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Merter M, Sahin U, İlhan O, Beksac M. Stem cell mobilizating effect of heparin in patients undergoing autologous stem cell transplantation. J Clin Apher 2023; 38:685-693. [PMID: 37503703 DOI: 10.1002/jca.22079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/29/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Adequate stem cell collection is essential for successful stem cell transplantation. Heparin enhances stem cell mobilization by competing with heparin sulfate proteoglycans. Heparin is also used as an anticoagulant before leukapheresis. Here, we evaluated the effects of heparin on stem cell mobilization in patients who underwent autologous stem cell transplantation (ASCT). METHODS We evaluated patients who underwent ASCT. Patients were divided into two groups: those who received heparin plus citrate (heparinized patients) and those who received citrate only (nonheparinized patients) for anticoagulation. Univariate and multivariate analyses were also performed. The collection efficiency 2 (CE2) for CD34+ cells was calculated and compared between heparinized and nonheparinized patients. RESULTS This study included 1017 patients. There were 478 (47%) heparinized and 539 (53%) nonheparinized patients. The number of collected CD34+ cells was significantly higher in heparinized patients (P < .00001). The multivariate analyses showed that using heparin was an independent positive factor for collected CD34+ cells (adj-R2 = 0.744; F = 369.331, P < .00001). CE2 was significantly higher in heparinized patients than in nonheparinized patients (66.8% vs 52.1%; P < .00001). The rate of collecting at least 2 × 106 /kg CD34+ cells was 3.3 times higher for heparinized patients in poor mobilizers (P < .00001). Heparinized patients had significantly higher total nucleated and mononuclear cell counts (P < .00001 and <.00001, respectively). CONCLUSION Heparin enhances stem cell collection and increases CE2. The use of heparin may reduce the need for other strategies to increase stem cell mobilization.
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Affiliation(s)
- Mustafa Merter
- Hematology Department, School of Medicine, Firat University, Elazıg, Turkey
| | - Ugur Sahin
- Hematology Department, School of Medicine, Ankara University, Ankara, Turkey
| | - Osman İlhan
- Hematology Department, School of Medicine, Ankara University, Ankara, Turkey
| | - Meral Beksac
- Hematology Department, School of Medicine, Ankara University, Ankara, Turkey
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Kırcalı E, Cengiz Seval G, Öztürk C, Yılmaz H, Koyun D, Civriz Bozdağ S, Toprak SK, Topçuoğlu P, Arslan Ö, Özcan M, Demirer T, İlhan O, Gürman G, Beksaç M, Kurt Yüksel M. Eltrombopag for the Treatment of Poor Graft Function Following Haematopoietic Cell Transplantation: Real-Life Data. Balkan Med J 2023; 40:51-56. [PMID: 36571427 PMCID: PMC9874246 DOI: 10.4274/balkanmedj.galenos.2022.2022-2-48] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/27/2022] Open
Abstract
Background Eltrombopag has an off-label indication for haematopoietic cell transplantation in patients experiencing delayed thrombocyte recovery and/or thrombocytopaenia. Aims To present our centre’s experience of using this agent not only for post- haematopoietic cell transplantation thrombocytopaenia but also for poor graft functioning in the post-haematopoietic cell transplantation setting. Study Design Retrospective cross-sectional study. Methods Thirty-nine patients who had persistent cytopaenia following haematopoietic cell transplantation and treated with eltrombopag at our centre between October 2011 and December 2021 were retrospectively identified. During this period, 9 (23.1%) and 30 (76.9%) patients who underwent allogeneic transplantations, respectively, received eltrombopag. Results The female-to-male ratio was 12:27, and the median transplant age was 49 (18-70) years. Eight (20.5%) patients had isolated thrombocytopaenia, 19 (49.4%) had bi-lineage cytopaenia and 12 (30.1%) had pancytopaenia. Patients received a median of 50 mg/day (25-150 mg/day) of eltrombopagfor a median duration of 82 (24-386) days. Nine (23.1%) patients had autologous haematopoietic cell transplantation, and 30 (76.9%) had allogeneic haematopoietic cell transplantation (14 unrelated, 9 sibling and 7 haploidentical). The median donor age was 32 (20-67) years. The median follow-up was 16.4 (1.8-84.3) months. The median pre-treatment platelet count was 11x109/l (1-23), which increased to 41x109/l (6-150). The median platelet count increment was 29.5x109/l (p = 0.001). The pre-treatment median neutrophil count was 1.19x109/l (0.39-5.1), which increased to 2.35 x109/l (0.1-5.33) (p = 0.05), and the pre-treatment median haemoglobin was 8.3 (6.2-14) g/dl, which increased to 10 (6.2-14) g/dl (p = 0.001) with eltrombopag. No eltrombopag-related hepatotoxicity occurred; however, 1 (2.6%) patient failed to continue treatment because of two consecutive episodes of deep venous thrombosis. Six (15.4%) patients were unresponsive to eltrombopag and dependent on blood product transfusions. After a median time of 82 days, 61.5% of the patients discontinued eltrombopag successfully. Conclusion The results confirmed that eltrombopag could provide a rapid, sustained response in patients with poor graft functioning after haematopoietic cell transplantation. This finding is essential given the high rate of non-relapse mortality caused by poor graft functioning after haematopoietic cell transplantation.
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Affiliation(s)
- Ekin Kırcalı
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey,* Address for Correspondence: Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey E-mail:
| | | | - Cemaleddin Öztürk
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hülya Yılmaz
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Derya Koyun
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sinem Civriz Bozdağ
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Selami Koçak Toprak
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Pervin Topçuoğlu
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Önder Arslan
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Muhit Özcan
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Taner Demirer
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Osman İlhan
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Günhan Gürman
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meral Beksaç
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meltem Kurt Yüksel
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
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Civriz Bozdağ S, Cengiz Seval G, Yönal Hindilerden İ, Hindilerden F, Andıç N, Baydar M, Aydın Kaynar L, Koçak Toprak S, Göksoy HS, Balık Aydın B, Demirci U, Can F, Özkocaman V, Gündüz E, Güven ZT, Özkurt ZN, Demircioğlu S, Beksaç M, İnce İ, Yılmaz U, Eroğlu Küçükdiler H, Abishov E, Yavuz B, Ataş Ü, Mutlu YG, Baş V, Özkalemkaş F, Üsküdar Teke H, Gürsoy V, Çelik S, Çiftçiler R, Yağcı M, Topçuoğlu P, Çeneli Ö, Abbasov H, Selim C, Ar MC, Yücel OK, Sadri S, Albayrak C, Demir AM, Güler N, Keklik M, Terzi H, Doğan A, Yegin ZA, Kurt Yüksel M, Sadri S, Yavaşoğlu İ, Beköz HS, Aksu T, Maral S, Erol V, Kaynar L, İlhan O, Bolaman AZ, Sevindik ÖG, Akyay A, Özcan M, Gürman G, Ünal Ş, Yavuz Y, Diz Küçükkaya R, Özsan GH. Clinical Characteristics and Outcome of COVID-19 in Turkish Hematological Malignancy Patients. Turk J Haematol 2021; 39:43-54. [PMID: 34521187 PMCID: PMC8886271 DOI: 10.4274/tjh.galenos.2021.2021.0287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARS-CoV- 2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixty-nine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.
