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Öğe Assessment of haematology patients with confirmed H1N1 positivity(Tubitak Scientific & Technical Research Council Turkey, 2012) Ozdemirkiran, Fusun; Pullukcu, Husnu; Cicek, Candan; Cagirgan, Seckin; Tombuloglu, Murat; Vural, Filiz; Saydam, GürayAim: H1N1 influenza virus infections in immunosuppressive patients cause complications. Clinical and laboratory findings of H1N1 positive haematology patients were evaluated in this study. Materials and methods: The "H1N1 Swine Influenza Suspicious Case Notification Form and Inpatient Follow-up Form" was prepared for 15 patients with suspected H1N1 infection between October 2009 and May 2010. H1N1 was detected by real-time RT-PCR assay. For all cases medical records were reviewed for clinical, demographic, and haematologic information. Results: H1N1 positivity was confirmed using real-time RT-PCR in 9 out of 15 patients (11 men, 4 women). One of the 9 patients had been followed up due to aplastic anaemia, 1 due to Evans syndrome, and the remaining 7 due to haematologic malignancy. Among the 9 patients diagnosed with H1N1,3 had previously undergone autologous haemopoietic stem cell transplantation (HSCT). H1N1 was detected in HSCT recipients in the early post-transplant period (range 7-21 days). The most prominent symptoms were as follows: high fever, cough, vomiting, nausea, and diarrhoea, in descending order. Oseltamivir was given to all patients. Eight patients responded to the treatment and recovered clinically. One patient (57-year-old female with multiple myeloma), required intensive care and she died due to severe sepsis and pneumonia. Conclusion: Our data show that subjective findings like headache and fatigue often seen in influenza infections were not the dominant clinical presentation in these patients. These infections should be considered in patients with haematological malignancy, and appropriate treatment and prophylaxis should be started early.Öğe Autologous hematopoietic progenitor cell mobilization and collection in adult patients presenting with multiple myeloma and lymphoma: A position-statement from the Turkish Society of Apheresis (TSA)(Pergamon-Elsevier Science Ltd, 2017) Tekgunduz, Emre; Arat, Mutlu; Goker, Hakan; Ozdogu, Hakan; Kaynar, Leylagul; Cagirgan, Seckin; Erkurt, Mehmet Ali; Vural, Filiz; Kiki, Ilhami; Altuntas, Fevzi; Demirkan, FatihAutologous hematopoietic cell transplantation (AHCT) is a routinely used procedure in the treatment of adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and relapsed/refractory settings. Successful hematopoietic progenitor cell mobilization (HPCM) and collection are the rate limiting first steps for application of AHCT. In 2015, alinost 1700 AHCT procedures have been performed for MM, HL and NHL in Turkey. Although there are recently published consensus guidelines addressing critical issues regarding autologous HPCM, there is a tremendous heterogeneity in terms of mobilization strategies of transplant centers across the world. In order to pave the way to a more standardized HPCM approach in Turkey, Turkish Society of Apheresis (TSA) assembled a working group consisting of experts in the field. Here we report the position statement of TSA regarding autologous HPCM mobilization strategies in adult patients presenting with MM and lymphoma. (C) 2017 Elsevier Ltd. All rights reserved.Öğe Autologous Stem Cell Transplantation for Adult Acute Myelocytic Leukemia in First Remission-Better Outcomes After Busulfan and Melphalan Compared With Busulfan and Cyclophosphamide: A Retrospective Study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)(Wiley, 2017) Gorin, Norbert-Claude; Labopin, Myriam; Czerw, Tomasz; Pabst, Thomas; Blaise, Didier; Dumas, Pierre-Yves; Nemet, Damir; Arcese, William; Trisolini, Silvia Maria; Wu, Depei; Huynh, Anne; Zuckerman, Tsila; Meijer, Ellen; Cagirgan, Seckin; Cornelissen, Jan; Houhou, Mohamed; Polge, Emmanuelle; Mohty, Mohamad; Nagler, ArnonBACKGROUND: Autologous stem cell transplantation (ASCT) for adult acute myelogenous leukemia (AML) is a valid therapeutic option for patients with good-risk and intermediate-risk disease. The authors used the registry of the European Society for Blood and Marrow Transplantation to compare combined busulfan and melphalan (BUMEL) with combined busulfan and cyclophosphamide (BUCY) before transplantation. METHODS: From 2005 to 2013, 853 patients with available cytogenetics underwent ASCT in first remission, including 