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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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Patir P, Cetin G, Sahin SE, Palak O, Aykas F, Inci A, Karakus V, Kurtoglu E. Real-life experience with plasmapheresis in newly diagnosed multiple myeloma accompanied by acute kidney injury. Ir J Med Sci 2024; 193:837-842. [PMID: 37768521 DOI: 10.1007/s11845-023-03535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVES The aim of this study was to retrospectively evaluate the effect of plasmapheresis treatment concomitant with chemotherapy and the number of sessions on renal improvement and survival in patients with newly diagnosed multiple myeloma (MM) presenting with acute kidney injury (AKI). MATERIAL AND METHODS Retrospective analysis was performed on 55 newly diagnosed MM patients who were presented with AKI to the Hematology Clinic of University of the Health Sciences Antalya Training and Research Hospital between 2013 and 2021. RESULTS The study included 55 patients between 39 and 91 years of age and comprised 22 (40%) women and 33 (60%) men. Forty-eight (87.3%) patients were treated with plasmapheresis and chemotherapy. Based on the median number of plasmapheresis sessions, the patients were grouped as ≤ 3 and > 3. A significant difference was observed in both groups between the mean values of repeated measurements at the time of diagnosis, after completion of plasmapheresis treatment, and at 1 month of plasmapheresis, when statistics of differences were evaluated for urea, creatinine, estimated glomerular filtration rate (eGFR) (ml/min), total protein, albumin, and globulin (p < 0.05); however, there was no difference between these parameters and the number of plasmapheresis sessions. The 1.16 (0.56-2.38) fold higher risk of ex found in patients with ≤ 3 plasmapheresis sessions compared to those with > 3 was not statistically significant (p > 0.05). CONCLUSION It was observed that plasmapheresis is beneficial in the short term for renal recovery in the treatment of MM with AKI and that > 3 plasmapheresis sessions have no superior effectiveness in renal improvement or survival.
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Affiliation(s)
- Pusem Patir
- Department of Hematology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.
| | - Gulay Cetin
- Department of Hematology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Sait Emir Sahin
- Department of Internal Medicine, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ozan Palak
- Department of Internal Medicine, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatma Aykas
- Department of Hematology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ayca Inci
- Department of Nephrology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Volkan Karakus
- Department of Hematology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Erdal Kurtoglu
- Department of Hematology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
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Guzel ER, Sarkaya NC, Kurtoglu AU, Karakus V, Kurtoglu E. Roles of ghrelin, hepcidin and HIF-2α in iron metabolism in iron deficiency anemia. Ir J Med Sci 2024:10.1007/s11845-024-03655-z. [PMID: 38492151 DOI: 10.1007/s11845-024-03655-z] [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: 11/29/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES This study investigates the roles of HIF-2α, hepcidin, and ghrelin in iron deficiency anemia (IDA), the most widespread nutritional disorder globally. MATERIAL AND METHODS Fifty IDA patients (18-50 years, BMI 19-25) and 40 healthy volunteers were studied. Hemoglobin, ferritin, hepcidin, HIF-2α, and ghrelin levels were analyzed. RESULTS IDA patients showed lower hemoglobin, ferritin, hepcidin, and ghrelin levels than the control group, but HIF-2α levels were similar. Positive correlations were observed in both groups between hepcidin and HIF-2α (p < 0.001), hepcidin and ghrelin (p < 0.001), and HIF-2α and ghrelin (p < 0.001). Hemoglobin was correlated positively with HIF-2α, and ferritin was correlated positively with HIF-2α in the patient group. CONCLUSION The study suggests that the low hepcidin levels in IDA patients enhance iron absorption. The lack of significant HIF-2α level differences may be due to the absence of chronic hypoxia in current hemoglobin levels of IDA patients. Moreover, the low ghrelin levels in patients and the correlations between ghrelin, hepcidin, and HIF-2α in both groups indicate their involvement in iron metabolism.
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Affiliation(s)
- Esra Rizaogullari Guzel
- Antalya Training and Research Hospital, Internal Medicine Clinic, Antalya Eğitim ve Araştırma Hastanesi, Varlık Mh. Kazım Karabekir Cd. 07100, Antalya, Turkey.
| | | | | | - Volkan Karakus
- Antalya Training and Research Hospital, Hematology Clinic, Antalya, Turkey
| | - Erdal Kurtoglu
- Antalya Training and Research Hospital, Hematology Clinic, Antalya, Turkey
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Atas U, Karakus V, Kurtoglu E. Could the 3'UTR+101G>C Mutation Detected in Two Sibling Cases Be a Mutation Affecting the Clinical Presentation in Thalassemia Patients? Mediterr J Hematol Infect Dis 2024; 16:e2024023. [PMID: 38468841 PMCID: PMC10927219 DOI: 10.4084/mjhid.2024.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Abstract
Due to letter to aditor, there is no abstract.
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Affiliation(s)
- Unal Atas
- Health Sciences University, Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkey
| | - Volkan Karakus
- Health Sciences University, Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkey
| | - Erdal Kurtoglu
- Health Sciences University, Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkey
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Tam C, Pinilla-Ibarz J, Castillo CG, Fenili AC, Huntley K, Karakus V, Mattar M, Miroli MA, Moura C, Pavlovsky M, Piotrowski F, Šimkovič M, Stilgenbauer S. Results of VOICE: a global survey of disease-specific knowledge and perspectives of real-world patients with CLL. Blood Adv 2023; 7:6819-6828. [PMID: 37722356 PMCID: PMC10679812 DOI: 10.1182/bloodadvances.2023010879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/20/2023] Open
Abstract
The Virtual Opinions poll Independent Centered on CLL patients' Experience (VOICE) evaluated patients' knowledge about chronic lymphocytic leukemia (CLL), their perspectives on diagnosis and treatment, and their unmet needs. Clinicians and patient advocacy group representatives developed and distributed the survey from March through December 2022 in 12 countries, and 377 patients with ≥1 line of previous CLL treatment responded from Europe, Latin America, the United States, Australia, Egypt, and Turkey. A majority of them (90%; 336/374) relied on their physicians for information regarding CLL and treatment. If at high risk, respondents prefer oral medications to intravenous (78%; 232/296), fixed duration treatment over treatment until progression (69%; 185/270), outpatient over inpatient treatments (91%; 257/283). Over three-fourths of respondents (78%; 286/368) wanted to be involved in treatment decisions, but a minority actually participated (44%; 138/313). COVID-19 vaccinations were widely available (97%; 273/281), but one-fifth (19%; 63/331) were unaware that CLL increases vulnerability to infections. Most patients' physicians explained their treatment options (84%; 297/355), and 90% (271/301) understood their treatment. Notably, >10% would continue treatment normally if they experienced cardiac problems or arrhythmias, whereas 23% would consider stopping treatment if they developed skin cancer. Treatment-associated side effects affected 27% to 43% of patients. These results in a global patient population highlight gaps in patients' knowledge of risk groups, their susceptibility to infections including COVID, and the side effects of common treatments. Such knowledge can guide the appropriate targeting of patient education initiatives by clinicians, advocates, and policymakers.