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Affiliation(s)
- Sinem Civriz Bozdağ
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | | | - İpek Yönal Hindilerden
- İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Fehmi Hindilerden
- İstanbul Bakırköy Sadi Konuk Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
| | - Neslihan Andıç
- Eskişehir Osmangazi University Faculty of Medicine, Department of Hematology, Eskisehir, Turkey
| | - Mustafa Baydar
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Lale Aydın Kaynar
- Gazi University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Selami Koçak Toprak
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Hasan Sami Göksoy
- Yeni yüzyıl University, Özel Gaziosmanpaşa Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Berrin Balık Aydın
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Ufuk Demirci
- Trakya University Faculty of Medicine, Department of Hematology, Edirne, Turkey
| | - Ferda Can
- Ankara City Hospital, Clinic of Internal Medicine, Ankara, Turkey
| | - Vildan Özkocaman
- Bursa Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Eren Gündüz
- Eskişehir Osmangazi University Faculty of Medicine, Department of Hematology, Eskisehir, Turkey
| | - Zeynep Tuğba Güven
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Zübeyde Nur Özkurt
- Gazi University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Sinan Demircioğlu
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Hematology, Konya, Turkey
| | - Meral Beksaç
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - İdris İnce
- Dr. Ersin Arslan Training and Research Hospital, Clinic of Hematology, Gaziantep, Turkey
| | - Umut Yılmaz
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | | | - Elgün Abishov
- Yeni yüzyıl University, Özel Gaziosmanpaşa Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Boran Yavuz
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
| | - Ünal Ataş
- Akdeniz University Faculty of Medicine, Department of Hematology, Antalya, Turkey
| | - Yaşa Gül Mutlu
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Volkan Baş
- Trakya University Faculty of Medicine, Department of Hematology, Edirne, Turkey
| | - Fahir Özkalemkaş
- Bursa Uludağ University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Bursa, Turkey
| | - Hava Üsküdar Teke
- Eskişehir Osmangazi University Faculty of Medicine, Department of Hematology, Eskisehir, Turkey
| | - Vildan Gürsoy
- Bursa City Hospital, Clinic of Hematology, Bursa, Turkey
| | - Serhat Çelik
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Rafiye Çiftçiler
- Aksaray Training and Research Hospital, Clinic of Hematology, Aksaray, Turkey
| | - Münci Yağcı
- Gazi University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Pervin Topçuoğlu
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Özcan Çeneli
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Hematology, Konya, Turkey
| | - Hamza Abbasov
- Yeni yüzyıl University, Özel Gaziosmanpaşa Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Cem Selim
- Adnan Menderes University Faculty of Medicine, Department of Hematology, Aydın, Turkey
| | - Muhlis Cem Ar
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Orhan Kemal Yücel
- Akdeniz University Faculty of Medicine, Department of Hematology, Antalya, Turkey
| | - Sevil Sadri
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Canan Albayrak
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Hematology, Samsun, Turkey
| | | | - Nil Güler
- Pamukkale University Faculty of Medicine, Department of Internal Medicine, Denizli, Turkey
| | - Muzaffer Keklik
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Hatice Terzi
- Cumhuriyet University Faculty of Medicine, Department of Hematology, Sivas, Turkey
| | - Ali Doğan
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Hematology, Van, Turkey
| | - Zeynep Arzu Yegin
- Gazi University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Meltem Kurt Yüksel
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Soğol Sadri
- Yeni yüzyıl University, Özel Gaziosmanpaşa Hospital, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - İrfan Yavaşoğlu
- Adnan Menderes University Faculty of Medicine, Department of Hematology, Aydın, Turkey
| | - Hüseyin Saffet Beköz
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Tekin Aksu
- University of Health Sciences Turkey, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Department of Pediatric Hematology and Oncology, Ankara, Turkey
| | - Senem Maral
- University of Health Sciences Turkey, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Veysel Erol
- Pamukkale University Faculty of Medicine, Department of Internal Medicine, Denizli, Turkey
| | - Leylagül Kaynar
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey
| | - Osman İlhan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Ali Zahit Bolaman
- Adnan Menderes University Faculty of Medicine, Department of Hematology, Aydın, Turkey
| | - Ömür Gökmen Sevindik
- Medipol University Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Arzu Akyay
- İnönü University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Malatya, Turkey
| | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Günhan Gürman
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Şule Ünal
- Hacettepe University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Yasemin Yavuz
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Reyhan Diz Küçükkaya
- İstanbul University Faculty of Science, Department of Molecular Biology and Genetic, İstanbul, Turkey
| | - Güner Hayri Özsan
- Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
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Narlı Özdemir Z, Şahin U, Dalva K, Baltacı MA, Uslu A, Öztürk C, Cengiz Seval G, Toprak SK, Kurt Yüksel M, Topçuoğlu P, Arslan Ö, Özcan M, Beksaç M, İlhan O, Gürman G, Civriz Bozdağ S. Highlighting the Prognostic Importance of Measurable Residual Disease Among Acute Myeloid Leukemia Risk Factors. Turk J Haematol 2021; 38:111-118. [PMID: 33112099 PMCID: PMC8171203 DOI: 10.4274/tjh.galenos.2020.2020.0157] [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: The optimal timing of measurable residual disease (MRD) evaluation in acute myeloid leukemia (AML) patients has not been well defined yet. We aimed to investigate the impact of MRD in pre- and post-allogeneic hematopoietic stem cell transplantation (AHSCT) periods on prognostic parameters. Materials and Methods: Seventy-seven AML patients who underwent AHSCT in complete morphological remission were included. MRD analyses were performed by 10-color MFC and 10-4 was defined as positive. Relapse risk and survival outcomes were assessed based on pre- and post-AHSCT MRD positivity. Results: The median age of the patients was 46 (range: 18-71) years, and 41 (53.2%) were male while 36 (46.8%) were female. The median follow-up after AHSCT was 12.2 months (range: 0.2-73.0). The 2-year overall survival (OS) in the entire cohort was 37.0%, with a significant difference between patients who were MRD-negative and MRD-positive before AHSCT, estimated as 63.0% versus 16.0%, respectively (p=0.005). MRD positivity at +28 days after AHSCT was also associated with significantly inferior 2-year OS when compared to MRD negativity (p=0.03). The risk of relapse at 1 year was 2.4 times higher (95% confidence interval: 1.1-5.6; p=0.04) in the pre-AHSCT MRD-positive group when compared to the MRD-negative group regardless of other transplant-related factors, including pre-AHSCT disease status (i.e., complete remission 1 and 2). Event-free survival (EFS) was significantly shorter in patients who were pre-AHSCT MRD-positive (p=0.016). Post-AHSCT MRD positivity was also related to an increased relapse risk. OS and EFS were significantly inferior among MRD-positive patients at +28 days after AHSCT (p=0.03 and p=0.019). Conclusion: Our results indicate the importance of MRD before and after AHSCT independently of other factors.