257 after receiving BUMEL and 596 after receiving BUCY. The proportion of patients with good-risk AML was lower in those who received BUMEL (14% vs 20%; P = .02). More patients who received BUMEL underwent autograft in molecular remission (89% vs 78%; P = .02). Three years after transplantation, the relapse incidence (RI) was 48.7%, the leukemia-free survival (LFS) rate was 47.7%, the overall survival (OS) rate was 66.2%, and the nonrelapse mortality (NRM) rate was 3.6%. RESULTS: Patients who underwent an autograft after receiving BUMEL fared better than those who underwent an autograft after receiving BUCY with a lower RI (39.5% vs 52.2%; hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.49-0.87; P = .003) a better LFS (55.4% vs 44.6%; HR, 0.69; 95% CI, 0.53-0.89; P = .005), and a better OS (73.8% vs 63%; HR, 0.62; 95% CI, 0.47-0.82; P = .0007). There was no difference in the NRM rate (BUMEL vs BUCY, 4.5% vs 3.2%, respectively). Among 74 patients in the BUMEL group and 187 in the BUCY group who underwent autograft in molecular remission, the RI was 30% versus 51%, respectively (univariate analysis; P = .01), and the LFS rate was 66% versus 47%, respectively (univariate analysis; P = .03). CONCLUSIONS: In patients with AML in first complete remission who undergo ASCT, the BUMEL combination is a better preparative regimen. (C) 2016 American Cancer Society.Öğe Autologous Stem Cell Transplantation for Adult Acute Myelocytic Leukemia in First Remission: Better Outcome Following Busulfan and Melphalan Compared to Busulfan and Cyclophosphamide : A Retrospective Study from the Acute Leukemia Working Party of the EBMT(Amer Soc Hematology, 2015) Gorin, Norbert Claude; Labopin, Myriam; Czerw, Tomasz; Leibundgut, Kurt; Blaise, Didier; Dumas, Pierre Yves; Nemet, Damir; Arcese, William; Foa, Roberto; Wu Depei; Huynh, Anne; Zuckerman, Tsila; Meijer, Ellen; Cagirgan, Seckin; Cornelissen, Jan; Mohty, Mohamed; Nagler, ArnonÖğe CD31 expression on peripheral blood stem cells predicts both early neutrophil and platelet engraftments(Pergamon-Elsevier Science Ltd, 2013) Donmez, Ayhan; Tombuloglu, Murat; Gulbahar, Okan; Arik, Bahar; Cagirgan, Seckin; Vural, Filiz; Gokmen, NihalNo detailed information currently exists about the immune phenotypic profiles of peripheral blood stem cells (PBSCs) obtained by different mobilization regimens. The effects of these profiles on the outcome of transplantation are largely unknown. In this prospective study, the surface immune phenotypic features (CD11a, CD18, CD31, CD38, CD44, CD62e, CD62L, CD90, CD117, CD135 and CD184 expression) of sorted PBSCs that had been mobilized by growth factor with (group I and group II) or without (group III) disease-specific chemotherapies were investigated. The immune phenotypic features on mobilized PBSCs in groups I, II and III were not significantly different. The CD31 (platelet endothelial cell adhesion molecule-1) positivity ratio on PBSCs inversely correlated with both the duration of neutrophil (r = -0.32, p = 0.03) and platelet (r = -0.36, p = 0.02) engraftment. No relationship was found between the engraftment (neutrophil and platelet) durations and CD184 (chemokine receptor CXC motif receptor 4 [CXCR4]) expression on PBSCs. We demonstrated that the surface immune phenotypic profiles on PBSCs obtained by several mobilization regimens were not different. To our knowledge, this is the first study to demonstrate that CD31 expression on human PBSCs may positively affect both neutrophil and platelet engraftment. Contrary to our expectations, CD184 (CXCR4) expression on PBSCs has no effect on neutrophil or platelet engraftment. Considered together, our results suggest that additional surface antigens (such as CD31) may be more effective in the homing process. (C) 2013 Elsevier Ltd. All rights reserved.Öğe Cholesterol levels in patients with multiple myeloma(Springer, 2008) Yavasoglu, Irfan; Tombuloglu, Murat; Kadikoylu, Gurhan; Donmez, Ayhan; Cagirgan, Seckin; Bolaman, ZahitHypocholesterolemia is seen in solid tumors and some hematological malignancies. We assessed cholesterol levels and the relationship between these levels and types and stages of multiple myeloma (MM) in the patients with MM. One-hundred two patients (60 male and 42 female) of mean age 59 +/- 11 years with MM were enrolled to this study. While 71.6% of the patients were Ig G type, 80.4% of the patients were at stage III. In the control group, there were 71 healthy persons (42 male and 29 female) of mean age 58 +/- 8 years. