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Öğe A Single-Center Retrospective Evaluation of The Incidence and Survival of Invasive Fungal Infection in Allogeneic Stem Cell Transplant Patients(Galenos Publishing House, 2024) Osabas, Emre; Gunes, Ajda; Soyer, Nur; Tobu, Mahmut; Sahin, Fahri; Saydam, Guray; Arda, Bilgin; Vural, FilizAim: The incidence of invasive fungal infection (IFI) is high in patients undergoing allogeneic hematopoietic stem cell transplantation. Despite new antifungal agents, IFI is still an important cause of mortality. Our study aimed to determine the risk factors of IFI and its effect on mortality. Materials and Methods: One hundred and fifty-four patients who underwent allogeneic transplantation were included in the study. Demographic characteristics, underlying disease, transplantation characteristics, and IFI status of all patients were evaluated retrospectively. The study group was divided into two: 75 patients with definite, high probability and possible IFI (group 1) and 79 patients without IFI (group 2) according to the criteria of the international committee. Results: Of 154 patients, 92 were male (59.7%) and 62 were female (40.3%) with a mean age of 41.87 +/- 14.04 years (range: 18-67 years). The most common transplant indication was acute myeloid leukemia in 58 patients (37.7%). In the analyzes performed on two groups, more IFI were observed in those who had acute graft-versus-host disease after transplantation (p= 0.035) and in those with CMV reactivation (p=0.002). The mean neutropenia duration was 30.89 +/- 20.40 in group 1 and 19.98 +/- 11.01 in group 2 (p=0.001). Underlying diseases, preparation regimen, donor compatibility, consanguineous marriage and IFI history were not found to be significant in terms of the development of IFI. The mortality rate due to IFI was found to be 24%. The mean duration of neutropenia was found to be longer in patients who died (p=0.02). Conclusion: In our study, the frequency of IFI, risk factors and mortality rates were found to be similar to the literature. It would be appropriate for each center to evaluate the frequency of IFI and the risk factors that increase it and decide which treatment strategy is more beneficial for their patients.Öğe Allogeneic Heamatopoietic Stem Cell Transplantation in Elderly Patients; Single Centre Experience(Nature Publishing Group, 2018) Bulbul, Hale; Atilla, Fatos Dilan; Soyer, Nur Akad; Tombuloglu, Murat; Tobu, Mahmut; Sahin, Fahri; Vural, Filiz[No Abstract Available]Öğe Allogeneic hematopoietic stem cell transplantation for Blastic Plazmositoid Dentritic Cell Neoplazm: Is The Best Treatment Option ?(Nature Publishing Group, 2018) Bulbul, Hale; Hekimgil, Mine; Ozsan, Nazan; Tobu, Mahmut[No Abstract Available]Öğe Allogeneic hematopoietic stem cell transplantation in adult aplastic anaemia patients: Promising treatment modality(Nature Publishing Group, 2019) Davulcu, Eren Arslan; Bulbul, Hale; Ulusoy, Yusuf; Soyer, Nur Akad; Karadag, Fatma Keklik; Arslan, Aysenur; Sahin, Fahri; Tobu, Mahmut; Saydam, Güray; Tombuloglu, Murat; Vural, FilizÖğe ANALYSIS OF PATIENTS WITH HEMATOLOGIC MALIGNANCIES UNDERGONE STEM CELL TRANSPLANTATION UNDER VORICONAZOLE PROPHYLAXIS(Nature Publishing Group, 2018) Davulcu, Eren Arslan; Soyer, Nur; Tombuloglu, Murat; Tobu, Mahmut; Saydam, Guray; Sahin, Fahri; Vural, Filiz[No Abstract Available]Öğe Carfilzomib experience in relapsed/refractory multiple myeloma: a single-center experience(Tubitak Scientific & Technical Research Council Turkey, 2018) Uysal, Ayse; Akad Soyer, Nur; Ozkan, Melda; Sahin, Fahri; Vural, Filiz; Tobu, Mahmut; Tombuloglu, Murat; Saydam, GürayBackground/aim: Carfilzomib (CFZ) is a new-generation proteasome inhibitor with significant activity in relapsed or refractory multiple myeloma (R/R-MM). We have retrospectively evaluated R/R-MM patients who were treated with CFZ plus dexamethasone. Materials and methods: Twenty-one R/R-MM patients who were treated with CFZ plus dexamethasone between October 2013 and January 2016 were screened. The patients were followed until March 2016 after CFZ treatment. Results: Ten (47.6%) of the