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Affiliation(s)
| | - Uğur Şahin
- Medicana International Ankara Hospital, Clinic of Hematology, Ankara, Turkey
| | - Klara Dalva
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Mehmet Akif Baltacı
- Ankara University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - Atilla Uslu
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Cemaleddin Öztürk
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | | | - Selami Koçak Toprak
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Meltem Kurt Yüksel
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Pervin Topçuoğlu
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Önder Arslan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Meral Beksaç
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Osman İlhan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Günhan Gürman
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Sinem Civriz Bozdağ
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
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Özdemir ZN, Şahin U, Yıldırım Y, Kaya CT, İlhan O. Lipoprotein apheresis efficacy and challenges: single center experience. Hematol Transfus Cell Ther 2021; 44:56-62. [PMID: 33745887 PMCID: PMC8885363 DOI: 10.1016/j.htct.2021.01.009] [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] [Received: 10/10/2020] [Revised: 12/05/2020] [Accepted: 01/12/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Lipoprotein apheresis (LA) is an extracorporeal therapy which removes apolipoprotein B-containing particles from the circulation. We evaluated techniques and efficiency of lipoprotein apheresis procedures applied to patients with familial and non-familial hypercholesterolemia (FH) at our center. Methods We retrospectively evaluated 250 LA procedures applied to 27 patients with dyslipidemia between March 2011 and August 2019. Results A total of 27 patients, of whom 19 (70.4%) were male and 8 (29.6%), female, were included. Eighteen (66.7%), 6 (22.2%) and 3 (11.1%) patients were diagnosed with non-FH, homozygous FH (HoFH) and heterozygous FH (HeFH), respectively. Two different apheresis techniques, direct adsorption of lipoproteins (DALI) (48.8%) and double filtration plasmapheresis (DFPP) (51.2%), were used. The change in the serum total cholesterol (TC) level was the median 302 mg/dl (171–604 mg/dl) (60.4%) in HoFH patients, 305 mg/dl (194–393 mg/dl) (60.8%) in HeFH patients and 227 mg/dl (75–749 mg/dl) (65.3%) in non-FH patients. The change in the serum low-density lipoprotein (LDL) level was the median 275 mg/dl (109–519 mg/dl) (64.2%), 232 mg/dl (207–291 mg/dl) (64.5%) and 325 mg/dl (22–735 mg/dl) (70.9%) in patients with HoFH, HeFH and non-FH, respectively. A significantly effective reduction in serum lipid levels, including TC, LDL and triglycerides, was achieved in all patients, regardless of the technique, p < .001. The decrease in the serum TC and LDL levels was significantly higher in the DFPP, compared to the DALI, being 220 mg/dl (−300 to 771) vs 184 mg/dl (64–415), p < .001 and 196 mg/dl (11–712) vs 157 mg/dl (54–340), p < .001, respectively. Conclusions Our results showed that LA is a highly effective treatment in reducing serum lipid levels and safe, without any major adverse event.
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Affiliation(s)
| | - Uğur Şahin
- Medicana International Ankara Hospital, Ankara, Turkey
| | | | | | - Osman İlhan
- Ankara University School of Medicine, Ankara, Turkey
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Kumru Şahin G, Kocabay HE, Kiremitçi S, İlhan O, Keven K. Acute Kidney Injury Due to Leukemic Infiltration in a Patient with Chronic Lymphocytic Leukemia. Turk J Haematol 2020; 38:167-168. [PMID: 33161685 PMCID: PMC8171201 DOI: 10.4274/tjh.galenos.2020.2020.0595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Gizem Kumru Şahin
- Ankara University Faculty of Medicine, Department of Nephrology, Ankara, Turkey
| | - Hasan Emre Kocabay
- Ankara University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - Saba Kiremitçi
- Ankara University Faculty of Medicine, Department of Medical Pathology, Ankara, Turkey
| | - Osman İlhan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Kenan Keven
- Ankara University Faculty of Medicine, Department of Nephrology, Ankara, Turkey
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Karataylı E, Soydemir E, Aksoy ZB, Kızılpınar M, Altay Koçak A, Karataylı SC, Yurdcu E, Yıldırım U, Güriz H, Bozdayı G, Yurdaydın C, İlhan O, Yıldırım Y, Hdv Study Group MHGA, Bozdayı AM. Evaluation of the results of MOTAKK hepatitis C virus RNA genotyping and hepatitis delta virus external quality assessment programs during 2015-2016. Turk J Gastroenterol 2020; 30:957-963. [PMID: 31767550 DOI: 10.5152/tjg.2019.18859] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS To evaluate the HCV RNA genotyping and HDV RNA tests that are performed in molecular microbiology laboratories in Turkey as part of a national external quality assessment programme, MOTAKK (Moleküler Tanıda Kalite Kontrol) (English translation: Quality control in molecular diagnostics). MATERIALS AND METHODS Plasmas having different HCV RNA genotypes were used to prepare HCV genotype control sera. The HDV RNA main stock was prepared from patients with chronic delta hepatitis who had a significant amount of viral load detected, as per the WHO reference materials on viral load studies that were compiled for the purpose of developing HDV RNA control sera. Samples with different viral loads were prepared from this main stock by dilution. The prepared controls were delivered to the registered laboratories. The laboratories carried out the relevant tests and entered their results via the MOTAKK web page. External quality assessment (EQA) reports of the participants were uploaded to the website as well. RESULTS In total, there were 23 participating laboratories, out of which 20 exclusively performed HCV genotyping, and 15 and 16 only performed HDV RNA in 2015 and 2016, respectively. The success rate of the results of the HCV genotype was 56-96% in 2015 and 30-95% in 2016. The tube with a 30% success rate had a recombinant type of HCV, therefore, it could not be detected in most of the laboratories. The HDV RNA results were evaluated qualitatively. Accordingly, HDV RNA detection rates of participant laboratories were 71-100% in 2015 and 50-100% in 2016. CONCLUSION This study was the first national external quality control program in Turkey regarding HCV RNA genotyping and HDV RNA in the field of molecular microbiology, and it was implemented successfully.
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Affiliation(s)
| | - Ege Soydemir
- Biotechnology Institute, Ankara University, Ankara, Turkey
| | | | | | - Aylin Altay Koçak
- Hepatology Institute, Ankara University, Ankara, Turkey;Department of Medical Microbiology, Başkent University School of Medicine, Ankara, Turkey
| | | | - Esra Yurdcu
- Hepatology Institute, Ankara University, Ankara, Turkey
| | - Umut Yıldırım
- Tomurcuk Technology, Cyberpark, Bilkent, Ankara, Turkey
| | - Haluk Güriz
- Cebeci Central Laboratory, Ankara University School of Medicine, Ankara, Turkey
| | - Gülendam Bozdayı
- Department of Medical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Cihan Yurdaydın
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - Osman İlhan
- Department of Haemotology, Ankara University School of Medicine, Ankara, Turkey
| | - Yasin Yıldırım
- Department of Haemotology, Therapeutic Apheresis Center, Ankara University School of Medicine, Ankara, Turkey
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Abstract
Philadelphia (Ph*)/BCR-ABL1-positive chronic myeloid leukemia (CML) is considered as a chronic life-long disease, which could be manageable with tyrosine kinase inhibitor (TKI) drugs. The aim of TKI drug treatment is to provide age- and sex-matched duration of life in a given patient with CML. Personalized CML treatment with TKI drugs is the key strategy. Individual treatment approach includes the harmonization of CML disease characteristics, clinical experience, and best available clinical evidence. Specific CML disease characteristics in a given patient include; CML disease risk, comorbidities, molecular profile, compliance, lifestyle, and drug off-target risk profile. CML research evidence includes; randomized clinical trials indicating the data on the efficacy, safety, tolerability, toxicity, possible long-term adverse events, and pharmacoeconomy of TKIs. Clinical and physician experience includes TKI availability, TKI reimbursability, drug experience, adherence, and BCR-ABL1 monitorization facilities. The key decision of choosing a TKI of choosing TKIs for CML should be made via the consideration of these variables. The aim of this paper is to outline the latest 2016 World Health Organization definition of CML and its proper management with TKI-class drugs.
