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Tokatlı M, Ismayilov R, Çınar OE, Haznedaroğlu İC. Nilotinib-Associated Multiple Silent Arterial Stenoses in a Patient with Chronic Myeloid Leukemia. Turk J Haematol 2024; 41:59-60. [PMID: 38153228 PMCID: PMC10918391 DOI: 10.4274/tjh.galenos.2023.2023.0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/28/2023] [Indexed: 12/29/2023] Open
MESH Headings
- Humans
- Constriction, Pathologic/complications
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications
- Pyrimidines/adverse effects
- Leukemia, Myeloid/complications
- Protein Kinase Inhibitors/adverse effects
- Antineoplastic Agents/adverse effects
- Leukemia, Myeloid, Chronic-Phase/complications
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Affiliation(s)
- Mert Tokatlı
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, Türkiye
| | - Rashad Ismayilov
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, Türkiye
| | - Olgu Erkin Çınar
- Hacettepe University Faculty of Medicine, Department of Hematology, Ankara, Türkiye
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Göker H, Çınar OE, Demiroğlu H, Malkan ÜY, Aladağ Karakulak E, Büyükaşık Y. Venetoclax and Azacitidine Treatment in Relapsed Acute Myeloid Leukemia after Hematopoietic Stem Cell Transplantation: A Cohort Study in the Real-World Setting of a Tertiary Center. Turk J Haematol 2023; 40:213-215. [PMID: 37314288 PMCID: PMC10476247 DOI: 10.4274/tjh.galenos.2023.2023.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/23/2023] [Indexed: 09/01/2023] Open
Affiliation(s)
- Hakan Göker
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Olgu Erkin Çınar
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Haluk Demiroğlu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Ümit Yavuz Malkan
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Elifcan Aladağ Karakulak
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Yahya Büyükaşık
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
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Göker H, Çınar OE, Demiroğlu H, Malkan ÜY, Aladağ Karakulak E, Büyükaşık Y. Venetoclax and Azacitidine Treatment in Relapsed Acute Myeloid Leukemia After Hematopoietic Stem Cell Transplantation: A Cohort Study in a Tertiary Center Real-World Setting. Turk J Haematol 2023. [PMID: 37314288 DOI: 10.4274/tjh.galenos.2023.2023-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- Hakan Göker
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Olgu Erkin Çınar
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Haluk Demiroğlu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Ümit Yavuz Malkan
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Elifcan Aladağ Karakulak
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
| | - Yahya Büyükaşık
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye
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Çınar OE, Erdoğdu B, Karadeniz M, Ünal S, Malkan ÜY, Göker H, Haznedaroğlu İC. Comment on Zamfir et al. Hematologic Malignancies Diagnosed in the Context of the mRNA COVID-19 Vaccination Campaign: A Report of Two Cases. Medicina 2022, 58, 874. Medicina (B Aires) 2022; 58:medicina58111575. [PMID: 36363532 PMCID: PMC9696869 DOI: 10.3390/medicina58111575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/23/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
The SARS-CoV-2 spike protein mRNA-based vaccines have prevented countless mortality and morbidity, and have an excellent risk/benefit ratio. However, various adverse events may rarely occur after the BNT162b2 vaccine, like any other medical intervention. The COVID-19 itself and the spike protein produced endogenously by mRNA vaccines may have immunological, microenvironmental, prothrombotic, and neoplastic effects. As a contribution to the published report, we would like to share our experience regarding four cases in which myeloid neoplasms emerged following the vaccination. Conclusions: There is no doubt that vaccination could continue along the lines of established universal recommendations. Meanwhile, all hematological adverse events must be closely monitored and reported. Further efforts should be focused on the probable pathobiological mechanisms and causalities of spike protein-related toxicity and clonal myeloid disorders.
