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Bozkurt C, Hazar V, Malbora B, Küpesiz A, Aygüneş U, Fışgın T, Karakükçü M, Kuşkonmaz B, Kılıç SÇ, Bayırlı D, Arman Bilir Ö, Yalçın K, Gözmen S, Uygun V, Elli M, Sarbay H, Küpesiz FT, Şaşmaz Hİ, Aksoy BA, Yılmaz E, Okur FV, Tekkeşin F, Yenigürbüz FD, Özek G, Atay AA, Bozkaya İO, Çelen S, Öztürkmen S, Güneş AM, Gürsel O, Güler E, Özcan A, Çetinkaya DU, Aydoğdu S, Özbek NY, Karasu G, Sezgin G, Doğru Ö, Albayrak D, Öztürk G, Aksoylar S, Daloğlu H, Odaman Al I, Evim MS, Akbayram S, Öncül Y, Zengin E, Albayrak C, Timur Ç, Kar YD, Çakmaklı HF, Tüfekçi Ö, Töret E, Antmen B. COVID-19 disease in children and adolescents following allogeneic hematopoietic stem cell transplantation: A report from the Turkish pediatric bone marrow transplantation study group. Pediatr Transplant 2024; 28:e14758. [PMID: 38659218 DOI: 10.1111/petr.14758] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 02/27/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Data on the risk factors and outcomes for pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited. OBJECTIVES The study aimed to analyze the clinical signs, risk factors, and outcomes for ICU admission and mortality in a large pediatric cohort who underwent allogeneic HSCT prior to COVID-19 infection. METHOD In this nationwide study, we retrospectively reviewed the data of 184 pediatric HSCT recipients who had COVID-19 between March 2020 and August 2022. RESULTS The median time from HSCT to COVID-19 infection was 209.0 days (IQR, 111.7-340.8; range, 0-3845 days). The most common clinical manifestation was fever (58.7%). While most patients (78.8%) had asymptomatic/mild disease, the disease severity was moderate in 9.2% and severe and critical in 4.4% and 7.6%, respectively. The overall mortality was 10.9% (n: 20). Deaths were attributable to COVID-19 in nine (4.9%) patients. Multivariate analysis revealed that lower respiratory tract disease (LRTD) (OR, 23.20, p: .001) and lymphopenia at diagnosis (OR, 5.21, p: .006) were risk factors for ICU admission and that HSCT from a mismatched donor (OR, 54.04, p: .028), multisystem inflammatory syndrome in children (MIS-C) (OR, 31.07, p: .003), and LRTD (OR, 10.11, p: .035) were associated with a higher risk for COVID-19-related mortality. CONCLUSION While COVID-19 is mostly asymptomatic or mild in pediatric transplant recipients, it can cause ICU admission in those with LRTD or lymphopenia at diagnosis and may be more fatal in those who are transplanted from a mismatched donor and those who develop MIS-C or LRTD.
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Affiliation(s)
- Ceyhun Bozkurt
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Istinye University School of Medicine, Bahçelievler Medicalpark Hospital, Istanbul, Turkey
| | - Volkan Hazar
- Department of Pediatric Hematology-Oncology, Memorial Health Group, Medstar Yıldız Hospital, Antalya, Turkey
| | - Barış Malbora
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - Alphan Küpesiz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Utku Aygüneş
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem Adana Hospital, Adana, Turkey
| | - Tunç Fışgın
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Bahçelievler Medicalpark Hospital, Altınbaş University School of Medicine, Istanbul, Turkey
| | - Musa Karakükçü
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Erciyes University School of Medicine, Kayseri, Turkey
| | - Barış Kuşkonmaz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hacettepe University School of Medicine, Ankara, Turkey
| | - Suar Çakı Kılıç
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Derya Bayırlı
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - Özlem Arman Bilir
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara City Hospital, Ankara, Turkey
| | - Koray Yalçın
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Salih Gözmen
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Behçet Uz Training and Research Hospital, Izmir, Turkey
| | - Vedat Uygun
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Antalya Hospital, Antalya, Turkey
| | - Murat Elli
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medipol University School of Medicine, Istanbul, Turkey
| | - Hakan Sarbay
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - Funda Tayfun Küpesiz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Hatice İlgen Şaşmaz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem Adana Hospital, Adana, Turkey
| | - Başak Adaklı Aksoy
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Bahçelievler Medicalpark Hospital, Altınbaş University School of Medicine, Istanbul, Turkey
| | - Ebru Yılmaz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Erciyes University School of Medicine, Kayseri, Turkey
| | - Fatma Visal Okur
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hacettepe University School of Medicine, Ankara, Turkey
| | - Funda Tekkeşin
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Fatma Demir Yenigürbüz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem University School of Medicine, Istanbul, Turkey
| | - Gülcihan Özek
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ege University School of Medicine, İzmir, Turkey
| | - Abdullah Avni Atay
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - İkbal Ok Bozkaya
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara City Hospital, Ankara, Turkey
| | - Suna Çelen
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Seda Öztürkmen