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in the patients with MM were significantly lower than the controls (p<0.001). There was no difference for the levels of very-low-density lipoprotein cholesterol and triglyceride between the two groups (p>0.05). Lipid parameters were not different between Ig types (p>0.05). The levels of TC and LDL-C in the patients with stage I were higher than those of stages II and III (p<0.001 and p<0.005, respectively). The levels of TC and LDL-C in the controls were not higher than the patients with stage I (p>0.05). HDL-C levels in the patients with stage III were lower than controls (p<0.001). Hypocholesterolemia are seen in the patients with MM. Hypocholesterolemia may be due to increased LDL clearance and utilization of cholesterol by myeloma cells.Öğe The clearance time of infused hematopoietic stem cell from the blood circulation(Pergamon-Elsevier Science Ltd, 2013) Donmez, Ayhan; Ozsan, Fatma; Arik, Bahar; Ozkayin, Nese; Cagirgan, Seckin; Mir, Sevgi; Vural, Filiz; Tombuloglu, MuratThere is no detailed information about the clearance time of infused hematopoietic stem cell (HSC) from the blood circulation in humans. In this prospective study, peripheral blood CD34+ cell counts were detected during the 4 days period following autologous HSC transplantation in 20 patients by means of flow cytometry. The median CD34+ cells were at the highest level in the first hour and decreased below pre-infusion values on the first day after HSC infusion. By nonparametric analysis, positive correlation was found between CD34+ cell levels at the first hour and the post-thaw CD34+ cell dose (r = 0.57, p = 0.01). An inverse correlation was determined between CD34+ cell levels at the first hour and neutrophil engraftment (r = -0.54, p = 0.01). Compared with the patients having CD34+ cell count of >= 2 mu L-1 in the first hour following HSC infusion, the patients having CD34+ cell count of <2 mu L-1 had delayed both neutrophil (20 vs. 12, p = 0.008) and platelet (47 vs. 11, p = 0.01) engraftments. Our results indicated that infused HSCs were removed from the blood circulation within 1 day. In addition, CD34+ cell levels at the first hour may be used as an important indicator to predict the delay of neutrophil and platelet engraftments. (c) 2013 Elsevier Ltd. All rights reserved.Öğe Clinical side effects during peripheral blood progenitor cell infusion(Pergamon-Elsevier Science Ltd, 2007) Donmez, Ayhan; Tombuloglu, Murat; Gungor, Ayse; Soyer, Nur; Saydam, Güray; Cagirgan, SeckinThere are several side effects which have been reported during the infusion of peripheral blood progenitor cells (PBPCs) either due to the infusion or the content of the infusate. We have evaluated the side effects detected during PBPCs infusion in 194 autologous and 25 allogeneic transplantations. In autologous cryopreserved PBPCs infusion, we detected a total of forty-nine (25.25%) side effect events during and after the infusion period. Forty-six (23.71%) of these side effects were detected during the infusion period including fifteen (7.73%) cardiac side effects, which required stopping the infusion, and thirty-one (15.97%) non-cardiac side effects, which did not require cessation of the infusion. Sinus bradycardia after a minimum of 45 min after completing the infusion was seen in three (1.54'%) patients. The median volume, dimethyl sulfoxide (DMSO) and total nucleated cell (TNC) content of the product were found to be significantly higher in patients with side effects compared to the group without any side effects (P < 0.05). The median volume and DMSO content were found to be significantly higher in patients with cardiac side effects compared to non-cardiac side effects (P < 0.05). There was no cardiac side effects in patients treated with an infusate containing 100 x 10(9) L-1 leukocytes. We did not observe any infusion-related side effects in patients given allogeneic non-cryopreserved PBPCs. We have concluded that the volume, DMSO and TNC content of autologous cryopreserved PBPCs product are directly related to clinical side effects. (c) 2006 Elsevier Ltd. All rights reserved.