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Affiliation(s)
| | - Işınsu Kuzu
- Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Osman İlhan
- Ankara University Faculty of Medicine, Therapeutic Apheresis Unit, Department of Hematology, Ankara, Turkey
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9
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Karataylı E, Soydemir E, Aksoy ZB, Kızılpınar M, Altay Koçak A, Karataylı SC, Yurdcu E, Yıldırım U, Güriz H, Bozdayı G, Yurdaydın C, İlhan O, Yıldırım Y, Bozdayı AM. [Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA external quality assessment national program results]. MIKROBIYOL BUL 2019; 52:348-366. [PMID: 30522421 DOI: 10.5578/mb.67081] [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: 11/15/2022]
Abstract
MOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load . The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports without problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products.
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Affiliation(s)
| | - Ege Soydemir
- Ankara University Biotechnology Institute, Ankara, Turkey
| | | | | | - Aylin Altay Koçak
- Baskent University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | | | - Esra Yurdcu
- Ankara University Hepatology Institute, Ankara, Turkey
| | - Umut Yıldırım
- Tomurcuk Technology, Cyberpark, Bilkent, Ankara, Turkey
| | - Haluk Güriz
- Ankara University Faculty of Medicine, Cebeci Central Laboratory, Ankara, Turkey
| | - Gülendam Bozdayı
- Gazi University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Cihan Yurdaydın
- Ankara University Faculty of Medicine, Division of Gastroenterology, Ankara, Turkey
| | - Osman İlhan
- Ankara University Faculty of Medicine, Division of Hematology, Ankara, Turkey
| | - Yasin Yıldırım
- Ankara University Faculty of Medicine, Division of Hematology, Therapeutic Apheresis Center, Ankara, Turkey
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Varan HD, Bay M, Ozturk A, Dalva K, İlhan O. Comparison of the methods evaluating post thawing viability of peripheral blood stem cell graft. Transfus Apher Sci 2019; 58:192-195. [PMID: 30928229 DOI: 10.1016/j.transci.2019.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/23/2019] [Accepted: 03/08/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Reliable and pratique methods are essential for rapid and accurate determination of post thawing viability of peripheral blood stem cell (PBSC) graft before hematopoietic stem cell transplantation. In this study, Trypan Blue (TP) Eosin Y (EO), and Acridine-orange-ethidium bromide (AO/EB), which are of the methods commonly used for the assessment of viability in clinic practice, were compared with the flow cytometry-7AAD (7AAD) method, which is a more sensitive method. The aim of this study is to examine which method evaluates postthawing viability in a more compatible manner with 7AAD. MATERIALS-METHODS Postthawing viability rates were examined simultaneously by means of four different methods before hematopoietic stem cell transplantation in a total of 20 PBSC graft. The results obtained from the AO/EB, TP, EO methods were evaluated with the flow cytometry-7AAD in terms of concordance. RESULTS The AO / EB was determined to be the method having the best concordance with the flow cytometry-7AAD method. Although, at a lower level compared to the AO/EB method, the EO method had a statistically significant concordance with the flow cytometry-7AAD method. No statistically significant concordance was detected between the TP method and 7AAD method in terms of viability results. CONCLUSION The AO/EB method was identified to be the method having the best compatibility with the flow cytometry -7AAD method in showing the viability of the cryopreserved PBSC graft. In the viability assessment of PBCS graft using light microscopy, the EO may be preferred since is more sensitive compared to the TP method.
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Affiliation(s)
- Hacer Dogan Varan
- Ankara University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey.
| | - Meltem Bay
- Ankara University Faculty of Medicine, Department of Hematology and BMT Unit, Therapeutic Apheresis Unit, Ankara, Turkey
| | - Aydin Ozturk
- Ankara University Faculty of Medicine, Department of Hematology and BMT Unit, Stem Cell Research Institute, Ankara, Turkey
| | - Klara Dalva
- Ankara University Faculty of Medicine, Department of Hematology and BMT Unit, Stem Cell Research Institute, Ankara, Turkey
| | - Osman İlhan
- Ankara University Faculty of Medicine, Department of Hematology and BMT Unit, Ankara, Turkey
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11
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Abstract
Hematopoietic Stem Cell Transplantation (HSCT) is a well estabished treatment modality for patients with severe disorders of the hematopoietic system. HSCT is the pioneer of not the adoptive immunotherapy but also cellular therapies. It was first performed in 1957; since then the transplantation numbers have increased every year in almost all parts of the World. However, the increase in the quality of this procedure was not as fast as the numbers. The first Standards for hematopoeietic cell collection, processing and transplantation in Europe was established in 1998 by the European Group for Bone Marrow Transplantation (EBMT) and The International Society for Hematotherapy and Graft Engineering Europe I (SHAGE Europe) and the Joint Accreditation Committee of ISCT EBMT (JACIE) was founded. JACIE is a non-profit voluntary organization that helps all the stakeholders of HSCT, the teams, goverments, regulators, payers and, mostly, the patients. In this review the aims and the twenty years history of JACIE in the World and in Turkey is explained.
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Affiliation(s)
- Meltem Kurt Yüksel
- Ankara University, School of Medicine Hematology, Department and Bone Marrow Transplantation Unit, Turkey.
| | - Osman İlhan
- Ankara University, School of Medicine Hematology, Department and Bone Marrow Transplantation Unit, Turkey.
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12
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Saydam G, Haznedaroglu IC, Kaynar L, Yavuz AS, Ali R, Guvenc B, Akay OM, Baslar Z, Ozbek U, Sonmez M, Aydin D, Pehlivan M, Undar B, Dagdas S, Ayyildiz O, Akkaynak DZ, Akin G, İlhan O. Outcomes with frontline nilotinib treatment in Turkish patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase. Hematology 2018; 23:1-7. [PMID: 29486663 DOI: 10.1080/10245332.2018.1444919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES Nilotinib is a BCR-ABL1 tyrosine kinase inhibitor approved for the treatment of patients with chronic myeloid leukemia in chronic phase (CML-CP). This study was the first prospective evaluation of the efficacy and safety of nilotinib in Turkish patients with newly diagnosed CML-CP. The primary endpoint of the study was the rate of major molecular response (MMR; BCR-ABL1 ≤ 0.1% on the International Scale [BCR-ABL1IS]) by 12 months. METHODS Patients with newly diagnosed CML-CP were treated with nilotinib 300 mg twice daily. This analysis was based on the first 12 months of follow-up in a 24-month study. This study is registered with ClinicalTrials.gov (NCT01274351). RESULTS Of 112 patients enrolled, 66.1% (80% CI, 59.7-72.0%) achieved MMR and 22.3% achieved a deep molecular response of MR4.5 (BCR-ABL1IS ≤0.0032%) by 12 months. During the first year of treatment, one patient progressed to blast crisis and two patients died. Safety results were consistent with previous studies. Most adverse events (AEs) were grade 1/2. Most frequently reported nonhematologic AEs of any grade were elevations in bilirubin, alanine aminotransferase, and triglycerides. CONCLUSION These results support the use of nilotinib 300 mg twice daily as a standard-of-care treatment option for patients with newly diagnosed CML-CP with low and intermediate risk.
