1
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Montoro J, Boumendil A, Finel H, Bramanti S, Castagna L, Blaise D, Dominietto A, Kulagin A, Yakoub-Agha I, Tbakhi A, Solano C, Giebel S, Gulbas Z, López Corral L, Pérez-Simón JA, Díez Martín JL, Sanz J, Farina L, Koc Y, Socié G, Arat M, Jurado M, Bermudez A, Labussière-Wallet H, Villalba M, Ciceri F, Martinez C, Nagler A, Sureda A, Glass B. Post-Transplantation Cyclophosphamide-Based Graft-versus-Host Disease Prophylaxis in HLA-Matched and Haploidentical Donor Transplantation for Patients with Hodgkin Lymphoma: A Comparative Study of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation. Transplant Cell Ther 2024; 30:210.e1-210.e14. [PMID: 38043802 DOI: 10.1016/j.jtct.2023.11.021] [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: 10/10/2023] [Revised: 11/15/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023]
Abstract
Post-transplantation cyclophosphamide (PTCy) has emerged as a promising approach for preventing graft-versus-host disease (GVHD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, there is a lack of studies examining the impact of this GVHD prophylaxis when different donor types are used in patients with Hodgkin lymphoma (HL). This study compared the outcomes of patients with HL undergoing HSCT from HLA-matched donors, including matched sibling donors (MSDs) and matched unrelated donors (MUDs), and haploidentical donors, using PTCy as the GVHD prophylaxis approach in all cohorts. We retrospectively compared outcomes of allo-HSCT from 166 HLA-matched donors (96 sibling and 70 unrelated donors) and 694 haploidentical donors using PTCy-based GVHD prophylaxis in patients with HL registered in the European Society for Blood and Marrow Transplantation database from 2010 to 2020. Compared to HLA-matched HSCT, haploidentical donor HSCT was associated with a significantly lower rate of platelet engraftment (86% versus 94%; P < .001) and a higher rate of grade II-IV acute GVHD (34% versus 24%; P = .01). The 2-year cumulative incidence of nonrelapse mortality (NRM) was significantly lower in the HLA-matched cohort compared to the haploidentical cohort (10% versus 18%; P = .02), resulting in a higher overall survival (OS) rate (82% versus 70%; P = .002). There were no significant differences between the 2 cohorts in terms of relapse, progression-free survival, or GVHD-free relapse-free survival. In multivariable analysis, haploidentical HSCT was associated with an increased risk of grade II-IV acute GVHD and NRM and worse OS compared to HLA-matched HSCT. Our findings suggest that in the context of PTCy-based GVHD prophylaxis, transplantation from HLA-matched donors appears to be a more favorable option compared to haploidentical HSCT.
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Affiliation(s)
- Juan Montoro
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Universidad Católica de Valencia, Spain.
| | - Ariane Boumendil
- European Society for Blood and Marrow Transplantation Lymphoma Working Party, Paris, France
| | - Hervé Finel
- European Society for Blood and Marrow Transplantation Lymphoma Working Party, Paris, France
| | - Stefania Bramanti
- Department of Oncology/Hematology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Luca Castagna
- Department of Oncology/Hematology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Didier Blaise
- Programme de Transplantation and Therapie Cellulaire, Marseille, France
| | - Alida Dominietto
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Aleksandr Kulagin
- RM Gorbacheva Research Institute, Pavlov University, Saint Petersburg, Russia
| | | | | | - Carlos Solano
- Hematology Department, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
| | - Sebastian Giebel
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Zafer Gulbas
- Anadolu Health Center Avliated John Hopkins, Kocaeli, Gebze, Turkey
| | | | - José A Pérez-Simón
- Servicio de Hematología, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), CSIC, Universidad de Sevilla, Spain
| | | | - Jaime Sanz
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Lucia Farina
- University of Milan. Hematology Division, Fondazione IRCCS Istituto. Nazionale dei Tumori di Milano, Milan, Italy
| | - Yener Koc
- Medical Park Hospitals, Beylikduzu, Istanbul, Turkey
| | - Gerard Socié
- Department of Hematology - BMT, Hematology Transplantation, Paris, France
| | - Mutlu Arat
- Demiroglu Bilim University Istanbul Florence Nightingale Hospital, Hematopoietic SCT Unit, Istanbul, Turkey
| | | | | | | | - Marta Villalba
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, Milano, Italy
| | - Carmen Martinez
- Hematopoietic Stem Cell Transplantation Unit, Hospital Clínic de Barcelona, Institute of Cancer and Blood Diseases, Barcelona, Spain
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Anna Sureda
- Hematology Department. Institut Català d'Oncologia, Hospital Duran i Reynals. Institut d'Investigació Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Bertram Glass
- Department of Hematology, Oncology and Stem Cell Transplantation, Asklepios Klinik St. Georg, Hamburg, Germany
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Birtas Atesoglu E, Gulbas Z, Uzay A, Ozcan M, Ozkalemkas F, Dal MS, Kalyon H, Akay OM, Deveci B, Bekoz H, Sevindik OG, Toptas T, Yilmaz F, Koyun D, Alkis N, Alacacioglu I, Sonmez M, Yavasoglu I, Tombak A, Mehtap O, Kurnaz F, Yuce OK, Karakus V, Turgut M, Kurekci DD, Ayer M, Keklik M, Buyuktas D, Ozbalak M, Ferhanoglu B. Glofitamab in relapsed/refractory diffuse large B-cell lymphoma: Real-world data. Hematol Oncol 2023; 41:663-673. [PMID: 37211991 DOI: 10.1002/hon.3174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 05/23/2023]
Abstract
Glofitamab is a CD3xCD20 bi-specific antibody with two fragments directed to the CD20 antigen and a single CD3-binding fragment. Encouraging response and survival rates were recently reported in a pivotal phase II expansion trial conducted in patients with relapsed/refractory (R/R) B-cell lymphoma. However, the real-world data of patients of all ages with no strict selection criteria are still lacking. Herein, this retrospective study aimed to evaluate the outcomes of diffuse large B-cell lymphoma (DLBCL) patients who received glofitamab via compassionate use in Turkey. Forty-three patients from 20 centers who received at least one dose of the treatment were included in this study. The median age was 54 years. The median number of previous therapies was 4, and 23 patients were refractory to first-line treatment. Twenty patients had previously undergone autologous stem cell transplantation. The median follow-up time was 5.7 months. In efficacy-evaluable patients, 21% and 16% of them achieved complete response and partial response, respectively. The median response duration was 6.3 months. The median progression-free survival (PFS) and overall survival (OS) was 3.3 and 8.8 months, respectively. None of the treatment-responsive patients progressed during the study period, and their estimated 1-year PFS and OS rate was 83%. The most frequently reported toxicity was hematological toxicity. Sixteen patients survived, while 27 died at the time of the analysis. The most common cause of death was disease progression. One patient died of cytokine release syndrome during the first cycle after receiving the first dose of glofitamab. Meanwhile, two patients died due to glofitamab-related febrile neutropenia. This is the largest real-world study on the effectiveness and toxicity of glofitamab treatment in R/R DLBCL patients. The median OS of 9 months seems promising in this heavily pretreated group. The toxicity related mortality rates were the primary concerns in this study.
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Affiliation(s)
- Elif Birtas Atesoglu
- Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey
| | - Zafer Gulbas
- Division of Hematology, Anadolu Medical Center, Kocaeli, Turkey
| | - Ant Uzay
- Division of Hematology, Acibadem Atakent Hospital, Istanbul, Turkey
| | - Muhit Ozcan
- Department of Internal Medicine, Division of Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Fahir Ozkalemkas
- Department of Internal Medicine, Division of Hematology, Uludag University Medical Faculty, Bursa, Turkey
| | - Mehmet Sinan Dal
- Division of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital, Ankara, Turkey
| | - Hakan Kalyon
- Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey
| | - Olga Meltem Akay
- Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey
| | - Burak Deveci
- Division of Hematology, Medstar Hospital, Antalya, Turkey
| | - Huseyin Bekoz
- Department of Internal Medicine, Division of Hematology, Medipol University Medical Faculty, Istanbul, Turkey
| | - Omur Gokmen Sevindik
- Department of Internal Medicine, Division of Hematology, Medipol University Medical Faculty, Istanbul, Turkey
| | - Tayfur Toptas
- Department of Internal Medicine, Division of Hematology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Fergun Yilmaz
- Department of Internal Medicine, Division of Hematology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Derya Koyun
- Department of Internal Medicine, Division of Hematology, Ankara University Medical Faculty, Ankara, Turkey
| | - Nihan Alkis
- Division of Hematology, Bursa City Hospital, Bursa, Turkey
| | - Inci Alacacioglu
- Department of Internal Medicine, Division of Hematology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| | - Mehmet Sonmez
- Department of Internal Medicine, Division of Hematology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Irfan Yavasoglu
- Department of Internal Medicine, Division of Hematology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Anil Tombak
- Department of Internal Medicine, Division of Hematology, Mersin University Medical Faculty, Mersin, Turkey
| | - Ozgur Mehtap
- Department of Internal Medicine, Division of Hematology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Fatih Kurnaz
- Division of Hematology, Kocaeli Medicalpark Hospital, Kocaeli, Turkey
| | - Orhan Kemal Yuce
- Department of Internal Medicine, Division of Hematology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Volkan Karakus
- Division of Hematology, Antalya Research and Training Hospital, Antalya, Turkey
| | - Mehmet Turgut
- Department of Internal Medicine, Division of Hematology, Ondokuzmayıs University Medical Faculty, Samsun, Turkey
| | - Derya Deniz Kurekci
- Department of Internal Medicine, Division of Hematology, Ondokuzmayıs University Medical Faculty, Samsun, Turkey
| | - Mesut Ayer
- Division of Hematology, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey
| | - Muzaffer Keklik
- Department of Internal Medicine, Division of Hematology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Deram Buyuktas
- Division of Hematology, V.K.V. American Hospital, Istanbul, Turkey
| | - Murat Ozbalak
- Division of Hematology, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey
| | - Burhan Ferhanoglu
- Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey
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Zinzani PL, Thieblemont C, Melnichenko V, Bouabdallah K, Walewski J, Majlis A, Fogliatto L, Garcia-Sancho AM, Christian B, Gulbas Z, Özcan M, Perini GF, Ghesquieres H, Shipp MA, Thompson S, Chakraborty S, Marinello P, Armand P. Pembrolizumab in relapsed or refractory primary mediastinal large B-cell lymphoma: final analysis of KEYNOTE-170. Blood 2023; 142:141-145. [PMID: 37130017 PMCID: PMC10651864 DOI: 10.1182/blood.2022019340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/02/2023] [Accepted: 04/10/2023] [Indexed: 05/03/2023] Open
Abstract
Previous analyses of the phase 2 KEYNOTE-170 (NCT02576990) study demonstrated effective antitumor activity and acceptable safety of pembrolizumab 200 mg given every 3 weeks for up to 35 cycles (∼2 years) in patients with relapsed/refractory (R/R) primary mediastinal B-cell lymphoma (PMBCL) whose disease progressed after or who were ineligible for autologous stem cell transplantation. The end points included objective response rate (ORR), progression-free survival (PFS), and duration of response (DOR) according to the investigator per 2007 Response Criteria; overall survival (OS); and safety. In this final analysis, median duration of follow-up was 48.7 months (range, 41.2-56.2). The ORR was 41.5% (complete response, 20.8%; partial response, 20.8%). The median DOR was not reached; no patients who achieved a complete response progressed at the data cutoff. The median PFS was 4.3 months; the 4-year PFS rate was 33.0%. The median OS was 22.3 months; the 4-year OS rate was 45.3%. At the data cutoff, 30 patients (56.6%) had any-grade treatment-related adverse events (AEs); the most common were neutropenia, asthenia, and hypothyroidism. Grade 3/4 treatment-related AEs occurred in 22.6% of the patients; no grade 5 AEs occurred. After 4 years of follow-up, pembrolizumab continued to provide durable responses, with promising trends for long-term survival and acceptable safety in R/R PMBCL.