Öğe Comparison of CD38, ZAP70 and hTERT Expression with Known Prognostic Markers in Patients with Chronic Lymphocytic Leukemia During Five-Year Follow- up Period(Akad Doktorlar Yayinevi, 2014) Vural, Filiz; Karaca, Emin; Soyer, Nur; Gunduz, Cumhur; Sahin, Fahri; Kosova, Buket; Saydam, Güray; Cagirgan, Seckin; Tombuloglu, Murat; Özkınay, Ferda; Cogulu, OzgurChronic Lymphocytic Leukemia (CLL) is the most common leukemia in adults. Recently CD38, ZAP70 and hTERT activity have been studied for the evaluation of the prognosis of CLL besides clinical staging and lymphocyte doubling time. There are inconsistent results regarding these markers for the evaluation of the prognosis in CLL patients. In this study CD38, ZAP70 and hTERT values in CLL patients were measured to make comparisons between each other and known prognostic factors. Thirty CLL patients who were included in the study were followed up for 5 years after the initial diagnosis. The mean hTERT value in CLL and control cases were 1.00 +/- 1.31 and 3.89 +/- 3.58, respectively (p< 0.05). The mean CD38 and ZAP70 were 6.20 +/- 7.60 and 5.51 +/- 5.67, respectively. No significant association was detected between CD38, ZAP70 and hTERT activity. There was no correlation between those parameters and known prognostic parameters such as Rai staging, peripheral lymphocyte levels, age, and sex of the patients, beta-2 microglobulin and reply to treatment in CLL. The overall five-year survival rate in CLL patients is 96.7%. The overall five-year survival rate in CLL patients is 96.7%. In conclusion, further studies including larger series of patients with longer follow-up periods are recommended.Öğe Current practice of autologous hematopoietic progenitor cell mobilization in adult patients with multiple myeloma and lymphoma: The results of a survey from Turkish hematology research and education group (ThREG)(Pergamon-Elsevier Science Ltd, 2017) Tekgunduz, Emre; Demirkan, Fatih; Vural, Filiz; Goker, Hakan; Ozdogu, Hakan; Kiki, Ilhami; Aydogdu, Ismet; Kaynar, Leylagul; Erkurt, Mehmet Ali; Cagirgan, Seckin; Besisik, Sevgi; Dagdas, Simten; Koca, Ebru; Kadikoylu, Gurhan; Gunduz, Eren; Yilmaz, Mehmet; Bekoz, Hulseyin; Ural, Ali Ugur; Basturk, Abdulkadir; Arat, Mutlu; Albayrak, Murat; Ozturk, Erman; Akyol, Alev; Bolaman, Ali Zahit; Nevruz, Oral; Ozkan, Hasan Atilla; Ozgur, Gokhan; Altuntas, FevziAutologous hematopoietic cell transplantation (AHCT) is an established treatment option for adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and/or relapsed/refractory disease settings. Although there are recently published consensus guidelines addressing critical issues regarding autologous hematopoietic progenitor cell mobilization (HPCM), mobilization strategies of transplant centers show high variability in terms of routine practice. In order to understand the current institutional policies regarding HPCM in Turkey and to obtain the required basic data for preparation of a national positional statement on this issue, Turkish Hematology Research and Education Group (ThREG) conducted a web-based HPCM survey. The survey was designed to include multiple-choice questions regarding institutional practice of HPCM in adults presenting MM, HL, and NHL. The representatives of 27 adult HCT centers participated to the study. Here we report the results of this survey shedding light on the real world experience in Turkey in terms of autologous HPCM mobilization strategies in patients presenting with MM and lymphoma. (C) 2017 Elsevier Ltd. All rights reserved.Öğe Determining Toxoplasma high-risk autologous and allogeneic hematopoietic stem cell transplantation patients by systematic pre-transplant PCR screening of stem cell originated buffy coat(Elsevier Ireland Ltd, 2012) Caner, Ayse; Donmez, Ayhan; Doskaya, Mert; Degirmenci, Aysu; Tombuloglu, Murat; Cagirgan, Seckin; Guy, Edward; Francis, Janet; Soyer, Nur Akad; Guruz, YukselThe diagnosis of Toxoplasma infection or disease in hematopoietic stem cell transplantation (HSCT) patients is achieved mainly by PCR screening; however screening did not find wide field of use in practice due to costly expenditures of PCR. This study aimed to determine patients at high risk of Toxoplasma infection or disease before transplantation by stem cell originated buffy coat PCR and subsequently to screen them. Buffy coats collected from 12 autologous and 18 allogeneic HSCF patients' donors were investigated by PCR before transplantation. After transplantation, blood and sera collected at fixed time intervals were screened by two PCR methods and serological assays. Screening results first time assessed a toxoplasmosis incidence level as 25% in autologous HSCT patients and increased incidence level in allogeneic HSCT patients to 22%. Importantly, huffy coat PCR was first time performed before transplantation, to determine the risk of toxoplasmosis. Buffy coat PCR results showed that four patients were at high risk of toxoplasmosis before transplantation. After transplantation, these patients experienced toxoplasmosis. In conclusion, for the determination of patients at risk of toxoplasmosis, clinicians should consider buffy coat PCR in combination with serology before transplantation. After transplantation, PCR screening can be initiated in high risk patients upon clinical suspicion. (C) 2012 Elsevier Ireland Ltd. All rights reserved.