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Affiliation(s)
- Constantine Tam
- Lymphoma Service, Alfred Hospital and Monash University, Melbourne, Australia
| | - Javier Pinilla-Ibarz
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Carolina G. Castillo
- Department of Hematology, Hospital Star Medica Lomas Verdes, Mexico City, Mexico
| | | | | | - Volkan Karakus
- Department of Hematology, Antalya Research and Training Hospital, Antalya, Turkey
| | - Mervat Mattar
- Hematology Unit, Department of Internal Medicine, Cairo University, Giza, Egypt
| | - Miguel A. Miroli
- Hospital Médico Policial Churruca-Visca, Buenos Aires, Argentina
| | - Catherine Moura
- Associaçäo Brasileira De Linfoma E Leucemia, São Paulo, Brazil
| | - Miguel Pavlovsky
- Department of Hematology, Fundacion para Combatir la Leucemia, Buenos Aires, Argentina
| | | | - Martin Šimkovič
- 4th Department of Internal Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic
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Chatzikonstantinou T, Scarfò L, Karakatsoulis G, Minga E, Chamou D, Iacoboni G, Kotaskova J, Demosthenous C, Smolej L, Mulligan S, Alcoceba M, Al-Shemari S, Aurran-Schleinitz T, Bacchiarri F, Bellido M, Bijou F, Calleja A, Medina A, Khan MA, Cassin R, Chatzileontiadou S, Collado R, Christian A, Davis Z, Dimou M, Donaldson D, Santos GD, Dreta B, Efstathopoulou M, El-Ashwah S, Enrico A, Fresa A, Galimberti S, Galitzia A, García-Serra R, Gimeno E, González-Gascón-y-Marín I, Gozzetti A, Guarente V, Guieze R, Gogia A, Gupta R, Harrop S, Hatzimichael E, Herishanu Y, Hernández-Rivas JÁ, Inchiappa L, Jaksic O, Janssen S, Kalicińska E, Kamel L, Karakus V, Kater AP, Kho B, Kislova M, Konstantinou E, Koren-Michowitz M, Kotsianidis I, Kreitman RJ, Labrador J, Lad D, Levin MD, Levy I, Longval T, Lopez-Garcia A, Marquet J, Martin-Rodríguez L, Maynadié M, Maslejova S, Mayor-Bastida C, Mihaljevic B, Milosevic I, Miras F, Moia R, Morawska M, Murru R, Nath UK, Navarro-Bailón A, Oliveira AC, Olivieri J, Oscier D, Panovska-Stavridis I, Papaioannou M, Papajík T, Kubova Z, Phumphukhieo P, Pierie C, Puiggros A, Rani L, Reda G, Rigolin GM, Ruchlemer R, Daniel de Deus Santos M, Schipani M, Schiwitza A, Shen Y, Simkovic M, Smirnova S, Abdelrahman Soliman DS, Spacek M, Tadmor T, Tomic K, Tse E, Vassilakopoulos T, Visentin A, Vitale C, von Tresckow J, Vrachiolias G, Vukovic V, Walewska R, Wasik-Szczepanek E, Xu Z, Yagci M, Yañez L, Yassin M, Zuchnicka J, Angelopoulou M, Antic D, Biderman B, Catherwood M, Claus R, Coscia M, Cuneo A, Demirkan F, Espinet B, Gaidano G, Kalashnikova OB, Laurenti L, Nikitin E, Pangalis GA, Panagiotidis P, Popov VM, Pospisilova S, Sportoletti P, Stavroyianni N, Tam C, Trentin L, Chatzidimitriou A, Bosch F, Doubek M, Ghia P, Stamatopoulos K. Other malignancies in the history of CLL: an international multicenter study conducted by ERIC, the European Research Initiative on CLL, in HARMONY. EClinicalMedicine 2023; 65:102307. [PMID: 38033506 PMCID: PMC10685149 DOI: 10.1016/j.eclinm.2023.102307] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
Background Patients with chronic lymphocytic leukemia (CLL) have a higher risk of developing other malignancies (OMs) compared to the general population. However, the impact of CLL-related risk factors and CLL-directed treatment is still unclear and represents the focus of this work. Methods We conducted a retrospective international multicenter study to assess the incidence of OMs and detect potential risk factors in 19,705 patients with CLL, small lymphocytic lymphoma, or high-count CLL-like monoclonal B-cell lymphocytosis, diagnosed between 2000 and 2016. Data collection took place between October 2020 and March 2022. Findings In 129,254 years of follow-up after CLL diagnosis, 3513 OMs were diagnosed (27.2 OMs/1000 person-years). The most common hematological OMs were Richter transformation, myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Non-melanoma skin (NMSC) and prostate cancers were the most common solid tumors (STs).The only predictor for MDS and AML development was treatment with fludarabine and cyclophosphamide with/without rituximab (FC ± R) (OR = 3.7; 95% CI = 2.79-4.91; p < 0.001). STs were more frequent in males and patients with unmutated immunoglobulin heavy variable genes (OR = 1.77; 95% CI = 1.49-2.11; p < 0.001/OR = 1.89; 95% CI = 1.6-2.24; p < 0.001).CLL-directed treatment was associated with non-melanoma skin and prostate cancers (OR = 1.8; 95% CI = 1.36-2.41; p < 0.001/OR = 2.11; 95% CI = 1.12-3.97; p = 0.021). In contrast, breast cancers were more frequent in untreated patients (OR = 0.17; 95% CI = 0.08-0.33; p < 0.001).Patients with CLL and an OM had inferior overall survival (OS) than those without. AML and MDS conferred the worst OS (p < 0.001). Interpretation OMs in CLL impact on OS. Treatment for CLL increased the risk for AML/MDS, prostate cancer, and NMSC. FCR was associated with increased risk for AML/MDS. Funding AbbVie, and EU/EFPIAInnovative Medicines Initiative Joint Undertaking HARMONY grant n° 116026.
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Affiliation(s)
| | - Lydia Scarfò
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Georgios Karakatsoulis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
- Department of Mathematics, University of Ioannina, Ioannina, Greece
| | - Eva Minga
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Dimitra Chamou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Gloria Iacoboni
- Department of Haematology, University Hospital Vall d'Hebron, Autonomous University, Barcelona, Spain
| | - Jana Kotaskova
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Lukas Smolej
- 4th Department of Internal Medicine-Haematology, University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic
| | | | - Miguel Alcoceba
- Department of Haematology, University Hospital of Salamanca (HUS-IBSAL), CIBERONC (CB16/12/00233) and Cancer Research Centre (CIC-IBMCC, USAL-CSIC), Salamanca, Spain
| | - Salem Al-Shemari
- Faculty of Medicine, Department of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | | | - Mar Bellido
- Hematology Department, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Anne Calleja
- Department of Hemato-Oncology, Institut Paoli Calmettes, Marseille, France
| | | | - Mehreen Ali Khan
- Department of Hematology and Stem Cell Transplant, Armed Forces Bone Marrow Transplant Center/National Institute of Blood and Marrow Transplant, Rawalpindi, Pakistan
| | - Ramona Cassin
- Hematology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | - Sofia Chatzileontiadou
- Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece
| | - Rosa Collado
- Servicio de Hematología, Consorcio Hospital General Universitario de Valencia, Fundación de Investigación Hospital General Universitario de Valencia, Valencia, Spain
| | - Amy Christian
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Maria Dimou
- Department of Hematology and Bone Marrow Transplantation Unit, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - David Donaldson
- Clinical Haematology, Belfast City Hospital, Belfast, United Kingdom
| | | | - Barbara Dreta
- Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Maria Efstathopoulou
- Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece
| | | | | | - Alberto Fresa
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Galitzia
- Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS "G. Brotzu", Cagliari, Italy
| | - Rocío García-Serra
- Servicio de Hematología, Consorcio Hospital General Universitario de Valencia, Fundación de Investigación Hospital General Universitario de Valencia, Valencia, Spain
| | - Eva Gimeno
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | | | | | - Valerio Guarente
- Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Romain Guieze
- Department of Hematology and Cell Therapy, Estaing University Hospital, Clermont-Ferrand, France
| | - Ajay Gogia
- Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ritu Gupta
- Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sean Harrop
- Peter MacCallum Cancer Centre, St Vincent's Hospital, University of Melbourne, Melbourne, VIC 3000, Australia
| | - Eleftheria Hatzimichael
- Faculty of Medicine, Department of Haematology, School of Health Sciences, University of Ioannina, Stavros Niarchos Avenue, Ioannina 45110, Greece
| | - Yair Herishanu
- Department of Hematology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Luca Inchiappa
- Department of Hemato-Oncology, Institut Paoli Calmettes, Marseille, France
| | - Ozren Jaksic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Susanne Janssen
- Dept of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Elżbieta Kalicińska
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation Wroclaw Medical University, Wroclaw, Poland
| | - Laribi Kamel
- Department of Hematology, Centre Hospitalier Le Mans, Le Mans, France
| | | | - Arnon P. Kater
- Dept of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Bonnie Kho
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China
| | - Maria Kislova
- Department of Hematology, Oncology, and Chemotherapy, S. P. Botkin's City Hospital, Moscow, Russia
| | | | - Maya Koren-Michowitz
- Department of Hematology, Shamir Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Ioannis Kotsianidis
- Department of Hematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Robert J. Kreitman
- Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jorge Labrador
- Department of Hematology, Hospital Universitario de Burgos, Burgos, Spain
| | - Deepesh Lad
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mark-David Levin
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Ilana Levy
- Hematology, Bnai-Zion Medical Center, Haifa, Israel
| | - Thomas Longval
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Alberto Lopez-Garcia
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Juan Marquet
- Hematology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Lucia Martin-Rodríguez
- Department of Haematology, University Hospital Vall d'Hebron, Autonomous University, Barcelona, Spain
| | - Marc Maynadié
- Biological Haematology Department, Dijon Bourgogne University Hospital, Haematological Malignancies Registry, LNC UMR 1231, Dijon 21000, France
| | - Stanislava Maslejova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Biljana Mihaljevic
- Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Milosevic
- Faculty of Medicine, Clinical Centre of Vojvodina, University of Novi Sad, Novi Sad, Serbia
| | - Fatima Miras
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Riccardo Moia
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Marta Morawska
- Experimental Hematooncology Department, Medical University of Lublin, Lublin, Poland
- Hematology Department, St. John's Cancer Center, Lublin, Poland
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS "G. Brotzu", Cagliari, Italy
| | - Uttam Kumar Nath
- Department of Medical Oncology & Hematology, All India Institute of Medical Sciences, Rishikesh, India