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Antalya Hospital, Antalya, Turkey
| | - Adalet Meral Güneş
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Uludağ University School of Medicine, Bursa, Turkey
| | - Orhan Gürsel
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Elif Güler
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Alper Özcan
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Erciyes University School of Medicine, Kayseri, Turkey
| | - Duygu Uçkan Çetinkaya
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hacettepe University School of Medicine, Ankara, Turkey
| | - Selime Aydoğdu
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Namık Yaşar Özbek
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara City Hospital, Ankara, Turkey
| | - Gülsün Karasu
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Gülay Sezgin
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Çukurova University School of Medicine, Adana, Turkey
| | - Ömer Doğru
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Marmara University School of Medicine, Istanbul, Turkey
| | - Davut Albayrak
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Samsun Hospital, Samsun, Turkey
| | - Gülyüz Öztürk
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem University School of Medicine, Istanbul, Turkey
| | - Serap Aksoylar
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ege University School of Medicine, İzmir, Turkey
| | - Hayriye Daloğlu
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Antalya Hospital, Antalya, Turkey
| | - Işık Odaman Al
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medipol University School of Medicine, Istanbul, Turkey
| | - Melike Sezgin Evim
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Uludağ University School of Medicine, Bursa, Turkey
| | - Sinan Akbayram
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Yurday Öncül
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Inönü University School of Medicine, Malatya, Turkey
| | - Emine Zengin
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Canan Albayrak
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Çetin Timur
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Yeter Düzenli Kar
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Afyon Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Hasan Fatih Çakmaklı
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara University School of Medicine, Ankara, Turkey
| | - Özlem Tüfekçi
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Ersin Töret
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Bülent Antmen
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem Adana Hospital, Adana, Turkey
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Gurbanov A, Gülhan B, Kuşkonmaz B, Okur FV, Uçkan Çetinkaya D, Ozdemir G, Taş N, Çelegen K, Ozaltin F, Duzova A, Topaloglu R. MO1015EARLY URINARY SYSTEM COMPLICATIONS IN CHILDREN WITH HEMATOPOETIC STEM CELL TRANSPLANTATION. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab108.0012] [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: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Urinary system complications after hematopoietic stem cell transplantation (HSCT) cause severe morbidity and mortality. The aim of the study is to investigate the incidence and risk factors of urinary system complications in patients who had HSCT during their childhood.
Method
Patients who had HSCT between January 2010-2019 with a minimum follow-up period of 6 months were included in the study. Data regarding urinary system complications were collected from the medical records of the patients. pRIFLE and KDIGO classification systems were used for the definition of acute kidney injury (AKI).
Results
167 patients (108 males and 59 females) with allogeneic (n=165) and autologous (n=2) HSCT were investigated for renal complications. In cohort, HSCT was performed in 41 patients (%24.6) secondary to malignant diseases and in 126 patients secondary to non-malignant diseases. Hemorrhagic cystitis (HC) developed in 28 patients (16.8%) after HSCT. The mean age of the patients with and without HC was 14.6±5.6 years and 10.5±6 years, respectively (p=0.044). Among patients with HC, 17 had concomitant viral infection. Presence of viral infection, gender, disease group, history conditioning regime, total body irradiation, acute graft-versus-host disease and veno-occlusive disease (VOD) did not have any effect on the development of HC in logistic regression analysis. In cohort, 126 patients (75.4%) developed AKI according to KDIGO classification (stage 1; 55 patients, stage 2; 36 patients, stage 3; 35 patients). The mean period of development of AKI after HSCT was 34±22 days. The risk of AKI (according to KDIGO) was higher in patients who had HSCT secondary to malignant diseases and/or who developed viral infections after HSCT (p=0.034 and p=0.013, respectively). Among patients, 71 patients (%42.5) developed AKI according to pRIFLE classification. The risk of AKI (according to pRIFLE) was higher in patients who had HSCT secondary to malignant diseases, who developed viral infections and/or who developed VOD during follow-up (p=0.043, p=0.001 and p=0.006, respectively). One patient developed thrombotic microangiopathy after HSCT. None of the patients had nephrotic syndrome during follow-up period.
Conclusion
Patients who had HSCT secondary to malignant disease, viral infections and/or VOD had higher risk of AKI and should be closely monitored.