Öğe Early Access Program Results From Turkey and a Literature Review on Daratumumab Monotherapy Among Heavily Pretreated Patients With Relapsed/Refractory Myeloma(Cig Media Group, Lp, 2020) Beksac, Meral; Aydin, Yildiz; Goker, Hakan; Turgut, Mehmet; Besisik, Sevgi Kalayoglu; Cagirgan, Seckin; Tekgunduz, EmreThe present study investigated the efficacy and safety profile of daratumumab monotherapy in 42 patients with relapsed refractory multiple myeloma through a Turkish early access program. the current findings have confirmed the efficacy of daratumumab monotherapy in heavily pretreated patients with refractory multiple myeloma because of the deep and durable responses and favorable safety and tolerability profile. Background: in countries where frontline drug approval is limited to first-generation proteasome inhibitors or immunomodulatory drugs, relapses have been both more frequent and less durable. We investigated real world data on the efficacy and safety of daratumumab monotherapy among patients with relapsed refractory multiple myeloma (RRMM) from Turkey using a prospective early access program. Patients and Methods: A total of 42 patients with RRMM after a minimum of 3 previous lines of proteasome inhibitor/immunomodulatory drug-based treatments were included from 25 centers across Turkey. Daratumumab monotherapy was administered intravenously at a dose of 16 mg/kg weekly (cycles 1-2), on alternate weeks (cycles 3-6), and monthly thereafter. Results: the median daratumumab monotherapy duration was 5.5 months (range, 0.2-28.7 months). the overall response rate was 45.2%, including 14 (33.3%) partial responses, 4 (9.5%) very good partial responses, and 1 (2.4%) complete response. the median duration of response was 4.9 months. the median progression-free survival (PFS) was 5.5 (95% confidence interval, 2.6-8.4 months) with 12- and 18-month PFS rates of 35.7% and 31.0%, respectively. the median overall survival was not reached; the 12- and 18-month overall survival rates were 64.3% and 59.5%, respectively. the depth of response had a significant effect on PFS (log-rank test, P = .026). Overall, of the 76 adverse events reported, 33 (43.4%) were grade >= 3; only 4 (9.52%) were grade 3 infusion-related reactions. No infusion-related reactions or adverse events led to treatment discontinuation. Conclusion: the present findings from our daratumumab early access program have confirmed the efficacy and safety profile of daratumumab monotherapy in heavily pretreated Turkish patients with RRMM.Öğe The Effect of Cryotherapy on the Prevention of Oral Mucositis and on the Oral pH Value in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation(Elsevier Science Inc, 2021) Baysal, Ebru; Sari, Dilek; Vural, Filiz; Cagirgan, Seckin; Saydam, Guray; Tobu, Mahmut; Sahin, FahriObjective: The aim of this study was to evaluate the effectiveness of cryotherapy on the prevention of oral mucositis (OM) and on the oral pH value in patients with multiple myeloma undergoing autologous stem cell transplantation. Data Sources: This nonrandomized controlled clinical trial was carried out in Bone Marrow Transplant Centers of three hospitals with total 32 patients. In addition to standard oral care, a total of 80 minutes of cryotherapy was applied to the experimental group. OM was assessed according to the World Health Organization's Oral Toxicity Scale before chemotherapy and for 21 days after chemotherapy (every day in the first 14 days, then every other day until the 21st day [if not discharged]). Conclusion: According to the findings, cryotherapy did not change the incidence of oral OM, and neither affected the severity of nor decreased the duration of it. Oral pH value was found to be significantly different between the patient groups only before and 1 day after chemotherapy. Implications for Nursing Practice: Cryotherapy is an inexpensive, easy-to-use method with no side effects; it would be beneficial to continue cryotherapy to prevent the development of OM in patients with cancer receiving drugs with a short half-life such as melphalan. It is also recommended to conduct further studies with different chemotherapy drugs with short half-lives to determine its effect on the prevention of OM development. (c) 2021 Elsevier Inc. All rights reserved.