| | - Almudena Navarro-Bailón
- Department of Haematology, University Hospital of Salamanca (HUS-IBSAL), CIBERONC (CB16/12/00233) and Cancer Research Centre (CIC-IBMCC, USAL-CSIC), Salamanca, Spain
| | - Ana C. Oliveira
- Department of Clinical Hematology, ICO, Hospital Duran i Reynals, IDIBELL, Barcelona, Spain
| | | | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Irina Panovska-Stavridis
- Medical Faculty, University Clinic of Hematology, University Ss. Cyril and Methodius, Skopje, North Macedonia
| | - Maria Papaioannou
- Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece
| | - Tomas Papajík
- Faculty of Medicine and Dentistry, Department of Hemato-Oncology, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Zuzana Kubova
- Faculty of Medicine and Dentistry, Department of Hemato-Oncology, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
| | | | - Cheyenne Pierie
- Dept of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Anna Puiggros
- Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Lata Rani
- Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Gianluigi Reda
- Hematology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | | | - Rosa Ruchlemer
- Department of Hematology, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel
| | | | - Mattia Schipani
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Annett Schiwitza
- Hematology and Oncology, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, Augsburg 86156, Germany
| | - Yandong Shen
- Royal North Shore Hospital, Sydney, NSW, Australia
| | - Martin Simkovic
- 4th Department of Internal Medicine-Haematology, University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic
| | - Svetlana Smirnova
- Consultative Hematology Department with a Day Hospital for Intensive High-Dose Chemotherapy, National Medical Research Center for Hematology, Moscow, Russia
| | | | - Martin Spacek
- First Faculty of Medicine, 1st Department of Medicine - Hematology, Charles University and General Hospital in Prague, Czech Republic
| | - Tamar Tadmor
- Hematology, Bnai-Zion Medical Center, Haifa, Israel
| | - Kristina Tomic
- Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Eric Tse
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Candida Vitale
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Julia von Tresckow
- Clinic for Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - George Vrachiolias
- Department of Hematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Vojin Vukovic
- Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Renata Walewska
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Ewa Wasik-Szczepanek
- Dept. Hematooncology and Bone Marrow Transplantation, Medical University in Lublin, Lublin, Poland
| | - Zhenshu Xu
- Fujian Provincial Key Laboratory of Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Munci Yagci
- Gazi University Medical Faculty, Ankara, Turkey
| | - Lucrecia Yañez
- Department of Hematology, University Hospital Marqués de Valdecilla, Santander, Spain
- Department of Hematological Malignancies and Stem Cell Transplantation, Research Institute of Marques de Valdecilla (IDIVAL), Santander, Spain
| | - Mohamed Yassin
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Doha, Qatar
| | - Jana Zuchnicka
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Maria Angelopoulou
- Haematology, University of Athens, Laikon General Hospital, Athens, Greece
| | - Darko Antic
- Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bella Biderman
- Department of Molecular Hematology, National Medical Research Center for Hematology, Moscow, Russia
| | - Mark Catherwood
- Clinical Haematology, Belfast City Hospital, Belfast, United Kingdom
| | - Rainer Claus
- Pathology, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, Augsburg 86156, Germany
- Faculty of Medicine, Comprehensive Cancer Center Augsburg, University of Augsburg, Stenglinstrasse 2, Augsburg 86156, Germany
| | - Marta Coscia
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | | | - Fatih Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Blanca Espinet
- Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Olga B. Kalashnikova
- Federal State Budgetary Educational Institution of Higher Education Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russian Federation, St. Petersburg, Russia
| | - Luca Laurenti
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Eugene Nikitin
- Department of Hematology, Oncology, and Chemotherapy, S. P. Botkin's City Hospital, Moscow, Russia
| | | | - Panagiotis Panagiotidis
- Department of Hematology and Bone Marrow Transplantation Unit, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Viola Maria Popov
- Hematology Department, Colentina Clinical Hospital, Bucharest, Romania
| | - Sarka Pospisilova
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Paolo Sportoletti
- Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Niki Stavroyianni
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Constantine Tam
- Peter MacCallum Cancer Centre, St Vincent's Hospital, University of Melbourne, Melbourne, VIC 3000, Australia
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | | | - Francesc Bosch
- Department of Haematology, University Hospital Vall d'Hebron, Autonomous University, Barcelona, Spain
| | - Michael Doubek
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Paolo Ghia
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
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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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Koctekin B, Dogan B, Erdem R, Buber H, Kurtoglu E, Karakus V. Investigation of the color discrimination ability using the Farnsworth-Munsell 100-hue test and structural changes by SS-OCT in patients with transfusion-dependent beta-thalassemia. Photodiagnosis Photodyn Ther 2023; 43:103716. [PMID: 37481147 DOI: 10.1016/j.pdpdt.2023.103716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/06/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
AIM This study aimed to examine the color discrimination ability of patients with transfusion-dependent beta-thalassemia (TDβ-T) in detail using the Farnsworth Munsell (FM) 100-hue test and to evaluate structural changes by swept source-optical coherence tomography (SS-OCT). MATERIAL AND METHODS This prospective, sectional study included 40 patients (79 eyes) with TDβ-T and 21 controls (42 eyes). The volunteers underwent a detailed ophthalmological examination and SS-OCT (DRI-OCT, Triton) imaging. Excluded were those with congenital color vision defects detected with the Ishihara pseudoisochromatic test. The patients' color vision was examined using the FM 100-hue test. The total error score (TES), the blue-yellow local error score (b-y LES), and the red-green local error score (r-g LES) were calculated. p <0.05 was considered significant. RESULTS The mean age was 30.34±6.94 years in the patient group and 32.26±6.43 years in the control group (p = 0.078). The patient group had a significantly lower hemoglobin level (9.25±0.87 g/dL vs. 14±1.79 g/dL, p <0.001) and a significantly higher ferritin level (2665.56±2658.05 μg/L vs. 52.87±69.59 μg/L, p<0.001) compared to the control group. The mean TES, b-y LES, and r-g LES were higher in the patients than in the controls (64.84±30.18 vs. 28.45±16.55, p<0.001, 34.21±17.54 vs. 15.67±10.07, p <0.001, and 29.32±15.72 vs. 12.12±7.94, p<0.001, respectively). The patients had a higher b-y LES than r-g LES (34.21±17.54 vs. 29.32±15.72, p = 0.015). Choroidal thickness was lower in the patients than in the controls (284.34±63.55 µm vs. 324.98±88.05 µm, p = 0.043). CONCLUSION We found that the color discrimination ability of the patients with TDβ-T was reduced in both the r-g and b-y color axes compared to the controls, and their color discrimination ability in the b-y color axis was more affected than in the r-g axis.
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Affiliation(s)
- Belkis Koctekin
- University of Health Sciences, Antalya Training and Research Hospital, Transfusion Center, Antalya, Turkey.
| | - Berna Dogan
- University of Health Sciences, Antalya Training and Research Hospital, Department of Ophthalmology, Antalya, Turkey
| | - Ramazan Erdem
- University of Health Sciences, Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkey
| | - Hakan Buber
- University of Health Sciences, Antalya Training and Research Hospital, Department of Ophthalmology, Antalya, Turkey
| | - Erdal Kurtoglu
- Kolan Hospital Group, Sisli Kolan International Department of Hematology, Istanbul, Turkey
| | - Volkan Karakus
- University of Health Sciences, Antalya Training and Research Hospital, Department of Hematology, Antalya, Turkey
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Koctekin B, Karakus V, Dogan B, Erdem R, Dogan U, Buber H, Kurtoglu E. Optical coherence tomography angiography findings in transfusion-dependent beta-thalassemia patients with and without splenectomy. Photodiagnosis Photodyn Ther 2023; 42:103282. [PMID: 36639006 DOI: 10.1016/j.pdpdt.2023.103282] [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: 12/05/2022] [Revised: 12/31/2022] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND Ocular involvement is common in transfusion-dependent beta-thalassemia (TDβ-T) patients. We aimed to investigate the effect of splenectomy on optical coherence tomography angiography (OCTA) findings in TDβ-T patients. METHODS The study is a prospective cross-sectional study. A total of 45 eyes of 23 patients with splenectomy (34.04±8.83 years), 18 eyes of 9 patients without splenectomy (27.44±5.43 years), and 54 eyes of 27 controls (33.22±6.44 years) were included. Vessel density in superficial capillary plexus, deep capillary plexus and radial peripapillary capillary, foveal avascular zone, choriocapillaris flow area, choroidal and retinal thickness detected by OCTA were evaluated. p < 0.05 was considered significant. RESULTS Vessel density of superficial capillary plexus and deep capillary plexus were similar in patients with and without splenectomy, and controls. Choriocapillaris flow area was significantly decreased in patients with splenectomy than that in those without splenectomy and controls (2.02±0.12 vs. 2.17±0.1 and 2.14±0.12; p < 0.001). Choroidal thickness was significantly lower in patients without splenectomy than in patients with splenectomy and controls (260.05±61.02 vs. 305.11±42.13 and 298.89±29.14, p = 0.008). Parafoveal and perifoveal thickness of the full retina and outer retina were significantly lower in patients without splenectomy than in patients with splenectomy and controls (301.06±10.0, 279.78±10.28 vs. 311.04±14.89, 290.87±13.67 and 316.63±13.57, 289.56±9.31, p < 0.001 and p = 0.002; 174.72±7.81, 167.17±6.21 vs. 182.87±8.81, 173.60±7.09 and 185.11±9.26, 173.96±6.79, p = 0.001 and p < 0.001, respectively). CONCLUSIONS OCTA findings can provide information about the microvascular effects of splenectomy on the retina of patients with TDβ-T.