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Affiliation(s)
- Anar Gurbanov
- Hacettepe University School of Medicine, Pediatrics, Ankara, Turkey
| | - Bora Gülhan
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Barış Kuşkonmaz
- Hacettepe University School of Medicine, Pediatric Hematology, Ankara, Turkey
| | - Fatma Visal Okur
- Hacettepe University School of Medicine, Pediatric Hematology, Ankara, Turkey
| | | | - Gulsah Ozdemir
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Nesrin Taş
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Kübra Çelegen
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Fatih Ozaltin
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Ali Duzova
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Rezan Topaloglu
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
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Köse S, Aerts-Kaya F, Uçkan Çetinkaya D, Korkusuz P. Stem Cell Applications in Lysosomal Storage Disorders: Progress and Ongoing Challenges. Adv Exp Med Biol 2021; 1347:135-162. [PMID: 33977438 DOI: 10.1007/5584_2021_639] [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] [Indexed: 11/28/2022]
Abstract
Lysosomal storage disorders (LSDs) are rare inborn errors of metabolism caused by defects in lysosomal function. These diseases are characterized by accumulation of completely or partially degraded substrates in the lysosomes leading to cellular dysfunction of the affected cells. Currently, enzyme replacement therapies (ERTs), treatments directed at substrate reduction (SRT), and hematopoietic stem cell (HSC) transplantation are the only treatment options for LSDs, and the effects of these treatments depend strongly on the type of LSD and the time of initiation of treatment. However, some of the LSDs still lack a durable and curative treatment. Therefore, a variety of novel treatments for LSD patients has been developed in the past few years. However, despite significant progress, the efficacy of some of these treatments remains limited because these therapies are often initiated after irreversible organ damage has occurred.Here, we provide an overview of the known effects of LSDs on stem cell function, as well as a synopsis of available stem cell-based cell and gene therapies that have been/are being developed for the treatment of LSDs. We discuss the advantages and disadvantages of use of hematopoietic stem cell (HSC), mesenchymal stem cell (MSC), and induced pluripotent stem cell (iPSC)-related (gene) therapies. An overview of current research data indicates that when stem cell and/or gene therapy applications are used in combination with existing therapies such as ERT, SRT, and chaperone therapies, promising results can be achieved, showing that these treatments may result in alleviation of existing symptoms and/or prevention of progression of the disease. All together, these studies offer some insight in LSD stem cell biology and provide a hopeful perspective for the use of stem cells. Further development and improvement of these stem cell (gene) combination therapies may greatly improve the current treatment options and outcomes of patients with a LSD.
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Affiliation(s)
- Sevil Köse
- Department of Medical Biology, Faculty of Medicine, Atilim University, Ankara, Turkey
| | - Fatima Aerts-Kaya
- Department of Stem Cell Sciences, Hacettepe University Graduate School of Health Sciences, Ankara, Turkey.,Hacettepe University Center for Stem Cell Research and Development (PEDI-STEM), Ankara, Turkey
| | - Duygu Uçkan Çetinkaya
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Hematology, Hacettepe University Center for Stem Cell Research and Development (PEDI-STEM), Ankara, Turkey.,Department of Stem Cell Sciences, Hacettepe University Graduate School of Health Sciences, Ankara, Turkey
| | - Petek Korkusuz
- Department of Histology and Embryology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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Ayhan S, Nemutlu E, Uçkan Çetinkaya D, Kır S, Özgül RK. Characterization of human bone marrow niches with metabolome and transcriptome profiling. J Cell Sci 2021; 134:jcs.250720. [PMID: 33526717 DOI: 10.1242/jcs.250720] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/13/2021] [Indexed: 12/28/2022] Open
Abstract
Bone marrow (BM) niches are special microenvironments that work in harmony with each other for the regulation and maintenance of hematopoiesis. Niche investigations have thus far been limited to various model organisms and animal studies; therefore, little is known about different niches in healthy humans. In this study, a special harvesting method for the collection of BM from two different anatomical regions in the iliac crest of humans was used to investigate the presence of different niches in BM. Additionally, metabolomic and transcriptomic profiles were compiled using comparative 'omics' technologies, and the main cellular pathways and corresponding transcripts and metabolites were identified. As a result, we found that the energy metabolism between the regions was different. This study provides basic broad data for regenerative medicine in terms of the design of the appropriate microenvironment for in vitro hematopoietic niche modeling, and identifies the normal reference values that can be compared in hematological disease.