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Çınar OE, Göker H, Fidan K, Aydın Ö, Pashayev T, Malkan ÜY, Velet M, Büyükaşık Y, Aksu S, Özcebe Oİ, Haznedaroğlu İC, Sayınalp N, Vural F, Turgut M, Ünal A, Demiroğlu H. Prophylactic Central Nervous System Irradiation Is Not Indispensable In Adult Patients With Acute Lymphoblastic Leukemia: A Multi-Center Retrospective Cohort Study. Turk J Haematol 2022; 39:152-159. [PMID: 35445593 PMCID: PMC9421337 DOI: 10.4274/tjh.galenos.2022.2021.0680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Studies comparing the efficacy and safety of prophylactic regimens for central nervous system (CNS) involvement in acute lymphoblastic leukemia (ALL) are scarce in adults. This multicenter retrospective study aimed to compare the efficacy of prophylactic regimens with and without CNS irradiation on the development of CNS relapse during follow-up. Materials and Methods: This was a multicenter comparative cohort study. A total of 203 patients were included from four tertiary care centers in Turkey. Patients were divided into two groups according to whether they received CNS irradiation or not. The groups were analyzed retrospectively regarding patient and disease characteristics, with the main focus being CNS relapse. Results: While 105 patients received chemotherapy-based prophylaxis, 98 patients received additional CNS irradiation. These groups were statistically comparable in terms of demographic characteristics and risk factors for CNS involvement. In the irradiation group, patients were younger and had more stem cell transplants. In a median of 23.8 (11.1-62.4) months, there was no difference between the two groups regarding CNS relapse-free survival (log-rank p=0.787). Conclusion: Craniospinal irradiation may not be indispensable for every adult patient with ALL, similarly to pediatric patients. It is crucial to avoid the long-term toxicities of radiation, especially in patients with long life expectancy. Craniospinal irradiation may be reserved for therapeutic use in cases of CNS relapse and prophylaxis for some high-risk patients.
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Affiliation(s)
| | - Hakan Göker
- Hacettepe University, Division of Hematology, Turkey
| | - Kemal Fidan
- Erciyes University, Division of Hematology, Turkey
| | - Öznur Aydın
- Ondokuz Mayıs University, Division of Hematology, Turkey
| | | | | | - Mustafa Velet
- Hacettepe University, Division of Hematology, Turkey
| | | | - Salih Aksu
- Hacettepe University, Division of Hematology, Turkey
| | | | | | | | - Filiz Vural
- Ege University, Division of Hematology, Turkey
| | - Mehmet Turgut
- Ondokuz Mayıs University, Division of Hematology, Turkey
| | - Ali Ünal
- Erciyes University, Division of Hematology, Turkey
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Karataş A, Malkan ÜY, Velet M, Demiroğlu H, Büyükaşık Y, Telli Dizman G, Inkaya AÇ, Erdoğdu B, Çınar OE, Aladağ E, Aksu S, Haznedaroğlu İC, Özcebe O, Sayınalp N, Göker H. The clinical course of COVID-19 in hematopoietic stem cell transplantation (HSCT) recipients. Turk J Med Sci 2021; 51:1647-1652. [PMID: 33878857 PMCID: PMC8569779 DOI: 10.3906/sag-2103-72] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/18/2021] [Indexed: 11/09/2022] Open
Abstract
Background/aim The disease caused by SARS-CoV-2 was named as COVID-19. There is as yet insufficient information about the effects of HSCT on the clinical course of COVID-19. In the present study, we aimed to investigate the clinical course of COVID-19 in patients who had undergone HSCT. Materials and methods We analyzed baseline characteristics, clinical course and findings of COVID-19, hospitalization and death rates, overall survival, and case fatality rates of HSCT recipients diagnosed with COVID-19 retrospectively. Results 57.6% of the patients underwent AHSCT, and 42.4% underwent allo-HSCT. 60.6%, 27.3%, and 12.1% of the patients had mild, moderate, and severe COVID-19 or critical illness, respectively. Overall, 45.5% were hospitalized, 12.1% required intensive care, and 9.1% necessitated invasive mechanical ventilation. The total CFR was 9.1% in HSCT recipients, 22.2% in patients with active hematologic malignancy, and 4.2% in patients without active hematologic malignancy. Conclusion It can be concluded that mortality of HSCT recipients is lower in patients whose primary disease is in remission compared to ones that are not in remission. Further studies with larger group patients are needed in order to delineate the effects of COVID-19 on HSCT patients.