Öğe The effect of hematopoietic progenitor cells' temperature on cardiac arrhythmias in patients given peripheral blood progenitor cells(Pergamon-Elsevier Science Ltd, 2006) Donmez, Ayhan; Zoghi, Mehdi; Cagirgan, Seckin; Acarlar, Ceylan; Tombuloglu, MuratBackground: Infusion of cryopreserved and non-cryopreserved hematopoietic progenitor cells (HPC) is associated with a broad variety of symptoms. In this study, we have investigated infusion-related toxicity regarding temperature of cryopreserved autologous peripheral blood progenitor cells (PBPCs) transplanted in 31 and allogeneic non-cryopreserved PBPCs in 4 patients receiving high dose chemotherapy and stem cells transplantation for hematological malignancies. Study design and method: A 24 h ECG-Holter recording system was used to obtain cardiac arrhythmias. Two milliliters HPC were collected from entrance site of venous access to evaluate the temperature of infused HPC. Results: We have detected arrhythmias in 17 (48.58%) of our patients before, during and after infusion. Median temperature of the infusat was 21 degrees C (18-28.2). Arrhythmias during infusion were detected in 8 (22.85%) patients. The temperatures of infused HPCs were not statistically different in group with and without arrhythmias as 22 degrees C and 21 degrees C, respectively (P > 0.05). And also, volume, contents [dimethylsulphoxide (DMSO), red blood cells (RBC), platelet (PLT), and total nucleated cell (TNQ)] of product, and rate of infusion speed did not have any effect on arrhythmias. Conclusion: As a result of this study, we have concluded that the temperature of HPC does not cause any systemic hypothermia and does not have any relation to arrhythmias detected during infusion. (c) 2006 Elsevier Ltd. All rights reserved.Öğe Epstein-Barr virus (EBV) positive diffuse large B cell lymphoma of the elderly-Experience of a single center from Turkey(Elsevier Gmbh, Urban & Fischer Verlag, 2013) Ozsan, Nazan; Cagirgan, Seckin; Saydam, Güray; Gunes, Ajda; Hekimgil, MineIn the 2008 WHO lymphoma classification, 'EBV-positive diffuse large B cell lymphoma (DLBCL) of the elderly is included as a new provisional entity. We aimed to evaluate the morphological, immunophenotypic, and clinical characteristics of the cases diagnosed as 'EBV-positive DLBCL of the elderly' in our center and compared them with the 'EBV-negative DLBCL' patients older than 50 years of age. EBV status was detected by Epstein-Barr early RNA (EBER) in situ hybridization analysis. By immunohistochemistry, a panel of antibodies for CD10, Bcl-2, Bcl-6, IRF4/MUM1, CD30, and Ki67 was performed. Out of 149 DLBCL patients older than 50 years, without any known history of immunodeficiency or prior lymphoma, eight patients who fulfill the criteria were re-evaluated. Five patients were male and three were female, with a median age of 67.6 years. Four patients presented with nodal involvement; others presented with bone and soft tissue, bone marrow, and spleen infiltrations. Five cases revealed predominantly monomorphic morphology, one also contained focal areas consistent with polymorphous subtype; and three patients revealed a polymorphous infiltrate. When classified according to 'Hans criteria', five were non-GCB, and three were of the GCB cell phenotype. All cases with polymorphous morphology were revealed to be of the non-GCB cell phenotype, and all expressed IRF4/MUM1. Two patients died with disease, four patients are alive and in complete remission following R-CHOP therapy, and two patients have just recently been diagnosed. When compared with the EBV-negative group, there are no reliable morphological and immunohistochemical features indicating EBV positivity. Therefore, EBER in situ hybridization analysis is necessary to identify 'EBV-positive DLBCL of the elderly'. Further studies are needed to fully understand the details of this disease, which can lead to new treatment modalities. (C) 2013 Elsevier GmbH. All rights reserved.