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Affiliation(s)
- Guray Saydam
- a Department of Internal Medicine , Ege University Medical Faculty Hospital , Izmir , Turkey
| | - Ibrahim C Haznedaroglu
- b Department of Internal Medicine , Hacettepe University Medical Faculty Hospital , Ankara , Turkey
| | - Leylagul Kaynar
- c Hematology Division , Erciyes University Medical Faculty Hospital , Kayseri , Turkey
| | - Akif S Yavuz
- d Department of Internal Medicine , Istanbul University Istanbul Medical Faculty , Istanbul , Turkey
| | - Ridvan Ali
- e Department of Internal Medicine , Uludag University Medical Faculty , Bursa , Turkey
| | - Birol Guvenc
- f Department of Internal Medicine , Cukurova University Medical Faculty Hospital , Adana , Turkey
| | - Olga M Akay
- g Department of Internal Medicine , Eskisehir Osmangazi University Medical Faculty Hospital , Eskisehir , Turkey
| | - Zafer Baslar
- h Cerrahpasa Medical Faculty , Istanbul University , Istanbul , Turkey
| | - Ugur Ozbek
- i Institute of Experimental Medicine (DETAE), Istanbul University , Istanbul , Turkey
| | - Mehmet Sonmez
- j Department of Internal Medicine , Karadeniz Technical University Medical Faculty , Trabzon , Turkey
| | - Demet Aydin
- k Hematology Department , Okmeydani Training and Research Hospital , Istanbul , Turkey
| | - Mustafa Pehlivan
- l Department of Internal Medicine , Gaziantep University Medical Faculty , Gaziantep , Turkey
| | - Bulent Undar
- m Department of Internal Medicine , Dokuz Eylul University Medical Faculty , Izmir , Turkey
| | - Simten Dagdas
- n Department of Internal Medicine , Ankara Numune Training and Research Hospital , Ankara , Turkey
| | - Orhan Ayyildiz
- o Department of Internal Medicine , Dicle University Medical Faculty Hospital , Diyarbakir , Turkey
| | | | - Gulnur Akin
- p Novartis Pharmaceuticals Corporation , Istanbul , Turkey
| | - Osman İlhan
- q Ankara University School of Medicine , Ankara , Turkey
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13
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Gündüz M, Özen M, Şahin U, Toprak SK, Civriz Bozdağ S, Kurt Yüksel M, Arslan Ö, Özcan M, Demirer T, Beksaç M, İlhan O, Gürman G, Topçuoğlu P. Subsequent malignancies after allogeneic hematopoietic stem cell transplantation. Clin Transplant 2017; 31. [PMID: 28432802 DOI: 10.1111/ctr.12987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 12/30/2022]
Abstract
We evaluated 979 patients for the development of post-transplant lymphoproliferative disease (PTLD) and solid malignancies after allogeneic hematopoietic stem cell transplantations (allo-HSCT) as a late complication. We found 15 (1.5%) subsequent malignancies; three of these malignancies were PTLD, and twelve were solid tumors. The median time from allo-HSCT to the development of PTLD was 9 (3-20) months and that from allo-HSCT to the development of solid tumors was 93 (6-316) months. The cumulative incidence of evolving subsequent malignancy in patients was 1.3% (±0.5 SE) at 5 years and 3.9% (±1.2 SE) at 10 years. The cumulative incidence of developing subsequent malignancy in patients with benign hematological diseases as the transplant indication was 7.4%±4.2 SE at 5 years. More subsequent malignancy developed in patients having ≥1 year chronic graft-vs-host disease (GVHD; 3.7% in ≥1 year chronic GVHD and 0.7% in <1 year chronic GVHD patient groups, P=.002). Subsequent epithelial tumor risk was higher in ≥1 year chronic GVHD patients than <1 year (3.7% vs 0.1%, P<.001). In multivariate analysis, benign hematological diseases as transplant indication (RR: 5.6, CI 95%: 1.4-22.3, P=.015) and ≥1 year chronic GVHD (RR: 7.1, 95% CI: 2.3-22.5, P=.001) were associated with the development of subsequent malignancy.
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Affiliation(s)
- Mehmet Gündüz
- Department of Hematology, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Mehmet Özen
- Department of Hematology, Ufuk University Faculty of Medicine, Ankara, Turkey
| | - Uğur Şahin
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Selami Koçak Toprak
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sinem Civriz Bozdağ
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meltem Kurt Yüksel
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Önder Arslan
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Muhit Özcan
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Taner Demirer
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meral Beksaç
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Osman İlhan
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Günhan Gürman
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Pervin Topçuoğlu
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
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14
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Özen M, Üstün C, Öztürk B, Topçuoğlu P, Arat M, Gündüz M, Atilla E, Bolat G, Arslan Ö, Demirer T, Akan H, İlhan O, Beksaç M, Gürman G, Özcan M. Allogeneic Transplantation in Chronic Myeloid Leukemia and the Effect of Tyrosine Kinase Inhibitors on Survival: A Quasi-Experimental Study. Turk J Haematol 2017; 34:16-26. [PMID: 27094579 PMCID: PMC5451684 DOI: 10.4274/tjh.2015.0346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: Tyrosine kinase inhibitors (TKIs) have changed the indications for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in chronic myeloid leukemia (CML). Therefore, we aimed to evaluate the effect of TKIs on allo-HSCT in CML. Materials and Methods: In this quasi-experimental study, we compared patient, disease, and transplantation characteristics as well as allo-HSCT outcomes between the pre-TKI era (before 2002) and the post-TKI era (2002 and later) in patients with CML. A total of 193 allo-HSCTs were performed between 1989 and 2012. Results: Patients in the post-TKI era had more advanced disease (>chronic phase 1) at the time of transplant and more frequently received reduced-intensity conditioning compared to patients in the pre-TKI era. Relapse/progression occurred more frequently in the year ≥2002 group than in the year <2002 group (48% vs. 32% at 5 years, p=0.01); however, overall survival (OS) was similar in these two groups (5-year survival was 50.8% vs. 59.5%, respectively; p=0.3). TKIs (with donor lymphocyte infusions or alone) for treatment of relapse after allo-HSCT were available in the post-TKI era and were associated with improved OS. While the rates of hematologic remission at 3 months after allo-HSCT were similar between TKI eras, patients having remission had better disease-free survival (DFS) [relative risk (RR): 0.15, confidence interval (CI) 95%: 0.09-0.24, p<0.001] and OS (RR: 0.14, CI 95%: 0.09-0.23, p<0.001). Male allo-HSCT recipients had worse DFS (RR: 1.7, CI 95%: 1.2-2.5, p=0.007) and OS (RR: 1.7, CI 95%: 1.1-2.6, p=0.02) than females. Conclusion: TKIs are an effective option for the treatment of relapse after allo-HSCT in CML. Hematologic remission after allo-HSCT is also an important factor for survival in CML patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Hematology and Bone Marrow Transplantation Unit, Ankara, Turkey Phone: +90-312-466 3550 E-mail: ,
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15
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Altıner Ş, Kutlay NY, İlhan O. Constitutional Trisomy 8 Mosaicism with Persistent Macrocytosis. Cytogenet Genome Res 2016; 150:35-39. [PMID: 27838684 DOI: 10.1159/000452358] [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] [Accepted: 08/01/2016] [Indexed: 11/19/2022] Open
Abstract
Constitutional trisomy 8 mosaicism (CT8M) is a rare chromosomal abnormality. The phenotype varies from normal features to severe malformations. CT8M increases the risk of developing leukemia and myelodysplastic syndrome. As CT8M is very rare, its diagnosis can easily be overlooked, especially in cases with mild phenotypes. Here, we report the diagnostic process of a 40-year-old female patient with CT8M and discuss the importance of follow-up in monitoring for hematological malignancies.