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Affiliation(s)
- Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli," Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | | | - Vladimir Melnichenko
- Department of Medical Oncology, Pirogov National Medical Surgical Center, Moscow, Russia
| | - Krimo Bouabdallah
- Department of Hematology and Cellular Therapy, University Hospital, Bordeaux, France
| | - Jan Walewski
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, European Reference Network, Warsaw, Poland
| | - Alejandro Majlis
- Department of Hemato-Oncology, Clinica Alemana de Santiago, Santiago, Chile
| | - Laura Fogliatto
- Department of Clinical Hematology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - A Martin Garcia-Sancho
- Department of Hematology, Hospital Universitario de Salamanca, Institute of Biomedical Research of Salamanca, Centro de Investigación Biomédica en Red Cáncer, Salamanca, Spain
| | - Beth Christian
- Division of Hematology, The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH
| | - Zafer Gulbas
- Department of Hematologic Oncology, Anadolu Medical Center, Gebze, Turkey
| | - Muhit Özcan
- Department of Hematology and Bone Marrow Transplantation Unit, Ankara University School of Medicine, Ankara, Turkey
| | | | - Herve Ghesquieres
- Department of Clinical Hematology, Lyon-Sud Hospital Center, Lyon, France
| | - Margaret A Shipp
- Department of Hematologic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Seth Thompson
- Department of Medical Oncology, Merck & Co, Inc, Rahway, NJ
| | | | | | - Philippe Armand
- Department of Hematologic Oncology, Dana-Farber Cancer Institute, Boston, MA
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4
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Ye Y, Labopin M, Chen J, Gulbas Z, Zhang X, Koc Y, Blaise D, Ciceri F, Polge E, Houhou M, Li L, Luo Y, Wu D, Huang H, Mohty M, Gorin NC. Similar outcomes following non-first-degree and first-degree related donor haploidentical hematopoietic cell transplantation for acute leukemia patients in complete remission: a study from the Global Committee and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. J Hematol Oncol 2023; 16:25. [PMID: 36934271 PMCID: PMC10024403 DOI: 10.1186/s13045-023-01421-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/08/2023] [Indexed: 03/20/2023] Open
Abstract
There are situations where non-first-degree (NFD) related donors have to be considered as alternatives to first-degree (FD) related donors for haploidentical hematopoietic cell transplantation (HAPLO). However, the efficacy of these NFD related transplants remains uncertain. All consecutive adult patients (≥ 18 years) with acute myelogenous leukemia (AML) or acute lymphocytic leukemia (ALL) in CR who underwent a first HAPLO between 2010 and 2021 in the European Society for Blood and Marrow Transplantation (EBMT) registry were analyzed. Exact matching and propensity score matching was used. The NFD-to-FD ratio was 1:3. 2703 patients (AML: n = 2047; ALL: n = 656) in CR received a first HAPLO from either NFD (n = 154) or FD (n = 2549) related donors in 177 EBMT centers. 123 NFD and 324 FD HAPLO were included for analysis after matching. Median patient age was 35.6 and 37.2 for the NFD and FD cohorts, respectively. Both cohorts reached good engraftment rates (NFD: 95.7% vs. FD, 95.6%; p = 0.78). The 2-year relapse incidence (NFD, 21.1% vs. FD, 22.6%; p = 0.84) and non-relapse mortality (NRM) (NFD, 13.2% vs. FD, 17.7%; p = 0.33) were not significantly different. The 2-year overall survival (OS) (NFD, 71.8% vs. FD, 68.3%; p = 0.56), leukemia-free survival (LFS) (NFD, 65.7% vs. FD, 59.7%; p = 0.6) and graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) (NFD, 50.9% vs. FD, 47.8%; p = 0.69) also showed no significant differences. The two cohorts showed no difference in terms of cumulative day 180 grade II-IV, grade III-IV acute GVHD, 2-year cumulative incidences of chronic and extensive chronic GVHD. For HAPLO in patients with acute leukemia, NFD related donors could be equivalent substitutions when FD related donors are not available.
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Affiliation(s)
- Yishan Ye
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, China
| | - Myriam Labopin
- EBMT Global Committee (Shanghai and Paris Offices) and Acute Leukemia Working Party, Hospital Saint-Antoine APHP and Sorbonne University, Paris, France
| | - Jia Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zafer Gulbas
- Anadolu Medical Center Hospital Bone Marrow Transplantation Department, Kocaeli, Turkey
| | - Xi Zhang
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Chongqing, China
| | - Yener Koc
- Medicana International Hospital Istanbul, Bone Marrow Transplant Unit, Istanbul, Turkey
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Fabio Ciceri
- Ospedale San Raffaele S.R.L., Haematology and BMT, Milan, Italy
| | - Emmanuelle Polge
- EBMT Global Committee (Shanghai and Paris Offices) and Acute Leukemia Working Party, Hospital Saint-Antoine APHP and Sorbonne University, Paris, France
| | - Mohamed Houhou
- EBMT Global Committee (Shanghai and Paris Offices) and Acute Leukemia Working Party, Hospital Saint-Antoine APHP and Sorbonne University, Paris, France
| | - Lin Li
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, China
| | - Yi Luo
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, China
| | - Depei Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, China.
| | - Mohamad Mohty
- EBMT Global Committee (Shanghai and Paris Offices) and Acute Leukemia Working Party, Hospital Saint-Antoine APHP and Sorbonne University, Paris, France.
- Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Sorbonne University, Paris, France.
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France.
| | - Norbert-Claude Gorin
- EBMT Global Committee (Shanghai and Paris Offices) and Acute Leukemia Working Party, Hospital Saint-Antoine APHP and Sorbonne University, Paris, France.
- Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Sorbonne University, Paris, France.
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France.
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Meric N, Parmaksız A, Gulbas Z. Patients experienced serious adverse reactions within one hour of hematopoietic stem-cell infusion. Transfus Clin Biol 2023; 30:82-86. [PMID: 35987476 DOI: 10.1016/j.tracli.2022.08.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 02/07/2023]
Abstract
METHODS SARs were examined occurred within 1 hour after initiating HSC product infusions in all HSCT done in Turkey's Anadolu Medical Center Hospital accredited for HSCTs between 2013 and 2015, targeting 315 patients. RESULTS SARs were carefully evaluated in this study based on a comparison of the amount of stem cells infused, age, frozen sample (FS) / non-frozen samples (NFS) between HSCs sources. Rate of SARs is significantly higher in FS infusions supports the hypothesis that DMSO plays an important role in the development of SAR. CONCLUSION The rate of SARs is significantly higher in infusions given using FSs confirms the hypothesis that the preservative agent DMSO plays an important role in the development of SAR. Our study provides guidance for future studies on the necessity of reducing the amount of DMSO in the HSCT product and using other alternative freezing agents instead of DMSO.
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Affiliation(s)
- Neslihan Meric
- Faculty of Engineering and Natural Sciences, Department of Molecular Biology and Genetics, Kütahya University of Health Sciences, Kütahya, Turkey.
| | - Ayhan Parmaksız
- Faculty of Medicine, Istanbul Health and Technology University, Istanbul, Turkey
| | - Zafer Gulbas
- Anadolu Health Center, Bone Marrow Transplantation Center, Kocaeli, Turkey
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Paksoy N, Ferhatoglu F, Dogan İ, Khanmammadov N, Iribas Celik A, Gulbas Z, Başaran M. High-dose chemotherapy followed by autologous stem cell transplantation for adult patients With first relapse of Ewing's sarcoma: A single institution experience. Medicine (Baltimore) 2022; 101:e32213. [PMID: 36626465 PMCID: PMC9750591 DOI: 10.1097/md.0000000000032213] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The prognosis of patients with Ewing's sarcoma family of tumors (ESFT) relapse is poor; the 5-year overall survival (OS) is 13%. We evaluated the effectivity of high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) in adult patients with ESFT relapse. Between January 2010 and January 2021, we retrospectively analyzed 20 patients with ESFT who received HDT upon relapse. A combination of busulfan with melphalan was used as a conditioning regimen before ASCT. The median follow-up from diagnosis and from first relapse was 46.08 months (range; 10.71-186.87) and 14.41 months (range; 4.34-104.11), respectively. The median of age patients was 21.2 years (range, 17.6-25.3), and 10 (50%) patients were female. The tumor originated from the bone in 13 patients and soft tissue in 7 patients. Twelve patients had early (<2 years) relapse, and 8 patients had late (>2 years) relapse. Before HDT, 13 (65%) and 7 (35%) patients had pulmonary and extrapulmonary metastasis, respectively. After induction chemotherapy, 14 patients achieved complete response. The median OS1 and OS2 were 51.6 months (95% confidence interval [CI], range: 16.2-87) and 15.7 months (95% CI, range: 10.2-21.2), respectively. The 1-, 2-, and 5-year OS rates were 50%, 30%, and 15%, respectively. One patient died (sepsis) 1 month after ASCT. In univariate analyses, a disease-free interval (DFI) of < 2 years (P = .008) and incomplete response (P = .021) before ASCT were poor prognostic factors for OS2.HDT with ASCT can result in long-term survival of patients with ESFT relapse. HDT should be considered an important treatment opt ion in patients with a DFI > 2 years and complete response before transplantation.
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Affiliation(s)
- Nail Paksoy
- Department of Medical Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey
- *Correspondence: Nail Paksoy, Department of Medical Oncology, Istanbul University Institute of Oncology, Millet street. No:10 34100, Istanbul, Turkey (e-mail: )
| | - Ferhat Ferhatoglu
- Department of Medical Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey
| | - İzzet Dogan
- Department of Medical Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey
| | - Nijat Khanmammadov
- Department of Medical Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey
| | - Ayca Iribas Celik
- Department of Radiation Oncology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Zafer Gulbas
- Department of Hematology, Anadolu Medical Center, Gebze, Turkey
| | - Mert Başaran
- Department of Medical Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey
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7
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Isik S, Gunden G, Gunduz E, Akay OM, Aslan A, Ozen H, Cilingir O, Erzurumluoglu Gokalp E, Kocagil S, Artan S, Gulbas Z, Durak Aras B. An Anomaly with Potential as a New Prognostic Marker in CLL with del(13q): Gain of 16p13.3. Cytogenet Genome Res 2021; 161:479-487. [PMID: 34915466 DOI: 10.1159/000520242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/15/2021] [Indexed: 11/19/2022] Open
Abstract
Deletion 13q [del(13q)] is a favorable prognostic marker if it is detected as a sole abnormality in chronic lymphocytic leukemia (CLL). However the clinical courses of cases with isolated del(13q) are quite heterogeneous. In our study, we investigated copy number variations (CNVs), loss of heterozygosity (LOH), and the size of del(13q) in 30 CLL patients with isolated del(13q). We used CGH+SNP microarrays in order to understand the cause of this clinical heterogeneity. We detected del(13q) in 28/30 CLL cases. The size of the deletion varied from 0.34 to 28.81 Mb, and there was no clinical effect of the deletion size. We found new prognostic markers, especially the gain of 16p13.3. These markers have statistically significant associations with short time to first treatment and advanced disease stage. Detecting both CNVs and LOH at the same time is an advantageous feature of aCGH+SNP. However, it is very challenging for the array analysis to detect mosaic anomalies. Therefore, it is very important to confirm the results by FISH. In our study, we detected approximately 9% mosaic del(13q) by microarray. In addition, the gain of 16p13.3 may affect the disease prognosis in CLL. However, additional studies with more patients are needed to confirm these results.
