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Hatipoğlu T, Esmeray Sönmez E, Hu X, Yuan H, Danyeli AE, Şeyhanlı A, Önal-Süzek T, Zhang W, Akman B, Olgun A, Özkal S, Alacacıoğlu İ, Özcan MA, You H, Küçük C. Plasma Concentrations and Cancer-Associated Mutations in Cell-Free Circulating DNA of Treatment-Naive Follicular Lymphoma for Improved Non-Invasive Diagnosis and Prognosis. Front Oncol 2022; 12:870487. [PMID: 35795062 PMCID: PMC9252432 DOI: 10.3389/fonc.2022.870487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/02/2022] [Indexed: 12/14/2022] Open
Abstract
Follicular lymphoma (FL) is the second most frequent non-Hodgkin lymphoma accounting for 10-20% of all lymphomas in western countries. As a clinically heterogeneous cancer, FL occasionally undergoes histological transformation to more aggressive B cell lymphoma types that are associated with poor prognosis. Here we evaluated the potential of circulating cell-free DNA (cfDNA) to improve the diagnosis and prognosis of follicular lymphoma patients. Twenty well-characterized FL cases (13 symptomatic and 7 asymptomatic) were prospectively included in this study. Plasma cfDNA, formalin-fixed paraffin-embedded (FFPE) tumor tissue DNA, and patient-matched granulocyte genomic DNA samples were obtained from 20 treatment-naive FL cases. Ultra-deep targeted next-generation sequencing was performed with these DNA samples by using a custom-designed platform including exons and exon-intron boundaries of 110 FL related genes. Using a strict computational bioinformatics pipeline, we identified 91 somatic variants in 31 genes in treatment-naive FL cases. Selected variants were cross-validated by using PCR-Sanger sequencing. We observed higher concentrations of cfDNA and a higher overlap of somatic variants present both in cfDNA and tumor tissue DNA in symptomatic FL cases compared to asymptomatic ones. Variants known to be associated with FL pathogenesis such as STAT6 p.D419 or EZH2 p.Y646 were observed in patient-matched cfDNA and tumor tissue samples. Consistent with previous observations, high Ki-67 staining, elevated LDH levels, FDG PET/CT positivity were associated with poor survival. High plasma cfDNA concentrations or the presence of BCL2 mutations in cfDNA showed significant association with poor survival in treatment-naive patients. BCL2 mutation evaluations in cfDNA improved the prognostic utility of previously established variables. In addition, we observed that a FL patient who had progressive disease contained histological transformation-associated gene (i.e. B2M and BTG1) mutations only in cfDNA. Pre-treatment concentrations and genotype of plasma cfDNA may be used as a liquid biopsy to improve diagnosis, risk stratification, and prediction of histological transformation. Targeted therapies related to oncogenic mutations may be applied based on cfDNA genotyping results. However, the results of this study need to be validated in a larger cohort of FL patients as the analyses conducted in this study have an exploratory nature.
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Affiliation(s)
- Tevfik Hatipoğlu
- İzmir Biomedicine and Genome Center, İzmir, Turkey
- İzmir International Biomedicine and Genome Institute, Dokuz Eylül University, İzmir, Turkey
| | - Esra Esmeray Sönmez
- İzmir Biomedicine and Genome Center, İzmir, Turkey
- İzmir International Biomedicine and Genome Institute, Dokuz Eylül University, İzmir, Turkey
| | - Xiaozhou Hu
- İzmir Biomedicine and Genome Center, İzmir, Turkey
- İzmir International Biomedicine and Genome Institute, Dokuz Eylül University, İzmir, Turkey
| | - Hongling Yuan
- İzmir International Biomedicine and Genome Institute, Dokuz Eylül University, İzmir, Turkey
| | - Ayça Erşen Danyeli
- Department of Pathology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Ahmet Şeyhanlı
- Department of Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Tuğba Önal-Süzek
- Department of Bioinformatics, Graduate School of Natural and Applied Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Weiwei Zhang
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Burcu Akman
- İzmir Biomedicine and Genome Center, İzmir, Turkey
- İzmir International Biomedicine and Genome Institute, Dokuz Eylül University, İzmir, Turkey
| | - Aybüke Olgun
- Department of Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Sermin Özkal
- Department of Pathology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - İnci Alacacıoğlu
- Department of Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Mehmet Ali Özcan
- Department of Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Hua You
- Department of Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Can Küçük, ; Hua You,
| | - Can Küçük
- İzmir Biomedicine and Genome Center, İzmir, Turkey
- İzmir International Biomedicine and Genome Institute, Dokuz Eylül University, İzmir, Turkey
- Department of Medical Biology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
- *Correspondence: Can Küçük, ; Hua You,
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Tombak A, Pepedil Tanrikulu F, Durusoy SS, Dinçyürek HD, Kaya E, Ümit EG, Yavasoglu İ, Mehtap Ö, Deveci B, Özcan MA, Terzi H, Okay M, Sayinalp N, Yilmaz M, Okan V, Kizikli A, Özcan Ö, Çetin G, Demircioglu S, Aydogdu İ, Saydam G, Davulcu EA, İlhan G, Uçar MA, Özet G, Akpinar S, Turgut B, Berber İ, Kurtoglu E, Sönmez M, Batur DS, Yildirim R, Özkocamaz V, Günes AK, Sahip B, Ertop S, Akay OM, Bastürk A, Dogu MH, Akdeniz A, Ünal A, Seyhanli A, Gürkan E, Çekdemir D, Ferhanoglu B. Efficacy and Safety of Ibrutinib Therapy in Patients with Chronic Lymphocytic Leukemia: Retrospective Analysis of Real-Life Data. Turk J Haematol 2021; 38:273-285. [PMID: 34448556 PMCID: PMC8656120 DOI: 10.4274/tjh.galenos.2021.2021.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: This study aimed to retrospectively evaluate the efficacy, safety, and survival outcome of single-agent ibrutinib therapy in chronic lymphocytic leukemia patients. Materials and Methods: A total of 136 patients (mean age ± standard deviation: 64.6±10.3 years, 66.9% males) who had received at least one dose of ibrutinib were included in this retrospective multicenter, noninterventional hospital-registry study conducted at 33 centers across Turkey. Data on patient demographics, baseline characteristics, laboratory findings, and leukemia-cell cytogenetics were retrieved. Treatment response, survival outcome including overall survival (OS) and progression-free survival (PFS), and safety data were analyzed. Results: Overall, 36.7% of patients were categorized as Eastern Cooperative Oncology Group (ECOG) class 2-3, while 44.9% were in Rai stage 4. Fluorescence in situ hybridization revealed the presence of del(17p) in 39.8% of the patients. Patients received a median of 2.0 (range: 0-7) lines of pre-ibrutinib therapy. Median duration of therapy was 8.8 months (range: 0.4-58.0 months). The 1-year PFS and OS rates were 82.2% and 84.6%, respectively, while median PFS time was 30.0 (standard error, 95% confidence interval: 5.1, 20.0-40.0) months and median OS time was 37.9 (3.2, 31.5-44.2) months. Treatment response (complete or partial response), PFS time, and OS time were better with 0-2 lines versus 3-7 lines of prior therapy (p<0.001, p=0.001, and p<0.001, respectively), with ECOG class 0-1 versus class 2-3 (p=0.006, p=0.011, and p=0.001, respectively), and with Rai stage 0-2 versus 3-4 (p=0.002, p=0.001, and p=0.002, respectively). No significant difference was noted in treatment response rates or survival outcome with respect to the presence of comorbidity, bulky disease, or del(17p). While 176 adverse events (AEs) were reported in 74 (54.4%) patients, 46 of those 176 AEs were grade 3-4, including pneumonia (n=12), neutropenia (n=11), anemia (n=5), thrombocytopenia (n=5), and fever (n=5). Conclusion: This real-life analysis confirms the favorable efficacy and safety profile of long-term ibrutinib treatment while emphasizing the potential adverse impacts of poorer ECOG performance status, heavy treatment prior to ibrutinib, and advanced Rai stage on patient compliance, treatment response, and survival outcomes.