patients were female and 11 (52.4%) of them were male. The median age was 62 (47-76) years. The median number of prior treatment lines was 3 (2-7). The median number of administered cycles of treatment for CFZ was 4 (1-10). The median overall response rate was 26.3%. The most common hematological adverse events were anemia and thrombocytopenia (38%). The most common nonhematological adverse event was fatigue (71.4%). One patient died because of a cerebrovascular event and 1 patient died because of pneumonia during the treatment period. The median duration of response rate and time to next therapy were 8 (7-9) and 3 (2-16) months, respectively. The median overall survival was 8 (0.5-33) months. Conclusion: Despite the small number of patients, our results suggest that CFZ provides acceptable responses in heavily pretreated R/R-MM patients.Öğe Changes in blood biochemistry thrombosis parameters 24 hours after stent-assisted endovascular treatment of intracranial aneurysms(Sage Publications Inc, 2024) Cinar, Celal; Oran, Ismail; Ozdemir, Halil Ibrahim; Kusbeci, Mahmut; Kavakli, Ramazan Kaan; Tobu, Mahmut; Parildar, ZuhalBackground and purpose This study aims to elucidate the early changes in blood biochemistry thrombosis parameters following stent-assisted endovascular treatment of intracranial aneurysms.Methods Consecutive patients with unruptured aneurysms undergoing stent implantation during endovascular treatment were included in this prospective study with approval from the local ethics committee. Blood samples were collected immediately before and 24 h after the procedure for biochemical analysis, including basic thrombosis indicators, bleeding tests, and a complete blood count.Results The study included 80 patients (60 women, 20 men) with 134 aneurysms. A total of 135 stents (110 flow-diverting, 25 standard) were used. Additionally, intrasaccular coiling was utilized in 28 aneurysms among 27 patients. Following the procedure, there was a significant decrease in activated partial thromboplastin time, fibrinogen, hemoglobin, and platelet levels, and a significant increase in prothrombin time, D-dimer, von Willebrand factor (vWF) activity/antigen ratio, and leukocyte levels in all patients. Correlation analyses revealed significant positive associations between platelet and fibrinogen levels, and a negative association between D-dimer and fibrinogen levels in the coil (-) group. Additionally, there was a significant negative correlation between aneurysm volume and vWF activity/antigen ratio, and procedure duration and thrombocyte count, while a positive association was found between aneurysm number and leukocyte count in the coil (-) group.Conclusions Analysis of blood chemistry alterations indicates that intravascular thrombosis occurs in the intracranial circulation following stent-assisted endovascular treatment of intracranial aneurysms. This thrombotic process is more pronounced in patients whose aneurysms were left open (i.e. flow-diverting stent alone).Öğe Clinical approach to corneal microcyst formation through cytarabine-related corneal toxicity(Taylor & Francis Ltd, 2023) Tas, Muhammed Dara; Devebacak, Ali; Gunes, Ajda; Tobu, Mahmut; Barut Selver, Ozlem[No abstract available]Öğe A complex t(15;22;17)(q22;q11.2;q21) variant of APL(Elsevier Science Inc, 2024) Ak, Bilgesu; Gungor, Ozge; Karaca, Emin; Durmaz, Burak; Bozer, Denis S.; Tobu, Mahmut; Akin, HalukThe present study described an extremely rare case of acute promyelocytic leukemia (APL) characterized by a complex three-way (15;22;17)(q22;q11.2;q21) translocation. Acute promyelocytic leukemia (APL) is a specific subtype of acute myeloid leukemia with distinctive clinical and therapeutic characteristics. Besides being characterized by the t(15;17)(q22;q12) translocation, this subtype is also notable for its response to all-transretinoic acid (ATRA) treatment. APL is highly responsive to a combination of ATRA and chemotherapeutic agents, achieving over 90 % complete remission rates and over 80 % long-term remission rates. In this case, a 79- year-old male patient presented with complaints of weakness, fatigue, and