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Affiliation(s)
- Sevgi Isik
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Gulcin Gunden
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Eren Gunduz
- Department of Hematology, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Olga Meltem Akay
- Department of Hematology, Faculty of Medicine, University of Koc, Istanbul, Turkey
| | - Abdulvahap Aslan
- Department of Hematology, Private Umit Hospital, Eskisehir, Turkey
| | - Hulya Ozen
- Department of Biostatistics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Oguz Cilingir
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Ebru Erzurumluoglu Gokalp
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Sinem Kocagil
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Sevilhan Artan
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Zafer Gulbas
- Department of Hematology, Anadolu Medical Center, İzmit, Turkey
| | - Beyhan Durak Aras
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey.,Translational Medicine Research and Clinical Center, University of Eskisehir Osmangazi, Eskisehir, Turkey
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8
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Cekdemir D, Ozkan HA, Korkmaz F, Ozgurel Y, Kural S, Tiryaki N, Gulbas Z. Role of Therapeutic Plasma Exchange in Guillain-Barre Syndrome after Allogeneic Hematopoietic Stem Cell Transplant: Report of Two Cases. Clin Lab 2021; 67. [PMID: 33739028 DOI: 10.7754/clin.lab.2020.200613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Guillain-Barre Syndrome (GBS) is an acute inflammatory polyneuropathy characterized with rapid, progressive, ascending, and symmetrical weakness and areflexia. It is supposed to be an autoimmune disease related with production of antibodies by T lymphocytes activated against antigenic proteins of the peripheral nerves. Guillain-Barre Syndrome occurring after hematopoietic stem cell transplant (HSCT) has been associated with viral infections or toxic effects of chemotherapy. METHODS We report two GBS cases after HSCT treated successfully by means of therapeutic plasma exchange. RESULTS In a total of 257 patients, 2 cases (0.8%) were diagnosed with GBS following HSCT. Allogeneic HSCT was performed and complete remission was achieved. Diagnosis of GBS was established on the 45th and 69th days with respect to clinical, cerebrospinal fluid, and electromyography findings. Patients did not respond to treatment consisting of intravenous immunoglobulins (IVIG) (1 g/kg/day) for 2 days and methylprednisolone (1 g/kg/day). Mechanical ventilation was indicated in one patient due to the involvement of respiratory muscles. Therapeutic plasma exchange resulted in complete recovery in both cases. CONCLUSIONS Guillain-Barre Syndrome is a rare but serious complication, which may occur after HSCT. Increased awareness and early diagnosis are crucial in the management of GBS. First line treatment consists of IVIG and steroids and therapeutic plasma exchange must be considered without delay in refractory cases.
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9
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Durak Aras B, Isik S, Uskudar Teke H, Aslan A, Yavasoglu F, Gulbas Z, Demirkan F, Ozen H, Cilingir O, Inci NS, Gunden G, Bulduk T, Erzurumluoglu Gokalp E, Kocagil S, Artan S, Akay OM. Which prognostic marker is responsible for the clinical heterogeneity in CLL with 13q deletion? Mol Cytogenet 2021; 14:2. [PMID: 33407772 PMCID: PMC7788884 DOI: 10.1186/s13039-020-00522-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/09/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Deletion of 13q14 [del(13q)] is the most common cytogenetic change (50%) in chronic lymphoblastic leukemia (CLL), and it is a good prognostic factor if it is detected as a sole aberration by FISH. However, it is observed the clinical course of CLL cases with del(13q) are quite heterogeneous and the responsible for this clinical heterogeneity has not been established yet. Some investigators suggest type II deletion (include RB1 gene) is associated with more aggressive clinical course. Also, it is suggested that the deletion burden and the deletion type have a prognostic effect. In this study, we aimed to investigate the effect of RB1 gene deletion, deletion burden and deletion type on overall survival (OS), disease stage and time to first treatment (TTFT) in patients with isolated del(3q). Sixty eight cases, detected isolated del(13q) were included in the study. Also, RB1 deletion was analyzed from peripheral blood of them using FISH. RESULTS RB1 deletion was detected in 41% of patients, but there was no statistically significant difference between RB1 deletion and TTFT, stage and OS (p > 0.05). At same time, statistically significant difference was detected between high del(13q) (> 80%) and TTFT (p < 0.05). CONCLUSION The statistical analysis of our data regarding to the association between RB1 deletion and deletion type, TTFT, disease stage, and OS has not confirmed type II deletion or biallelic deletion cause poor prognosis. However, our data supports the deletion burden has a prognostic effect. More studies are needed to elucidate the cause of the clinical heterogeneity of CLL cases with del(13q).
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Affiliation(s)
- Beyhan Durak Aras
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey.
| | - Sevgi Isik
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Hava Uskudar Teke
- Department of Hematology, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Abdulvahap Aslan
- Department of Hematology, Private Umit Hospital, Eskisehir, Turkey
| | - Filiz Yavasoglu
- Department of Hematology, Faculty of Medicine, University of Afyonkarahisar Health Sciences, Afyon, Turkey
| | - Zafer Gulbas
- Department of Hematology, Anadolu Medical Center, Kocaeli, Turkey
| | - Fatih Demirkan
- Department of Oncology, Faculty of Medicine, University of Dokuz Eylul, Izmir, Turkey
| | - Hulya Ozen
- Department of Biostatistics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Oguz Cilingir
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Nur Sena Inci
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Gulcin Gunden
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Tuba Bulduk
- Department of Hematology, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Ebru Erzurumluoglu Gokalp
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Sinem Kocagil
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Sevilhan Artan
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Olga Meltem Akay
- Department of Hematology, Faculty of Medicine, University of Koc, Istanbul, Turkey
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10
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Capra M, Beksac M, Richardson P, Unal A, Corradini P, Delimpasi S, Gulbas Z, Mikala G, Neylon A, Symeonidis A, Bringhen S, Moreau P, Velde H, Campana F, Guennec S, Spicka I. ISATUXIMAB PLUS POMALIDOMIDE AND DEXAMETHASONE IN PATIENTS WITH RELAPSED/REFRACTORY MULTIPLE MYELOMA AND SOFT-TISSUE PLASMACYTOMAS: ICARIA-MM SUBGROUP ANALYSIS. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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11
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Beksac M, Aydin Y, Goker H, Turgut M, Besisik SK, Cagirgan S, Tuglular T, Vural F, Yagci M, Alacacioglu I, Aytan P, Goksoy HS, Gulbas Z, Gunes AK, Gurkan E, Hacioglu SK, Karti SS, Kaynar L, Ozdogu H, Paydas S, Solmaz S, Sonmez M, Tekgunduz E, Yildirim R, Ilhan O. Early Access Program Results From Turkey and a Literature Review on Daratumumab Monotherapy Among Heavily Pretreated Patients With Relapsed/Refractory Myeloma. Clinical Lymphoma Myeloma and Leukemia 2020; 20:e474-e484. [DOI: 10.1016/j.clml.2020.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/14/2022]
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12
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Armand P, Murawski N, Molin D, Zain J, Eichhorst B, Gulbas Z, Hawkes EA, Pagel JM, Phillips T, Ribrag V, Svoboda J, Stathis A, Chatterjee A, Orlowski R, Marinello P, Christian B. Pembrolizumab in relapsed or refractory Richter syndrome. Br J Haematol 2020; 190:e117-e120. [PMID: 32544980 PMCID: PMC7496875 DOI: 10.1111/bjh.16762] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
| | - Niels Murawski
- Universitäts-klinikum des Saarlandes Innere Medizin I, Homburg, Germany
| | - Daniel Molin
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | | | | | - Eliza A Hawkes
- Olivia Newton-John Cancer Research Institute, Austin Health, Victoria, Australia
| | - John M Pagel
- Swedish Center for Blood Disorders and Stem Cell Transplants, Swedish Cancer Institute, Seattle, WA, USA
| | | | | | - Jakub Svoboda
- Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | - Beth Christian
- The James Cancer Hospital and Solove Research Institute, Ohio State University, Columbus, OH, USA
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13
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Bekoz H, Ozbalak M, Karadurmus N, Paydas S, Turker A, Toptas T, Tuglular TF, Altuntas F, Cakar MK, Sonmez M, Gulbas Z, Demir N, Kaynar L, Yildirim R, Karadogan I, Arat M, Kapucu I, Aslan NA, Ozkocaman V, Turgut M, Yuksel MK, Ozcan M, Hacioglu SK, Barista I, Demirkaya M, Saydam G, Toprak SK, Yilmaz M, Demirkol O, Ferhanoglu B. Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience. Ann Hematol 2020; 99:2565-2576. [DOI: 10.1007/s00277-020-04077-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 05/04/2020] [Indexed: 01/01/2023]
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14
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Gulbas Z. Allogeneic stem cell transplantation in elderly lymphoma patients: Single-center experience. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e19519] [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: 11/20/2022] Open
Abstract
e19519 Background: Autologous stem cell transplantation is used as consolidation therapy in relapsed lymphoma patients. However, outcome of lymphoma patients relapsing after autologous stem cell transplantation is poor and allogeneic stem cell transplantation which can be curative is used in the transplant eligible patients in this setting. Besides, allogeneic stem cell transplantation can be an option before autologous stem cell transplantation in some high risk patients. In this study, we aimed to analyze the results of lymphoma patients older than 60 years of age who had undergone allogeneic transplantation in our center. Methods: We collected the data of lymphoma patients older than 60 years of age who had undergone allogeneic transplantation in our center and analyzed the results. Results: There were 20 patients over the age of 60 who had undergone allogeneic stem cell trasplantation with the diagnosis of lmphoma between 2011 and 2019. 18 patients had Non-Hodgkin lymphoma and 2 patients had Hodgkin lymphoma. 12 patients (60%) had been transplanted from HLA-matched sibling, while 6 patients (30%) had been transplanted from unrelted donors and 2 patients (10%) had been transplanted from haploidentical donors. The median age of the patients was 62 (61-66) and 30% of the patients were female. During the follow-up time only 1 patient had relapsed. The 2 year progression free survival (PFS) rate was 32% and the 2 year overall survival (OS) rate was 32%. The OS curve is shown in Figure 1. 100 day mortality was 30% and 1 year non-relapse mortalty (NRM) was 50%. The characteristics and results of the patients are summarized in Table 1. Conclusions: In the present study, although the number of patients is low, we showed that lymphoma patients over 60 years of age have a 2 year overall survival rate of 32% and a relapse rate of 5% suggesting that allogeneic stem cell transplantation which has a curative potential may be employed in transplant eligible elderly lymphoma patients.