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Affiliation(s)
- Anil Tombak
- Department of Internal Medicine - Hematology, Mersin University Medical Faculty, Mersin, Turkey
| | | | | | | | - Emin Kaya
- Inönü Universitesi, Hematology Inönü Universitesi Turgut Özal Tıp Merkezi Hematoloji BD, Malatya, Turkey
| | | | | | - Özgür Mehtap
- University of Kocaeli, Hematology Kocaeli University, Hematology Department, Kocaeli, Turkey
| | - Burak Deveci
- Medstar Antayla Hospital, Hematology, Medstar Antayla Hospital, Antalya, Turkey
| | | | - Hatice Terzi
- Cumhuriyet University, Hematology Cumhuriyet University, Sivas, Turkey
| | - Müfide Okay
- Hacettepe Universitesi Tip Fakultesi, Internal Medicine, Hematology, Turkey
| | - Nilgün Sayinalp
- Hacettepe Universitesi Tip Fakültesi, Internal Medicine, Hematology, Turkey
| | | | - Vahap Okan
- Gaziantep University School of Medicine, Department of Hematology, Gaziantep, Turkey
| | - Alperen Kizikli
- Gaziantep University School of Medicine, Department of Hematology, Gazıantep, Turkey
| | - Ömer Özcan
- Bezmialem Vakif University, Istanbul, Turkey
| | - Güven Çetin
- Bezmialem Vakif University, İstanbul, Turkey
| | - Sinan Demircioglu
- Necmettin Erbakan University, Meram School of Medicine, Hematology Meram School of Medicine, Konya, Turkey
| | | | - Güray Saydam
- Ege University Hospital Hematology 6th Floor Internal Medicine, Izmir, Turkey
| | - Eren Arslan Davulcu
- Ege University Hospital Hematology 6th. Floor Internal Medicine, Izmir, Turkey
| | - Gül İlhan
- Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Mehmet Ali Uçar
- Ankara Numune Training and Research Hospital, Department of Hematology Ankara, Turkey
| | - Gülsüm Özet
- Ankara Numune, Training and Research Hospital, Department of Hematology Ankara, Turkey
| | - Seval Akpinar
- Namık Kemal University Medical Faculty, Hematology, Tekirdağ, Turkey
| | - Burhan Turgut
- Namık Kemal University Medical Faculty, Hematology, Tekirdag, Turkey
| | - İlhami Berber
- İnönü Üniversity, Hematology İnönü Üniversity Malatya, Turkey
| | - Erdal Kurtoglu
- Antalya Eğitim-Araştırma Hastanesi, Hematology, Antalya, Turkey
| | - Mehmet Sönmez
- Karadeniz Technical University, School of Medicine, Department of Haematology Trabzon, Turkey
| | - Derya Selim Batur
- Karadeniz Technical University School of Medicine, Department of Haematology Trabzon, Turkey
| | | | - Vildan Özkocamaz
- Uludag University School of Medicine, Division of Hematology, Bursa, Turkey
| | - Ahmet Kürsad Günes
- Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Birsen Sahip
- Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Sehmus Ertop
- Zonguldak Bülent Ecevit University Zonguldak, Turkey
| | | | - Abdülkadir Bastürk
- Istanbul Training and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Mehmet Hilmi Dogu
- Istanbul Training and Research Hospital, Hematology Clinic, Istanbul, Turkey
| | - Aydan Akdeniz
- Mersin University Medical Faculty, Department of Hematology, Mersin, Turkey
| | - Ali Ünal
- Erciyes University, Kayseri, Turkey
| | | | - Emel Gürkan
- Çukurova Universitesi, Hematology Adana Turkey
| | - Demet Çekdemir
- Anadolu Saglik Merkezi, Bone Marrow Transplantation Center, Department of Hematology, Kocaeli, Turkey
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3
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Çekdemir D, Güvenç S, Özdemirkıran F, Eser A, Toptaş T, Özkocaman V, Haydaroğlu Şahin H, Ermiş Turak E, Esen R, Cömert M, Sadri S, Aslaner M, Uncu Ulu B, Karakuş A, Bapur DS, Alacacıoğlu İ, Aydın D, Tekinalp A, Namdaroğlu S, Ceran F, Tarkun P, Kiper D, Çetiner M, Yenerel M, Demir AM, Yılmaz G, Terzi H, Atilla E, Malkan ÜY, Acar K, Öztürk E, Tombak A, Sunu C, Salim O, Alayvaz N, Sayan Ö, Ozan Ü, Ayer M, Gökgöz Z, Andıç N, Kızılkılıç E, Noyan F, Özen M, Pepedil Tanrıkulu F, Alanoğlu G, Özkan HA, Aslan V, Çetin G, Akyol Erikçi A, Deveci B, Ersoy Dursun F, Dermenci H, Aytan P, Gündüz M, Karakuş V, Özlü C, Demircioğlu S, Akay Yanar OM, Özatlı D, Ündar L, Tiftik EN, Türköz Sucak AG, Haznedaroğlu İ, Özcan M, Şencan M, Tombuloğlu M, Özet G, Bilgir O, Turgut B, Özcan MA, Payzın KB, Sönmez M, Ayyıldız O, Dal MS, Ertop Ş, Turgut M, Soysal T, Kaya E, Ünal A, Pehlivan M, Atagündüz I, Tuğlular Fıratlı T, Saydam G, Diz Küçükkaya R. A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience. Turk J Haematol 2019; 36. [PMID: 31327186 PMCID: PMC6863031 DOI: 10.4274/tjh.galenos.2018.0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). MATERIALS AND METHODS A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. RESULTS The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). CONCLUSION Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors.