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Affiliation(s)
- Selda Ayhan
- Center for Stem Cell Research and Development/PEDI-STEM and Department of Stem Cell Sciences, Health Sciences Institute, Hacettepe University, Sıhhıye, Ankara 06100, Turkey.,Department of Pediatric Metabolism, Institute of Child Health, Hacettepe University, Sıhhıye, Ankara 06100, Turkey
| | - Emirhan Nemutlu
- Faculty of Pharmacy, Department of Analytical Chemistry, Hacettepe University, Sıhhıye, Ankara 06100, Turkey
| | - Duygu Uçkan Çetinkaya
- Center for Stem Cell Research and Development/PEDI-STEM and Department of Stem Cell Sciences, Health Sciences Institute, Hacettepe University, Sıhhıye, Ankara 06100, Turkey.,Department of Pediatrics, Division of Hematology, Hacettepe University, Sıhhıye, Ankara 06100, Turkey
| | - Sedef Kır
- Faculty of Pharmacy, Department of Analytical Chemistry, Hacettepe University, Sıhhıye, Ankara 06100, Turkey
| | - Rıza Köksal Özgül
- Department of Pediatric Metabolism, Institute of Child Health, Hacettepe University, Sıhhıye, Ankara 06100, Turkey
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Özdemir E, Emet A, Hashemihesar R, Yürüker ACS, Kılıç E, Uçkan Çetinkaya D, Turhan E. Articular Cartilage Regeneration Utilizing Decellularized Human Placental Scaffold, Mesenchymal Stem Cells and Platelet Rich Plasma. Tissue Eng Regen Med 2020; 17:901-908. [PMID: 33030679 DOI: 10.1007/s13770-020-00298-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/10/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Articular cartilage repair has been a challenge in orthopedic practice due to the limited self-regenerative capability. Optimal treatment method for cartilage defects has not been defined. We investigated the effect of decellularized human placental (DHP) scaffold, mesenchymal stem cells (MSC) and platelet-rich plasma (PRP) on hyaline cartilage regeneration in a rat model. METHODS An osteochondral defect was created in trochlea region of the femur in all groups, bilaterally. No additional procedure was performed in control group (n = 14). Only the DHP scaffold was applied to the P group (n = 14). The DHP scaffold and 1 × 106 MSCs were applied to the PS group (n = 14). The DHP scaffold and PRP were applied to the PP group (n = 14). The DHP scaffold, 1 × 106 MSCs and PRP were applied to the PSP group (n = 14). Outcome measures at 12 weeks included Pineda histology score and qualitative histology. RESULTS The mean Pineda scores of P, PS, PP, and PSP groups were significantly better than the control group (p = 0.031, p = 0.002, p < 0.001, p < 0001, respectively). There was no statistically difference in mean Pineda scores of P, PS, PP, and PSP groups (p > 0.05). CONCLUSION In conclusion, the DHP scaffold appears to be a promising scaffold on hyaline cartilage regeneration. The augmentation of DHP scaffold with MSCs and PRP combinations did not enhance its efficacy on articular cartilage regeneration.
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Affiliation(s)
- Erdi Özdemir
- Department of Orthopedics and Traumatology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey.
| | - Abdülsamet Emet
- Department of Orthopedics and Traumatology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey
| | - Ramin Hashemihesar
- Department of Histology and Embryology, Faculty of Medicine, Istanbul Aydin University, 34295, Istanbul, Turkey
| | | | - Emine Kılıç
- Center for Stem Cell Research and Development, Hacettepe University, 06100, Ankara, Turkey
| | - Duygu Uçkan Çetinkaya
- Center for Stem Cell Research and Development, Hacettepe University, 06100, Ankara, Turkey
| | - Egemen Turhan
- Department of Orthopedics and Traumatology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey
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Gurbanov A, Gülhan B, Kuşkonmaz B, Okur FV, Uçkan Çetinkaya D, Ozdemir G, Taş N, Çelegen K, Ozaltin F, Duzova A, Topaloglu R. P1809EARLY URINARY SYSTEM COMPLICATIONS IN CHILDREN WITH HEMATOPOIETIC STEM CELL TRANSPLANTATION. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1809] [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: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Urinary system complications after hematopoietic stem cell transplantation (HSCT) cause severe morbidity and mortality. The aim of the study is to investigate the incidence and risk factors of urinary system complications in patients who had HSCT during their childhood.
Method
Patients who had HSCT between January 2010-2019 with a minimum follow-up period of 6 months were included in the study. Data regarding urinary system complications were collected from the medical records of the patients. pRIFLE and KDIGO classification systems were used for the definition of acute kidney injury (AKI).
Results
167 patients (108 males and 59 females) with allogeneic (n=165) and autologous (n=2) HSCT were investigated for renal complications. In cohort, HSCT was performed in 41 patients (%24.6) secondary to malignant diseases and in 126 patients secondary to non-malignant diseases. Hemorrhagic cystitis (HC) developed in 28 patients (16.8%) after HSCT. The mean age of the patients with and without HC was 14.6±5.6 years and 10.5±6 years, respectively (p=0.044). Among patients with HC, 17 had concomitant viral infection. Presence of viral infection, gender, disease group, history conditioning regime, total body irradiation, acute graft-versus-host disease and veno-occlusive disease (VOD) did not have any effect on the development of HC in logistic regression analysis. In cohort, 126 patients (75.4%) developed AKI according to KDIGO classification (stage 1; 55 patients, stage 2; 36 patients, stage 3; 35 patients). The mean period of development of AKI after HSCT was 34±22 days. The risk of AKI (according to KDIGO) was higher in patients who had HSCT secondary to malignant diseases and/or who developed viral infections after HSCT (p=0.034 and p=0.013, respectively). Among patients, 71 patients (%42.5) developed AKI according to pRIFLE classification. The risk of AKI (according to pRIFLE) was higher in patients who had HSCT secondary to malignant diseases, who developed viral infections and/or who developed VOD during follow-up (p=0.043, p=0.001 and p=0.006, respectively). One patient developed thrombotic microangiopathy after HSCT. None of the patients had nephrotic syndrome during follow-up period.