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15
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Turan RD, Albayrak E, Uslu M, Siyah P, Alyazici LY, Kalkan BM, Aslan GS, Yucel D, Aksoz M, Tuysuz EC, Meric N, Durdagi S, Gulbas Z, Kocabas F. Development of Small Molecule MEIS Inhibitors that modulate HSC activity. Sci Rep 2020; 10:7994. [PMID: 32409701 PMCID: PMC7224207 DOI: 10.1038/s41598-020-64888-3] [Citation(s) in RCA: 16] [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] [Received: 09/30/2019] [Accepted: 04/20/2020] [Indexed: 12/24/2022] Open
Abstract
Meis1, which belongs to TALE-type class of homeobox gene family, appeared as one of the key regulators of hematopoietic stem cell (HSC) self-renewal and a potential therapeutical target. However, small molecule inhibitors of MEIS1 remained unknown. This led us to develop inhibitors of MEIS1 that could modulate HSC activity. To this end, we have established a library of relevant homeobox family inhibitors and developed a high-throughput in silico screening strategy against homeodomain of MEIS proteins using the AutoDock Vina and PaDEL-ADV platform. We have screened over a million druggable small molecules in silico and selected putative MEIS inhibitors (MEISi) with no predicted cytotoxicity or cardiotoxicity. This was followed by in vitro validation of putative MEIS inhibitors using MEIS dependent luciferase reporter assays and analysis in the ex vivo HSC assays. We have shown that small molecules named MEISi-1 and MEISi-2 significantly inhibit MEIS-luciferase reporters in vitro and induce murine (LSKCD34l°w cells) and human (CD34+, CD133+, and ALDHhi cells) HSC self-renewal ex vivo. In addition, inhibition of MEIS proteins results in downregulation of Meis1 and MEIS1 target gene expression including Hif-1α, Hif-2α and HSC quiescence modulators. MEIS inhibitors are effective in vivo as evident by induced HSC content in the murine bone marrow and downregulation of expression of MEIS target genes. These studies warrant identification of first-in-class MEIS inhibitors as potential pharmaceuticals to be utilized in modulation of HSC activity and bone marrow transplantation studies.
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Affiliation(s)
- Raife Dilek Turan
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey.,LabCell, Acibadem University, Istanbul, Turkey
| | - Esra Albayrak
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Merve Uslu
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Pinar Siyah
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Lamia Yazgi Alyazici
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | | | | | - Dogacan Yucel
- Faculty of Medicine, University of Minnesota, Minnesota, USA
| | - Merve Aksoz
- MRC Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Emre Can Tuysuz
- Department of Medical Genetics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Neslihan Meric
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey.,Bone Marrow Transplantation Center, Anadolu Medical Center, Kocaeli, Turkey
| | - Serdar Durdagi
- Department of Biophysics, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Zafer Gulbas
- Bone Marrow Transplantation Center, Anadolu Medical Center, Kocaeli, Turkey
| | - Fatih Kocabas
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey.
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16
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Ilhan O, Seval GC, Uzay A, Kaya E, Ozturk ZN, Deveci B, Yavasoglu I, Ural AU, Bekoz HS, Ayli M, Sevindik OG, Bozdag SC, Yuksel MK, Gulbas Z. Ibrutinib As a Promising Treatment for Pulmonary Complications Due to Refractory Chronic Graft Versus Host Disease. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Dholaria B, Labopin M, Angelucci E, Ciceri F, Diez-Martin JL, Bruno B, Sica S, Koc Y, Gulbas Z, Schmid C, Blaise D, Carella A, Visani G, Savani B, Nagler A, Mohty M. Outcomes of Acute Myelogenous Leukemia Patients Undergoing Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide: Impact of Total Body Irradiation Versus Chemotherapy-Based Myeloablative Conditioning. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Armand P, Rodig S, Melnichenko V, Thieblemont C, Bouabdallah K, Tumyan G, Özcan M, Portino S, Fogliatto L, Caballero MD, Walewski J, Gulbas Z, Ribrag V, Christian B, Perini GF, Salles G, Svoboda J, Zain J, Patel S, Chen PH, Ligon AH, Ouyang J, Neuberg D, Redd R, Chatterjee A, Balakumaran A, Orlowski R, Shipp M, Zinzani PL. Pembrolizumab in Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma. J Clin Oncol 2019; 37:3291-3299. [PMID: 31609651 PMCID: PMC6881098 DOI: 10.1200/jco.19.01389] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [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: 12/26/2022] Open
Abstract
PURPOSE Patients with relapsed or refractory primary mediastinal large B-cell lymphoma (rrPMBCL) have a poor prognosis, and their treatment represents an urgent and unmet need. Because PMBCL is associated with genetic aberrations at 9p24 and overexpression of programmed cell death-1 (PD-1) ligands (PD-L1), it is hypothesized to be susceptible to PD-1 blockade. METHODS In the phase IB KEYNOTE-013 (ClinicalTrials.gov identifier: NCT01953692) and phase II KEYNOTE-170 (ClinicalTrials.gov identifier: NCT02576990) studies, adults with rrPMBCL received pembrolizumab for up to 2 years or until disease progression or unacceptable toxicity. The primary end points were safety and objective response rate in KEYNOTE-013 and objective response rate in KEYNOTE-170. Secondary end points included duration of response, progression-free survival, overall survival, and safety. Exploratory end points included association between biomarkers and pembrolizumab activity. RESULTS The objective response rate was 48% (7 complete responses; 33%) among 21 patients in KEYNOTE-013 and 45% (7 complete responses; 13%) among 53 patients in KEYNOTE-170. After a median follow-up time of 29.1 months in KEYNOTE-013 and 12.5 months in KEYNOTE-170, the median duration of response was not reached in either study. No patient with complete response experienced progression, including 2 patients with complete response for at least 1 year off therapy. Treatment-related adverse events occurred in 24% of patients in KEYNOTE-013 and 23% of patients in KEYNOTE-170. There were no treatment-related deaths. Among 42 evaluable patients, the magnitude of the 9p24 gene abnormality was associated with PD-L1 expression, which was itself significantly associated with progression-free survival. CONCLUSION Pembrolizumab is associated with high response rate, durable activity, and a manageable safety profile in patients with rrPMBCL.
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Affiliation(s)
| | | | | | | | | | - Gayane Tumyan
- N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - Muhit Özcan
- Ankara University Medical School, Ankara, Turkey
| | | | | | | | - Jan Walewski
- Maria Sklodowska-Curie Institute Oncology Center, Warszawa, Poland
| | | | | | - Beth Christian
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Pier Luigi Zinzani
- Institute of Hematology, Seràgnoli University of Bologna, Bologna, Italy
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19
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Aksoz M, Albayrak E, Aslan GS, Turan RD, Alyazici LY, Siyah P, Tuysuz EC, Canikyan S, Yucel D, Meric N, Gulbas Z, Sahin F, Kocabas F. c-Myc Inhibitor 10074-G5 Induces Murine and Human Hematopoietic Stem and Progenitor Cell Expansion and HDR Modulator Rad51 Expression. Curr Cancer Drug Targets 2019; 19:479-494. [DOI: 10.2174/1568009618666180905100608] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 04/24/2018] [Accepted: 08/25/2018] [Indexed: 12/29/2022]
Abstract
Background:c-Myc plays a major role in the maintenance of glycolytic metabolism and hematopoietic stem cell (HSC) quiescence.Objective:Targeting modulators of HSC quiescence and metabolism could lead to HSC cell cycle entry with concomitant expansion.Methods and Results:Here we show that c-Myc inhibitor 10074-G5 treatment leads to 2-fold increase in murine LSKCD34low HSC compartment post 7 days. In addition, c-Myc inhibition increases CD34+ and CD133+ human HSC number. c-Myc inhibition leads to downregulation of glycolytic and cyclindependent kinase inhibitor (CDKI) gene expression ex vivo and in vivo. In addition, c-Myc inhibition upregulates major HDR modulator Rad51 expression in hematopoietic cells. Besides, c-Myc inhibition does not alter proliferation kinetics of endothelial cells, fibroblasts or adipose-derived mesenchymal stem cells, however, it limits bone marrow derived mesenchymal stem cell proliferation. We further demonstrate that a cocktail of c-Myc inhibitor 10074-G5 along with tauroursodeoxycholic acid (TUDCA) and i-NOS inhibitor L-NIL provides a robust HSC maintenance and expansion ex vivo as evident by induction of all stem cell antigens analyzed. Intriguingly, the cocktail of c-Myc inhibitor 10074-G5, TUDCA and L-NIL improves HDR related gene expression.Conclusion:These findings provide tools to improve ex vivo HSC maintenance and expansion, autologous HSC transplantation and gene editing through modulation of HSC glycolytic and HDR pathways.