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Affiliation(s)
- Demet Çekdemir
- Anadolu Medical Center, Bone Marrow Transplantation Center, Department of Hematology, Kocaeli, Turkey,* Address for Correspondence: Anadolu Medical Center, Bone Marrow Transplantation Center, Department of Hematology, Kocaeli, Turkey Phone: +90 542 484 87 47 E-mail:
| | - Serkan Güvenç
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Hematology, İstanbul, Turkey
| | - Füsun Özdemirkıran
- İzmir Atatürk Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Ali Eser
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Tayfur Toptaş
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Vildan Özkocaman
- Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Handan Haydaroğlu Şahin
- Gaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Esra Ermiş Turak
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Ramazan Esen
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Melda Cömert
- İnönü University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Sevil Sadri
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Müzeyyen Aslaner
- Bülent Ecevit University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Zonguldak, Turkey
| | - Bahar Uncu Ulu
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Abdullah Karakuş
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Derya Selim Bapur
- Karadeniz Teknik University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey
| | - İnci Alacacıoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Demet Aydın
- Okmeydanı Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Atakan Tekinalp
- Namık Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey
| | - Sinem Namdaroğlu
- İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Funda Ceran
- Ankara Numune Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Pınar Tarkun
- Kocaeli University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kocaeli, Turkey
| | - Demet Kiper
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Mustafa Çetiner
- Koç University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Mustafa Yenerel
- İstanbul University İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Ahmet Muzaffer Demir
- Trakya University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Edirne, Turkey
| | - Güven Yılmaz
- Dr. Lütfi Kırdar Kartal Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Hatice Terzi
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Erden Atilla
- Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Ümit Yavuz Malkan
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Kadir Acar
- Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Erman Öztürk
- Koç University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Anıl Tombak
- Mersin University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mersin, Turkey
| | - Cenk Sunu
- Sakarya University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sakarya, Turkey
| | - Ozan Salim
- Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Nevin Alayvaz
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Özkan Sayan
- Medicana Çamlıca Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Ülkü Ozan
- Medical Park Hospital, Clinic of Hematology, Bursa, Turkey
| | - Mesut Ayer
- Haseki Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Zafer Gökgöz
- Medicana International Ankara Hospital, Clinic of Hematology, Ankara, Turkey
| | - Neslihan Andıç
- Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Eskişehir, Turkey
| | - Ebru Kızılkılıç
- Acıbadem Kozyatağı Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Figen Noyan
- Başkent University İstanbul Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Mehmet Özen
- Tokat Gaziosmanpaşa University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tokat, Turkey
| | | | - Güçhan Alanoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Isparta, Turkey
| | - Hasan Atilla Özkan
- Yeditepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Vahap Aslan
- Ümit Hospital, Clinic of Hematology, Eskişehir, Turkey
| | - Güven Çetin
- Bezmialem Vakıf University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Alev Akyol Erikçi
- İstanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Burak Deveci
- Medstar Antalya Hospital, Clinic of Hematology, Antalya, Turkey
| | - Fadime Ersoy Dursun
- Göztepe Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Hasan Dermenci
- Haydarpaşa Numune Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Pelin Aytan
- Başkent University Training and Research Hospital, Bone Marrow and Stem Cell Transplantation Center, Department of Hematology, Adana, Turkey
| | - Mehmet Gündüz
- Atatürk Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Volkan Karakuş
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Hematology, Muğla, Turkey
| | - Can Özlü
- Ministry of Health Erzurum Regional Training and Research Hospital, Clinic of Hematology, Erzurum, Turkey
| | - Sinan Demircioğlu
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Olga Meltem Akay Yanar
- Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Eskişehir, Turkey
| | - Düzgün Özatlı
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Levent Ündar
- Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Eyüp Naci Tiftik
- Mersin University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mersin, Turkey
| | - Ayhan Gülsan Türköz Sucak
- Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - İbrahim Haznedaroğlu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Mehmet Şencan
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Murat Tombuloğlu
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Gülsüm Özet
- Ankara Numune Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Oktay Bilgir
- İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Burhan Turgut
- Namık Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey
| | - Mehmet Ali Özcan
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Kadriye Bahriye Payzın
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Hematology, İstanbul, Turkey
| | - Mehmet Sönmez
- Karadeniz Teknik University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey
| | - Orhan Ayyıldız
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Mehmet Sinan Dal
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Şehmus Ertop
- Bülent Ecevit University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Zonguldak, Turkey
| | - Mehmet Turgut
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Teoman Soysal
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Emin Kaya
- İnönü University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Ali Ünal
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Mustafa Pehlivan
- Gaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Işık Atagündüz
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Tülin Tuğlular Fıratlı
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Güray Saydam
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Reyhan Diz Küçükkaya
- İstanbul University Science Faculty, Department of Molecular Biology and Genetics, İstanbul, Turkey
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4
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Çekdemir D, Güvenç S, Özdemirkıran F, Eser A, Toptaş T, Özkocaman V, Haydaroğlu Şahin H, Ermiş Turak E, Esen R, Cömert M, Sadri S, Aslaner M, Uncu Ulu B, Karakuş A, Selim Bapur D, Alacacıoğlu İ, Aydın D, Tekinalp A, Namdaroğlu S, Ceran F, Tarkun P, Kiper D, Çetiner M, Yenerel M, Demir AM, Yılmaz G, Terzi H, Atilla E, Malkan ÜY, Acar K, Öztürk E, Tombak A, Sunu C, Salim O, Alayvaz N, Sayan Ö, Ozan Ü, Ayer M, Gökgöz Z, Andıç N, Kızılkılıç E, Noyan F, Özen M, Pepedil Tanrıkulu F, Alanoğlu G, Özkan HA, Aslan V, Çetin G, Akyol Erikçi A, Deveci B, Ersoy Dursun F, Dermenci H, Aytan P, Gündüz M, Karakuş V, Özlü C, Demircioğlu S, Akay Yanar OM, Özatlı D, Ündar L, Tiftik EN, Türköz Sucak AG, Haznedaroğlu İ, Özcan M, Şencan M, Tombuloğlu M, Özet G, Bilgir O, Turgut B, Özcan MA, Payzın KB, Sönmez M, Ayyıldız O, Dal MS, Ertop Ş, Turgut M, Soysal T, Kaya E, Ünal A, Pehlivan M, Atagündüz I, Tuğlular Fıratlı T, Saydam G, Diz Küçükkaya R. A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience. Turk J Haematol 2019; 36:230-237. [PMID: 31327186 DOI: 10.4274/tjh.galenos.2019.2018.0307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors.