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Affiliation(s)
- Ayşe Karataş
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ümit Yavuz Malkan
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Velet
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Haluk Demiroğlu
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yahya Büyükaşık
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gülçin Telli Dizman
- Department of Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ahmet Çağkan Inkaya
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Batuhan Erdoğdu
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Olgu Erkin Çınar
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elifcan Aladağ
- Department of Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Salih Aksu
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Osman Özcebe
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nilgün Sayınalp
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hakan Göker
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Karataş A, İnkaya AÇ, Demiroğlu H, Aksu S, Haziyev T, Çınar OE, Alp A, Uzun Ö, Sayınalp N, Göker H. Prolonged viral shedding in a lymphoma patient with COVID-19 infection receiving convalescent plasma. Transfus Apher Sci 2020; 59:102871. [PMID: 32694044 PMCID: PMC7333597 DOI: 10.1016/j.transci.2020.102871] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 01/01/2023]
Abstract
Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first identified in Wuhan, China; and spread all over the world. Reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2 usually returns to negative in 20 days post-infection, but prolonged positivity has been reported up to 63 days. A case whose viral shedding lasted 60 days is reported from China. Herein we report a patient with a history of autologous stem cell transplantation (ASCT) for lymphoma whose RT-PCR test remained positive for SARS-CoV-2 for 74 days. The prolonged RT-PCR positivity, despite convalescent plasma infusion, may suggest that the given antibodies may be ineffective in terms of viral clearance. In patients with hematological malignancies or immunosuppression, such as ASCT, may lead to prolonged viral shedding, and strict isolation is warranted for long-term SARS-CoV-2 infection control.
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Affiliation(s)
- Ayşe Karataş
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Ankara, Turkey
| | - Ahmet Çağkan İnkaya
- Hacettepe University Faculty of Medicine, Department of Infectious Diseases, Ankara, Turkey
| | - Haluk Demiroğlu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Ankara, Turkey
| | - Salih Aksu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Ankara, Turkey
| | - Tahmaz Haziyev
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Ankara, Turkey
| | - Olgu Erkin Çınar
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Ankara, Turkey
| | - Alpaslan Alp
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Ömrüm Uzun
- Hacettepe University Faculty of Medicine, Department of Infectious Diseases, Ankara, Turkey
| | - Nilgün Sayınalp
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Ankara, Turkey
| | - Hakan Göker
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Ankara, Turkey.
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Çınar OE, Sayınalp B, Aladağ Karakulak E, Avşar Karataş A, Velet M, İnkaya AÇ, Ersoy Ortaç NE, Öcal S, Aksu S, Haznedaroğlu İC, Sayınalp N, Özcebe Oİ. Convalescent (immune) plasma treatment in a myelodysplastic COVID-19 patient with disseminated tuberculosis. Transfus Apher Sci 2020; 59:102821. [PMID: 32487513 PMCID: PMC7258803 DOI: 10.1016/j.transci.2020.102821] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 12/11/2022]
Abstract
During the ongoing COVID-19 pandemic due to the SARS-CoV-2 virus of which evidence-based medical paradigms cannot be easily applied; difficult clinical decisions shall be required particularly in the 'difficult-to-treat' cases of high risk group with associated comorbidities. Convalescent immune plasma therapy is a promising option as a sort of 'rescue' treatment in COVID-19 immune syndrome, where miraculous antiviral drugs are not available yet. In this report, we aim to convey our experience of multi-task treatment approach with convalescent immune plasma and anti-cytokine drug combination in a COVID-19 patient with extremely challenging comorbidities including active myeloid malignancy, disseminated tuberculosis and kidney failure.
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Affiliation(s)
- Olgu Erkin Çınar
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Turkey.
| | - Başak Sayınalp
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Turkey
| | - Elifcan Aladağ Karakulak
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Turkey
| | - Ayşe Avşar Karataş
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Turkey
| | - Mustafa Velet
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Turkey
| | - Ahmet Çağkan İnkaya
- Hacettepe University Faculty of Medicine, Department of Infectious Diseases, Turkey
| | - Nazmiye Ebru Ersoy Ortaç
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Intensive Care Unit, Turkey
| | - Serpil Öcal
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Intensive Care Unit, Turkey
| | - Salih Aksu
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Turkey
| | | | - Nilgün Sayınalp
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Turkey
| | - Osman İlhami Özcebe
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Hematology Unit, Turkey
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