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Affiliation(s)
- Belkis Koctekin
- Transfusion Center, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkiye.
| | - Volkan Karakus
- Department of Hematology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Berna Dogan
- Department of Ophthalmology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Ramazan Erdem
- Department of Hematology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Ugur Dogan
- Department of General Surgery, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Hakan Buber
- Department of Ophthalmology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Erdal Kurtoglu
- Department of Hematology, Kolan Hospital Group, Sisli Kolan International, Istanbul, Turkey
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Karakus V, Atas U, Uzuntas S, Dere Y, Meteoglu I. A Rare Nephrotic Syndrome Related to Chronic Lymphocytic Leukemia: Focal Segmental Glomerulosclerosis. Cureus 2022; 14:e31545. [DOI: 10.7759/cureus.31545] [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] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
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11
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Akpinar S, Tekgunduz E, Esen R, Yilmaz M, Karakus V, Vural F, Gediz F, Aydogdu I, Kaynar L, Goker H, Kelkitli E, Ayyildiz O, Demirkan F. Prospective registry of adult patients receiving therapeutic plasma exchange with a presumptive diagnosis of thrombotic microangiopathy (TMA): The Turkish hematology research and education group (ThREG)-TMA02 study. Transfus Apher Sci 2022; 61:103365. [PMID: 35120823 DOI: 10.1016/j.transci.2022.103365] [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: 11/17/2022]
Abstract
Thrombotic microanjiopathy (TMA) is a pathological diagnosis characterized by abnormalities of small vessels leading to microvascular thrombosis of arterioles and capillaries. The current prospective, non-interventional, multicenter study aimed to define the distribution of different TMA forms in adult Turkish patients who were referred for therapeutic plasma exchange (TPE) for presumptive diagnosis of TMA. Patients with serum ADAMTS13 activity <5% were diagnosed as having acquired thrombotic thrombocytopenic purpura (aTTP). Patients presenting with ADAMTS13 activity 6-10 % / normal renal function and patients with ADAMTS13 activity >10 %, normal renal function and no secondary TMA were treated as unclassified TMA. The study included a total of 80 patients (women: 50; man: 30) with a median age of 48 (20-74). Detailed evaluation at 1 month after hospital admission revealed aTTP, secondary TMA, infection/complement-associated hemolytic uremic syndrome and unclassified TMA in 29 (36.2 %), 22 (27.5 %), 23 (28.8 %) and 6 (7.5 %) patients respectively. As subclassification of various TMAs will dictate specific therapy, proper diagnosis in a timely manner is of utmost clinical significance.
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Affiliation(s)
- Seval Akpinar
- Namık Kemal University Medical School, Department of Internal Medicine, Division of Hematology, Tekirdag, Turkey.
| | - Emre Tekgunduz
- Memorial Bahcelievler Hospital Adult Hematology and BMT Clinic, Istanbul, Turkey
| | - Ramazan Esen
- Yuzuncu Yıl University Medical School, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Mehmet Yilmaz
- Sanko University Medical School, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Volkan Karakus
- Mugla Sıtkı Kocman University Medical School, Department of Internal Medicine, Division of Hematology, Mugla, Turkey
| | - Filiz Vural
- Ege University Medical School, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
| | - Fusun Gediz
- Medicalpark Hospital, Hematology and BMT Clinic, Izmir, Turkey
| | - Ismet Aydogdu
- Celal Bayar University Medical School, Department of Internal Medicine, Division of Hematology, Manisa, Turkey
| | - Leylagul Kaynar
- Erciyes University Medical School, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Hakan Goker
- Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Engin Kelkitli
- Ondokuz Mayis University Medical School, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Orhan Ayyildiz
- Dicle University Medical School, Department of Internal Medicine, Division of Hematology, Diyarbakir, Turkey
| | - Fatih Demirkan
- Dokuz Eylul University Medical School, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
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12
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Akpınar S, Tekgunduz E, Erkurt MA, Esen R, Yılmaz M, Karakus V, Vural F, Gediz F, Aydogdu I, Kaynar L, Korkmaz S, Goker H, Kelkitli E, Ayyıldız O, Demirkan F. Prospective registry of adult patients receiving therapeutic plasma exchange with a presumptive diagnosis of thrombotic microangiopathy (TMA): The Turkish hematology research and education group (ThREG)-TMA02 study. Transfus Apher Sci 2021:103312. [PMID: 34799244 DOI: 10.1016/j.transci.2021.103312] [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: 11/19/2022]
Abstract
Thrombotic microangiopathy(TMA) is a pathological diagnosis characterized by abnormalities of small vessels leading to microvascular thrombosis of arterioles and capillaries. The current prospective, non-interventional, multicenter (n:18) study aimed to define distribution of different TMA forms in adult Turkish patients who were referred for therapeutic plasma exchange (TPE) for a presumptive diagnosis of TMA. Patients with serum ADAMTS13 activity <5% were diagnosed as acquired thrombotic thrombocytopenic purpura (aTTP). Patients presenting with ADAMTS13 activity 6-10 % / normal renal function and patients with ADAMTS13 activity >10 %, normal renal function and no secondary TMA were treated as unclassified TMA. The study included a total of 97 patients (female: 60; male: 30) with a median age of 48 (18-74). Detailed evaluation at 1 month after hospital admission revealed aTTP, secondary TMA, infection/complement-associated hemolytic uremic syndrome and unclassified TMA in 32 (33 %), 33 (34 %), 26 (27 %) and 6 (6%) patients respectively. As subclassification of various TMAs will dictate specific therapy, proper diagnosis in a timely manner is of utmost clinical significance.
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Affiliation(s)
- Seval Akpınar
- Namık Kemal University Medical School, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey.
| | - Emre Tekgunduz
- Memorial Bahcelievler Hospital Adult Hematology and BMT Clinic, Istanbul, Turkey
| | - Mehmet Ali Erkurt
- Inonu University Medical School, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Ramazan Esen
- Yuzuncu Yıl University Medical School, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Mehmet Yılmaz
- Sanko University Medical School, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Volkan Karakus
- Mugla Sıtkı Kocman University Medical School, Department of Internal Medicine, Division of Hematology, Mugla, Turkey
| | - Filiz Vural
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
| | - Fusun Gediz
- Medicalpark Hospital, Hematology and BMT Clinic, Izmir, Turkey
| | - Ismet Aydogdu
- Celal Bayar University Medical Faculty, Department of Internal Medicine, Division of Hematology, Manisa, Turkey
| | - Leylagul Kaynar
- Erciyes University Faculty of Medicine, Department of Hematology, Kayseri, Turkey
| | - Serdal Korkmaz
- University of Health Sciences, Kayseri City Training and Research Hospital, Department of Hematology, Kayseri, Turkey
| | - Hakan Goker
- Hacettepe University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Engin Kelkitli
- Ondokuz Mayis University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Orhan Ayyıldız
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakir, Turkey
| | - Fatih Demirkan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, Izmir, Turkey
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13
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Karadag FK, Yenerel MN, Yılmaz M, Uskudar H, Ozkocaman V, Tuglular TF, Erdem F, Unal A, Ayyildiz O, Ozet G, Comert M, Kaya E, Ayer M, Salim O, Guvenc B, Ozdogu H, Mehtap Ö, Sonmez M, Guler N, Hacioglu S, Aydogdu İ, Bektas O, Toprak SK, Kaynar L, Yagci M, Aksu S, Tombak A, Karakus V, Yavasoglu İ, Onec B, Ozcan MA, Undar L, Ali R, Ilhan O, Saydam G, Sahin F. Evaluation of clinical characteristics of patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab in Turkey: a multicenter retrospective analysis. Am J Blood Res 2021; 11:279-285. [PMID: 34322292 PMCID: PMC8303018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/04/2021] [Indexed: 06/13/2023]
Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare X-linked genetic disorder. On the contrary to its name, it is a multisystemic disease and various symptoms other than hemoglobinuria could be occurred. It could be life threatening especially because of thromboembolic events. In the last decade, a terminal complement inhibition with eculizumab approved with promising results for PNH patients. We conducted this study to evaluate the long term experience of eculizumab therapy from Turkey for the first time. Our cohort included 138 patients with PNH treated with eculizumab between January 2008 and December 2018 at 28 centers in Turkey. Laboratory and clinical findings at the time of diagnosis and after eculizumab therapy were recorded retrospectively. The median age was 39 (range 18-84) years and median granulocyte PNH clone size was 74% (range 3.06-99.84%) at the time of diagnosis. PNH with bone marrow failure syndrome was detected in 49 patients and the rest of 89 patients had classical PNH. Overall 45 patients (32.6%) had a history of any prior thrombotic event before eculizumab therapy and only 2 thrombotic events were reported during the study period. Most common symptoms are fatigue (75.3%), hemoglobinuria (18.1%), abdominal pain (15.2%) and dysphagia (7.9%). Although PNH is commonly related with coombs negativity, we detected coombs positivity in 2.17% of patients. Seven months after the therapy, increased hemoglobin level was seen and remarkably improvement of lactate dehydrogenase level during the treatment was occurred. In addition to previous studies, our real life data support that eculizumab is well tolerated with no serious adverse events and improves the PNH related findings.