petechial rash, with no other significant medical history except for diabetes mellitus and hypertension. Conventional cytogenetic methods, dual- color dual-fusion, and dual-color break-apart fluorescent in situ hybridization techniques together identified the t (15;22;17) translocation. RT-PCR analysis was performed for expression of PML/RARA fusion transcripts. The patient, diagnosed with APL, exhibited a complete response to all-trans retinoic acid (ATRA) and idarubicin treatment. In this paper, we present the second documented case of t(15;22;17) and explore the remarkable remission observed following treatment with All-Trans Retinoic Acid (ATRA).Öğe CYTOMEGALOVIRUS INFECTION IN ALLOGENEIC HEMATOPOIETIC CTEM CELL TRANSPLANT PATIENTS WITH HEMATOLOGICAL DISEASES: A SINGLE CENTER EXPERIENCE(Nature Publishing Group, 2018) Davulcu, Eren Arslan; Soyer, Nur; Sahin, Fahri; Saydam, Guray; Tombuloglu, Murat; Tobu, Mahmut; Vural, Filiz[No Abstract Available]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 Hormone Replacement Treatment on Thrombin-Activatable Fibrinolysis Inhibitor Activity Levels in Patients with Hashimoto Thyroiditis(Japan Soc Internal Medicine, 2009) Cetinkalp, Sevki; Tobu, Mahmut; Karadeniz, Muammer; Buyukkececi, Filiz; Yilmaz, CandegerBackground Hypothyroid patients have increased risk of cardiovascular diseases, and several mechanisms have been considered responsible in these patients. Although, a few studies demonstrated fibrinolytic system changes in hypothyroid patients, there is no study demonstrating TAFI activity in hypothyroid Hashimoto's thyroiditis patients. The aim of this study was to evaluate TAFI activity status and the effect of L thyroxin hormone replacement treatment on fibrinolytic system in this patient group. Methods Thirty patients with hypothyroid Hashimoto thyroiditis (all were female and the mean age was 44.3 +/- 14.6 years, ranging between 17-68 years) were enrolled to study. Their TSH levels were high (27.2 +/- 5.2 mU/L) and Free T3 and Free T4 hormone levels were below than normal. In this study, euthyroid 20 healthy volunteers (mean age 32.5 +/- 4.9 years, range 26-42 years) were adopted. L-thyroxin treatment before and after TAFI activity levels were measured in patients. Results In the control group, TAFI activity levels were 9.6 +/- 0.4 mu g/mL. In patients with L-thyroxin before and after treatment there were high levels of TAFI activity value of 14.2 +/- 0.9 and 12.9 +/- 0.8 mu g/mL, respectively. In the patient group, after L-thyroxin treatment TAFI activity levels were decreased but they were not statistically significant (p=0.187). When compared to the control group, high levels of TAFI activity were observed in the patient group (p<0.0001). Conclusion Our data demonstrated that in Hashimoto thyroiditis, patients have high levels of TAFI activity compared to controls. A high level of TAFI activity suggests fibrinolytic deficit or thrombotic tendency in hypothyroid patients and this deficit is persistent after L-thyroxine replacement.Öğe The effect of polycythemia vera on hearing functions: Evaluation of twenty-one patients(Wiley, 2019) Dogan, Esma E.; Uslu, Mustafa; Ozkan, Melda Comert; Unal, Hatice D. Kiper; Saydam, Güray; Ogut, Mehmet F.; Tobu, MahmutÖğe Efficacy and safety of lenalidomide and dexamethasone in patients with relapsed/refractory multiple myeloma: a real-life experience(Tubitak Scientific & Technical Research Council Turkey, 2018) Soyer, Nur; Patir, Pusem; Uysal, Ayse; Duran, Mustafa; Unal, Hatice Demet; Durusoy, Raika; Tombuloglu, Murat; Sahin, Fahri; Tobu, Mahmut; Vural, Filiz; Saydam, GürayBackground/aim: In Turkey, lenalidomide plus dexamethasone (RD) has been used to treat relapsed/refractory multiple myeloma (RRMM) since 2010. This retrospective, single-center study evaluated the efficacy and tolerability of RD in patients with RRMM between October 2010 and June 2016. Materials and methods: Patients' records were reviewed, and overall (OS) and progression-free survival (PFS) were assessed. Results: One hundred and twenty patients (71 males; 59.2%) were included in the study. The median number of