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Affiliation(s)
- Demet Çekdemir
- Anadolu Medical Center, Bone Marrow Transplantation Center, Department of Hematology, Kocaeli, Turkey
| | - Serkan Güvenç
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Hematology, İstanbul, Turkey
| | - Füsun Özdemirkıran
- İzmir Atatürk Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Ali Eser
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Tayfur Toptaş
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Vildan Özkocaman
- Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Handan Haydaroğlu Şahin
- Gaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Esra Ermiş Turak
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Ramazan Esen
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Melda Cömert
- İnönü University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Sevil Sadri
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Müzeyyen Aslaner
- Bülent Ecevit University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Zonguldak, Turkey
| | - Bahar Uncu Ulu
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Abdullah Karakuş
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Derya Selim Bapur
- Karadeniz Teknik University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey
| | - İnci Alacacıoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Demet Aydın
- Okmeydanı Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Atakan Tekinalp
- Namık Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey
| | - Sinem Namdaroğlu
- İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Funda Ceran
- Ankara Numune Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Pınar Tarkun
- Kocaeli University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kocaeli, Turkey
| | - Demet Kiper
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Mustafa Çetiner
- Koç University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Mustafa Yenerel
- İstanbul University İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Ahmet Muzaffer Demir
- Trakya University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Edirne, Turkey
| | - Güven Yılmaz
- Dr. Lütfi Kırdar Kartal Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Hatice Terzi
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Erden Atilla
- Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Ümit Yavuz Malkan
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Kadir Acar
- Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Erman Öztürk
- Koç University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Anıl Tombak
- Mersin University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mersin, Turkey
| | - Cenk Sunu
- Sakarya University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sakarya, Turkey
| | - Ozan Salim
- Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Nevin Alayvaz
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Özkan Sayan
- Medicana Çamlıca Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Ülkü Ozan
- Medical Park Hospital, Clinic of Hematology, Bursa, Turkey
| | - Mesut Ayer
- Haseki Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Zafer Gökgöz
- Medicana International Ankara Hospital, Clinic of Hematology, Ankara, Turkey
| | - Neslihan Andıç
- Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Eskişehir, Turkey
| | - Ebru Kızılkılıç
- Acıbadem Kozyatağı Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Figen Noyan
- Başkent University İstanbul Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Mehmet Özen
- Tokat Gaziosmanpaşa University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tokat, Turkey
| | | | - Güçhan Alanoğlu
- Süleyman Demirel University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Isparta, Turkey
| | - Hasan Atilla Özkan
- Yeditepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Vahap Aslan
- Ümit Hospital, Clinic of Hematology, Eskişehir, Turkey
| | - Güven Çetin
- Bezmialem Vakıf University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Alev Akyol Erikçi
- İstanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Burak Deveci
- Medstar Antalya Hospital, Clinic of Hematology, Antalya, Turkey
| | - Fadime Ersoy Dursun
- Göztepe Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Hasan Dermenci
- Haydarpaşa Numune Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Pelin Aytan
- Başkent University Training and Research Hospital, Bone Marrow and Stem Cell Transplantation Center, Department of Hematology, Adana, Turkey
| | - Mehmet Gündüz
- Atatürk Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Volkan Karakuş
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Hematology, Muğla, Turkey
| | - Can Özlü
- Ministry of Health Erzurum Regional Training and Research Hospital, Clinic of Hematology, Erzurum, Turkey
| | - Sinan Demircioğlu
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Van, Turkey
| | - Olga Meltem Akay Yanar
- Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Eskişehir, Turkey
| | - Düzgün Özatlı
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Levent Ündar
- Akdeniz University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Antalya, Turkey
| | - Eyüp Naci Tiftik
- Mersin University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Mersin, Turkey
| | - Ayhan Gülsan Türköz Sucak
- Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - İbrahim Haznedaroğlu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Mehmet Şencan
- Cumhuriyet University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Sivas, Turkey
| | - Murat Tombuloğlu
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Gülsüm Özet
- Ankara Numune Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Oktay Bilgir
- İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Burhan Turgut
- Namık Kemal University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey
| | - Mehmet Ali Özcan
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Kadriye Bahriye Payzın
- Yeni Yüzyıl University Gaziosmanpaşa Hospital, Department of Hematology, İstanbul, Turkey
| | - Mehmet Sönmez
- Karadeniz Teknik University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey
| | - Orhan Ayyıldız
- Dicle University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Diyarbakır, Turkey
| | - Mehmet Sinan Dal
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Clinic of Hematology, Ankara, Turkey
| | - Şehmus Ertop
- Bülent Ecevit University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Zonguldak, Turkey
| | - Mehmet Turgut
- Ondokuz Mayıs University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Samsun, Turkey
| | - Teoman Soysal
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Emin Kaya
- İnönü University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey
| | - Ali Ünal
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Kayseri, Turkey
| | - Mustafa Pehlivan
- Gaziantep University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Gaziantep, Turkey
| | - Işık Atagündüz
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Tülin Tuğlular Fıratlı
- Marmara University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Güray Saydam
- Ege University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İzmir, Turkey
| | - Reyhan Diz Küçükkaya
- İstanbul University Science Faculty, Department of Molecular Biology and Genetics, İstanbul, Turkey
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5
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Adıyaman SC, Alacacıoğlu İ, Danyeli AE, Türkyılmaz D, Sevindik ÖG, Demirkan F, Pişkin Ö, Özcan MA, Ündar B, Özkal Ş, Özsan GH. Prognostic Factors in Elderly Patients with Diffuse Large B-Cell Lymphoma and Their Treatment Results. Turk J Haematol 2019. [DOI: 10.4274/tjh.galenos.2019.0218.0219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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6
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Adıyaman SC, Alacacıoğlu İ, Ersen Danyeli A, Türkyılmaz D, Sevindik ÖG, Demirkan F, Pişkin Ö, Özcan MA, Ündar B, Özkal S, Özsan GH. Prognostic Factors in Elderly Patients with Diffuse Large B-Cell Lymphoma and Their Treatment Results. Turk J Haematol 2019; 36:81-87. [PMID: 30724061 PMCID: PMC6516089 DOI: 10.4274/tjh.galenos.2019.2018.0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). The treatment of older NHL patients has always been a struggle; however, treatment statistics have begun showing favorable results similar to those of younger DLBCL patients thanks to newer treatment protocols. Here, we analyze the progress of our own elderly DLBCL patients who were followed between 2000 and 2016 in our center. Materials and Methods: Eighty-seven DLBCL patients, who were diagnosed and treated in the Dokuz Eylül University Department of Hematology between 2000 and 2016, were included in this study. Median age was 72 (65-89) years and 13 (14.9%) patients were older than 80 years. Results: Median follow-up time was 19 months and 45 patients (51.7%) died during the follow-up period. Median overall survival (OS) was 55 months and median progression-free survival was calculated as 27 months. Sixty-three patients (72.4%) received standard R-CHOP therapy. Complete response was seen in 46 (52.9%) patients. The median survival time for patients who had complete response was 136 months (p<0.001); however, OS was not statistically different between older (>80 years) and younger patients (p=0.236). Conclusion: According to our findings, we think that being able to complete standard R-CHOP therapy is vital for the survival rate of elderly DLBCL patients.