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Affiliation(s)
| | | | - Mehmet Yılmaz
- Department of Hematology Gaziantep, Gaziantep UniversityGaziantep, Turkey
| | - Hava Uskudar
- Department of Hematology, Eskisehir Osmangazi UniversityEskisehir, Turkey
| | | | | | - Fuat Erdem
- Department of Hematology, Ataturk UniversityErzurum, Turkey
| | - Ali Unal
- Department of Hematology, Erciyes UniversityKayseri, Turkey
| | - Orhan Ayyildiz
- Department of Hematology, Dicle UniversityDiyarbakir, Turkey
| | - Gülsüm Ozet
- Department of Hematology, Ankara Numune HospitalAnkara, Turkey
| | - Melda Comert
- Department of Hematology, Gulhane Research and Training HospitalAnkara, Turkey
| | - Emin Kaya
- Department of Hematology, Malatya Inonu UniversityMalatya, Turkey
| | - Mesut Ayer
- Department of Hematology, Haseki Research and Training HospitalIstanbul, Turkey
| | - Ozan Salim
- Department of Hematology, Akdeniz UniversityAntalya, Turkey
| | - Birol Guvenc
- Department of Hematology, Cukurova UniversityAdana, Turkey
| | - Hakan Ozdogu
- Department of Hematology, Baskent UniversityAdana, Turkey
| | - Özgur Mehtap
- Department of Hematology, Kocaeli UniversityKocaeli, Turkey
| | - Mehmet Sonmez
- Department of Hematology, Karadeniz Technical UniversityTrabzon, Turkey
| | - Nil Guler
- Department of Hematology, Pamukkale UniversityDenizli, Turkey
| | - Sibel Hacioglu
- Department of Hematology, Pamukkale UniversityDenizli, Turkey
| | - İsmet Aydogdu
- Department of Hematology, Celal Bayar UniversityManisa, Turkey
| | - Ozlen Bektas
- Department of Hematology, Karadeniz Technical UniversityTrabzon, Turkey
| | | | - Lale Kaynar
- Department of Hematology, Gazi UniversityAnkara, Turkey
| | - Munci Yagci
- Department of Hematology, Gazi UniversityAnkara, Turkey
| | - Salih Aksu
- Department of Hematology, Hacettepe UniversityAnkara, Turkey
| | - Anil Tombak
- Department of Hematology, Mersin UniversityMersin, Turkey
| | - Volkan Karakus
- Department of Hematology, Muğla Sıtkı Kocman UniversityMugla, Turkey
| | - İrfan Yavasoglu
- Department of Hematology, Adnan Menderes UniversityAydın, Turkey
| | - Birgul Onec
- Department of Hematology, Düzce UniversityTrabzon, Turkey
| | | | - Levent Undar
- Department of Hematology, Akdeniz UniversityAntalya, Turkey
| | - Rıdvan Ali
- Department of Hematology, Uludag UniversityBursa, Turkey
| | - Osman Ilhan
- Department of Hematology, Ankara UniversityAnkara, Turkey
| | - Guray Saydam
- Department of Hematology, Ege UniversityIzmir, Turkey
| | - Fahri Sahin
- Department of Hematology, Ege UniversityIzmir, Turkey
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Goren Sahin D, Akay OM, Keklik M, Okan V, Karakus A, Demir C, Erkurt MA, Ilkkilic K, Yildirim R, Akgun Cagliyan G, Aksu S, Dogu MH, Dal MS, Karakus V, Gemici AI, Terzi H, Kelkitli E, Sivgin S, Unal A, Yilmaz M, Ayyildiz O, Korkmaz S, Eser B, Altuntas F. Clinical characteristics and therapeutic outcomes of paroxysmal nocturnal hemoglobinuria patients in Turkey: a multicenter experience. Ann Hematol 2021; 100:1667-1675. [PMID: 33988739 DOI: 10.1007/s00277-021-04554-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/02/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study is to collect paroxysmal nocturnal hemoglobinuria (PNH) patient data from hematology centers all over Turkey in order to identify clinical features and management of PNH patients. Patients with PNH were evaluated by a retrospective review of medical records from 19 different institutions around Turkey. Patient demographics, medical history, laboratory findings, and PNH-specific information, including symptoms at the diagnosis, complications, erythrocyte, and granulocyte clone size, treatment, and causes of death were recorded. Sixty patients (28 males, 32 females) were identified. The median age was 33 (range; 17-77) years. Forty-six patients were diagnosed as classic PNH and 14 as secondary PNH. Fatigue and abdominal pain were the most frequent presenting symptoms. After eculizumab became available in Turkey, most of the patients (n = 31/46, 67.4%) were switched to eculizumab. Three patients with classic PNH underwent stem cell transplantation. The median survival time was 42 (range; 7-183 months) months. This study is the first and most comprehensive review of PNH cases in Turkey. It provided us useful information to find out the differences between our patients and literature, which may help us understand the disease.
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Affiliation(s)
- Deniz Goren Sahin
- Department of Hematology, Demiroglu Bilim University, Istanbul, Turkey.
| | | | - Muzaffer Keklik
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Vahap Okan
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | | | - Cengiz Demir
- Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | | | - Kadir Ilkkilic
- Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Rahsan Yildirim
- Division of Hematology, Medical Park Antalya Hospital, Antalya, Turkey
| | | | - Salih Aksu
- Department of Hematology, Hacettepe University, Ankara, Turkey
| | - Mehmet Hilmi Dogu
- Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Sinan Dal
- Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Volkan Karakus
- Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey
| | - Ali Ihsan Gemici
- Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Hatice Terzi
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Engin Kelkitli
- Department of Hematology, Ondokuz Mayis University, Samsun, Turkey
| | - Serdar Sivgin
- Division of Hematology, Acibadem Kayseri Hospital, Kayseri, Turkey
| | - Ali Unal
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Mehmet Yilmaz
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | - Orhan Ayyildiz
- Department of Hematology, Dicle University, Diyarbakir, Turkey
| | - Serdal Korkmaz
- Kayseri City Training and Research Hospital, University of Health Sciences, Kayseri, Turkey
| | - Bulent Eser
- Division of Hematology, Medical Park Antalya Hospital, Antalya, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
- Department of Hematology, Yildirim Beyazit University, Ankara, Turkey
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15
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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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Pektas G, Karakus V, Cetin D, Edgunlu T. A study of the correlation between the serum Latexin levels and the mTORC subunits Raptor and Rictor in the molecular pathogenesis of chronic lymphocytic leukemia. Med-Science 2021. [DOI: 10.5455/medscience.2021.02.067] [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: 11/03/2022] Open
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17
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Cetinkaya PU, Azik FM, Karakus V, Huddam B, Yilmaz N. β2-Microglobulin, Neutrophil Gelatinase-Associated Lipocalin, and Endocan Values in Evaluating Renal Functions in Patients with β-Thalassemia Major. Hemoglobin 2020; 44:147-152. [PMID: 32441176 DOI: 10.1080/03630269.2020.1766486] [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: 01/19/2023]
Abstract
Chronic anemia, transfusion-associated iron deposition, and chelating agents lead to renal impairment in β-thalassemia (β-thal) patients. The present study aimed to determine the most reliable and practical method in assessing and predicting renal injury in β-thal major (β-TM) patients. Therefore, we assessed the predictive values of urine β2-microglobulin (β2-MG) and neutrophil gelatinase-associated lipocalin (NGAL) levels, their ratios to urine creatinine, and serum endocan level. Sixty β-TM patients and 30 healthy controls were included. Renal functions of the patients and controls were evaluated by means of urine protein/creatinine ratio, urine β2-MG, urine NGAL, and serum endocan level. The β-TM and control groups were comparable in terms of the demographic characteristics. Of the β-TM patients, 26.7% had glomerular hyperfiltration and 41.7% had proteinuria. Compared with the control group, the β-TM group had significantly higher levels of urine protein/creatinine, urine β2-MG, urine β2-MG/creatinine, urine NGAL, urine NGAL/creatinine, and serum endocan. These parameters did not differ between the chelating agent subgroups in the patient group. Urine β2-MG/creatinine and NGAL/creatinine ratios were the parameters with high specificity in predicting proteinuria. There were significant correlations of urine β2-MG, urine NGAL, and serum endocan levels with serum ferritin concentration. Urine β2-MG/creatinine, NGAL/creatinine, and protein/creatinine ratios were correlated with each other in the patient group. Positive correlations of urine β2-MG, urine NGAL, and serum endocan levels with serum ferritin concentration indicated that iron deposition was associated with endothelial damage and renal injury.
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Affiliation(s)
- Petek Uzay Cetinkaya
- Department of Child Health and Diseases, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Fatih Mehmet Azik
- Department of Child Health and Diseases, Hematology Oncology, Mugla Sitki Kocman University, Faculty of Medicine, Mugla, Turkey
| | - Volkan Karakus
- Department of Hematology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Bulent Huddam
- Department of Nephrology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Nigar Yilmaz
- Department of Biochemistry, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
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18
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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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19
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Guvercin G, Karakus V, Aksit M, Dere Y, Aktar M, Alpay H, Bozkaya G, Tatar E. Matrix metalloproteinase-9, 10, and stress hyperglycaemia in acute kidney injury. Eur J Clin Invest 2018; 48:e12963. [PMID: 29856477 DOI: 10.1111/eci.12963] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 05/30/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study investigated the effect of matrix metalloproteinase (MMP)-9 and 10, and stress hyperglycaemia on the necessity of emergency renal replacement therapy (RRT) and mortality in nondiabetic geriatric patients with acute kidney injury (AKI). MATERIALS AND METHODS The present observational and longitudinal study included 101 nondiabetic geriatric patients (age >65 years) with AKI. The serum levels of MMP-9 and MMP-10 were evaluated in these patients. Serum glucose level >140 mg/dL at the time of admission was accepted as stress hyperglycaemia. RESULTS The average age of patients was 81 ± 7.1 years. Stress hyperglycaemia was diagnosed in 34.6% of the cases; the majority of these cases were patients with high-serum urea, CRP, and chronic kidney disease. The average levels of MMP-9 and MMP-10 were found to be 199 ± 38 and 16.5 ± 7.5 ng/mL, respectively. Thirty-one cases (30.6%) mortality during hospitalization and 20 cases (20%) underwent emergency RRT. Multiregression analysis showed the serum urea (P < .001) and stress hyperglycaemia (P = .03) to be independently associated with mortality. Also, serum urea (P = .01), potassium level (P = .03), and MMP-10 levels (P = .03) were independently associated with the necessity of the emergency RRT. The MMP-9 levels exhibited no relation with the necessity of emergency RRT and mortality. CONCLUSION Stress hyperglycaemia is a common condition among nondiabetic geriatric patients with AKI and is related to mortality. Serum MMP-10 levels serve as an important predictor of the necessity of emergency RRT in these patients.