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Affiliation(s)
- Merve Aksoz
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Esra Albayrak
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Galip Servet Aslan
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Raife Dilek Turan
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Lamia Yazgi Alyazici
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Pınar Siyah
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Emre Can Tuysuz
- Biotechnology Program, Graduate School of Natural and Applied Sciences, Yeditepe University, 34755, Istanbul, Turkey
| | - Serli Canikyan
- Onkim Stem Cell Technologies, Istanbul Technical University - KOSGEB, Istanbul, Turkey
| | - Dogacan Yucel
- Faculty of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Neslihan Meric
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Zafer Gulbas
- Bone Marrow Transplantation Center, Anadolu Medical Center, Kocaeli, Turkey
| | - Fikrettin Sahin
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
| | - Fatih Kocabas
- Regenerative Biology Research Laboratory, Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey
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Shimoni A, Labopin M, Angelucci E, Blaise D, Ciceri F, Koc Y, Gulbas Z, Diez-Martin JL, Bruno B, Castagna L, Martino M, Rovira M, Mohty M, Nagler A. Graft-Versus-Leukemia Effect after Haplo-Identical Stem Cell Transplantation with Post-Transplant Cyclophosphamide in Patients with AML- No Association with Graft-Versus-Host Disease (GVHD): A Study on Behalf of the Acute Leukemia Working Party of EBMT. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.239] [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: 10/27/2022]
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21
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Cekdemir D, Atasoyu EM, Gulbas Z. FP145ACUTE KIDNEY INJURY DEVELOPING IN THE EARLY PERIOD IN THE PATIENTS UNDERGOING AUTOLOG AND ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Demet Cekdemir
- Hematology Bone Marrow Transplantation Unit, Anadolu Medical Center, Kocaeli, Turkey
| | | | - Zafer Gulbas
- Haematology, Bone Marrow Transplantation Unit, Anadolu Medical Center, Kocaeli, Turkey
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Atasoyu EM, Cekdemir D, Gulbas Z. FP119RESULTS FROM EARLY PERIOD OF THE PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING AUTOLOG AND ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp119] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Demet Cekdemir
- Haematology, Bone Marrow Transplantation Unit, Anadolu Medical Center, Kocaeli, Turkey
| | - Zafer Gulbas
- Haematology, Bone Marrow Transplantation Unit, Anadolu Medical Center, Kocaeli, Turkey
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23
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Zinzani P, Thieblemont C, Melnichenko V, Osmanov D, Bouabdallah K, Walewski J, Majlis A, Fogliatto L, Caballero Barrigón M, Christian B, Gulbas Z, Özcan M, Salles G, Shipp M, Balakumaran A, Chlosta S, Chatterjee A, Armand P. Efficacy and safety of pembrolizumab in relapsed/refractory primary mediastinal large B-cell lymphoma (rrPMBCL): interim analysis of the KEYNOTE-170 phase 2 trial. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_49] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- P. Zinzani
- Institute of Hematology "L. e A. Seràgnoli"; University of Bologna; Bologna Italy
| | | | - V. Melnichenko
- Hematology; The National Medical Surgical Сentre named after N.I. Pirogov, Moscow; Russian Federation
| | - D. Osmanov
- Russian Academy of Medical Sciences; N.N. Blokhin Russian Oncological Research Center; Moscow Russian Federation
| | - K. Bouabdallah
- Hematology and Cell Therapy; Groupe Hospitalier du Haut Leveque; Pessac France
| | - J. Walewski
- Lymphoid Malignancy; Maria Sklodowska-Curie Institute - Oncology Center; Warsaw Poland
| | - A. Majlis
- Hematology, University of Chile; Hospital del Salvador; Santiago Chile
| | - L. Fogliatto
- Hematology; Hospital de Clinicas de Porto Alegre; Porto Alegre Brazil
| | | | - B. Christian
- Division of Hematology; Ohio State University - James Comprehensive Cancer Center; Columbus USA
| | - Z. Gulbas
- Hematologic Oncology; Anadolu Medical Center; Gebze Turkey
| | - M. Özcan
- Division of Hematology; Ankara University School of Medicine; Ankara Turkey
| | - G.A. Salles
- Hospices Civils de Lyon, Cancer Research Center of Lyon; Claude Bernard University Lyon; Pierre Benite France
| | - M.A. Shipp
- Division of Hematologic Neoplasia; Dana-Farber Cancer Institute; Boston USA
| | | | - S. Chlosta
- Clinical Research; Merck & Co., Inc.; Kenilworth USA
| | - A. Chatterjee
- Clinical Research; Merck & Co., Inc.; Kenilworth USA
| | - P. Armand
- Division of Hematologic Neoplasia; Dana-Farber Cancer Institute; Boston USA
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24
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Ferhanoglu B, Bekoz H, Karadurmus N, Paydas S, Gulbas Z, Turker A, Toptas T, Firatli Tuglular T, Tekgunduz E, Kaya A, Tastemir N, Arat M, Pepedil Tanrikulu F, Ozkocaman V, Abali H, Turgut M, Kaynar L, Karadogan I, Ozbalak M, Dogu M, Kabukcu Hacioglu S, Yildirim R, Barista I, Kurt Yuksel M, Sonmez M. Nivolumab for relapsed or refractory Hodgkin lymphoma: Experience in Turkey. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_63] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- B. Ferhanoglu
- Department of Internal Medicine, Division of Hematology; Koc University School of Medicine; Istanbul Turkey
| | - H. Bekoz
- Department of Internal Medicine, Division of Hematology; Medipol University Medical Faculty; Istanbul Turkey
| | - N. Karadurmus
- Department of Internal Medicine, Division of Medical Oncology; Gulhane Research and Training Hospital; Ankara Turkey
| | - S. Paydas
- Department of Internal Medicine, Division of Medical Oncology; Cukurova University; Adana Turkey
| | - Z. Gulbas
- Division of Hematology; Anadolu Medical Center; Izmit Turkey
| | - A. Turker
- Department of Internal Medicine, Division of Medical Oncology; Hacettepe University Medical Faculty; Ankara Turkey
| | - T. Toptas
- Department of Internal Medicine, Division of Hematology; Marmara University Medical Faculty; Istanbul Turkey
| | - T. Firatli Tuglular
- Department of Internal Medicine, Division of Hematology; Marmara University Medical Faculty; Istanbul Turkey
| | - E. Tekgunduz
- Division of Hematology; Dr Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital; Ankara Turkey
| | - A. Kaya
- Division of Hematology; Dr Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital; Ankara Turkey
| | - N. Tastemir
- Department of Internal Medicine, Division of Hematology; Istanbul University, Istanbul Medical Faculty; Istanbul Turkey
| | - M. Arat
- Division of Hematology; Florence Nighthingale Hospital; Istanbul Turkey
| | - F. Pepedil Tanrikulu
- Division of Hematology; Baskent University Dr Turgut Noyan Research and Training Center; Adana Turkey
| | - V. Ozkocaman
- Department of Internal Medicine, Division of Hematology; Uludag University Medical Faculty; Bursa Turkey
| | - H. Abali
- Division of Medical Oncology; Acıbadem University Medical Faculty Adana Hospital; Adana Turkey
| | - M. Turgut
- Department of Internal Medicine, Division of Hematology; Ondokuz Mayıs University Medical Faculty; Samsun Turkey
| | - L. Kaynar
- Department of Internal Medicine, Division of Hematology; Erciyes University Medical Faculty; Kayseri Turkey
| | - I. Karadogan
- Division of Hematology; Antalya Medstar Hospital; Antalya Turkey
| | - M. Ozbalak
- Division of Internal Medicine; Batman Kozluk State Hospital; Batman Turkey
| | - M. Dogu
- Division of Hematology; Istanbul Research and Training Hospital; Istanbul Turkey
| | - S. Kabukcu Hacioglu
- Department of Internal Medicine, Division of Hematology; Pamukkale University Medical Faculty; Denizli Turkey
| | - R. Yildirim
- Department of Internal Medicine, Division of Hematology; Ataturk University Medical Faculty; Erzurum Turkey
| | - I. Barista
- Department of Internal Medicine, Division of Medical Oncology; Hacettepe University Medical Faculty; Ankara Turkey
| | - M. Kurt Yuksel
- Department of Internal Medicine, Division of Hematology; Ankara University Medical Faculty; Ankara Turkey
| | - M. Sonmez
- Department of Internal Medicine, Division of Hematology; Karadeniz Technical University; Trabzon Turkey
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25
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Savani BN, Labopin M, Canaani J, Huang XJ, Arcese W, Tischer J, Koc Y, Bruno B, Gulbas Z, Blaise D, Maertens JA, Ehninger G, Baron F, Gorin N, Esteve J, Schmid C, Giebel S, Ciceri F, Mohty M, Nagler A. ABO Mismatching and Haploidentical Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia—a Report from the ALWP of the EBMT. Biol Blood Marrow Transplant 2017. [DOI: 10.1016/j.bbmt.2017.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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26
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Piemontese S, Ciceri F, Labopin M, Arcese W, Kyrcz-Krzemien S, Santarone S, Huang H, Beelen D, Gorin NC, Craddock C, Gulbas Z, Bacigalupo A, Mohty M, Nagler A. A comparison between allogeneic stem cell transplantation from unmanipulated haploidentical and unrelated donors in acute leukemia. J Hematol Oncol 2017; 10:24. [PMID: 28103944 PMCID: PMC5248464 DOI: 10.1186/s13045-017-0394-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [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] [Received: 10/26/2016] [Accepted: 01/03/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the absence of a HLA-matched related or matched unrelated donor, allogeneic stem cell transplantation (allo-SCT) from mismatched unrelated donors or haploidentical donors are potential alternatives for patients with acute leukemia with an indication to allo-SCT. The objective of this study was to compare the outcome of allo-SCT from T cell-replete haploidentical (Haplo) versus matched (MUD 10/10) or mismatched unrelated donor at a single HLA-locus (MMUD 9/10) for patients with acute leukemia in remission. METHODS Two hundred sixty-five adult patients with de novo acute leukemia in first or second remission that received a Haplo-SCT between January 2007 and December 2013 were compared with 2490 patients receiving a MUD 10/10 and 813 receiving a MMUD 9/10. Propensity score weighted analysis was conducted in order to control for disease risk imbalances between the groups. RESULTS The weighted 3-year non-relapse mortality and relapse incidence were 29 and 30% for Haplo, 21 and 29% for MUD 10/10, and 29 and 25% for MMUD 9/10, respectively. The weighted 3-year leukemia-free survival (LFS) and overall survival (OS) were 41 and 46% for Haplo, 50 and 56% for MUD 10/10, and 46 and 48% for MMUD 9/10, respectively. Using weighted Cox model, both LFS and OS were significantly higher in transplants from MUD 10/10 compared from those in Haplo but not different between transplants from MMUD 9/10 and Haplo. The type of donor was not significantly associated with neither acute nor chronic graft-versus-host disease. CONCLUSIONS Patients with acute leukemia in remission have better outcomes if transplanted from a MUD 10/10. We did not find any significant difference in outcome between transplants from MMUD 9/10 and Haplo, suggesting that both can be equally used in the absence of a 10/10 MUD. KEY POINT 1: Better outcomes using fully (10/10) matched unrelated donor for allo-SCT in acute leukemia in remission. KEY POINT 2: Similar outcomes after allo-SCT from unmanipulated haploidentical graft or mismatched (9/10) unrelated donor in acute leukemia in remission.
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Affiliation(s)
- Simona Piemontese
- Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy.,EBMT ALWP Office, Hospital Saint Antoine, Paris, France
| | - F Ciceri
- Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy.,EBMT ALWP Office, Hospital Saint Antoine, Paris, France
| | - M Labopin
- EBMT ALWP Office, Hospital Saint Antoine, Paris, France.,Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France
| | - W Arcese
- Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy
| | - S Kyrcz-Krzemien
- University Department of Hematology and BMT, Medical University of Silesia, Katowice, Poland
| | - S Santarone
- Department of Hematology, Ospedale Civile, Pescara, Italy
| | - H Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - D Beelen
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - N C Gorin
- EBMT ALWP Office, Hospital Saint Antoine, Paris, France.,Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France
| | - C Craddock
- Center for Clinical Hematology, Queen Elizabeth Hospital, Birmingham, UK
| | - Z Gulbas
- Bone Marrow Transplantation Department, Anadolu Medical Center Hospital, Gebze, Turkey
| | - A Bacigalupo
- Division of Hematology II, IRCCS, San Martino University Hospital IST, Genoa, Italy
| | - M Mohty
- EBMT ALWP Office, Hospital Saint Antoine, Paris, France.,Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France
| | - A Nagler
- EBMT ALWP Office, Hospital Saint Antoine, Paris, France.,Division of Hematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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27
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Sahin G, Temiz G, Ozkurt S, Bal C, Bozaci I, Bayrak Torun C, Akay OM, Uslu S, Yalcin AU, Gulbas Z, Kiper H. Effect of Transplant on Platelet Function Markers (P-Selectin and Platelet Aggregation) and Adiponectin in Renal Transplant Patients. EXP CLIN TRANSPLANT 2016; 16:160-165. [PMID: 27267514 DOI: 10.6002/ect.2016.0105] [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: 11/05/2022]
Abstract
OBJECTIVES In chronic kidney disease, both bleeding and thrombotic complications are observed, although with expected recovery after a successful transplant. Adiponectin has protective properties with respect to atherogenesis and inflammation. Plasma adiponectin levels are markedly elevated among patients with end-stage renal disease and are lower after kidney transplant. However, this topic is still debated in the literature. Here, we evaluated the effect of transplant on platelet function markers (P-selectin and platelet aggregation) and adiponectin in renal transplant patients. MATERIALS AND METHODS Our study included 14 renal transplant patients. Preoperative and week 1, month 1, month 6, year 1, and year 2 samples after transplant were studied. In addition to plasma adiponectin, P-selectin levels, and platelet aggregation tests, biochemical tests and coagulation parameters were also studied. RESULTS We observed a significant decrease in adiponectin levels 2 years after transplant. Platelet function tests with ADP and collagen were significantly improved, and no changes in P-selectin, ristocetin, and epinephrine levels were observed. CONCLUSIONS According to our findings, glomerular filtration rate has an important effect on platelet function, but adiponectin levels became normal only in the second year after transplant. Late improvement of low-density lipoprotein cholesterol and adiponectin after transplant suggested to us that patients with kidney transplant may still have risk of cardiovascular events, especially in the first years.