Öğe Epstein-Barr virus (EBV) positive diffuse large B cell lymphoma of the elderly-Experience of a single center from Turkey(Elsevier Gmbh, Urban & Fischer Verlag, 2013) Ozsan, Nazan; Cagirgan, Seckin; Saydam, Güray; Gunes, Ajda; Hekimgil, MineIn the 2008 WHO lymphoma classification, 'EBV-positive diffuse large B cell lymphoma (DLBCL) of the elderly is included as a new provisional entity. We aimed to evaluate the morphological, immunophenotypic, and clinical characteristics of the cases diagnosed as 'EBV-positive DLBCL of the elderly' in our center and compared them with the 'EBV-negative DLBCL' patients older than 50 years of age. EBV status was detected by Epstein-Barr early RNA (EBER) in situ hybridization analysis. By immunohistochemistry, a panel of antibodies for CD10, Bcl-2, Bcl-6, IRF4/MUM1, CD30, and Ki67 was performed. Out of 149 DLBCL patients older than 50 years, without any known history of immunodeficiency or prior lymphoma, eight patients who fulfill the criteria were re-evaluated. Five patients were male and three were female, with a median age of 67.6 years. Four patients presented with nodal involvement; others presented with bone and soft tissue, bone marrow, and spleen infiltrations. Five cases revealed predominantly monomorphic morphology, one also contained focal areas consistent with polymorphous subtype; and three patients revealed a polymorphous infiltrate. When classified according to 'Hans criteria', five were non-GCB, and three were of the GCB cell phenotype. All cases with polymorphous morphology were revealed to be of the non-GCB cell phenotype, and all expressed IRF4/MUM1. Two patients died with disease, four patients are alive and in complete remission following R-CHOP therapy, and two patients have just recently been diagnosed. When compared with the EBV-negative group, there are no reliable morphological and immunohistochemical features indicating EBV positivity. Therefore, EBER in situ hybridization analysis is necessary to identify 'EBV-positive DLBCL of the elderly'. Further studies are needed to fully understand the details of this disease, which can lead to new treatment modalities. (C) 2013 Elsevier GmbH. All rights reserved.Öğe Extramedullary Relapse in a CML Patient after Allogeneic Stem Cell Transplantation(Hindawi Ltd, 2017) Yilmaz, Asu Fergun; Soyer, Nur; Ozsan, Nazan; Cagirgan, Seckin; Gunes, Ajda; Comert, Melda; Sahin, Fahri; Saydam, Güray; Gunel, Nur Selvi; Vural, FilizMyeloid or granulocytic sarcoma (GS) is a tumoral lesion consisting of immature granulocytic cells. It is a rare entity during the course of CML patients especially after allogeneic stem cell transplantation (SCT). Relapse without bone marrow involvement is much rarer. We report a case of CML patient who relapsed with isolated granulocytic sarcoma after allogeneic SCT during cytogenetic and molecular remission. 28-year-old male was diagnosed as CML and allogeneic SCT was performed because of refractory disease to tyrosine kinase inhibitors. Complete cytogenetic and molecular response was achieved after allogeneic SCT followed by dasatinib treatment. Approximately 5 years after the transplantation, very rapidly progressive lesion was documented and diagnosed as GS although he was at molecular and cytogenetic remission. The patient died during chemotherapy due to sepsis. GS relapse after allogeneic SCT is a very rare type of relapse in CML patients with molecular and cytogenetic remission. Since it is a very aggressive disease with a poor prognosis, combined chemoradiotherapies with other possible options like DLI or second allogeneic SCT should be considered as soon as the diagnosis is confirmed.Öğe Factor V G1691A (Leiden) and prothrombin G20210A gene mutation status, and thrombosis in patients with chronic myeloproliferative disorders(Aves Yayincilik, 2011) Soyer, Nur; Kucukarslan, Ali Sahin; Sahin, Fahri; Cekdemir, Demet; Kosova, Buket; Eroglu, Zuhal; Tobu, Mahmut; Tombuloglu, Murat; Cagirgan, Seckin; Donmez, Ayhan; Vural, Filiz; Saydam, GürayObjective: The aim of this study was to examine Factor V G1691A (Leiden) (FVL) and prothrombin G20210A (PT) gene mutation status, and their relationship with thrombosis in patients with chronic myeloproliferative disorders (CMPDs). Materials and Methods: The study included 160 patients with a CMPD that were regularly followed-up between 1993 and 2009. FVL and PT mutation status was established based on blood samples analyzed via PCR using specific primers. Results: The frequency of FVL and PT mutation was 12.5% and 4.4%, respectively. In total, 27 episodes of thrombosis occurred in 24 (15%) of the patients, and there wasn't an association between the observed thrombotic events, and FVL or PT