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Affiliation(s)
- Guray Guvercin
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Volkan Karakus
- Division of Hematology, Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey
| | - Murat Aksit
- Department of Biochemistry, Izmir Bozyaka Education and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Yelda Dere
- Division of Pathology, Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey
| | - Merve Aktar
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Hasan Alpay
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Giray Bozkaya
- Department of Biochemistry, Izmir Bozyaka Education and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Erhan Tatar
- Department of Nephrology, Izmir Bozyaka Education and Research Hospital, Health Sciences University, Izmir, Turkey
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20
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Polat AK, Belli AA, Karakus V, Dere Y. Deferasirox-induced urticarial vasculitis in a patient with myelodysplastic syndrome. An Bras Dermatol 2018; 92:59-61. [PMID: 29267448 PMCID: PMC5726679 DOI: 10.1590/abd1806-4841.20176688] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 01/10/2017] [Indexed: 12/14/2022] Open
Abstract
Deferasirox is an iron chelator agent used in the treatment of diseases with iron
overload, such as thalassemia and myelodysplastic syndrome. Although the
majority of adverse reactions of deferasirox involve gastrointestinal symptoms
and increase in serum creatinine and transaminases, skin rashes, such as
maculopapular and urticarial eruptions, have also been reported. This study
reports a case of myelodysplastic syndrome with urticarial vasculitis due to
deferasirox therapy. Drug eruption was been confirmed by means of a challenge
test, together with histopathological and clinical findings. To the best of our
knowledge, we report the first case of deferasirox-induced urticarial
vasculitis. Physicians should be aware of the possibility of urticarial
vasculitis on deferasirox therapy and the fact that the discontinuation of the
drug generally results in improvement.
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Affiliation(s)
- Asude Kara Polat
- Department of Dermatology, Istanbul Training and Research Hospital - Istanbul, Turkey
| | - Asli Akin Belli
- Department of Dermatology, Mugla Sitki Kocman University Training and Research Hospital - Mugla, Turkey
| | - Volkan Karakus
- Department of Hematology, Mugla Sitki Kocman University Training and Research Hospital - Mugla, Turkey
| | - Yelda Dere
- Department of Pathology, Mugla Sitki Kocman University, Faculty of Medicine - Mugla, Turkey
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21
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Tekgündüz E, Yılmaz M, Erkurt MA, Kiki I, Kaya AH, Kaynar L, Alacacioglu I, Cetin G, Ozarslan I, Kuku I, Sincan G, Salim O, Namdaroglu S, Karakus A, Karakus V, Altuntas F, Sari I, Ozet G, Aydogdu I, Okan V, Kaya E, Yildirim R, Yildizhan E, Ozgur G, Ozcebe OI, Payzin B, Akpinar S, Demirkan F. A multicenter experience of thrombotic microangiopathies in Turkey: The Turkish Hematology Research and Education Group (ThREG)-TMA01 study. Transfus Apher Sci 2018; 57:27-30. [PMID: 29503132 DOI: 10.1016/j.transci.2018.02.012] [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] [Indexed: 12/17/2022]
Abstract
Thrombotic microangiopathies (TMAs) are rare, but life-threatening disorders characterized by microangiopathic hemolytic anemia and thrombocytopenia (MAHAT) associated with multiorgan dysfunction as a result of microvascular thrombosis and tissue ischemia. The differentiation of the etiology is of utmost importance as the pathophysiological basis will dictate the choice of appropriate treatment. We retrospectively evaluated 154 (99 females and 55 males) patients who received therapeutic plasma exchange (TPE) due to a presumptive diagnosis of TMA, who had serum ADAMTS13 activity/anti-ADAMTS13 antibody analysis at the time of hospital admission. The median age of the study cohort was 36 (14-84). 67 (43.5%), 32 (20.8%), 27 (17.5%) and 28 (18.2%) patients were diagnosed as thrombotic thrombocytopenic purpura (TTP), infection/complement-associated hemolytic uremic syndrome (IA/CA-HUS), secondary TMA and TMA-not otherwise specified (TMA-NOS), respectively. Patients received a median of 18 (1-75) plasma volume exchanges for 14 (153) days. 81 (52.6%) patients received concomitant steroid therapy with TPE. Treatment responses could be evaluated in 137 patients. 90 patients (65.7%) achieved clinical remission following TPE, while 47 (34.3%) patients had non-responsive disease. 25 (18.2%) non-responsive patients died during follow-up. Our study present real-life data on the distribution and follow-up of patients with TMAs who were referred to therapeutic apheresis centers for the application of TPE.
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Affiliation(s)
- Emre Tekgündüz
- Ankara Oncology Hospital, Hematology and BMT Clinic, Ankara, Turkey.
| | - Mehmet Yılmaz
- Gaziantep University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Mehmet Ali Erkurt
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Ilhami Kiki
- Erzurum University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Erzurum, Turkey
| | - Ali Hakan Kaya
- Ankara Oncology Hospital, Hematology and BMT Clinic, Ankara, Turkey
| | - Leylagul Kaynar
- Erciyes University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Inci Alacacioglu
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
| | - Guven Cetin
- Bezmialem University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Istanbul, Turkey
| | - Ibrahim Ozarslan
- Gaziantep University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Irfan Kuku
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Gulden Sincan
- Erzurum University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Erzurum, Turkey
| | - Ozan Salim
- Akdeniz University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Sinem Namdaroglu
- Bozyaka Education and Research Hospital, Hematology Clinic, Izmir, Turkey
| | - Abdullah Karakus
- Dicle University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakir, Turkey
| | - Volkan Karakus
- Mugla Sitki Kocman University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mugla, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Hospital, Hematology and BMT Clinic, Ankara, Turkey
| | - Ismail Sari
- Pamukkale University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Denizli, Turkey
| | - Gulsum Ozet
- Ankara Numune Education and Research Hospital, Hematology and BMT Clinic, Ankara, Turkey
| | - Ismet Aydogdu
- Celal Bayar University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Manisa, Turkey
| | - Vahap Okan
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Emin Kaya
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Rahsan Yildirim
- Erzurum University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Erzurum, Turkey
| | - Esra Yildizhan
- Erciyes University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Gokhan Ozgur
- Gulhane Military Medical Academy University, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Osman Ilhami Ozcebe
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Bahriye Payzin
- Katip Celebi University, Ataturk Training and Research Hospital, Hematology Clinic, Izmir, Turkey
| | - Seval Akpinar
- Sisli Hamidiye Etfal Education and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Fatih Demirkan
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
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22
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Kucukseymen S, Oner Yuksel I, Cagirci G, Koklu E, Karakus V, Cay S, Kus G, Kurtoglu E, Arslan S. Heart Rate Recovery as a Novel Test for Predicting Cardiac Involvement in Beta-Thalassemia Major. Acta Cardiol Sin 2017; 33:410-419. [PMID: 29033512 DOI: 10.6515/acs20161104a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Abnormal heart rate recovery (HRR) is predictive of cardiac mortality. Autonomic abnormalities in beta-thalassemia major (TM) patients have been reported in previous studies. However, the importance of low HRR in exercise stress test in TM patients has not yet been ascertained. Therefore, this study will be the first of its kind in the literature. METHODS Exercise stress test was performed on 56 TM patients who were being treated at the Thalassemia Center of our hospital, along with 46 non-TM iron deficiency anemia (IDA) patients as a control group. Values for HHR were recorded at 1, 2, 3, 4 and 5 min, and HRR was calculated by the difference of heart rate at peak exercise and at a specific time interval following the onset of recovery. RESULTS All HRR values were found to be lower in TM patients compared to those in the IDA group. Exercise capacity [metabolic equivalents (METs)] was also found to be low in these patients (p < 0.001) as well. Total exercise time was significantly lower in the TM group compared to the IDA group (8.40 ± 1.7 min vs. 11.17 ± 1.51 min, p < 0.001). Exercise capacity (METs) was also lower in the TM group compared to the IDA group. Mean T2* value was 28.3 ± 13.7 ms in TM patients on magnetic resonance imaging (MRI). In addition, there are 18 TM patients with T2* value was < 20 ms. CONCLUSIONS This study found that TM was independently associated with low HRR. Such a condition is an indicator of autonomic dysfunction in TM patients, since abnormal HRR is related to impaired autonomic response. In addition, impaired HRR may be a marker of early cardiac involvement in patients, whose T2* value is high on MRI. Modifying HRR with a cardiac rehabilitation program in TM patients with impaired HRR is a field open for further investigation.
