürk HA, Aylı M, Şahin O. Clinical features and possible prognostic factors in patients with marginal zone lymphoma: retrospective analysis from two centers. Leuk Res 2019. [DOI: 10.1016/s0145-2126(19)30277-2] [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: 11/26/2022]
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Aras MR, Albayrak M, Maral S, Cömert P, Yıldız A, Sağlam B. A rare association, myelofibrosis secondary to essential thrombocytosis and monoclonal gammopathy of undetermined significance. Leuk Res 2019. [DOI: 10.1016/s0145-2126(19)30313-3] [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: 11/16/2022]
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Maral S, Bakanay SM, Kucuksahin O, Dilek I. Lupus-like symptoms with anti-RNP/Sm and anti-nuclear antibodies positivity: An extremely rare adverse event of dasatinib. J Oncol Pharm Pract 2019; 26:738-741. [PMID: 31359838 DOI: 10.1177/1078155219863469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Dasatinib is a potent tyrosine-kinase inhibitor which is used for chronic myeloid leukemia treatment. Pleural effusion is a frequent side effect in patients during dasatinib treatment. Pulmonary arterial hypertension is a rare and life-threatening adverse event of dasatinib. The relationship between dasatinib and autoimmune disorders is unclear, but there are reports of possible mechanisms that have triggered autoimmunity by dasatinib. CASE REPORT A 53-year-old male was diagnosed with chronic myeloid leukemia and initiated imatinib mesylate as a treatment. Imatinib was changed to dasatinib as the patient was unresponsive in the first year of treatment. In the fourth year of dasatinib when chronic myeloid leukemia was in both hematological and cytogenetical remission, the patient presented with bilateral massive exudative pleural effusion. Echocardiography was consistent with pericardial effusion with right ventricle enlargement and normal left-side cardiac function. Pulmonary arterial hypertension was diagnosed with high systolic pulmonary arterial pressure. When he had fever and arthralgia, further investigation showed positivity of anti-nuclear antibodies (1/160 titer) and anti-RNP/Sm, which have high specificity for the diagnosis of Systemic Lupus Erythematosus (SLE). MANAGEMENT AND OUTCOME Dasatinib was discontinued and nilotinib was initiated. As the pleural effusion persisted despite diuretics and methylprednisolone, mycophenolate mofetil was initiated as a steroid-sparing immune-suppressive agent. The lupus-like symptoms disappeared, and antibodies became undetectable after dasatinib discontinuation. Pericardial effusion improved and pleural effusion did not relapse. DISCUSSION Screening for auto-antibodies may be recommended for patients with a history or symptoms of autoimmune disease before starting dasatinib. All patients who develop pleural effusion while on dasatinib treatment should be investigated for antibodies for lupus.
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Affiliation(s)
- Senem Maral
- Department of Hematology, Dıskapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Sule Mine Bakanay
- Department of Hematology, Ataturk Research and Training Hospital, Ankara, Turkey
| | - Orhan Kucuksahin
- Department of Rheumatology, Ataturk Research and Training Hospital, Ankara, Turkey
| | - Imdat Dilek
- Department of Hematology, Ataturk Research and Training Hospital, Ankara, Turkey
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Afacan-Öztürk HB, Falay M, Albayrak M, Yıldız A, Öztürk ҪP, Maral S, Özet G. CD81 Expression in the Differential Diagnosis of Chronic Lymphocytic Leukemia. Clin Lab 2019; 65. [PMID: 30868852 DOI: 10.7754/clin.lab.2018.180802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Immunophenotyping has a central role in CLL. However, CLL is a very heterogenous disease, both morphologically and immunophenotypically; thus, its diagnosis may prove a challenge. We investigated CD81 ex-pression in the differential diagnosis of CLL and MCL. METHODS We retrospectively examined CD81 expression with 8 color Multiparameter Flow cytometry devices in 101 CLL and 19 MCL cases. RESULTS We found negative CD81 expression in CLL cases whereas it was positive in MCL cases. CONCLUSIONS Our results suggest that CD81 may be a valuable marker for the differential diagnosis of CLL. We are of the opinion that it should be definitely included in the diagnostic algorithm for CLL.