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Affiliation(s)
- Süleyman Cem Adıyaman
- Dokuz Eylül University Faculty of Medicine, Department of Internal Medicine, İzmir, Turkey
| | - İnci Alacacıoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Ayça Ersen Danyeli
- Dokuz Eylül University Faculty of Medicine, Department of Pathology, İzmir, Turkey
| | - Doğuş Türkyılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Ömür Gökmen Sevindik
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Fatih Demirkan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Özden Pişkin
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Mehmet Ali Özcan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Bülent Ündar
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Sermin Özkal
- Dokuz Eylül University Faculty of Medicine, Department of Pathology, İzmir, Turkey
| | - Güner Hayri Özsan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
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7
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Solmaz Medeni Ş, Türkyılmaz D, Acar C, Sevindik ÖG, Yüksel F, Pişkin Ö, Özcan MA, Demirkan F, Ündar B, Alacacıoğlu İ, Özsan GH. Does Reinfusion of Stem Cell Products on Multiple Days Affect Engraftment? Turk J Haematol 2018; 35:271-276. [PMID: 29923493 PMCID: PMC6256826 DOI: 10.4274/tjh.2018.0071] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objective: High-doses of melphalan treatment with autologous stem cell transplantation in multiple myeloma (MM) remains a major treatment modality in suitable patients. A minimal dose of 2x106/kg CD34+ cells is preferred to achieve engraftment. Some patients need multiple leukapheresis procedures to achieve the necessary number of CD34+ cells, but this can cause a high volume of stem cell product that cannot be given in a single day. Whether or not the number of infusion days affects engraftment has not been studied before. We aimed to evaluate the impact of reinfusion of stem cells on multiple days on engraftment results. Materials and Methods: Demographic features, CD34+ cell doses, neutrophil and platelet engraftment days, hospitalization days, and number of infusion days of 149 autologous transplantations of 143 MM patients were evaluated retrospectively. Results: The data of 143 MM patients who were transplanted were analyzed retrospectively. Median age was 55±8.5 (range: 26-70) years with a male/female ratio of 91/58. Hospitalization days for all patients were 24±6 (range: 14-50) days. Mean CD34+ cell number was (7.5±5.3)x106/kg (range: 1.5-31x106/kg). CD34+ cells were reinfused in 1 day in 80.5% (n=120) of the patients, 2 days in 18.2% of the patients (n=27), and 3 days in 1.3% of the patients (n=2). For 29 patients, reinfusion was applied in more than 1 day because of the high volume of stem cell product. We did not see any dimethyl sulfoxide toxicity, cardiac arrhythmia, or volume overload complications. Hypertensive attacks during infusion were easily controlled by furosemide treatment. In the group with multiple infusions, the infused CD34+ cell numbers had a mean of (4.8±2.8)x106/kg, and in the single infusion group the mean was (8.1±5.5)x106/kg. There were no statistical differences between the two groups regarding platelet and neutrophil engraftment days (p=0.850, r=0.820 and p=0.500, r=0.440). There was no statistical difference between the two groups for hospitalization days (p=0.060, r=0.050). Conclusion: In cases with a high volume of stem cell product to acquire adequate stem cells, reinfusion can be safely applied across multiple days without any delay in engraftment.
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Affiliation(s)
- Şerife Solmaz Medeni
- University of Health Sciences, İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | - Doğuş Türkyılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Celal Acar
- University of Health Sciences, İzmir Bozyaka Training and Research Hospital, Clinic of Hematology, İzmir, Turkey
| | | | - Faize Yüksel
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Özden Pişkin
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Mehmet Ali Özcan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Fatih Demirkan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Bülent Ündar
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - İnci Alacacıoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Güner Hayri Özsan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
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Büyükkurt N, Özcan MA, Ergene Ü, Payzın B, Tunalı S, Demirkan F, Özsan H, Pişkin Ö, Ündar B. The Effect of FcγRIIIA Gene Polymorphism on the Treatment of Diffuse Large B-cell Non-Hodgkin Lymphoma: A Multicenter Prospective Observational Study. Turk J Haematol 2017; 32:152-7. [PMID: 26316483 PMCID: PMC4451483 DOI: 10.4274/tjh.2013.0367] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective: The curative treatment approach for diffuse large B-cell lymphoma (DLBCL) is controversial even in the rituximab (R) era. The aim of this study was to examine the FcγRIIIA gene polymorphism distribution of DLBCL patients who had been treated with R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Furthermore, we investigated the impact of FcγRIIIA gene polymorphism on the overall response rate (ORR) and overall survival (OS). Materials and Methods: Patients from 3 centers in the Aegean region of Turkey who had newly diagnosed CD20-positive DLBCL were enrolled in the study. The single nucleotide polymorphisms of the FcγRIIIA gene were analyzed by real time-PCR. The response to treatment was determined in the middle and at the end of the protocol. During 2 years of follow-up, the patients were clinically and radiologically evaluated for disease status every 3 months. Results: Thirty-six patients were included in the study and the distributions of F/F, V/F, and V/V types of alleles of FcγRIIIA were 25%, 50%, and 25%, respectively. Twenty-seven patients were considered as evaluable according to ORR and OS. The patients’ ORR was 87.5%, 100%, and 50% in the F/F, V/F, and V/V allele groups, respectively. We did not establish any statistically significant differences among the 3 alleles groups in respect to ORR (p=0.93). The OS within 2 years in the F/F, V/F, and V/V allele groups was 62.5%, 100%, and 100%, respectively. The OS in the F/F allele group was found to be lower than in the other 2 allele groups (p=0.01). Conclusion: The distribution of gene polymorphisms in our study group was similar to those of previous studies. While ORR was similar between the groups, our results highlight a lower OS in F/F patients compared to other allele groups of FcγRIIIA.