Conclusion
Patients who had HSCT secondary to malignant disease, history of viral infections and/or VOD had higher risk of AKI and should be closely monitored.
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Affiliation(s)
- Anar Gurbanov
- Hacettepe University School of Medicine, Pediatrics, Ankara, Turkey
| | - Bora Gülhan
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Barış Kuşkonmaz
- Hacettepe University School of Medicine, Pediatric Hematology, Ankara, Turkey
| | - Fatma Visal Okur
- Hacettepe University School of Medicine, Pediatric Hematology, Ankara, Turkey
| | | | - Gulsah Ozdemir
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Nesrin Taş
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Kübra Çelegen
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Fatih Ozaltin
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Ali Duzova
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Rezan Topaloglu
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
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7
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Gurbanov A, Gülhan B, Kuşkonmaz B, Okur FV, Uçkan Çetinkaya D, Ozdemir G, Taş N, Çelegen K, Ozaltin F, Duzova A, Topaloglu R. P1825ANALYSIS OF LATE RENAL COMPLICATIONS AND RISK FACTORS IN CHILDREN WITH HEMATOPOIETIC STEM CELL TRANSPLANTATION. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1825] [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: 11/12/2022] Open
Abstract
Abstract
Background and Aims
The aim of the study is to investigate the incidence and risk factors of hypertension (HT) and chronic kidney disease (CKD) in patients who had hematopoietic stem cell transplantation (HSCT) during their childhood.
Method
Patients who had HSCT between January 2010-2019 with a minimum follow-up period of 6 months were included in the study. Data regarding renal complications were collected from the medical records of the patients. Guidelines of European Society of Hypertension (ESH) and American Academy of Pediatrics (APA) were used for the evaluation of hypertension. 24-hr ambulatory blood pressure monitoring (ABPM) was performed in children older than 5 years of age (68 patients). Ambulatory hypertension is diagnosed when systolic and/or diastolic blood pressure (BP) load is higher than 25%. Ambulatory prehypertension is diagnosed when mean systolic and/or diastolic BP is less than 95th percentile with systolic and/or diastolic BP load higher than 25%.
Results
A total of 72 patients (41 males and 31 females) were included in the study. The mean age of the patients at last visit was 10.8±4 years. ABPM revealed ambulatory HT in 6 patients (8.8%) and ambulatory prehypertension in 12 patients (17.6%). Office BP revealed HT in 3 patients (4.2%) and increased BP in four patients (5.6%) according to APA guideline (2017). In cohort, 12 patients with normal office BP (according to APA guideline) had ambulatory prehypertension or hypertension with ABPM. Office BP revealed HT in 1 patient (1.4%) and high-normal BP in 3 patients (4.2%) according to ESH guideline. In cohort, 15 patients with normal office BP (according to ESH guideline) had ambulatory prehypertension or hypertension with ABPM (Table 1). After a mean follow-up period of 4.4±2.5 years, CKD developed in 8 patients (11.1%). Patients with chronic graft-versus-host disease, with HLA-mismatched HSCT and/or transplantation of peripheric or cord blood hematopoietic stem cells had increased risk of CKD (p=0.041, p=0.033 and p=0.002, respectively).
Conclusion
Patients with HSCT should be regularly followed for the development of HT and ABPM should be used on regular basis. Patients with risk factors should be closely monitored for the development of CKD.