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Affiliation(s)
- Şule Altıner
- Department of Medical Genetics, Ankara University School of Medicine, Ankara, Turkey
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16
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Soyer N, Haznedaroğlu İC, Cömert M, Çekdemir D, Yılmaz M, Ünal A, Çağlıyan G, Bilgir O, İlhan O, Özdemirkıran F, Kaya E, Şahin F, Vural F, Saydam G. Multicenter Retrospective Analysis of Turkish Patients with Chronic Myeloproliferative Neoplasms. Turk J Haematol 2016; 34:27-33. [PMID: 27094252 PMCID: PMC5451685 DOI: 10.4274/tjh.2016.0005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: Chronic myeloproliferative neoplasms (CMPNs) that include polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) are Philadelphia-negative malignancies characterized by a clonal proliferation of one or several lineages. The aim of this report was to determine the demographic features, disease characteristics, treatment strategies, and survival rates of patients with CMPNs in Turkey. Materials and Methods: Across all of Turkey, 9 centers were enrolled in the study. We retrospectively evaluated 708 CMPN patients’ results including 390 with ET, 213 with PV, and 105 with PMF. Results: The JAK2V617F mutation was found positive in 86% of patients with PV, in 51.5% of patients with ET, and in 50.4% of patients with PMF. Thrombosis and bleeding at diagnosis occurred in 20.6% and 7.5% of PV patients, 15.1% and 9% of ET patients, and 9.5% and 10.4% of PMF patients, respectively. Six hundred and eight patients (85.9%) received cytoreductive therapy. The most commonly used drug was hydroxyurea (89.6%). Leukemic and fibrotic transformations occurred at rates of 0.6% and 13.2%. The estimated overall survival in PV, ET, and PMF patients was 89.7%, 85%, and 82.5% at 10 years, respectively. There were no significant differences between survival in ET, PV, and PMF patients at 10 years. Conclusion: Our patients’ results are generally compatible with the literature findings, except for the relatively high survival rate in PMF patients. Hydroxyurea was the most commonly used cytoreductive therapy. Our study reflects the demographic features, patient characteristics, treatments, and survival rates of Turkish CMPN patients.
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Affiliation(s)
- Nur Soyer
- Ege University Faculty of Medicine, Department of Hematology, İzmir, Turkey Phone: +90 232 390 42 87 E-mail:
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17
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Tekgündüz E, Şencan İ, Kapuağası A, Ünal D, Öztürk M, Gümüş E, Göker H, Tavil EB, Ertem M, Çetin M, Arat M, Soysal T, Karakaşlı O, Sur HY, Yeşilipek A, Ferhanoğlu B, Uçkan D, İlhan O, Altuntaş F. Hematopoietic cell transplantation activity of Turkey in 2014: Ongoing increase in HCT rates. Transfus Apher Sci 2016; 54:53-9. [PMID: 26899916 DOI: 10.1016/j.transci.2016.01.013] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hematopoietic cell transplantation is an established treatment option with curative potential for a variety of clinical conditions. The last decade especially witnessed a remarkable increase in HCT activity in Turkey. In 2014, 696 pediatric and 2631 adult (total 3327) HCT were performed in Turkey. Corresponding transplant rates per 10 million inhabitants for autologous-HCT and allogeneic-HCT were 226 and 202, respectively. Total HCT procedures in Turkey increased 177% in the last 5 years and 791% in the last 14 years. This report focuses mainly on HCT activity of Turkey in 2014 based on the national HCT registry and presents a general picture of national HCT activity.
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Affiliation(s)
- Emre Tekgündüz
- Hematology and HCT Transplantation Clinic, Ankara Oncology Hospital, Ankara, Turkey
| | - İrfan Şencan
- Ministry of Health, Republic of Turkey, Ankara, Turkey
| | | | - Doğan Ünal
- Ministry of Health, Republic of Turkey, Ankara, Turkey
| | - Murat Öztürk
- Ministry of Health, Republic of Turkey, Ankara, Turkey
| | - Eyüp Gümüş
- Ministry of Health, Republic of Turkey, Ankara, Turkey
| | - Hakan Göker
- School of Medicine, Department of Internal Medicine, Division of Hematology, Hacettepe University, Ankara, Turkey
| | - Emine Betül Tavil
- School of Medicine, Department of Pediatrics, Division of Hematology, Hacettepe University, Ankara, Turkey
| | - Mehmet Ertem
- Faculty of Medicine, Department of Pediatric Hematology, Ankara University, Ankara, Turkey
| | - Mustafa Çetin
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Erciyes University, Kayseri, Turkey
| | - Mutlu Arat
- HSCT Unit, Sisli Florence Nightingale Hospital, Istanbul, Turkey
| | - Teoman Soysal
- Cerrahpasa Medical School, Department of Internal Medicine, Division of Hematology, Istanbul University, Istanbul, Turkey
| | | | | | - Akif Yeşilipek
- School of Medicine, Department of Pediatric Hematology, Oncology and BMT Unit, Akdeniz University, Antalya, Turkey
| | - Burhan Ferhanoğlu
- Medical School, Department of Hematology, Koç University, Istanbul, Turkey
| | - Duygu Uçkan
- School of Medicine, Department of Pediatrics, Division of Hematology, Hacettepe University, Ankara, Turkey
| | - Osman İlhan
- Department of Internal Medicine, Division of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Fevzi Altuntaş
- Department of Internal Medicine, Division of Hematology, Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey
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Özcan ÖU, Sayın T, Soğut G, Heper A, Göksülük H, Vurgun VK, Kaya CT, Üstün EE, İlhan O, Erol Ç. Quilty effect after extracorporeal photopheresis in a patient with severe refractory cardiac allograft rejection. Turk J Haematol 2014; 31:430-1. [PMID: 25541667 PMCID: PMC4454065 DOI: 10.4274/tjh.2014.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Özgür Ulaş Özcan
- Ankara University Faculty of Medicine, Department of Cardiology, Ankara, Turkey. E-mail:
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Özen M, Yılmaz G, Coşkun B, Topçuoğlu P, Öztürk B, Gündüz M, Atilla E, Arslan Ö, Özcan M, Demirer T, İlhan O, Konuk N, Balık İ, Gürman G, Akan H. A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction. Turk J Haematol 2014; 33:41-7. [PMID: 26376622 PMCID: PMC4805340 DOI: 10.4274/tjh.2014.0010] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: The increased risk of infection for patients caused by construction and renovation near hematology inpatient clinics is a major concern. The use of high-efficiency particulate absorption (HEPA) filters can reduce the risk of infection. However, there is no standard protocol indicating the use of HEPA filters for patients with hematological malignancies, except for those who have undergone allogeneic hematopoietic stem cell transplantation. This quasi-experimental study was designed to measure the efficacy of HEPA filters in preventing infections during construction. Materials and Methods: Portable HEPA filters were placed in the rooms of patients undergoing treatment for hematological malignancies because of large-scale construction taking place near the hematology clinic. The rates of infection during the 6 months before and after the installation of the portable HEPA filters were compared. A total of 413 patients were treated during this 1-year period. Results: There were no significant differences in the antifungal prophylaxis and treatment regimens between the groups. The rates of infections, clinically documented infections, and invasive fungal infections decreased in all of the patients following the installation of the HEPA filters. When analyzed separately, the rates of invasive fungal infections were similar before and after the installation of HEPA filters in patients who had no neutropenia or long neutropenia duration. HEPA filters were significantly protective against infection when installed in the rooms of patients with acute lymphocytic leukemia, patients who were undergoing consolidation treatment, and patients who were neutropenic for 1-14 days. Conclusion: Despite the advent of construction and the summer season, during which environmental Aspergillus contamination is more prevalent, no patient or patient subgroup experienced an increase in fungal infections following the installation of HEPA filters. The protective effect of HEPA filters against infection was more pronounced in patients with acute lymphocytic leukemia, patients undergoing consolidation therapy, and patients with moderate neutropenia.