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Affiliation(s)
- Nurhilal Büyükkurt
- Başkent University Faculty of Medicine, Adana Education and Research Centre, Clinic of Hematology, Adana, Turkey Phone: +90 322 327 27 27 E-mail:
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Boğa C, Bolaman Z, Çağırgan S, Karadoğan İ, Özcan MA, Özkalemkaş F, Saba R, Sönmez M, Şenol E, Akan H, Akova M. Recommendations for Risk Categorization and Prophylaxis of Invasive Fungal Diseases in Hematological Malignancies: A Critical Review of Evidence and Expert Opinion (TEO-4). Turk J Haematol 2017; 32:100-17. [PMID: 26316478 PMCID: PMC4451478 DOI: 10.4274/tjh.2014.0277] [Citation(s) in RCA: 5] [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] [Indexed: 12/31/2022] Open
Abstract
This is the last of a series of articles on invasive fungal infections prepared by opinion leaders in Turkey. The aim of these articles is to guide clinicians in managing invasive fungal diseases in hematological malignancies and stem cell transplantation based on the available best evidence in this field. The previous articles summarized the diagnosis and treatment of invasive fungal disease and this article aims to explain the risk categorization and guide the antifungal prophylaxis in invasive fungal disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Hamdi Akan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey Phone: +90 532 424 26 40 E-mail:
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Demir T, Akıncı B, Yener S, Argun L, Özcan MA, Eraslan S. Endothelium-Dependent Hemostatic Factors in Women with Previous Gestational. tjem 2016. [DOI: 10.4274/tjem.3477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Tombak A, Uçar MA, Akdeniz A, Tiftik EN, Gören Şahin D, Akay OM, Yıldırım M, Nevruz O, Kis C, Gürkan E, Solmaz ŞM, Özcan MA, Yıldırım R, Berber İ, Erkurt MA, Fıratlı Tuğlular T, Tarkun P, Yavaşoğlu İ, Doğu MH, Sarı İ, Merter M, Özcan M, Yıldızhan E, Kaynar L, Mehtap Ö, Uysal A, Şahin F, Salim O, Sungur MA. The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study. Turk J Haematol 2016; 33:273-280. [PMID: 27095141 PMCID: PMC5204180 DOI: 10.4274/tjh.2015.0203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 12/01/2022] Open
Abstract
Objective: In this study, we aimed to investigate the efficacy and safety of azacitidine (AZA) in elderly patients with acute myeloid leukemia (AML), including patients with >30% bone marrow (BM) blasts. Materials and Methods: In this retrospective multicenter study, 130 patients of ≥60 years o ld who were ineligible for intensive chemotherapy or had progressed despite conventional treatment were included. Results: The median age was 73 years and 61.5% of patients had >30% BM blasts. Patients received AZA for a median of four cycles (range: 1-21). Initial overall response [including complete remission (CR)/CR with incomplete recovery/partial remission] was 36.2%. Hematologic improvement (HI) of any kind was documented in 37.7% of all patients. HI was also documented in 27.1% of patients who were unresponsive to treatment. Median overall survival (OS) was 18 months for responders and 12 months for nonresponders (p=0.005). In the unresponsive patient group, any HI improved OS compared to patients without any HI (median OS was 14 months versus 10 months, p=0.068). Eastern Cooperative Oncology Group performance status of <2, increasing number of AZA cycles (≥5 courses), and any HI predicted better OS. Age, AML type, and BM blast percentage had no impact. Conclusion: We conclude that AZA is effective and well tolerated in elderly comorbid AML patients, irrespective of BM blast count, and HI should be considered a sufficient response to continue treatment with AZA.
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Affiliation(s)
- Anıl Tombak
- Mersin University Faculty of Medicine, Department of Hematology, Mersin, Turkey, Phone: +90 532 346 07 67, E-mail:
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Özdemirkıran F, Payzın B, Kiper HD, Kabukçu S, Akgün Çağlıyan G, Kahraman S, Sevindik ÖG, Ceylan C, Kadıköylü G, Şahin F, Keskin A, Arslan Ö, Özcan MA, Kabukçu G, Görgün G, Bolaman Z, Büyükkeçeci F, Bilgir O, Alacacıoğlu İ, Vural F, Tombuloğlu M, Gökgöz Z, Saydam G. Eltrombopag for the Treatment of Immune Thrombocytopenia: The Aegean Region of Turkey Experience. Turk J Haematol 2015; 32:323-8. [PMID: 25914025 PMCID: PMC4805331 DOI: 10.4274/tjh.2014.0152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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] [Indexed: 12/01/2022] Open
Abstract
Objective: Immune thrombocytopenia (ITP) is an immune-mediated disease characterized by transient or persistent decrease of the platelet count to less than 100x109/L. Although it is included in a benign disease group, bleeding complications may be mortal. With a better understanding of the pathophysiology of the disease, thrombopoietin receptor agonists, which came into use in recent years, seem to be an effective option in the treatment of resistant cases. This study aimed to retrospectively assess the efficacy, long-term safety, and tolerability of eltrombopag in Turkish patients with chronic ITP in the Aegean region of Turkey. Materials and Methods: Retrospective data of 40 patients with refractory ITP who were treated with eltrombopag in the Aegean region were examined and evaluated. Results: The total rate of response was 87%, and the median duration of response defined as the number of the platelets being over 50x109/L was 19.5 (interquartile range: 5-60) days. In one patient, venous sinus thrombosis was observed with no other additional risk factors due to or related to thrombosis. Another patient with complete response and irregular follow-up for 12 months was lost due to sudden death as the result of probable acute myocardial infarction. Conclusion: Although the responses to eltrombopag were satisfactory, patients need to be monitored closely for overshooting platelet counts as well as thromboembolic events.