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Affiliation(s)
- Anar Gurbanov
- Hacettepe University School of Medicine, Pediatrics, Ankara, Turkey
| | - Bora Gülhan
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Barış Kuşkonmaz
- Hacettepe University School of Medicine, Pediatric Hematology, Ankara, Turkey
| | - Fatma Visal Okur
- Hacettepe University School of Medicine, Pediatric Hematology, Ankara, Turkey
| | | | - Gulsah Ozdemir
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Nesrin Taş
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Kübra Çelegen
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Fatih Ozaltin
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Ali Duzova
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Rezan Topaloglu
- Hacettepe University School of Medicine, Pediatric Nephrology, Ankara, Turkey
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8
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Erden S, Kuşkonmaz BB, Çetinkaya DU, Ünal F, Özsungur B. Pediatric bone marrow transplantation: Psychopathologic features in recipients along with siblings. Psychooncology 2019; 28:1995-2001. [DOI: 10.1002/pon.5179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Semih Erden
- Department of Child and Adolescent PsychiatryNecmettin Erbakan University Faculty of Medicine Konya Turkey
| | - Bülent Barış Kuşkonmaz
- Department of Child Health and Diseases Hematology UnitHacettepe University Faculty of Medicine Ankara Turkey
| | - Duygu Uçkan Çetinkaya
- Department of Child Health and Diseases Hematology UnitHacettepe University Faculty of Medicine Ankara Turkey
| | - Fatih Ünal
- Department of Child and Adolescent PsychiatryHacettepe University Faculty of Medicine Ankara Turkey
| | - Berna Özsungur
- Department of Child and Adolescent PsychiatryHacettepe University Faculty of Medicine Ankara Turkey
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9
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Abstract
Mucolipidosis type II (ML-II, I-cell disease) is a fatal inherited lysosomal storage disease caused by a deficiency of the enzyme N-acetylglucosamine-1-phosphotransferase. A characteristic skeletal phenotype is one of the many clinical manifestations of ML-II. Since the mechanisms underlying these skeletal defects in ML-II are not completely understood, we hypothesized that a defect in osteogenic differentiation of ML-II bone marrow mesenchymal stem cells (BM-MSCs) might be responsible for this skeletal phenotype. Here, we assessed and characterized the cellular phenotype of BM-MSCs from a ML-II patient before (BBMT) and after BM transplantation (ABMT), and we compared the results with BM-MSCs from a carrier and a healthy donor. Morphologically, we did not observe differences in ML-II BBMT and ABMT or carrier MSCs in terms of size or granularity. Osteogenic differentiation was not markedly affected by disease or carrier status. Adipogenic differentiation was increased in BBMT ML-II MSCs, but chondrogenic differentiation was decreased in both BBMT and ABMT ML-II MSCs. Immunophenotypically no significant differences were observed between the samples. Interestingly, the proliferative capacity of BBMT and ABMT ML-II MSCs was increased in comparison to MSCs from age-matched healthy donors. These data suggest that MSCs are not likely to cause the skeletal phenotype observed in ML-II, but they may contribute to the pathogenesis of ML-II as a result of lysosomal storage-induced pathology.
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Affiliation(s)
- Sevil Köse
- Department of Medical Biology and Genetics, Faculty of Medicine, Atılım University, Ankara, Turkey.,Center for Stem Cell Research and Development (PEDI-STEM), Hacettepe University, Ankara, Turkey
| | - Fatima Aerts Kaya
- Center for Stem Cell Research and Development (PEDI-STEM), Hacettepe University, Ankara, Turkey.,Department of Stem Cell Sciences, Graduate School of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Barış Kuşkonmaz
- Center for Stem Cell Research and Development (PEDI-STEM), Hacettepe University, Ankara, Turkey.,BMT Unit, Department of Pediatric Hematology, Hacettepe University Children's Hospital, Ankara, Turkey
| | - Duygu Uçkan Çetinkaya
- Center for Stem Cell Research and Development (PEDI-STEM), Hacettepe University, Ankara, Turkey.,Department of Stem Cell Sciences, Graduate School of Health Sciences, Hacettepe University, Ankara, Turkey.,BMT Unit, Department of Pediatric Hematology, Hacettepe University Children's Hospital, Ankara, Turkey
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10
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Okur FV, Cevher İ, Özdemir C, Kocaefe Ç, Çetinkaya DU. Osteopetrotic induced pluripotent stem cells derived from patients with different disease-associated mutations by non-integrating reprogramming methods. Stem Cell Res Ther 2019; 10:211. [PMID: 31315669 PMCID: PMC6637500 DOI: 10.1186/s13287-019-1316-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/21/2019] [Accepted: 06/30/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Autosomal recessive osteopetrosis is a genetically and phenotypically heterogeneous disease, caused by defects in osteoclast formation and function. The only available treatment is allogeneic stem cell transplantation that has still high morbidity and mortality. The goal of the present study was to generate iPSCs from bone marrow-derived MSCs of osteopetrosis patients with three most common mutations by using two different integration-free gene transfer methods and compare their efficiencies. The secondary objective was to select the most appropriate integration-free production method for our institutional iPSC bank using this rare disease as a prototype. METHODS Two different integration-free gene transfer methods (episomal and Sendai viral vectors) were tested and compared on the same set of patient samples exhibiting three different mutations associated with osteopetrosis. Generated iPSCs were characterized by standard assays, including immunophenotyping, immunocytochemistry, RT-PCR, embryoid body, and teratoma assays. Karyotype analyses were performed to evaluate genetic stability. RESULTS iPSC lines exhibiting typical ESC-like colony morphology were shown to express pluripotency markers by immunofluorescence staining. Over 90% of the cells were found positive for SSEA-4 and OCT3/4 and negative/weak positive for CD29 by flow cytometry. Immunohistochemical staining of teratoma and spontaneously differentiated embryoid body sections confirmed their trilineage differentiation potential. All iPSC lines expressed pluripotency-related genes. Karyotype analyses were found normal. Direct sequencing of PCR-amplified DNA showed that disease-related mutations were retained in the patient-specific iPSCs. CONCLUSION Generation of iPSC using SeV and episomal DNA vectors have several advantages over other methods like the ease of production, reliability, high efficiency, and safety, which is required for translational research. Furthermore, owing to the pluripotency and self-renewal capacity, patient-specific iPSCs seem to be ideal cell source for the modeling of a rare genetic bone disease like osteopetrosis to identify osteoclast defects, leading to clinical heterogeneity in osteopetrosis patients, especially among those with different mutations in the same gene.