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Affiliation(s)
- Mehmet Özen
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey. Phone: +90 312 595 70 99 E-mail:
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20
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Tekgündüz E, Altuntaş F, Şıvgın S, Akı ŞZ, Dönmez A, Topçuoğlu P, Yıldırım R, Baysal NA, Ayyıldız E, Yüksel MK, Sarı İ, Tombuloğlu M, Ünal A, İlhan O. Plerixafor use in patients with previous mobilization failure: A multicenter experience. Transfus Apher Sci 2012; 47:77-80. [DOI: 10.1016/j.transci.2012.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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Şanlı H, Akay BN, Soydan E, Koçyiğit P, Arat M, İlhan O. Clinical Aspects Of Sclerodermatous Type Graft-Versus-Host Disease After Allogeneic Hematopoietic Cell Transplantation. Turk J Haematol 2010; 27:91-8. [PMID: 27263450 DOI: 10.5152/tjh.2010.06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE We aimed to evaluate the clinical features of sclerodermatous chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (AHSCT). METHODS We retrospectively analyzed 423 patients who underwent AHSCT. We assessed age, sex, pre-transplant diagnosis, conditioning regimen, GVHD prophylaxis, and occurrence of acute GVHD (aGVHD), chronic lichenoid and chronic systemic GVHD, and clinical properties of sclerodermatous GVHD. RESULTS Sclerotic skin lesions developed in 22 patients after a mean of 752±647 days (median 480). aGVHD appeared in 17 patients, with hepatic involvement in 2, gastrointestinal tract involvement in 2 and skin involvement in 13 of these patients. Extensive chronic GVHD (liver, pulmonary, skin and oral mucosa) developed in 12 patients. Sclerosis was generalized in 19 patients (86.4%) and localized in 3 patients (13.6%). Leopard skin eruption appeared in 8 (36.4%) of the 19 patients with generalized sclerodermatous changes. In most cases, sclerotic lesions appeared on the trunk, and distal parts of the extremities were spared. Eight patients (36.4%) progressed from lichenoid to sclerodermatous lesions, 2 (9.1%) with lichenoid and sclerodermatous phases together and 12 (55.5%) with de novo sclerodermatous lesions. Five patients died because of late transplant-related complications. CONCLUSION Sclerodermatous GVHD has a late onset and may be quite disabling. Unlike scleroderma, acral involvement is seen rarely. Although most lesions do not disappear in the course of the disease, most patients have a good prognosis.
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Affiliation(s)
| | - Bengü Nisa Akay
- Department of Dermatology, Ankara University Faculty of medicine Ibni Sina Hospital, 06100 Ankara, Turkey Phone: +90 312 508 25 58 E-mail:
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İlhan O, Topçuoğlu P, Arat M, Soydan EA, Yuksel MK, Arslan Ö, Özcan M, Gürman G, Demirer T, Akan H, Konuk N, Uysal A. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute myeloblastic leukemia (AML): A single center experience. Turk J Haematol 2008; 25:87-93. [PMID: 27264446] [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
OBJECTIVE We retrospectively analyzed the impact of pre- and post-transplant variables on the outcome of transplanta¬tion in 145 consecutive patients with acute myeloblastic leukemia (AML) allografted from their HLA-identical siblings in our single center cohort. RESULTS The stem cell source used was bone marrow (BM) (36.6%) or peripheral blood (PB) (63.4%). Both neutrophil and platelet engraftments were observed on the median 14th day. Engraftment was faster in the PB group than in the BM group (p<0.0001). Severe acute graft versus host disease (aGvHD) was observed in 27.9% of the patients while chronic (c)GvHD developed in 61.2%. The use of PB was associated with more severe aGvHD. Estimated leukemia-free survival (LFS) and overall survival (OS) at 10 years were 43.4%±5.2% and 52.7%±4.6%, respectively. CONCLUSION Both in univariate and multivariate analyses for LFS and OS, remission status at transplant and the presence of aGvHD were independent risk factors.
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Affiliation(s)
- Osman İlhan
- Department of Hematology, Stem Cell Transplantation Unit, Ankara University Faculty of Medicine, Ankara, Turkey, Tel: +90 312 595 70 99 E-mail:
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Coşkun HŞ, İlhan O, Özcan M, Ayaz S, Dalva K, Üstün C, Arat M. Serum transforming growth factor beta 1 levels in multiple myeloma patients. Turk J Haematol 2006; 23:47-52. [PMID: 27265228] [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
Cytokinesis plays an important role in the etiology of multiple myeloma. The transforming growth factor (TGF) beta 1 levels in 82 sera from 60 patients with multiple myeloma were analyzed by ELISA. Fourty one sample were obtained before treatment from newly diagnosed patients, 22 after treatment from the same patients and 19 from relapsed/refractory patients. Serum median TGF level of newly diagnosed patients was 769.5 ng/mL (126-1853), and the relapsed/refractory patients had similar levels. TGF levels after chemotherapy were not different between patients that reached plateau phase and those who remained refractory. We found a negative correlation between TGF and C-reactive protein and blood urea nitrogen and a positive correlation between TGF and hemoglobin level in newly diagnosed patients. After treatment, it was determined that TGF levels at diagnosis were higher in patients who reached plateau phase than in the refractory patients. Elevated serum TGF concentration at diagnosis in multiple myeloma patients may be a favorable predictor of response.