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Affiliation(s)
- Füsun Özdemirkıran
- Katip Çelebi University Faculty of Medicine, Atatürk Research and Education Hospital, Clinic of Hematology, İzmir, Turkey E-mail:
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Katgı A, Sevindik ÖG, Gökbulut AA, Özsan GH, Yüksel F, Solmaz ŞM, Alacacıoğlu İ, Özcan MA, Demirkan F, Baran Y, Pişkin Ö. Nilotinib Does Not Alter the Secretory Functions of Carotid Artery Endothelial Cells in a Prothrombotic or Antithrombotic Fashion. Clin Appl Thromb Hemost 2014; 21:678-83. [DOI: 10.1177/1076029614550817] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: There have been concerns about the possible prothrombotic effects of nilotinib, especially in patients having cardiovascular risk factors. The potential mechanism behind the increased risk of thromboembolic events is still not clear. Objectives: In this study, we aimed to evaluate possible harmful effects of nilotinib on endothelial cells. To this aim, we examined proliferative capacity and secretory functions of healthy human carotid artery endothelial cells (HCtAECs) in response to nilotinib. Methods: 3-(4,5-Dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide (MTT) cell proliferation method was used to determine antiproliferative effects of nilotinib on HCtAECs. The HCtAECs were incubated with 5, 10, and 100 nmol/L doses of nilotinib for 72 hours. Then, in order to assess the endothelial function, levels of nitric oxide (NO), von Willebrand factor (vWF), tissue plasminogen activator, plasminogen activator inhibitor 1 (PAI-1), and endothelin 1 (ET-1) were evaluated using enzyme-linked immunosorbent assay from tissue culture supernatants. Results: There were slight but statistically significant decreases in cell proliferation in response to nilotinib. Nilotinib increased the secretion of t-PA, PAI-1, and vWF in a dose-dependent manner when compared with the untreated control group. The ET-1 secretion was lower in 5 nmol/L and higher in 10 and 100 nmol/L nilotinib-treated cells as compared to untreated cells. Regarding NO secretion, lower levels were observed in 5 and 10 nmol/L, and higher levels were detected in 100 nmol/L nilotinib-treated cells as compared to untreated control group cells. Conclusion: Considering the results obtained in our study, nilotinib does not affect the functions of endothelial cells either in a prothrombotic or an antithrombotic fashion, despite a dose-dependent decline in cell viability.
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Affiliation(s)
- Abdullah Katgı
- Department of Hematology, Dokuz Eylul University, Izmir, Turkey
| | | | - Aysun Adan Gökbulut
- Department of Molecular Biology and Genetics, Izmir Institute of Technology, Izmir, Turkey
| | | | - Faize Yüksel
- Department of Hematology, Dokuz Eylul University, Izmir, Turkey
| | | | | | | | - Fatih Demirkan
- Department of Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Yusuf Baran
- Department of Molecular Biology and Genetics, Izmir Institute of Technology, Izmir, Turkey
| | - Özden Pişkin
- Department of Hematology, Dokuz Eylul University, Izmir, Turkey
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Erçetin AP, Aktaş S, Pişkin Ö, Ateş H, Zadeoğluları ZF, Turgut NH, Özcan MA. The correlation between T regulatory cells and autologous peripheral blood stem cell transplantation in multiple myeloma. Turk J Haematol 2011; 28:107-14. [PMID: 27109178 DOI: 10.5152/tjh.2011.26] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Multiple myeloma (MM) is characterized by malignant proliferation of plasmocytes and their precursors. T regulatory cells (Tregs) have a role in immunosuppression and control of autoimmunity, and are currently an important topic in the study of immune response to tumor cells. The correlation between Tregs and autologous peripheral blood stem cell transplantation (APBSCT) in MM has not been studied. The aim of this study was to compare CD4+CD25+FOXP3+ Treg, CD200, and PD-1 levels in MM patients that did and did not undergo APBSCT. METHODS Peripheral blood samples were collected from 28 MM patients ranging in age from 41 to 78 years for analysis of CD4CD25+ FOXP3+ Tregs, PD-1 (CD279), and CD200. Peripheral blood mononuclear cells were isolated via density gradient centrifugation. Four-color flow cytometry was performed. Using a sequential gating strategy, Tregs were identified as CD4+CD25+FOXP3+ T-cells. Results were analyzed using the Mann Whitney U non-parametric test and a compare means test. p values <0.05 were considered statistically significant. RESULTS The study included 28 MM patients (10 female and 18 male). In all, 11 of the patients underwent APBSCT. The level of Tregs identified as CD4+CD25+FOXP3+ T-cells was higher in the patients that underwent APBSCT (p=0.042). CD200 and PD-1 levels did not significantly differ between the 2 groups (p=0.711 and p=0.404, respectively). There weren't any statistically significant differences in CD200, PD-1, or CD4+CD25+FOXP3+ T-cell levels between the patients that did and did not undergo APBSCT (p>0.05). CONCLUSION Treg levels were higher in the patients that underwent APBSCT. Tregs are crucial for the induction and maintenance of peripheral tolerance to self-antigens. In addition, Tregs can suppress immune responses to tumor antigens; however, APBSCT and Treg levels were not correlated with CD200 or PD-1 expression. Relationship of Tregs with prognosis needs to be determined by studies that include larger cohorts.
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Affiliation(s)
- Ayşe Pınar Erçetin
- Department of Institute of Oncology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey, Phone: +90 232 412 58 73 E-mail:
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Pişkin Ö, Özcan MA, Özcan GH, Ateş H, Demirkan F, Alacacıoğlu İ, Ündar B. Synergistic effect of imatinib mesylate and fludarabine combination on Philadelphia chromosome-positive chronic myeloid leukemia cell lines. Turk J Haematol 2007; 24:23-27. [PMID: 27263481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Fludarabine-containing combinations have additive cell killing against leukemic blasts in vitro. It has also been shown that imatinib mesylate combined with fludarabine or cladribine had an additive effect on CML CFU-GM cells. In this regard, we aimed to investigate the effect of fludarabine-imatinib mesylate combination against CML blastic phase cell lines K562 and Meg-01. XTT test was performed for proliferation and inhibition assay. According to obtained data, five different effective concentrations of each drug in 25 different combinations were tested. Results of the combination studies were analyzed with isobologram. At IC20, imatinib mesylate and fludarabine combination showed synergism and strong synergism in K562 and Meg-01 cells, respectively. At IC50 and IC75, combination indexes (CI) indicated strong synergism and synergism. Based on our results, the fludarabine- based chemotherapy regimens can be used for those patients with CML blastic phase in combination with imatinib mesylate.