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Şentürk Yıkılmaz A, Bakanay ŞM, Akinci S, Maral S, Mustafayev F, Alisik M, Erel Ö, Dilek İ. Thiol – Disulphide Homeostasis in Polycythemia Vera. Dicle Tıp Dergisi 2019. [DOI: 10.5798/dicletip.574893] [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: 11/14/2022] Open
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Yıldız A, Albayrak M, Pala Ç, Afacan Öztürk HB, Maral S, Şahin O, Cömert P. The incidence and risk factors of thrombosis and the need for thromboprophylaxis in lymphoma and leukemia patients: A 9-year single-center experience. J Oncol Pharm Pract 2019; 26:386-396. [DOI: 10.1177/1078155219851540] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BackgroundPatients with cancer are at increased risk of thromboembolic complications. There is no evidence-based guideline on the use of routine prophylaxis in hematological malignancies except in patients with multiple myeloma. The purpose of this study was to determine the incidence and risk factors of thrombosis and suggest a rationale for primary thromboprophylaxis in acute leukemia and lymphoma patients.Patients and methodsA retrospective study was conducted on newly-diagnosed acute leukemia and lymphoma patients who presented at our institution from November 2009 to March 2018. The study included a total of 157 patients with acute leukemia and 238 patients with lymphoma. The groups were analyzed to determine the incidence and risk factors of thromboembolic complications.ResultsThe incidence of all thrombotic complications was 10.12% (40/395) including 11.4% (18/157) in patients with acute leukemia and 9.2% (22/238) in patients with lymphoma. The majority of events occurred in the first 6 months. Acute leukemia patients with thrombosis had a higher number of comorbidities than those without thrombosis ( p < 0.05). Lymphoma patients with thrombotic complications had significantly higher beta-2-microglobulin and lactate dehydrogenase levels compared to those without thrombosis ( p < 0.05). Major bleeding events developed in five (3.1%) acute leukemia patients and two (0.8%) lymphoma patients. All the major bleeding events occurred when the patients were thrombocytopenic (platelet < 50,000/mm3).ConclusionsAcute leukemia patients with any comorbidity and lymphoma patients with higher lactate dehydrogenase and beta-2-microglobulin are at high risk of developing thromboembolic complications. The prophylactic use of anticoagulant should be considered for those patients especially in the first 6 months.
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Affiliation(s)
- Abdulkerim Yıldız
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Murat Albayrak
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Çiğdem Pala
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Hacer B Afacan Öztürk
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Senem Maral
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Osman Şahin
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Pınar Cömert
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
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Cömert P, Albayrak M, Yıldız A, Şahin O, Öztürk ÇP, Maral S, Güneş G, Afacan Öztürk HB, Sağlam B. An acute transverse myelitis attack after autologous stem cell transplantation: A rare case. Transfus Apher Sci 2019; 58:341-343. [DOI: 10.1016/j.transci.2019.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 03/25/2019] [Accepted: 05/08/2019] [Indexed: 11/25/2022]
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Sahin O, Albayrak M, Yıldız A, Pala Ç, Aktas L, Maral S, Afacan Öztürk HB, Cömert P. Refractory Thrombotic Thrombocytopenic Purpura in a patient with Kaposi sarcoma. Transfus Apher Sci 2019; 58:187-189. [PMID: 30910619 DOI: 10.1016/j.transci.2019.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/19/2018] [Revised: 02/21/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
The case is here presented of a 70-year old male patient with rare coexistence of Kaposi Sarcoma and resistant Thrombotic Thrombocytopenic Purpura (TTP). The Kaposi lesions were determined before the diagnosis of TTP and were exacerbated after receiving TTP-associated immunosuppressive therapy, in particular associated with rituximab. TTP in this case was resistant to conventional therapies such as steroid and plasma exchange and current immunosuppressive (rituximab, cyclophosphamide, vincristin) treatments. Novel treatment agents consisting of bortezomib and eculizumab given to the patient were also ineffective. To the best of our knowledge, this case presents the first case of coexistence of TTP and Kaposi sarcoma from Turkey and the challenge of refractory TTP management.
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Affiliation(s)
- Osman Sahin
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey.
| | - Murat Albayrak
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Abdulkerim Yıldız
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Çiğdem Pala
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Levent Aktas
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Senem Maral
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Hacer Berna Afacan Öztürk
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Pınar Cömert
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, Ankara, Turkey
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Afacan Öztürk HB, Albayrak M, Pala Öztürk Ç, Yıldız A, Maral S, Önder E. A first time report on the coocurrence of sarcoidosis and ALK(-) CD30(+) anaplastic large cell lymphoma that is highly responsive to brentuximab vedotin treatment. J Oncol Pharm Pract 2019; 25:1801-1805. [PMID: 30909793 DOI: 10.1177/1078155219837331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sarcoidosis is known to be associated with higher incidence of solid tumors and hematological malignancies. ALK(-) CD30(+) anaplastic large cell lymphoma is a type of non-Hodgkin lymphoma showing poor prognosis, and seldom co-occurs with sarcoidosis. As this rare and highly mortal disease did not respond to classical chemotherapies and showed remission with brentuxumab vedontin treatment, we are presenting our first case reported from Turkey hoping to contribute to the literature.