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Affiliation(s)
- Garip Sahin
- From the Department of Nephrology, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey
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28
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Sahin G, Akay OM, Uslu S, Bal C, Yalcin AU, Gulbas Z. Association between endothelial and platelet function markers and adiponectin in renal transplanted recipients on cyclosporine and tacrolimus immunosuppression based therapy. Nephrology (Carlton) 2016; 20:392-8. [PMID: 25650527 DOI: 10.1111/nep.12413] [Citation(s) in RCA: 5] [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: 01/28/2015] [Indexed: 12/20/2022]
Abstract
AIM Coagulation abnormalities, endothelial dysfunction and arteriosclerosis play a key role in cardiovascular disease state observed in transplanted patients. Plasma adiponectin levels are lower following kidney transplantation. However, there is still a debate about this topic in the literature. This study evaluated, adiponectin levels associated with markers of endothelial dysfunction and platelet function in renal transplant patients. METHODS Sixty-six renal transplant patients were studied. Patients were grouped according to immunosuppression regimen. Group 1 (n = 36) were treated with cyclosporine A based regimes and group 2 (n = 30) were treated with tacrolimus based regimes. Plasma adiponectin, asymmetric dimethyl arginine (ADMA), sP-selectin levels and platelet aggregation tests were studied and were compared with those in control group (n = 15, group 3). RESULTS Adiponectin, sP-selectin and ADMA levels were higher in group 1 and statistically significant differences were observed compared with those of group 2 and group 3, respectively (P < 0.001, P < 0.05, P < 0.05). Platelet aggregation values induced by agonists were lower in group 1 than group 2 and group 3, but the difference did not reach statistical significance (P > 0.05). CONCLUSION Adiponectin levels are elevated in line with ADMA and sP-selectin levels. Since CsA induces higher adiponectin levels, platelet activation and endothelial dysfunction. These changes may be responsible for the increased risk of post-transplant cardiovascular events in renal transplant patients.
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Affiliation(s)
- Garip Sahin
- Nephrology Department, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey
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Andic N, Goren Sahin D, Meltem Akay O, Uskudar Teke H, Gunduz E, Gulbas Z. Utility of flow cytometric κ and λ light chain analysis of peripheral blood. J BUON 2015; 20:1322-1326. [PMID: 26537081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Monoclonality in the peripheral blood can be shown by flow cytometric analysis of kappa (κ) and lambda (λ) light chain ratio of B lymphocytes. We aimed to show the utility of this method in patients with unknown causes of lymphadenopathy and/or splenomegaly. METHODS This method was performed in 81 adult patients with undefined causes of lymphadenopathy and splenomegaly. RESULTS 18 (22%) of these patients had clonality and all of them were diagnosed as B cell lymphoma later. None of the patients with benign causes had clonality in the peripheral blood. We could not find any relationship between presence of clonality and type and stage of lymphoma and bone marrow involvement. CONCLUSION This method is easy to perform, cheap and non-invasive and yet it can give valuable information about the malignant nature of a suspected disease. If there is a sign of clonality in the peripheral blood, more invasive diagnostic procedures should be performed rather than watch and wait.
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Affiliation(s)
- Neslihan Andic
- Eskisehir Osmangazi University School of Medicine, Department of Hematology, Eskisehir, Turkey
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30
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Atesoglu EB, Hacıhanefioglu A, Gulbas Z. Beta-2 microglobulin predicts the outcome after autologous stem cell transplantation in non-Hodgkin lymphoma. Transfus Apher Sci 2015; 52:65-71. [PMID: 25577449 DOI: 10.1016/j.transci.2014.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/27/2014] [Revised: 12/01/2014] [Accepted: 12/15/2014] [Indexed: 11/18/2022]
Abstract
Autologous stem cell transplantation (ASCT) is an established therapeutic modality in the treatment of lymphomas, especially in the relapse setting. In the present study, we aimed to define pretransplantation factors including Beta-2 microglobulin (β2m) that influence outcomes following ASCT in patients with non-Hodgkin lymphoma (NHL). We analyzed retrospectively 78 NHL patients who had undergone ASCT from August 2010 to January 2013. The 2-year overall survival (OS) was 70% and the progression-free survival (PFS) was 60%. While remission status less than complete remission (CR) emerged to be a poor prognostic factor for OS in univariate analysis, high β2m levels and comorbidity indices revealed to be independent poor risk factors for both OS and PFS. The present study demonstrated that even if the patient is in CR before ASCT if he has high β2m, the 2-year OS decreases from 100% to 49%. Moreover, lymphopenia for the first time was demonstrated to predict PFS in ASCT in NHL patients. Our findings suggest that β2m at transplantation predict the outcome after ASCT in NHL and further investigation with larger sample sizes is warranted.
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Affiliation(s)
| | | | - Zafer Gulbas
- Bone Marrow Transplantation Center, Anadolu Medical Center Hospital, Kocaeli, Turkey.
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Birtas Atesoglu E, Tarkun P, Demirsoy ET, Geduk A, Mehtap O, Batman A, Kaya F, Cekmen MB, Gulbas Z, Hacıhanefioglu A. Soluble Programmed Death 1 (PD-1) Is Decreased in Patients With Immune Thrombocytopenia (ITP): Potential Involvement of PD-1 Pathway in ITP Immunopathogenesis. Clin Appl Thromb Hemost 2014; 22:248-51. [PMID: 25510412 DOI: 10.1177/1076029614562952] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Immune thrombocytopenia (ITP) is an autoimmune disease characterized by dysregulation of T cells. Programmed death (PD) 1 and programmed death 1 ligand 1 (PD-L1) are cosignaling molecules, and the major role of the PD-1 pathway is the inhibition of self-reactive T cells and to protect against autoimmune diseases. We measured levels of serum soluble PD 1 (sPD-1) and serum soluble PD-L1 (sPD-L1) in 67 patients with ITP (24 newly diagnosed ITP [ndITP], 43 chronic ITP [cITP]) and 21 healthy controls (HCs). We determined decreased serum sPD-1 levels both in patients with ndITP and in patients with cITP when compared to HC. Moreover, there was a positive correlation between sPD-1 levels and platelet counts. The sPD-L1 levels were decreased in patients with ndITP when compared to patients with cITP. This is the first study investigating PD-1 signaling pathway in ITP. Decreased sPD-1 levels may have a role in ITP pathogenesis as without the inhibitory regulation of PD-1, sustained activation of T cells may cause inflammatory responses which is the case in ITP.
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Affiliation(s)
| | - Pinar Tarkun
- Department of Hematology, Kocaeli University, Kocaeli, Turkey
| | | | - Ayfer Geduk
- Department of Hematology, Kocaeli University, Kocaeli, Turkey
| | - Ozgur Mehtap
- Department of Hematology, Kocaeli University, Kocaeli, Turkey
| | - Adnan Batman
- Department of Internal Medicine, Kocaeli University, Kocaeli, Turkey
| | - Fatih Kaya
- Department of Internal Medicine, Kocaeli University, Kocaeli, Turkey
| | | | - Zafer Gulbas
- Hematology Department, Anadolu Medical Center Hospital, Kocaeli, Turkey
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Aktas A, Kurt E, Gulbas Z. Cytokine expression before and after aspirin desensitization therapy in aspirin-exacerbated respiratory disease. Inflammation 2014; 36:1553-9. [PMID: 23912646 DOI: 10.1007/s10753-013-9699-7] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Aspirin exacerbated respiratory disease (AERD) is induced by acetylsalicylic acid (ASA) and/or nonsteroidal antiinflammatory drugs (NSAIDs). Effects of desensitization on many mediators have been examined previously, but few studies addressed the influence of desensitization on T lymphocytes and T lymphocyte-derived cytokines. This study was performed to examine peripheral blood lymphocyte (PBL) cytokine expression in aspirin-sensitive patients who have asthma before and after aspirin desensitization. In this study, the release of interleukin-2 (IL-2), interleukin-4 (IL-4), and interferon-gamma (IFN-γ) by CD4+ T lymphocytes prior to aspirin desensitization were also measured at intracellular levels, and expression of these cytokines after 1 month aspirin desensitization was evaluated. Twelve patients with AERD were included in the study. Two different control groups were formed, one consisted of 15 healthy people and second 12 aspirin tolerant asthmatic (ATA) patients using aspirin. A blood sample was collected prior to desensitization, and the tests were repeated by taking a second blood sample 1 month after the 4-day desensitization treatment. The proportion of lymphocytes secreting IFN-γ in the study group was 15.61 ± 4.40 % before desensitization and 15.08 ± 5.89 % after desensitization. The rate of IFN-γ secreting CD4+ T lymphocytes was 20.51 ± 4.41 % in the normal control group and 16.07 ± 5.7 % in the ATA group (p = 0.021). The ratio of CD4+ T lymphocyte secreting IFN-γ was reduced in patients with AERD before desensitization compared to normal control group (p = 0.040). The levels of IL-2, IL-4, and the subsets of lymphocyte were not different before and after desensitization compared to control groups.
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Affiliation(s)
- Ayse Aktas
- Division of Allergy and Immunology, Department of Internal Medicine, Celal Bayar University School of Medicine, Manisa, Turkey,
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33
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Ozkan HA, Bal C, Gulbas Z. Chemomobilization with high-dose etoposide and G-CSF results in effective and safe stem cell collection in heavily pretreated lymphoma patients: report from a single institution study and review. Eur J Haematol 2014; 92:390-7. [DOI: 10.1111/ejh.12266] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Hasan Atilla Ozkan
- Anadolu Medical Center Hospital; Bone Marrow Transplantation Center; Gebze Kocaeli Turkey
| | - Cengiz Bal
- Bioistatistic Department; Eskişehir Osmangazi University School of Medicine; Meşelik Eskişehir Turkey
| | - Zafer Gulbas
- Anadolu Medical Center Hospital; Bone Marrow Transplantation Center; Gebze Kocaeli Turkey
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Gulbas Z, Ozkan HA, Ozer UG, Bal C. Results of Haploidentical Allogeneic Haematopoietic Stem-Cell Transplantation in Patients with Acute Leukaemia: A Single Centre Experience. Biol Blood Marrow Transplant 2014. [DOI: 10.1016/j.bbmt.2013.12.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Uskudar Teke H, Gulbas Z, Bal C. Serum levels of cytokines and prevalence of autoantibodies in lymphoma patients and their prognostic value. J BUON 2014; 19:191-197. [PMID: 24659663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Recent studies have shown that cytokines and autoantibodies that have an important role in pathogenesis of lymphoma can be used as prognostic markers. In this study, we aimed to determine the prognostic significance of a large panel of serum cytokines and compare them with a control group, and also to see for any relationship with known classical prognostic factors, the frequency of autoantibody positivity and autoimmune phenomena in patients with untreated non Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL). METHODS For cytokine studies blood samples were obtained in the morning after fasting for at least 8-12 h. We used empty tubes for serum and EDTA-containing tubes for plasma samples. Blood samples were then transferred to laboratory in 5-10 min, plasma and sera were separated by centrifugation, and stored at -75 ?C until assayed. Then, all sera were warmed to room temperature. All the cytokine levels were studied with Panomics Company ProcartaTM Human Cytokine multiplex kits. RESULTS In lymphoma patients INF-ggr; was related with thyroglobulin antibody positivity and IL-6 with direct Coombs positivity. IL-6 was the most important cytokine connected with lymphopenia and B symptoms in lymphoma patients. IL-1β, INF-γ, IL-2 and IL-4 were markers associated with poor prognosis in HL. At least one autoantibody was positive in 50% of NHL and HL patients. At least one antiphospholipid antibody (APA) was positive in 26% of NHL and 38% of HL patients. CONCLUSION TNF-α and IL-6 are poor prognostic factors that may be included in the International Prognostic Index (IPI). To understand the effects of autoantibodies in the prognosis of HL and NHL, long-term patient follow-up studies are required.