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Affiliation(s)
- Fatma Visal Okur
- Hacettepe University, Center for Stem Cell Research and Development PEDI-STEM, Ankara, Turkey. .,Division of Pediatric Hematology and Bone Marrow Transplantation Unit, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - İnci Cevher
- Hacettepe University, Center for Stem Cell Research and Development PEDI-STEM, Ankara, Turkey
| | - Cansu Özdemir
- Hacettepe University, Center for Stem Cell Research and Development PEDI-STEM, Ankara, Turkey
| | - Çetin Kocaefe
- Hacettepe University, Center for Stem Cell Research and Development PEDI-STEM, Ankara, Turkey.,Department of Medical Biology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Duygu Uçkan Çetinkaya
- Hacettepe University, Center for Stem Cell Research and Development PEDI-STEM, Ankara, Turkey.,Division of Pediatric Hematology and Bone Marrow Transplantation Unit, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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11
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Dilli D, Kılıç E, Yumuşak N, Beken S, Uçkan Çetinkaya D, Karabulut R, Zenciroğlu AL. Additive effect of mesenchymal stem cells and defibrotide in an arterial rat thrombosis model. ARCH ARGENT PEDIATR 2018; 115:249-256. [PMID: 28504490 DOI: 10.5546/aap.2017.eng.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/29/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND/AIM In this study, we aimed to investigate the additive effect of mesenchymal stem cells (MSC) and defibrotide (DFT) in a rat model of femoral arterial thrombosis. METHODS Thirty Sprague Dawley rats were included. An arterial thrombosis model by ferric chloride (FeCl3) was developed in the left femoral artery. The rats were equally assigned to 5 groups: Group 1-Sham-operated (without arterial injury); Group 2-Phosphate buffered saline (PBS) injected; Group 3-MSC; Group 4-DFT; Group 5-MSC + DFT. All had two intraperitoneal injections of 0.5 ml: the 1st injection was 4 h after the procedure and the 2nd one 48 h after the 1st injection. The rats were sacrificed 7 days after the 2nd injection. RESULTS Although the use of human bone marrow-derived (hBM) hBM-MSC or DFT alone enabled partial resolution of the thrombus, combining them resulted in near-complete resolution. Neovascularization was two-fold better in hBM-MSC + DFT treated rats (11.6 ± 2.4 channels) compared with the hBM-MSC (3.8 ± 2.7 channels) and DFT groups (5.5 ± 1.8 channels) (P < 0.0001 and P= 0.002, respectively). CONCLUSION The combined use of hBM-MSC and DFT in a rat model of arterial thrombosis showed additive effect resulting in near-complete resolution of the thrombus.
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Affiliation(s)
- Dilek Dilli
- Department of Neonatology, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Emine Kılıç
- Department of Life Sciences, Hemosoft IT and Training Services, Technopolis of Hacettepe University, Ankara, Turkey.,PEDI-STEM Center for Stem Cell Research and Development, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nihat Yumuşak
- Department of Veterinary Pathology, Harran University Faculty of Veterinary Medicine, Şanlıurfa, Turkey
| | - Serdar Beken
- Department of Neonatology, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Duygu Uçkan Çetinkaya
- PEDI-STEM Center for Stem Cell Research and Development, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ramazan Karabulut
- Departments of Pediatric Surgery, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ayşegu L Zenciroğlu
- Department of Neonatology, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
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12
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Kuşkonmaz B, Ünal Ş, Bayhan T, Aytaç Eyüboğlu S, Tavil B, Çetin M, Gümrük F, Uçkan Çetinkaya D. Successful Outcome With Fludarabine-Based Conditioning Regimen for Hematopoietic Stem Cell Transplantation From Related Donor in Fanconi Anemia: A Single Center Experience From Turkey. Pediatr Blood Cancer 2016; 63:695-700. [PMID: 26703084 DOI: 10.1002/pbc.25844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 10/20/2015] [Accepted: 10/22/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Fanconi anemia (FA) is a heterogeneous autosomal recessive (and rarely X linked) disorder, which is characterized by congenital malformations, progressive bone marrow failure, and predisposition to malignancies. Hematopoietic stem cell transplantation (HSCT) is the only definitive treatment for the hematological manifestations in FA. PROCEDURE Twenty-seven patients with FA underwent HSCT using fludarabine (Flu) based regimen at our center between April 2004 and May 2014. One patient who developed acute leukemia before HSCT was excluded from the study. The remaining 26 patients were included. The median age of the patients at the time of transplantation was 9.6 years (range 5.6-17.0 years) and male/female ratio was 19/7. Donors were Human leukocyte antigen (HLA)-identical sibling in 18 patients, HLA-identical other relatives in six patients, and HLA 1-antigen mismatched sibling in two patients. Conditioning regimen consisted of Flu, cyclophosphamide, and antithymocyte globulin. RESULTS All patients engrafted but one developed poor graft function and underwent second HSCT. Acute graft versus host disease (GVHD) (≥grade 2) occurred in two patients (7.6%) and chronic GVHD in one patient (3.9%). Three patients developed venoocclusive disease (11.5%). Survival rate was 96.2% (25/26) at a median follow-up of 54 months (10-131 months) and all patients who survived were in good clinical condition. None of the patients developed secondary malignancy during the follow-up period. CONCLUSIONS The present study from Turkey, a middle-income country, shows successful transplant outcome with low toxicity using Flu-based conditioning in patients with FA who underwent HSCT from HLA-related donors.