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Pişkin Ö, Özsan GH, Ateş H, Özcan MA, Demirkan F, Alacacıoğlu İ, Ündar B. The effect of imatinib mesylate on the erythroid colony formation from patients with polycythemia vera in the presence of different cytokines. Turk J Haematol 2006; 23:136-141. [PMID: 27265480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
It has been shown that imatinib mesylate, a drug used in the treatment of chronic myelogenous leukemia, inhibits the effect of stem cell factor, which has a central role in erythropoiesis. In some polycythemia vera (PV) patients, it has inhibited autonomous erythroid colony growth in vitro and decreased the need for phlebotomy. In this study we have investigated the effect of insulin like growth factor (IGF)-I, stem cell factor (SCF) and erythropoietin (Epo) with interleukin (IL)-3, granulocyte macrophage-colony stimulating factor (GM-CSF) and granulocyte-colony stimulating factor (G-CSF) in the presence of imatinib mesylate on the erythroid progenitors derived from peripheral blood mononuclear cells of three patients with PV and four healthy controls in semisolid medium. Erythroid colony formation from hematopoietic progenitors obtained from healthy controls was observed only in the presence of all cytokines. However, the number of erythroid colonies could not reach that of patients with PV. Inhibition of imatinib mesylate on erythroid colony growth was evident. Hematopoietic progenitors of patients with PV displayed two types of colony formation: the first type was exogenous cytokine-independent and was hypersensitive to current cytokines, and the second displayed hypersensitivity to current exogenous cytokines, but was exogenous cytokine-dependent. For both types, the inhibitory effect of imatinib mesylate was striking in the presence of all cytokines including IL-3, GM-CSF and Epo. There is no direct evidence yet that imatinib mesylate could inhibit the effect of IL-3, G-CSF, GM-CSF, Epo and IGF-I on erythropoiesis. Considering former studies together with results of this study, it can be argued that imatinib mesylate is effective in PV on the intersecting signal transduction mechanisms in which stem cell factor and its receptor may have a part.
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Özcan MA, Pişkin Ö, Alacacıoğlu İ, Ündar B. Platelet satellitism in a pregnant woman. Turk J Haematol 2006; 23:119. [PMID: 27265295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
t(1;3)(p36;p21) is a recurrent reciprocal translocation found in a subset of myelodysplastic syndrome (MDS)/acute myelogenous leukemia (AML) characterized by trilineage dysplasia, especially dysmegakaryopoiesis and poor prognosis. In the literature, some authors have suggested that this recurrent translocation is closely associated with prior chemotherapy including alkylating agents in various hematologic malignancies. We identified a recurring translocation, t(1;3)(p36;p21), in our patient with MDS/AML(M2), although she had not been given any kind of treatment previously.
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Özcan MA, Akarsu M, Demirkan F, Akpınar H, Yüksel F, Özsan GH, Ündar B, Pişkin Ö, Alacacıoğlu İ. Plasma levels of thrombin activatable fibrinolysis inhibitor antigen in active and inactive inflammatory bowel disease. Turk J Haematol 2006; 23:94-99. [PMID: 27265290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND The clinical course of patients with inflammatory bowel disease (IBD) is frequently complicated by thromboembolic events and may involve the arterial and venous systems. Although not uniformly documented, several studies document substantial alterations in markers of coagulation and fibrinolysis in patients with IBD. METHODS 45 patients with IBD (31 UC,14 CD) were included in the study. Age and sex matched 16 volunteers were used as a control group. TAFI antigen was determined using an ELISA kit VisuLiseTM for quantitative measurement. RESULTS Inflammatory parameters such as white blood cell, platelet levels, erythrocyte sedimentation rate, C-reactive protein were found to be significantly higher in active disease group compared to inactive patients. Coagulation parameters of prothrombin time, activated partial thromboplastin time and d-dimer levels showed no significant difference between active and inactive IBD. Fibrinogen levels were significantly higher in clinically active IBD patients. Plasma TAFI levels demonstrated no significant difference between active and control, inactive and control as well as active and inactive groups. We observed no significant changes in levels of β-TG and PF-4 between active and inactive disease group. CONCLUSIONS We studied plasma TAFI levels in IBD. In conclusion, plasma TAFI levels does not appear to represent to be a marker of activation in IBD in contrast to literature. So further studies covering more patients with different clinic and disease activity status might improve the perspective on this issue.
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Özcan MA, Pişkin Ö, Alacacıoğlu İ, Savran Y, Özsan HG. Images in Hematology. Turk J Haematol 2004; 21:49. [PMID: 27263648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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Demırkan F, Özsan GH, Özcan MA, Vural F, Öztop İ, Yüksel E, Ündar B. Refractory Thrombocytopenia with Multilineage Dysplasia: A Rare Type of Myelodysplastic Syndrome. Turk J Haematol 2003; 20:25-30. [PMID: 27265331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Thrombocytopenia may be the presenting cytopenia of myelodysplastic syndrome (MDS) and is named as refractory thrombocytopenia (RT) and categorized in the refractory cytopenia with multilineage dysplasia (RCMD) group according to the recent World Health Organization (WHO) classification of the acute leukemias and MDS. Abnormal cytogenetics can be found in 60% to 80% of patients with MDS. Most common cytogenetic abnormalities include monosomy 5, 5q-, monosomy 7, trisomy 8, deletion 20q and loss of X or Y chromosome. Here we report clinical features and outcomes of nine patients with RT. Cytogenetic abnormalities were detected in seven. Among two patients who have a normal karyotype at diagnosis, one of them transformed to acute myeloid leukemia (AML). During a median follow-up of 29 months, two patients died of hemorrhagia and one of AML. The features and prognosis of patients with RT needs to be determined by larger series.
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Demirkan F, Özsan GH, Özcan MA, Vural F, Çabuk M, Ündar B. Plasma Cell Leukemia: A Report of 5 Cases and Review of the Literature. Turk J Haematol 2001; 18:275-279. [PMID: 27264469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Plasma cells are occasionally observed in the peripheral blood of the patients with multiple myeloma. When the number of these circulating cells is significant, the term of plasma cell leukemia is used. We report 5 cases of plasma cell leukemia with poor prognosis with review of the literature.
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Özsan GH, Pişkin Ö, Demirkan F, Ateş H, Özcan MA, Ündar B. Effect of Sialic Acid on Platelet Cryopreservation. Turk J Haematol 2001; 18:251-257. [PMID: 27264466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Sialic acid is a molecule which is responsible for the net negative surface charge of platelets. We investigated the effect of sialic acid on fresh and cryopreserved platelets. Platelet samples were obtained by platelet apheresis from 8 healthy donors. Platelet suspensions with different sialic acid concentrations (0, 1, 2 and 4 mg/mL) were studied for ADP and ristocetin induced platelet aggregation, basal and ADP induced P-selectin and glycoprotein- Ib/IX expression. Then platelet samples were cryopreserved in 5% DMSO with or without 4 mg/mL sialic acid. After thawing, P-selectin expression was compared with the control group. Six samples were also washed after thawing and P-selectin expression was again compared to unwashed samples. Sialic acid suppressed ADP induced platelet aggregation and P-selectin expression in a dose dependent manner. In cryopreserved samples, P-selectin expression of 4 mg/mL sialic acid containing group was found significantly higher than the control group (p< 0.001). In cryopreserved control group, P-selectin expression of thawedwashed group was significantly higher than thawed-unwashed group (p< 0.05). Our results indicate that sialic acid is not a good cryoprotective agent. Washing procedure after thawing to eliminate DMSO causes significant platelet activation.
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