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Affiliation(s)
- Hacer Berna Afacan Öztürk
- 1 Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Murat Albayrak
- 1 Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Çiğdem Pala Öztürk
- 1 Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Abdulkerim Yıldız
- 1 Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Senem Maral
- 1 Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Evrim Önder
- 2 Department of Pathology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Maral S, Bakanay S, Akıncı S, Yıkılmaz A, Comert P, Dilek I. The least incompatible crossmatch red blood cell transfusion by biological compatibility test. Glob J Transfus Med 2019. [DOI: 10.4103/gjtm.gjtm_37_19] [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: 11/04/2022] Open
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Maral S, Bakanay SM, Yikilmaz AS, Dilek I. Development of plasma cell leukemia in a patient with chronic myeloid leukemia while on treatment with imatinib mesylate. J Cancer Res Ther 2018; 14:1431-1433. [PMID: 30488870 DOI: 10.4103/0973-1482.192762] [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: 11/04/2022]
Abstract
Plasma cell leukemia (PCL) is a rare and an aggressive form of plasma cell dyscrasias. We report a 67-year-old male with PCL which developed while on imatinib mesylate (IM) therapy 38 months after diagnosis of chronic myeloid leukemia (CML). The patient has been treated successfully with bortezomib, melphalan and prednisolone. To our knowledge, only one case of PCL superimposed on Philadelphia positive CML has been reported in the literature and this was before the IM era.
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Affiliation(s)
- Senem Maral
- Department of Hematology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Sule Mine Bakanay
- Department of Hematology, Yildirim Beyazit University, Ankara, Turkey
| | | | - Imdat Dilek
- Department of Hematology, Yildirim Beyazit University, Ankara, Turkey
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Yıldız A, Albayrak M, Pala Ç, Şahin O, Afacan Öztürk HB, Güneş G, Maral S, Okutan H. Infections in patients with lymphoma: An analysis of incidence, relationship and risk factors. J Infect Dev Ctries 2018; 12:741-747. [PMID: 31999632 DOI: 10.3855/jidc.10399] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/05/2018] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Bacterial infections and febrile neutropenia (FN) are major causes of morbidity and mortality in patients with hematological malignancy. The aim of this study was to investigate the incidence and risk factors of infections in lymphoma patients. METHODOLOGY This retrospective study was conducted on 200 lymphoma patients diagnosed and treated between January 2009 and December 2017 in Diskapi Yildirim Beyazit Training and Research Hospital, a tertiary referral hospital in Ankara, Turkey. RESULTS The mean follow-up period was 20.09 ± 19.81 months. The incidence of infection episode (IE) was 32.5% (65/200) and FN was 18.5% (37/200). Analysis of the data revealed that patients with IE had significantly higher rates of diagnosis of primary central nervous system lymphoma (PCNSL), lower baseline hemoglobin, lower baseline hematocrit, higher baseline lactate dehydrogenase levels, higher usage of central cathater, and a higher number of chemotherapy lines compared to patients with no IE. In logistic regression analysis, disease subtype of PCNSL, usage of central catheter and lactate deyhydrogenase (LDH) were found to increase the risk of infection. The odds ratio for PCNSL was 37.866 (p = 0.003), 2.679 for central catheter (p = 0.008) and 1.001 for LDH (p = 0.011). CONCLUSIONS The risk of infection in patients with lymphoma was associated with central catheter usage, higher LDH levels and a diagnosis of PCNSL. Baseline hematological parameters were not determined to have any impact on the occurrence of infection. Patients with these risk factors should be monitored more carefully and the maximum level of infection prevention should be taken.
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Affiliation(s)
- Abdulkerim Yıldız
- Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Murat Albayrak
- Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Çiğdem Pala
- Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Osman Şahin
- Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Hacer Berna Afacan Öztürk
- Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Gürsel Güneş
- Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Senem Maral
- Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Harika Okutan
- Lösante's Children and Adult Hospital, Ankara, Turkey.
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Yıldız A, Öztürk HBA, Albayrak M, Pala Ç, Şahin O, Maral S, Okutan H. Is antimicrobial prophylaxis necessary for lymphoma patients? A single centre, real-life experience. J Oncol Pharm Pract 2018; 25:1381-1387. [DOI: 10.1177/1078155218795323] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Prophylaxis is strongly recommended in patients with hematological malignancy who are usually at higher risk for infection and neutropenic fever. It is still unclear whether or not there is a definite need for antimicrobial prophylaxis in intermediate-risk hematology patients such as those with lymphoma. Methods A retrospective analysis was made of patients admitted from January 2009 to December 2017 to the Hematology Department of Diskapi Yildirim Beyazit Training and Research Hospital, a tertiary referral hospital in Ankara, Turkey. The study included patients who were diagnosed with any type of lymphoma and given chemotherapy. Routine antimicrobial prophylaxis was administered to 127 lymphoma patients, and not to 65 lymphoma patients. These two groups were compared in respect of the incidence of total infection episodes (IE), febrile neutropenia episodes, and nonneutropenic clinically documented infection episodes. Results For all patients with lymphoma and subtypes of non-Hodgkin lymphoma or Hodgkin lymphoma, no significant difference was determined between the groups in respect of the total incidence of IE, febrile neutropenia and nonneutropenic clinically documented infection both during the first-line chemotherapy and throughout the total follow-up period ( p > 0.05). Patients with prophylaxis had a higher incidence of IE, which was treated with parenteral antibiotics both during the first-line chemotherapy and throughout the total follow-up period ( p < 0.05). Conclusion Antimicrobial prophylaxis was seen to have no effect on the total incidence of infection episode and febrile neutropenia. Therefore, the routine use of antimicrobial prophylaxis should not be recommended for patients with lymphoma.