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Affiliation(s)
- Barış Kuşkonmaz
- Division of Bone Marrow Transplantation, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Şule Ünal
- Division of Hematology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Turan Bayhan
- Division of Hematology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Selin Aytaç Eyüboğlu
- Division of Hematology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Betül Tavil
- Division of Hematology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Mualla Çetin
- Division of Hematology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Fatma Gümrük
- Division of Hematology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Duygu Uçkan Çetinkaya
- Division of Bone Marrow Transplantation, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
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13
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Affiliation(s)
- Şule Ünal
- Hacettepe University Faculty of Medicine, Division of Pediatric Hematology, Ankara, Turkey Phone: +90 312 305 11 70 E-mail:
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14
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Tan G, Sağlam N, Köprü ÇZ, Köse S, Onur MA, Özcan AG, Çetinkaya DU, Korkusuz P. Interaction of mesenchymal stem and HeLa cells with gold nanoparticles. Curr Opin Biotechnol 2013. [DOI: 10.1016/j.copbio.2013.05.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Sabuncuoğlu S, Öztaş Y, Çetinkaya DU, Özgüneş N, Özgüneş H. Oxidative protein damage with carbonyl levels and nitrotyrosine expression after chemotherapy in bone marrow transplantation patients. Pharmacology 2012; 89:283-6. [PMID: 22538733 DOI: 10.1159/000337040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 01/16/2012] [Indexed: 11/19/2022]
Abstract
Protein oxidation is defined as the covalent modification ofa protein, induced either directly by reactive oxygen species/reactive nitrogen species or indirectly by reaction with secondary by-products of oxidative stress. Protein carbonyls are the most commonly measured products of protein oxidation. Additionally, nitrotyrosine is a product of tyrosine nitration mediated by reactive nitrogen species such as peroxynitrite anion and nitrogen dioxide. Samples were collected before the preparative regimen (10 days before transplantation; day –10), on transplantation day (day 0), and after transplantation (days 7, 14, and 28) from 16 pediatric allogeneic hematopoietic stem cell transplantation (HSCT) patients.The erythrocyte 3-nitrotyrosine expression was shown to be significantly increased after chemotherapy. In accordance, the mean plasma carbonyl levels on days 14 and 28 were significantly higher than on the other days. High dose chemotherapy applied in the preparative regimen of HSCT may be responsible for this long-term oxidation of plasma proteins. These results show that high-dose chemotherapy resulted in protein oxidation both in plasma and in erythrocytes in HSCT patients.
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Affiliation(s)
- Suna Sabuncuoğlu
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Hacettepe University, Sihhiye/Ankara, Turkey.
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16
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Ünal Ş, Kuşkonmaz B, Tavil B, Aytaç Elmas S, Uçkan Çetinkaya D, Çetin M, Haliloğlu M, Gümrük F. Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy or in post-transplantation period with primary complaint of chest pain. Turk J Haematol 2010; 27:34-37. [PMID: 27265796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
We describe herein four children with acute lymphoblastic leukemia who were diagnosed as pulmonary fungal infection after presenting with chest pain. The plain radiologic evaluations failed to reveal any positive findings, whereas computerized tomography (CT) scanning showed nodular opacification with or without cavitation. This experience suggests that chest pain may be an initial symptom of an invasive fungal infection in patients with leukemia, and CT scan of the lungs should be performed urgently for the early diagnosis and treatment, despite normal plain X-rays.
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Affiliation(s)
- Şule Ünal
- Hacettepe University, Division of Pediatric Hematology, 06100 Ankara, Turkey Phone: +90 312 305 11 70 E-mail:
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