prior lines of treatment was one (1-4); 72 patients (60.0%) received RD as second-line therapy and 51 patients (42.5%) had previously undergone autologous stem cell transplantation (ASCT). The overall response rate was 72.5%, with 19% of these patients achieving a complete response. The median length of follow-up and duration of response to RD was 14 months and 19 months, respectively. Median OS and PFS were 32 and 21 months, respectively. Prior ASCT, an overall response, and treatment with RD for >12 cycles were identified as independent prognostic factors for OS and PPS. Adverse events (AEs) occurred in 69 (57.5%) and 14 patients (11.7%) discontinued treatment due to AEs. Conclusions: We found RD to be safe, well tolerated, and effective in RRMM in everyday clinical practice in Turkey.Öğe Epidemiology and analysis of invasive fungal infections in patients with hematological malignancies: a single-center real-life experience(Tubitak Scientific & Technical Research Council Turkey, 2017) Soyer, Nur; Unal, Hatice Demet Kiper; Vural, Filiz; Sahin, Fahri; Tobu, Mahmut; Donmez, Ayhan; Tombuloglu, Murat; Arda, Bilgin; Saydam, GürayBackground/aim: Invasive fungal infection (IFI) causes morbidity and mortality among patients with hematological malignancies. We evaluated the incidence and treatment characteristics of IFIs between October 2012 and December 2013. Materials and methods: Patients who received chemotherapy or stem cell transplantation were retrospectively evaluated. Fungal infections were classified according to EORTC criteria. Results: Prophylaxis and antifungal therapy were given in 30.5% and 23.6% of 522 chemotherapy courses, respectively. The incidence of proven/probable IFI was 6.7%. The incidence of IFI among patients who received prophylaxis was significantly higher than among those who did not receive it (11.3% vs. 4.6%, P = 0.005). There was no significant difference between patients who received mold-active and no mold-active prophylaxis (P = 0.098). The most common single agent therapy and causative pathogen was liposomal amphotericin B (57.1%) and Aspergillus (n = 5), respectively. IFI-attributable mortality rate was 14.2% in 6 weeks. Conclusion: The IFI incidence and mortality rate were similar to that reported in the literature. The IFI rate was higher in the group using prophylaxis, as this is a high-risk group. Although the IFI rate was not significantly different between groups using prophylaxis, patients should be followed closely for the effective use of posaconazole prophylaxis.Öğe Evaluation of BK Polyomavirus Infection Frequency and Risk Factors Following Allogeneic Stem Cell Transplantation (allo-SCT): A Single Center Experience(Cig Media Group, Lp, 2023) Gezici, Barış; Soyer, Nur Akad; Gunes, Ajda Ersoy; Saydam, Güray; Tobu, Mahmut; Şahin, Fahri; Vural, Filiz[No abstract available]Öğe EVALUATION OF BK POLYOMAVIRUS INFECTION FREQUENCY, RISK FACTORS AND EFFECT ON SURVIVAL FOLLOWING ALLOGENEIC STEM CELL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE(Springernature, 2023) Gezici, Baris; Soyer, Nur Akad; Güneş, Ajda Ersoy; Saydam, Güray; Tobu, Mahmut; Sahin, Fahri; Soylu, Mehmet[No abstract available]Öğe EVALUATION OF CYTOMEGALOVIRUS INFECTION FREQUENCY, RISK FACTORS AND EFFECT ON SURVIVAL FOLLOWING ALLOGENEIC STEM CELL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE(Springernature, 2023) Gezici, Barış; Güneş, Ajda Ersoy; Akad Soyer, Nur; Saydam, Güray; Tobu, Mahmut; Şahin, Fahri; Soylu, Mehmet[No abstract available]Öğe Evaluation of Cytomegalovirus Infection/Disease Frequency and Risk Factors Following Allogeneic Stem Cell Transplantation: A Single Center Experience(Cig Media Group, Lp, 2023) Gezici, Barış; Ersoy Güneş, Ajda; Soyer, Nur Akad; Saydam, Güray; Tobu, Mahmut; Şahin, Fahri; Vural, Filiz[No abstract available]Öğe EVALUATION OF EFFICACY IN FOLINIC ACID PREVENTING ORAL MUCOSITIS AFTER METHOTREXATE CONTAINED GVHD PROPHLAXIS FOR ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION(Springernature, 2023) Sevgili, Bahar; Güneş, Ajda; Bozer, Denis Sabriye; Soyer, Nur; Tobu, Mahmut; Şahin, Fahri; Saydam, Güray[No abstract available]