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Affiliation(s)
- Selcuk Kucukseymen
- Department of Cardiology, Antalya Education and Research Hospital, Antalya
| | - Isa Oner Yuksel
- Department of Cardiology, Antalya Education and Research Hospital, Antalya
| | - Goksel Cagirci
- Department of Cardiology, Antalya Education and Research Hospital, Antalya
| | - Erkan Koklu
- Department of Cardiology, Antalya Education and Research Hospital, Antalya
| | - Volkan Karakus
- Department of Hematology, Muğla Sıtkı Koçman University, School of Medicine, Muğla
| | - Serkan Cay
- Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara
| | - Gorkem Kus
- Department of Cardiology, Antalya Education and Research Hospital, Antalya
| | - Erdal Kurtoglu
- Department of Hematology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Sakir Arslan
- Department of Cardiology, Antalya Education and Research Hospital, Antalya
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23
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Karakus V, Kurtoğlu A, Soysal DE, Dere Y, Bozkurt S, Kurtoğlu E. Evaluation of Iron Overload in the Heart and Liver Tissue by Magnetic Resonance Imaging and its Relation to Serum Ferritin and Hepcidin Concentrations in Patients with Thalassemia Syndromes. Indian J Hematol Blood Transfus 2017; 33:389-395. [PMID: 28824242 PMCID: PMC5544633 DOI: 10.1007/s12288-016-0735-2] [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] [Received: 05/26/2016] [Accepted: 09/29/2016] [Indexed: 01/16/2023] Open
Abstract
Iron overload is one of the major prognostic factor in thallassemia patients. We aimed to evaluate iron accumulation in the heart and liver by MRI in thalassemia major, thalassemia intermedia, and S-ß thalassemia patients and to examine its association with ferritin and hepcidin levels. Serum ferritin and hepcidin levels were recorded. Iron overload (IOL) in the heart and liver parenchyma was determined based on the standardized T2* and R2 values measured by MRI. The results were evaluated considering the tissue iron overload, serum ferritin and hepcidin levels. Comparing the 109 patients with the 30 healthy controls revealed the mean age: 24.4 ± 11 versus 31.2 ± 5 years, median levels of serum ferritin: 1693 versus 40 ng/mL, and hepcidin: 1.94 versus 0.355 ng/mL; p < 0.001, respectively. Comparison of age, serum ferritin and hepcidin levels and MRI findings of the patients with or without IOL revealed that, ferritin and T2* were significantly different in the patients with IOL in cardiac tissue (p = 0.004 and p < 0.001), and, age, ferritin and R2 were significantly different in the patients with IOL in liver tissue (p = 0.036, p < 0.001 and p < 0.001). The MRI-based T2* and R2 values were moderately and inversely correlated with serum ferritin (r = -0.37; p < 0.001 and r = -0.46; p < 0.001). No correlations were found between the MRI-based T2*, R2 values and serum hepcidin. A moderate and positive correlation existed between serum ferritin and hepcidin (r = 0.45; p < 0.001). We considered that, enhanced intestinal iron absorption characterized by decreased serum hepcidin levels in the intervals between successive transfusions were resulted in iron accumulation in our patients.
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Affiliation(s)
- Volkan Karakus
- Department of Hematology, Muğla Sıtkı Koçman University Training and Research Hospital, 48000 Muğla, Turkey
- Department of Hematology, Antalya Research and Training Hospital, 07000 Konyaaltı, Antalya, Turkey
| | - Ayşegül Kurtoğlu
- Department of Biochemistry, Antalya Research and Training Hospital, 07000 Konyaaltı, Antalya, Turkey
| | - Dilek Ersil Soysal
- Department of Internal Medicine, Faculty of Medicine, Izmir University of Economics, 35360 Balçova, Izmir, Turkey
| | - Yelda Dere
- Department of Pathology, Muğla Sıtkı Koçman University Faculty of Medicine, 48000 Muğla, Turkey
| | - Selen Bozkurt
- Department of Biostatistics and Medical Informatics, Akdeniz University Faculty of Medinice, 48000 Antalya, Turkey
| | - Erdal Kurtoğlu
- Department of Hematology, Antalya Research and Training Hospital, 07000 Konyaaltı, Antalya, Turkey
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24
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Derin S, Azik FM, Topal Y, Topal H, Karakus V, Cetinkaya PU, Sahan M, Erdem Azik T, Kocabas CN. The Incidence of Ototoxicity in Patients Using Iron Chelators. J Int Adv Otol 2017; 13:136-139. [DOI: 10.5152/iao.2016.1852] [Citation(s) in RCA: 7] [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: 11/22/2022] Open
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25
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Sari F, Inci A, Karakus V, Yilmaz B, Sarikaya M, Olmaz R, Kurtoglu E. Eculizumab experience in an adult patient with atypical hemolytic uremic syndrome. Saudi J Kidney Dis Transpl 2017; 28:388-391. [PMID: 28352025 DOI: 10.4103/1319-2442.202783] [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: 11/04/2022] Open
Abstract
Atypical hemolytic-uremic syndrome is a disease characterized by nonimmune hemolytic anemia, thrombocytopenia, and renal failure. In this study, we present a case of a patient with atypical hemolytic-uremic syndrome treated successfully with eculizumab. A 20-year-old female was admitted with clinical signs of atypical hemolytic syndrome. The laboratory findings were as follows: hemoglobin 9.2 g/dL, platelet count 18 × 103/μL, creatinine 4.69 mg/dL, schistocytes were in peripheral blood smear, lactate dehydrogenase 2080 U/L, and emergency plasmapheresis procedure with fresh frozen plasma were initiated. The patient was anuric within 12 h of her admittance. ADAMTS13 activity was normal. Her mother's cousin developed acute rejection immediately after receiving a renal transplant and died two months later. As she did not respond to the treatment and considering her family history, eculizumab was initiated which resulted in platelet counts starting to rise on day 5, and the patient no longer needed dialysis after 22 days.
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Affiliation(s)
- Funda Sari
- Department of Nephrology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ayça Inci
- Department of Nephrology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Volkan Karakus
- Department of Hematology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Banu Yilmaz
- Department of Nephrology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Metin Sarikaya
- Department of Nephrology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Refik Olmaz
- Department of Nephrology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Erdal Kurtoglu
- Department of Hematology, Antalya Training and Research Hospital, Antalya, Turkey
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26
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Sahin F, Akay OM, Ayer M, Dal MS, Ertop S, Ilhan O, Karakus V, Ozcan MA, Ozkocaman V, Ozsan H, Salim O, Tobu M, Tombak A, Tuglular TF, Yilmaz M, Unal A, Yenerel MN, Saydam G. Pesg PNH diagnosis, follow-up and treatment guidelines. Am J Blood Res 2016; 6:19-27. [PMID: 27570707 PMCID: PMC4981648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 06/28/2016] [Indexed: 06/06/2023]
Abstract
PNH Education and Study Group (PESG) have been established in December 2013 as a non-profit, independent, medical organization www.pesg.org. Paroxysmal Nocturnal Hemoglobinuria (PNH) is a multi-systemic disease that should be treated with a multidisciplinary approach. Patients may apply to the clinics other than the hematology due to variability and diversity of clinical findings which lower the rate of diagnosis due to low awareness about PNH. PNH might be overlooked and diagnosis might be delayed. Regarding these, PESG was established with the collaboration of Immunology, Cardiology, Thorax Diseases (Pulmonology), Neurology, Gastroenterology, General Surgery and Urology specialists in addition to hematologists dealing with PNH. The PESG study group aims to increase the awareness about PNH, including training activities about PNH, strengthening the relations between clinics and planning of clinical studies as a goal. It is the first professional organization focusing on PNH, in Turkey.In this guideline, we want to facilitate the diagnosis attributes of physicians from all specializations that deal with PNH and its systemic complications. One can perceive this as a tailor made guideline of international guidelines but not a compilation.