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Akar R, Durdu S, Arat M, Eren NT, Arslan Ö, Çorapçıoğlu T, Sancak T, Uzun B, Kİr M, İlhan O, Özyurda Ü. Therapeutic Angiogenesis by Autologous Transplantation of Bone Marrow Mononuclear Cells for Buerger's Patients with Retractable Limb Ischaemia: A Preliminary Report. Turk J Haematol 2004; 21:13-21. [PMID: 27263642] [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
Bone marrow implantation into ischaemic limbs could enhance angiogenesis by supplying endothelialprogeniter cells and angiogenic cytokinesot factors. We investigated efficacy and safety of autologousimplantation of bonemarrow-mononuclearcells (BMMC)in patients with ischaemic limbs due to Buerger's disease. We commence daciinical study to test cell therapy with autologous BMMC in patients with ischaemic limbs at the University of Ankara School of Medicine. In order for the patients to qualify for BMMC implantation, they should have critical limb ischaemia define das ischaemic rest painin a limb with or without non healing ulcers, should not respond to previous iloprost infusions and smoking cessation six months prior to evaluation and should not be candidates for nonsurgicalor surgical revascularisation. Primaryend points were safety andfeasibility of the treatmentand total healing of the most importantlesion. Secondary endpoints were total relief of rest pain without the need for analgesies,change in peak walkingtime (PWT)at 12 weeks, improvements in ankle-brachial pressure index(ABI), transcutaneous oxygen saturation using pulse oximetry(SaO2),angiographic evidence of newcollatera lvesselformation, tissue perfusion in the affected extremity using Thallium perfusions cintigraphyW. hilepatients(meanage46.7: !: 10.3years)were undergeneraal naesthesiaw, eharvested bonemarrow(519: t 45.5mUfromtheposteridilriacspineA. fterredbloodcell(RBCd) epletiaannd volumereduction using a continuous flow cell separator,we achieved 91% RBC depletian and concentrated /~MMC to a final volume and concentration of 51.5: t io.1 mLand7.04: t 1.9 x ioe7/mL total nucleated cells, respectively W.eimplantedBMMC (mean12.16: t 4.3 x ioe8) within three hours after marrow aspiration by intramuscular injection into the gastrocnemiusmuscle of ischaemic legs. Isotonic saline were injected into the other extremityin as similar fashion as control. 13 Unilateral intramuscular administration of BMMC was not associated with any complications. The primary efficacy end point, total healing of the most importantlesion, was achieved in three patients. All patients were followed up for at least four weeks. The secondary measures; change in PWT(LlPWT)at 12 weeks, total relief of rest pain without the need of analgesics improved in three patjents. These improvements were sustained for 24 weeks in the first two patients. Digital subtraction angiographic studies before and 3 months after the BMMC implantation showed the presence of a new vascular collateral network across the affected arteries in three patients. Preliminary results of the presentedstudy are promising. Thus, bone marrow maybe a potential source of cells for Buerger'spatients with end-stage Iimbischaemia refractory to other medical treatment modalities.
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Kurt Yüksel M, Arat M, Arslan Ö, Beksaç M, İlhan O. Autologous Platelet Collection and Storage to Support Thrombocytopenia in a Leukemia Patient with Platelet Alloimmunization Undergoing Chemotherapy. Turk J Haematol 2003; 20:233-236. [PMID: 27263520] [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
Platelet alloimmunization occurs frequently in multitransfused patients. To prevent the posttransfusion complications donor white blood cells (WBCs) must be removed from the platelet concentrates (PC). But sometimes the centrifugation and filtration of WBC is not enough and in such conditions HLA-matched PC are recommended. Cryopreservation of autologous PC offers a potential solution to this problem. We investigated the feasibility of supporting the aplastic period after chemotherapy in a 54-year-old leukemia patient with autologous platelets collected by apheresis and cryopreserved. Our case report demonstrates that autologous apheresis platelet transfusion might be a feasible approach to high risk patients with bleeding tendencies.
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Arslan Ö, Arat M, Göktürk S, Ayyıldız E, İlhan O. Therapeutic Plasma Exchange and the Clinical Applications. Turk J Haematol 2003; 20:7-17. [PMID: 27265329] [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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Alanoğlu G, Özet G, Dalva K, Kuzu I, Erekul S, İlhan O, Beksaç M. Extramedullary Presentation of Biclonal IgGk and IgAk Multiple Myeloma. Turk J Haematol 2002; 19:421-425. [PMID: 27264980] [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
Multiple myeloma is characterized by plasma cell infiltration of the bone marrow and the presence of a monoclonal protein in the plasma or the urine in 90% of cases. Major manifestations of the disease are bone pain, anemia, renal insufficiency and recurrent infections. Less frequent presentations are hepatic and splenic enlargement (5% of cases), lymphadenopathy (4%) and biclonal gammopathy (1%). In this report we describe a biclonal multiple myeloma presenting with cervical lymphadenopathy and sternal mass. The immunohistochemical study of the lymph node and the flow cytometric analysis of the bone marrow showed IgGk and IgAk biclonality. In this report the features of lymph node involvement and biclonality constitute a rare presentation of multiple myeloma.
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Arıkan Akan Ö, Bengisun JS, Batı A, Arat M, İlhan O, Akan H. A Case of Catheter Related Septicemia Caused by Corynebacterium jeikeium. Turk J Haematol 2002; 19:47-50. [PMID: 27264626] [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
Corynebacterium spp. has been gaining importance in immunosuppressive patients. This report of a 15-year-old girl with acute myeloblastic leukemia who developed catheter related septicemia with Corynebacterium jeikeium is presented to point out the importance of microorganisms of the normal flora, which were dismissed as contaminants in Clinical Microbiology Laboratories in the past.
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Dilek İ, İdilman R, Fenkçi S, Üstün C, Koç H, İlhan O, Akan H. Immunosuppressive Therapy-Induced Hepatotoxicity in Patients with Aplastic Anemia. Turk J Haematol 2000; 17:111-117. [PMID: 27263500] [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
Immunosuppressive therapy is a treatment for aplastic anemia patients who are not candidates for hematopoietic stem cell transplantation. The aim of the study to evaluate the frequency and severity of immunosuppressive therapy-induced hepatotoxicity in patients with aplastic anemia. The records of 27 patients with aplastic anemia who had eceived immunosuppressive therapy were received and determined for evidence of hepatotoxicity. The patients were divided into three groups. Group 1 was treated with antithymocyte/antilymphocyte globulin and cyclosporin A, group 2 received onl yyclosporin-A and group 3 was treated with antithymocyte/antilymphocyte globulin + cyclosporin-A and granulocyte macrophage colony-stimulating factor. All patients in group 1 had an initial increase in AST and ALT levels after therapy, but these tests abnormalities returned to normal in each case (p> 0.05). There was no detectable change in AST and ALT levels in group 2 (p>0.05). In group 3, five patients had an increase in ALT and AST levels in the initial several days after therapy was started but he levels gradually returnedto normal by the second or third week of therapy.
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İdilman R, Üstün C, Aslan Ö, Özcan M, Arat M, Bozkaya H, Bozdayı M, Şengezer T, Uzunalimoğlu Ö, Dökmeci A, İlhan O, Koç H, Akan H. The Incidence of Hepatitis G Virus in Patients with Hematological Malignancies: The Relationship to the Number of Blood and Blood Products Transfusions. Turk J Haematol 2000; 16:67-71. [PMID: 27265856] [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
The hepatitis G virus has been detected in patients with post-transfusion hepatitis. The precise transmission rate of the hepatitis G virus is not clear. This study aims to investigate the transmission rate of HGV and the relationship between the number of blood transfusions and the blood products used in multitransfused patients with hematological malignancies. Serum samples were obtained from 80 patients with hematologic malignancies hospitalized between January 1997 and December 1998 at Ibn'i Sina Hospital, University of Ankara. The patients were divided into three groups according to transfusion numbers. Group A received between 0 and 10 units of blood and blood products, Group B received 10-20 units, and Group C received more than 20 units. All patients received blood and blood products for a median of 6.8 Units/whole life. The hepatitis G virus was detected using the reverse transcription polymerase chain reaction. Of the eighty patients, four (5.0 %) were HBs-Ag positive, one (1.25%) was Anti-HCV positive, and one (1.25%) was HGV-RNA positive. Multiple blood transfusions may be an important risk factor for transmission-transmitted viral infections, but based upon the present experience, there is no significant relationship between the number of blood transfusions and blood products and the transmission rate of HGV infection in patients with hematological malignancies.
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