mutations. Hepatic vein thrombosis was noted in 3 patients that had FVL mutation, of which 1 also had PT mutation. Conclusion: We did not observe a relationship between thrombosis, and FVL or PT mutations in CMPD patients; however, 3 of the patients that had hepatic vein thrombosis also had FVL mutation. Larger studies are needed to more clearly determine if all CMPD patients with hepatic vein thrombosis need be investigated for FVL and PT mutation. (Turk J Hematol 2011; 28: 306-11)Öğe Factors influencing engraftment in autologous peripheral hematopoetic stem cell transplantation (PBSCT)(Pergamon-Elsevier Science Ltd, 2007) Ergene, Ulku; Cagirgan, Seckin; Pehlivan, Mustafa; Yilmaz, Mumtaz; Tombuloglu, MuratAutologous peripheral blood stem cells transplantation (PBSCT) is a therapeutic option which can be used in various hematological neoplastic disorders; and it can prolong disease free survival and total survival and at times it may be curative. In this study, we investigated variables influencing PBSCT in 91 patients who had undergone PBSCT between 1998 and 2002 in our center, retrospectively. PBSC collection was performed after mobilization with G-CSF or chemotherapy plus growth factor. Only high dose chemotherapy was used for conditioning regimes. The median number of CD34+ was 11.5 x 10(6)/kg. Posttransplant neutrophil engraftment (> 500/mu L) was requiring a median of 10 days, it was 13 days for platelet engraftment (> 20,000/mu L). For neutrophil and platelet engraftment, we investigated; sex, age, diagnosis and CD34+ cells, the time interval between diagnosis and transplantation, number of apheresis, conditioning regime, growth factor initiation day as independent variables. In univariate analysis CD34+ cell number (> 10 x 10(6)/kg), time interval more than one year between diagnosis and transplantation and BEAM conditioning was found to be significant for neutrophil engraftment. But in multivariate analysis none of them was found to be significant. For platelet engraftment in univariate analysis CD34+ cell number (> 7 x 10(6)/kg), primary diagnosis of multiple myeloma initiation day of growth factor (> 2 day) was found to be significant. In multivariate analyses only CD34+ cell count was found to be significant (p = 0.005). In conclusion, as in previous studies we found that the only predictor of engraftment kinetics was CD34+ cell count. (c) 2006 Published by Elsevier Ltd.Öğe FAS/FASL gene polymorphisms in Turkish patients with chronic myeloproliferative disorders(Termedia Publishing House Ltd, 2017) Ozdemirkiran, Fusun Gediz; Nalbantoglu, Sinem; Gokgoz, Zafer; Payzin, Bahriye Kadriye; Vural, Filiz; Cagirgan, Seckin; Berdeli, AfigIntroduction: Chronic myeloproliferative disorders (CMPD) are chronic myeloid hematological disorders, characterized by increased myeloid cell proliferation and fibrosis. Impaired apoptotic mechanisms, increased cell proliferation, uncontrolled hematopoietic cell proliferation and myeloaccumulation may contribute to the pathogenesis of CMPD. The aim of our study was to show the possible role of FAS/FASL gene polymorphisms in CMPD pathogenesis and investigate the association with clinical parameters and susceptibility to disease. Material and methods: We included 101 (34 polycythemia vera (PV), 23 primary myelofibrosis (PMF), 44 essential thrombocythemia (ET)) CMPD patients diagnosed according to the WHO classification criteria and 95 healthy controls in this study. All the patients and the controls were investigated for FAS/FASL gene expression, allele frequencies and phenotype features, and also FAS mRNA levels were analyzed. Results: Chronic myeloproliferative disorders patients showed increased FAS-670AG + GG genotype distribution compared with the control group (p < 0.05). While the A allele was more frequent in both groups, AG genotype was more frequent in CMPD patients. There was no association between FAS-670A>G gene polymorphism and some clinical parameters such as splenomegaly and thrombosis (p > 0.05). No statistically significant difference in FASL+843C>T genotype or allele frequency was found between groups (p > 0.05). Moreover, no statistically significant difference was detected in FASL and JAK2V617F mutations (p > 0.05). FAS mRNA expression was 1.5-fold reduced in patients compared to healthy subjects. Conclusions: According to our findings, FAS/FASL gene expression may contribute to the molecular and immunological pathogenesis of CMPD. More investigations are needed to support these data.