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Affiliation(s)
- Abdulkerim Yıldız
- Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Hacer BA Öztürk
- Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Murat Albayrak
- Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Çiğdem Pala
- Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Osman Şahin
- Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Senem Maral
- Department of Hematology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Harika Okutan
- Department of Adult Hematology, Lösante's Children and Adult Hospital, Ankara, Turkey
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Maral S, Albayrak M, Pala C, Yildiz A, Sahin O, Ozturk HB. Dimethyl Sulfoxide-Induced Tonic-Clonic Seizure and Cardiac Arrest During Infusion of Autologous Peripheral Blood Stem Cells. Cell Tissue Bank 2018; 19:831-832. [DOI: 10.1007/s10561-018-9718-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 07/28/2018] [Indexed: 11/24/2022]
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Yıldız A, Şahin O, Yayar O, Öztürk ÇP, Afacan Öztürk HB, Maral S, Okutan H, Albayrak M. The rare coexistence of high titer inhibitor development and gastrointestinal stromal tumor in a patient with severe hemophilia: A case report. Transfus Apher Sci 2018; 57:398-400. [DOI: 10.1016/j.transci.2018.04.023] [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] [Received: 01/21/2018] [Revised: 04/17/2018] [Accepted: 04/24/2018] [Indexed: 01/20/2023]
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Maral S, Acar M, Balcik OS, Uctepe E, Hatipoglu OF, Akdeniz D, Altun HU, Kosar A, Gunduz M, Gunduz E. Matrix Metalloproteinases 2 and 9 Polymorphism in Patients With Myeloproliferative Diseases: A STROBE-Compliant Observational Study. Medicine (Baltimore) 2015; 94:e732. [PMID: 25906101 PMCID: PMC4602695 DOI: 10.1097/md.0000000000000732] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Chronic myeloproliferative disorders such as polycythemia vera (PV), essential thrombocytosis (ET), and idiopathic myelofibrosis arise from clonal proliferation of neoplastic stem cells in the bone marrow. Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases that have potential to degrade all types of extracellular matrix (ECM) and also play a role in remodeling of the ECM. It is known that MMPs play a role in bone marrow remodeling.The primary goal of our study is to explore the relationship between chronic myeloproliferative diseases and some of MMP gene polymorphisms. The demonstration of a relationship will help to understand whether these polymorphisms may be a potential early diagnosis marker of the diseases.Patients were selected from outpatient clinics of Turgut Ozal University Hospital, Ankara, Turkey, between December 2010 and May 2011. Twenty-eight patients that previously diagnosed and followed-up with PV, 17 with secondary polycythemia (SP), and 12 with ET were enrolled in the study, along with a control group of 22 healthy people.DNA was isolated from peripheral blood. Using polymerase chain reaction-restriction fragment length polymorphism method, MMP2 and MMP9 gene polymorphisms were analyzed with agarose gel electrophoresis. There was a statistically significant difference between the study groups and the control group in terms of Gln279Arg polymorphisms rates of MMP9. The highest MMP9 Gln279Arg polymorphism rate was observed in the ET group. But nobody from the control group had polymorphic MMP9. There was no statistically significant difference between the groups in terms of MMP2-735 C > T polymorphism rates.In conclusion, MMP9 gene Gln279Arg polymorphism was associated with ET, SP, and PV diseases. Hence, we believe that these gene polymorphisms may play a role in the mechanism of bone marrow fibrosis and may be a factor that increases the risk of thrombosis. Illumination of the molecular basis of the relationship between MMP-thrombosis and MMP-fibrosis provides a better understanding of the pathophysiology of PV and ET diseases and will allow new approaches to diagnosis and treatment.
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Affiliation(s)
- Senem Maral
- From the Department of Internal Medicine (SM, DA); Division of Hematology (OSB, AK); Department of Medical Genetics (MA, EU, OFH, MG, EG); Department of Medical Microbiology (HUA); and Department of Otolaryngology (MG), Turgut Özal University Faculty of Medicine, Ankara, Turkey
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