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Affiliation(s)
- Fahri Sahin
- Department of Hematology, Ege UniversityIzmir, Turkey
| | | | - Mesut Ayer
- Department of Hematology, Haseki Training and Research HospitalIstanbul, Turkey
| | - Mehmet Sinan Dal
- Department of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research HospitalAnkara, Turkey
| | - Sehmus Ertop
- Department of Hematology, Bulent Ecevit UniversityZonguldak, Turkey
| | - Osman Ilhan
- Department of Hematology, Ankara UniversityAnkara, Turkey
| | - Volkan Karakus
- Department of Hematology, Mugla Sıtkı Kocman UniversityMugla, Turkey
| | | | | | - Hayri Ozsan
- Department of Hematology, Dokuz Eylul UniversityIzmir, Turkey
| | - Ozan Salim
- Department of Hematology, Akdeniz UniversityAntalya, Turkey
| | - Mahmut Tobu
- Department of Hematology, Ege UniversityIzmir, Turkey
| | - Anil Tombak
- Department of Hematology, Mersin UniversityMersin, Turkey
| | | | - Mehmet Yilmaz
- Department of Hematology, Gaziantep UniversityGaziantep, Turkey
| | - Ali Unal
- Department of Hematology, Erciyes UniversityKayseri, Turkey
| | | | - Guray Saydam
- Department of Hematology, Ege UniversityIzmir, Turkey
- On behalf of PNH Education and Study Group (PESG)
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27
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Yuksel IO, Koklu E, Kurtoglu E, Arslan S, Cagirci G, Karakus V, Kus G, Cay S, Kucukseymen S. The Association between Serum Ferritin Level, Tissue Doppler Echocardiography, Cardiac T2* MRI, and Heart Rate Recovery in Patients with Beta Thalassemia Major. Acta Cardiol Sin 2016; 32:231-8. [PMID: 27122954 DOI: 10.6515/acs20150824a] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND It is generally well-understood that iron-mediated cardiomyopathy is the major complication that can arise from beta thalassemia major (TM). Therefore, early diagnosis, risk stratification, and the effective treatment of beta TM patients are clinically important to optimize long-term positive outcomes. METHODS This study included 57 beta TM patients with a mean age of 25 ± 7 years. We determined the serum ferritin level, echocardiography, heart rate recovery (HRR), and cardiac magnetic resonance (CMR) T2* in all patients. CMR T2* findings were categorized as normal myocardium (T2* > 20 ms), and myocardial involvement (T2* ≤ 20 ms). HRR values at 1-5 min (HRR1-5) were recorded; Subsequently. HRR was calculated by subtracting the heart rate at each time point from the heart rate at peak exercise. RESULTS There was a significant negative correlation between the serum ferritin level and the cardiac T2* MRI findings (r = -0.34, p = 0.009). A similar result was found in the negative correlation between serum ferritin and all heart rate recovery values. There was a significant positive correlation between HRR1, HRR2, and HRR3 values, and CMR T2* (T2* heart rate recovery (HRR)1: r = 0.51, p < 0.001; T2* HRR2: r = 0.48, p < 0.001; T2* HRR3: r = 0.47, p < 0.001, respectively). CONCLUSIONS The serum ferritin level and echocardiography can be used to predict the presence of myocardial iron load in beta TM patients. Therefore, HRR can be used to screen beta TM patients, and the clinical use of HRR can be a predictive marker for autonomic dysfunction in beta TM patients. KEY WORDS Beta thalassemia major • Cardiac magnetic resonance T2* • Heart rate recovery • Iron overload • Serum ferritin level • Tissue Doppler imaging.
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Affiliation(s)
| | | | - Erdal Kurtoglu
- Department of Haematology, Antalya Education and Research Hospital
| | | | | | - Volkan Karakus
- Department of Haematology, Antalya Education and Research Hospital
| | | | - Serkan Cay
- Department of Cardiology, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey
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28
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Celik B, Bulut T, Sedele M, Sezer C, Karakus V. Extramedullary hematopoiesis within cystic renal cell carcinoma with oncocytic and chromophobe cell types: A case report. Oncol Lett 2014; 7:909-913. [PMID: 24520308 PMCID: PMC3919790 DOI: 10.3892/ol.2014.1801] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 12/23/2013] [Indexed: 12/15/2022] Open
Abstract
Extramedullary hematopoiesis (EMH) is a phenomenon in which hematopoietic cells are found in sites other than the bone marrow. It is usually observed in the liver and spleen but may occasionally be found within solid tumors. The current case report presents a 69-year-old female patient who presented with a renal cyst. Histopathological examination following surgical removal of the cyst revealed a lining of oncocytic- and chromophobe-type cells with capsular invasion and a mass forming EMH with evident bone trabeculae within the cyst wall. Circulating hematopoietic stem cells in the blood and their colonization within tissues is discussed in the present case report, emphasizing certain types of renal cell carcinoma.
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Affiliation(s)
- Betul Celik
- Department of Pathology, Antalya Training Hospital, Antalya 07040, Turkey
| | - Tangul Bulut
- Department of Pathology, Antalya Training Hospital, Antalya 07040, Turkey
| | - Murat Sedele
- Department of Pathology, Antalya Training Hospital, Antalya 07040, Turkey
| | - Cem Sezer
- Department of Pathology, Antalya Training Hospital, Antalya 07040, Turkey
| | - Volkan Karakus
- Department of Hematology, Antalya Training Hospital, Antalya 07040, Turkey
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29
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Soysal DE, Karakus V, Pekdiker M, Simsek H, Soysal A. The metabolic syndrome prevalence and associated social and economic factors in a population of age between 30 and 69years: from the ongoing trial of Balcova Heart Study. Eur J Intern Med 2013; 24:e80-1. [PMID: 23321483 DOI: 10.1016/j.ejim.2012.12.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 12/08/2012] [Accepted: 12/12/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Dilek Ersil Soysal
- Department of Internal Medicine, University of Katip Celebi, Ataturk Research and Training Hospital, Izmir, Turkey.
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30
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Arabul M, Karakus F, Alper E, Kandemir A, Celik M, Karakus V, Yucel K, Unsal B. Comparison of multidetector CT and endoscopic ultrasonography in malignant pancreatic mass lesions. ACTA ACUST UNITED AC 2012; 59:1599-603. [PMID: 22155849 DOI: 10.5754/hge11608] [Citation(s) in RCA: 3] [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: 11/30/2022]
Abstract
BACKGROUND/AIMS Endoscopic ultrasonography (EUS) has been shown to be superior to conventional CT in detecting and staging pancreatic cancer. We conducted a prospective trial to compare EUS and MDCT, in discriminating benign/malignant, in determining local and vascular invasion of a suspected pancreatic cancer and deciding its resectability. METHODOLOGY The study was performed at the Gastroenterology Department of Izmir Ataturk Training and Research Hospital, from June 2009 to June 2010, all patients with suspected pancreatic and periampullary tumors referred to our department were enrolled. A total of 56 patients were evaluated at the beginning. Five patients having distal CBD tumor (n=2), gallbladder tumor (n=1) and papillary tumor (n=2) were excluded from the study. Analysis was done for the remaining 51 patients. RESULTS For the diagnosis of resectability/unresectability, EUS alone demonstrated a definite role in 4 (9%) of the 43 patients in confirming surgical and pathologic results and MDCT alone demonstrated a definite role in 6 (14%) of the 43 patients in confirming their results. An accurate diagnostic decision regarding resectability/unresectability was accomplished in 27 (63%) patients with EUS and MDCT. CONCLUSIONS While MDCT is clinically quite effective, in terms of a correct resectability/unresectability decision, EUS should also be used.
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Affiliation(s)
- Mahmut Arabul
- Department of Gastroenterology, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
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31
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Kurtoglu E, Karakus V, Deveci B, Nayir M. P-62 REFRACTORY IDIOPATHIC THROMBOCYTOPENIC PURPURA TREATED BY IMMUNOABSORPTION WITH TRYPTOPHAN COLUMN. Transfus Apher Sci 2012. [DOI: 10.1016/s1473-0502(12)70098-8] [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: 10/27/2022]
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32
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Karakus V, Deveci B, Nayir F, Aydin E, Kurtoglu E. P-66 TREATMENT OF PLASMA REFRACTORY THROMBOTIC THROMBOCYTOPENIC PURPURA WITH DOUBLE-FILTRATION MEMBRANE PLASMAPHERESIS. Transfus Apher Sci 2012. [DOI: 10.1016/s1473-0502(12)70102-7] [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: 10/27/2022]
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33
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Soysal DE, Karakus V, Seren AR, Tatar E, Celik M, Hızar S. Evaluation of transient hyperglycemia in non-diabetic patients with febrile neutropenia. Eur J Intern Med 2012; 23:342-6. [PMID: 22560382 DOI: 10.1016/j.ejim.2011.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 12/14/2011] [Accepted: 12/20/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND We aimed to examine the effect of transient hyperglycemia in non-diabetic patients with febrile neutropenia. METHODS A total of 86 patients with febrile neutropenia were evaluated between June 2006 and December 2009. After measuring random blood glucose level at admission, cases with stress hyperglycemia were included in the study. Stress hyperglycemia was defined as documented random blood glucose level of 140 mg/dl and above without known diabetes mellitus, impaired glucose tolerance and impaired fasting glucose. A Multinational Association for Supportive Care in Cancer (MASCC) scoring system was used for the prediction of low and high risk patients according to medical complications at the onset of the febrile episode. RESULTS There were more patients with stress hyperglycemia than the patients with normoglycemia in the high risk group (p = 0.001). The growth of gram negative bacteria and fungi was higher in patients with stress hyperglycemia than with normoglycemia (p = 0.001). The patients receiving antifungal therapy had a higher rate of stress hyperglycemia than the patients without receiving antifungal therapy (p = 0.009). The patients with stress hyperglycemia had higher mortality rates than the patients with normoglycemia (p = 0.007). According to the MASCC risk-index, stress hyperglycemia increased 3.35 fold in the high risk patients compared to the low risk patients (p = 0.046) and 4.14 fold in the patients treated with antibacterial and antifungal agents compared to the patients treated with only antibacterial agents (p = 0.038). CONCLUSION Patients with stress hyperglycemia had more adverse clinical outcomes than patients with normoglycemia. We think further studies are needed to evaluate the relationship between stress hyperglycemia and febrile neutropenia.
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Affiliation(s)
- Dilek Ersil Soysal
- 1st Department of Internal Medicine, Ataturk Research and Training Hospital, Izmir, Turkey.
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