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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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Gemici AI, Sevindik ÖG, Akar S, Tunca M. Vitamin B12 levels in familial Mediterranean fever patients treated with colchicine. Clin Exp Rheumatol 2013; 31:57-59. [PMID: 24064015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 05/30/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disease characterised by paroxysmal attacks of serosal inflammation. Colchicine is highly effective in preventing these attacks but it may also disrupt the intestinal absorption of vitamin B12. We hypothesised that patients treated with colchicine for a prolonged period could develop deficiency of the vitamin. METHODS Ninety-five adult FMF patients on regular colchicine treatment for at least 2 years and age and sex-matched 90 healthy controls were enrolled and complete blood count with platelets, vitamin B12 and folic acid were measured in each person. We also investigated 15 adult FMF patients who were not yet on colchicine. RESULTS The mean vitamin B12 values were not significantly different between the groups (352.12 (SD=171.62) pg/mL vs. 360.96 (SD=146.53) pg/mL, p=0.71), but there were significantly more vitamin B12 deficient cases among FMF patients (12 vs. 3; p=0.021) and 3 out of these 12 had megaloblastic anaemia. None of the vitamin B12 deficient controls had anaemia. We could not identify any disorder which might have causative effect for the deficiency among this subgroup. The mean vitamin B12 value of 15 colchicine-naïve cases was not significantly different from patients on colchicine (p=0.356). CONCLUSIONS We did not observe significant vitamin B12 deficiency among colchicine-treated FMF patients but some cases may be more prone to developing this potentially serious disorder.
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Affiliation(s)
- Ali Ihsan Gemici
- Department of Hematology, Celal Bayar University School of Medicine, Manisa, Turkey.
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