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Affiliation(s)
- Hava Uskudar Teke
- Eskisehir Osmangazi University Medical School, Hematology Division, Eskisehir University, Eskisehir, Turkey
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Ozkan HA, Bal C, Gulbas Z. Assessment and comparison of acute cardiac toxicity during high-dose cyclophosphamide and high-dose etoposide stem cell mobilization regimens with N-terminal pro-B-type natriuretic peptide. Transfus Apher Sci 2013; 50:46-52. [PMID: 24382557 DOI: 10.1016/j.transci.2013.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 11/19/2013] [Accepted: 12/02/2013] [Indexed: 01/25/2023]
Abstract
This study was undertaken to prospectively evaluate and compare the acute effect of high-dose (HD), cyclophosphamide (CY) and HD etoposide (ET) on cardiac function assessed by plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients undergoing stem-cell mobilization. NT-proBNP was measured at baseline and 6h after completion of mobilization chemotherapy (MC) in 58 patients. Of 58 patients, 33 received HD CY, and 25 received HD ET. The mean baseline NT-proBNP values were similar between the CY and ET group (119.5 vs 149, respectively, p>0.05). NT-proBNP levels were increased in almost all patients, except 2 from CY group. A significant difference between NT-proBNP concentrations at baseline and 6h after completion of MC was observed in both groups (p<0.001). The value of changes in NT-proBNP was more significant in the ET group. The changes in NT-proBNP according to the MC regimens were analyzed and a cut-off value of 422pg/ml was determined. Based on this cut-off value, only the type of MC was significantly correlated with the chances in NT-proBNP concentrations. Receiving HD ET as a MC was found to be 5.25 times more cardiotoxic compared to the HD CY. Congestive heart failure was seen in 3 (5.2%) patients. Our results suggest that stem cell mobilization with HD CY and HD ET cause acute cardiac toxicity mediated by neurohumoral activation, which was detected by the increases in cardiac biomarker NT-proBNP, and as a matter of fact cardiotoxicity of HD ET seems to be more potent than those exhibited by HD CY.
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Affiliation(s)
- Hasan Atilla Ozkan
- Anadolu Medical Center Hospital, Bone Marrow Transplantation Center, Cumhuriyet Mah. 2255 sk. No. 3, Gebze 41400, Kocaeli, Turkey
| | - Cengiz Bal
- Biostatistic Department, Eskişehir Osmangazi University School of Medicine, Meşelik, 26480 Eskişehir, Turkey
| | - Zafer Gulbas
- Anadolu Medical Center Hospital, Bone Marrow Transplantation Center, Cumhuriyet Mah. 2255 sk. No. 3, Gebze 41400, Kocaeli, Turkey.
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Ozkan HA, Ozer UG, Bal C, Gulbas Z. Daily vs every other day administration of G-CSF following autologous peripheral stem cell transplantation: A prospective randomized study. Transfus Apher Sci 2013; 49:163-7. [DOI: 10.1016/j.transci.2013.01.019] [Citation(s) in RCA: 2] [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] [Received: 08/07/2012] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
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Hakko E, Ozkan HA, Karaman K, Gulbas Z. Analysis of cerebral toxoplasmosis in a series of 170 allogeneic hematopoietic stem cell transplant patients. Transpl Infect Dis 2013; 15:575-80. [PMID: 24103000 DOI: 10.1111/tid.12138] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [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: 04/11/2012] [Revised: 10/16/2012] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Cerebral toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant patients, which mostly is caused by reactivation of latent disease. METHODS In this study, we report an analysis of cerebral toxoplasmosis in a series of 170 allogeneic stem cell transplant patients during a 30-month period at our institution. RESULTS Among these allogeneic stem cell transplant patients, 5 were diagnosed with cerebral toxoplasmosis by brain magnetic resonance imaging and polymerase chain reaction of Toxoplasma gondii DNA. The incidence of cerebral toxoplasmosis was found to be 2.94%. CONCLUSION Mortality rate is known to be very high in cerebral toxoplasmosis; therefore, it is life saving to diagnose the disease in the early stages and start treatment promptly, especially in high-endemic countries like Turkey.
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Affiliation(s)
- E Hakko
- Infectious Diseases, Anadolu Medical Center, Kocaeli, Turkey
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Gunduz E, Celebioglu M, Meltem Akay O, Uskudar Teke H, Sahin Mutlu F, Gulbas Z. The role of flow cytometry in the diagnosis of non- Hodgkin's lymphoma, Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node specimens. J BUON 2013; 18:739-745. [PMID: 24065493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE In this study we aimed to compare the flow cytometry (FC) results of patients with B cell lymphoma, T cell lymphoma, Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node and investigate the role of FC in malignant or non malignant conditions. METHODS Ninety patients were divided into 5 groups according to histopathology results. Patients were compared according to cytokeratin and positivity percentage of the following surface markers: CD45, CD19, CD5, CD19-CD5, CD4, CD8, CD3,CD16-CD56, CD10, CD10-CD19, CD23, CD20, CD4-CD8, CD3-CD16-56, CD30, CD38, kappa and lambda light chains, CD20-CD23. Patients were also compared according to the intensity of the expression (exp) of same markers. ROC curve analysis was performed for CD19+ cell percentage, CD38 exp, kappa/lambda and lambda/kappa ratios. RESULTS 1) Kappa/lambda and lambda/kappa ratios can distinguish B cell lymphoma from T cell lymphoma, Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node; 2) CD19+ cell percentage can distinguish T cell lymphoma from Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node; 3) CD38 exp can partly distinguish B cell lymphoma from T cell lymphoma, Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node and T cell lymphoma from granulomatous inflammation, T cell lymphoma from reactive lymph node, Hodgkin's lymphoma from reactive lymph node. CONCLUSION Flow cytometry has a role in distinguishing lymphomas from non malignant lesions.
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Affiliation(s)
- E Gunduz
- Eskisehir Osmangazi University School of Medicine, Department of Hematology, Eskisehir, Turkey
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Sahin DG, Gunduz E, Akay OM, Gulbas Z. Central nervous system relapse in a patient with acute promyelocytic leukaemia: does the risk stratification matter? BMJ Case Rep 2013; 2013:bcr-2013-009456. [PMID: 23749823 DOI: 10.1136/bcr-2013-009456] [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: 11/04/2022] Open
Abstract
Extramedullary relapse is an uncommon complication of acute promyelocytic leukaemia (APL). The most common site of extramedullary relapse is the central nervous system (CNS), and the majority of CNS relapses occur in patients with high-risk disease in which white blood cell count at presentation is greater than 10×10(3)/μL. The best management of such patients is still controversial. We describe a 47-year-old man with APL who developed two CNS relapses which were diagnosed through the presence of t(15;17)(q22;q21) on PCR of the cerebrospinal fluid (CSF), despite presenting initially with intermediate-risk disease. We conclude that the intermediate risk group is very heterogeneous and these patients sometimes may behave like high-risk patients. Also, clinicians should take into account symptoms that can be related to CNS relapse in patients with APL and consider lumbar puncture even if radiological imaging does not reveal anything.
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Affiliation(s)
- Deniz Goren Sahin
- Department of Hematology, Eskisehir Osmangazi University, Eskisehir, Turkey.
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Cantaluppi V, De Lena M, Beltramo S, Ferrario S, Dellepiane S, Figliolini F, Bruno S, Biancone L, Segoloni GP, Tetta C, Camussi G, Prasad N, Jaisawal A, Yadav B, Agarwal V, Tripathi D, Nunez-Lozano R, Quiros Y, Sanchez-Gonzalez P, Perez de Obanos MP, Ruiz J, Lopez-Hernandez FJ, Lopez-Novoa JM, Yang JW, Kim JS, Lee JY, Park HC, Han BG, Choi SO, Matsuyama M, Yoshimura R, Hayama T, Chargui J, Touraine JL, Yoshimura N, Zanazzi M, Carta P, Caroti L, Antognoli G, Pinzani P, Salvianti F, Villari D, Minetti E, Genina A, Ismail W, Soliman A, Ucar H, Akbas HS, Yilmaz VT, Aktas A, Suleymanlar G, Yucel G, Cappuccilli ML, La Manna G, Capelli I, Baraldi O, Cuna V, Battaglino G, Todeschini P, Feliciangeli G, Scolari MP, Stefoni S, Loiacono E, Votta B, Amore A, Ranghino A, Camilla R, Peruzzi L, Donadio ME, Serriello I, Gallo R, Puccinelli MP, Coppo R, Sahin G, Meltem Akay O, Uslu S, Bal C, Ugur Yalcin A, Gulbas Z, George J. Transplantation: basic science. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Akay OM, Aslan V, Gulbas Z. Serum LDH elevation should not be necessarily attributed to disease activity in patients with thrombotic thrombocytopenic purpura. Transfus Apher Sci 2012; 47:373-4. [PMID: 22999643 DOI: 10.1016/j.transci.2012.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Accepted: 07/31/2012] [Indexed: 10/27/2022]
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Keskin M, Ustuner Z, Dincer M, Etiz D, Celik H, Gulbas Z. Importance of serum VEGF and basic FGF levels in determining response to treatment and survival in patients with metastatic colorectal cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e21050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21050 Background: Colorectal cancer has an important place in worldwide death from cancer causes. Angiogenesis, in which angiogenic factors such as VEGF and basic FGF have a key role, is an important factor in patient survival with respect to progression and metastatic spreading in colorectal cancer. In this study, we aimed to determine that whether serum VEGF and bFGF pre- and post-treatment serum levels are decisive in evaluating response to treatment and progression in metastatic colorectal cancer (mCRC) patients treated with FOLFIRI-bevacizumab. Methods: In 33 mCRC patients treated in our department serum VEGF and bFGF levels were monitored in the beginning of treatment and until progression during FOLFIRI-bevacizumab treatment before 4.-, 8.- and 12.-regimens. Serum levels of VEGF and bFGF were assssed using the quantitative sandwich enzyme immunoassay technique. Results: In our study serumVEGF and bFGF levels were significantly higher than the healthy controls (p<0.001). We found that the patients with pre-treatment high serum bFGF levels have significantly short PFS and with pre-treatment high serum LDH levels have significantly short overall survival (OS). In patients with pre-treatment low serum VEGF value (< 147.79 pg/ml) had significantly longer OS (27.93 vs 23.27 mounts, P:0.026) in metastatic rectum cancer. In multivariate analysis were found to be prognostic factors VEGF levels and side of tumor for PFS and VEGF levels and whether to be operated of tumor for OS. Conclusions: Serum VEGF level was detected to be one of the factors that determine PFS and OS in mCRC. Pretreatment serum bFGF levels were determined PFS and monitorization of serum bFGF during treatment was found to be releated to response to treatment. Pretreatment serum LDH level was detected to determine OS in metastatic CRC. Although there was no statistical significance, in mCRC patients, whose pretreatment serum VEGF were high, PSK was longer with bevacizumab treatment. The important of pretreatment high serum VEGF level to select for treatment of bevacizumab will be planed in metastatic CRC requires to be confirmed in comprehensive, prospective studies.
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Affiliation(s)
- Muge Keskin
- Department of Internal Medicine, Medical Faculty of Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Zeki Ustuner
- Department of Medical Oncology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Murat Dincer
- Medical Faculty of Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Durmus Etiz
- Medical Faculty of Eskisehir Osmangazi University, Eskisehir, Turkey
| | - H.Eray Celik
- Department of Biostatistics, Letters and Science Faculty of Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Zafer Gulbas
- Professor of Department of Hematology, Medical Faculty of Eskisehir Osmangazi University, Eskisehir, Turkey
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Aksu AEK, Saracoglu ZN, Sabuncu I, Ciftci E, Gulbas Z, Isiksoy S. Necrotic ulcer: a manifestation of leukemia cutis. Skinmed 2012; 10:108-110. [PMID: 22545328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 71-year-old man presented to our dermatological clinic with a 3-month history of a wound on his leg. He complained of weakness for the past few months. On his dermatological examination he had a 3x3-cm necrotic ulcer on his left tibia (Figure 1). On physical examination, there was 1 x 1-cm axillary lymphadenopathy. There was no other lymph node enlargement, hepatosplenomegaly, or gingival hypertrophy. Peripheral blood results showed 2.4x103/mm3 leukocytes (normal range 4-11 x 103/mm3) with 66% neutrophils. The hemoglobin value was 10.1 g/dL (13-18 g/dL), and the platelet count was 63x103/mm3 (150-440 x 103/mm3). No blasts were detected in a peripheral blood smear. His lactate dehydrogenase level was 567 U/L (240-480 U/L). All other results of blood chemistry were within normal limits. Punch biopsy of the skin lesion showed ulceration and dense dermal acute and chronic inflammation. There was a superficial and deep perivascular and periadnexal infiltrate of neoplastic cells composed of relatively abundant eosinophilic cytoplasm and large nuclei with blastic chromatin and occasional small nucleoli (Figure 2). Mitotic figures were prominent. Immunohistochemical stains were performed, and the neoplastic cells were CD3, CD20, CD138, and S100 protein negative. Myeloperoxidase and CD68 were positive. The histopathological findings were consistent with leukemic infiltration. Examination of bone marrow biopsy revealed that the blastic cells constituted more than 20% of the bone marrow cellularity. Cytogenetic analysis of bone marrow aspiration with fluorescence in situ hybridization was negative for inversion 16, t(8;21) and t(15;7). Histochemical stains for myeloperoxidase, sudan black, periodic acid-Schiff, and alpha naphthyl acetate were also negative. Blastic cells were DR, CD13, CD117, and CD34 positive and CD5, CD7, CD10, CD14, CD19, CD20, CD33, CD41, CD56, CD64, and CD79 negative according to flow cytometry immunophenotyping. Blastic cells were 35% in the bone marrow. Based on the findings of bone marrow examination, the patient was diagnosed as having acute myeloblastic leukeamia (AML) with minimal differentiation (subtype MO) according to French-American-British and World Health Organization classification. The examination of abdominal ultrasonography and thorocic and abominal computed tomography revealed no metastases. The patient was treated with chemotherapy that consisted of cytarabin and daunorubicin. After chemotherapy, the lesion regressed. One month after chemotherapy, the patient presented to the hospital with a complaint of fever. He was diagnosed with febrile neutropenia. He died of cardiac failure 12 months after appearance of skin infiltration.
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Affiliation(s)
- Ayse Esra Koku Aksu
- Department of Dermatology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
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Canbaz P, Uskudar-Teke H, Aksu K, Keren M, Gulbas Z, Kurt E. Nasal eosinophilia can predict bronchial hyperresponsiveness in persistent rhinitis: evidence for united airways disease concept. Am J Rhinol Allergy 2011; 25:120-4. [PMID: 21679516 DOI: 10.2500/ajra.2011.25.3574] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nasal eosinophils may be indicative of bronchial hyperresponsiveness (BHR) in rhinitis concerning the "united airways disease" theory. This study was designed to evaluate the relationship between nasal eosinophilia and BHR in persistent perennial rhinitis patients. METHODS Thirty-seven patients (12 males and 25 females, mean age: 33.3 ± 10.4 years) were included in the study. Skin-prick test, nasal symptom score, nasal smears, methacholine bronchial challenge test, and nasal rhinometry were obtained in all patients. Eosinophil count in nasal smears was expressed as a percentage of the total cells. None of the patients had asthma. RESULTS There was no difference between the number of atopic and nonatopic patients having BHR (4/20 versus 4/17; chi-squared = 0.07; p > 0.05). Total nasal flow was lower and percentage of nasal eosinophils was higher in the patients with BHR than in patients without BHR (p = 0.012 and p = 0.009, respectively). A cutoff point of 68% nasal eosinophils yielded a sensitivity of 100% (63.1-100) and a specificity of 58.6% (38.9-76.5) to determine the presence of BHR. Positive likelihood ratio for the value of eosinophils above cutoff value was 2.42 (1.8-3.3). CONCLUSION This study shows the relationship between nasal eosinophils and BHR in persistent perennial rhinitis patients. Nasal eosinophil percentage below cutoff value indicates that a patient does not have BHR.
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Affiliation(s)
- Pelin Canbaz
- Department of Pulmonary Diseases-Allergy, Eskisehir Osmangazi University Medical Faculty, Turkey.
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Gunduz E, Akay OM, Birdane A, Gulbas Z. Stem Cell Therapy for Congestive Heart Failure. J Stem Cells Regen Med 2011. [PMID: 24693176 PMCID: PMC3908273 DOI: 10.46582/jsrm.0702014] [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: 11/19/2022]
Affiliation(s)
- E Gunduz
- Eskisehir Osmangazi University School of Medicine, Department of Hematology , Eskisehir, Turkey
| | - O M Akay
- Eskisehir Osmangazi University School of Medicine, Department of Hematology , Eskisehir, Turkey
| | - A Birdane
- Eskisehir Osmangazi University School of Medicine, Department of Cardiology , Eskisehir, Turkey
| | - Z Gulbas
- Anadolu Health Center, Bone Marrow Transplantation Center , Gebze, Turkey
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Sahin G, Akay OM, Bal C, Yalcin AU, Gulbas Z. The effect of calcineurin inhibitors on endothelial and platelet function in renal transplant patients. Clin Nephrol 2011; 76:218-225. [PMID: 21888859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND/AIM Posttransplant cardiovascular mortality is still an important problem in renal transplant patients. In addition to conventional coronary risk factors, coagulation abnormalities play a key role in the hypercoagulable state observed in transplanted patients. Though renal transplantation eliminates cardiovascular disease risk factors by restoring renal function, it introduces new cardiovascular risks derived, in part from immunosupressive medications. We aimed to assess the effect of calcineurin inhibitors on endothelial function, platelet activation and aggregation in renal transplant patients. METHODS 62 renal transplant were studied. Staging was performed according to immunosuppression regimen. Group 1 (n = 37) were treated with cyclosporine/mycophenolate mofetil/methylprednisolone and Group 2 (n = 25) were treated with tacrolimus/mycophenolate mofetil/methylprednisolone. The control group consisted of 16 healthy subjects (Group 3). Hematological and biochemical tests, asymmetric dimethyl arginine (ADMA), sP-selectin levels and platelet aggregation tests were studied. RESULTS ADMA levels were higher in Group1 and statistically significant differences were observed compared with those of Group 2 and Group 3 (p < 0.05). Platelet aggregation values induced by all agonists (Adenosine diphosphate (ADP), epinephrine, ristocetin, collagen) were lower in Group 1 than Group 2 and Group 3, but the difference did not reach statistical significance (p > 0.05). There was a negative correlation between cyclosporine level and platelet aggregation values induced by ADP (r = -0.43, p < 0.01), ristocetin (r = -0.40, p < 0.05), epinephrine (r = -0.41, p < 0.05), and collagen (r = -0.43, p < 0.01). sP-selectin levels were appreciably higher in Group 1 and statistically significant differences were observed compared with those of Group 2 (p < 0.05) and Group 3 (p < 0.01). CONCLUSION The results of our study suggest that CsA induces platelet activation without inducing platelet aggregation. Endothelial dysfunction due to vascular endothelial damage reflected by increases in ADMA values may increase the tendency for thrombotic events in patients who had undergone renal transplantation.
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Affiliation(s)
- G Sahin
- Eskisehir Osmangazi University Medical School, Eskisehir, Turkey.
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Gunduz E, Akay OM, Bal C, Gulbas Z. Can thrombelastography be a new tool to assess bleeding risk in patients with idiopathic thrombocytopenic purpura? Platelets 2011; 22:516-20. [PMID: 21557684 DOI: 10.3109/09537104.2011.571317] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Thrombelastography (TEG) analyses the status of blood coagulation including abnormalities associated with low platelet count. The aim of this study was to investigate the changes in TEG parameters in idiopathic thrombocytopenic purpura (ITP) patients. Thirty nine patients with ITP (platelet count < 100 × 103 µl⁻¹) were included in the study. Age-matched 17 patients with thrombocytopenia due to chemotherapy were selected as a control group. Platelet count was positively correlated with maximum clot formation (MCF) in INTEM (r = 0.716, p < 0.001) and MCF in EXTEM (r = 0.679, p < 0.001); negatively correlated with clot formation time (CFT) in INTEM (r = -0.755, p < 0.001) and CFT in EXTEM (r = -0.585, p < 0.001) in ITP patients. Platelet count was positively correlated with MCF in INTEM (r = 0.776, p < 0.001) and MCF in EXTEM (r = 0.878, p < 0.001); negatively correlated with CFT in INTEM (r = -0.627, p < 0.001) in control group. Receiver operating characteristic curves to describe the critical platelet count and fibrinogen level that affect MCF revealed 31 × 103 µl⁻¹ and 375 mg dl⁻¹ as cut-off values, respectively. In conclusion, ROTEM determines the contribution of fibrinogen and platelets to clot strength in patients with ITP. MCF appears to be the most important TEG parameter in predicting bleeding in ITP patients that makes TEG superior to other hemostatic tests.
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Affiliation(s)
- Eren Gunduz
- Department of Hematology, Eskisehir Osmangazi University School of Medicine, Eskisehir 26480, Turkey
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Cetinbas F, Yelken B, Gulbas Z. Role of glutamine administration on cellular immunity after total parenteral nutrition enriched with glutamine in patients with systemic inflammatory response syndrome. J Crit Care 2010; 25:661.e1-6. [DOI: 10.1016/j.jcrc.2010.03.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 03/04/2010] [Accepted: 03/29/2010] [Indexed: 01/10/2023]
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