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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 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 First report of brown rot caused by Monilinia fructicola (Winter) Honey on sweet cherry in Turkey(Springer, 2019) Uysal, Ayse; Kinay-Teksur, Pervin; Poyraz, DilekÖğe Long-Term Outcomes of Allogeneic Stem Cell Transplantation for Relapsed/Refractory Hodgkin and Non-Hodgkin Lymphoma: Multi-center Experience from Turkey(Springer India, 2024) Uysal, Ayse; Soyer, Nur Akad; Ozdogu, Hakan; Goker, Hakan; Cinar, Olgu Erkin; Deveci, Burak; Yilmaz, Asu FergunThis multicenter retrospective study evaluated the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on survival and safety in patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). A total of 110 patients with R/R HL or NHL who underwent allo-HSCT between July 2007 and October 2022 at 7 adult stem cell transplant centers were evaluated. Progression-free survival (PFS), graft versus host disease-free survival (GRFS), and overall survival (OS) were the primary endpoints, and NRM was the secondary endpoint. Forty-one (37.3%) of the total patients were diagnosed with HL, 69 (62.7%) with NHL. The median age at the time of allo-HCT was 39.5 years (16-67), of which 66 (60%) were male. The median follow-up was 67.5 +/- 8.1 months, and the rates of 5-year OS, PFS, and GRFS were 38.4%, 37%, and 34.8%, respectively. On multivariate analysis, CR/PR disease status after allo-HCT was significantly associated with longer PFS (HR: 13.47, 95% CI: 5.80-31.26, p = 0.000) and OS (HR: 5.23, 95% CI: 2.93-9.34, p = 0.000). CR/PR disease status after allo-HCT (HR: 5.79, 95% CI: 3.22-10.40, p = 0.000) and grade 1-2 acute GvHD (HR: 2.33, 95% CI: 1.25-4.35, p = 0.008) were significantly associated with longer GRFS. The 5-year cumulative incidence of NRM was 24.8% (95% CI, 12.5-36.7). The most common conditioning regimen was reduced intensity. Transplant outcomes are not influenced by disease subtype. However, the achievement of a CR/PR response after allo-HCT significantly prolongs OS, PFS and GRFS. In addition, the presence of acute grade 1-2 GvHD was found to be another factor prolonging GRFS. These results support the feasibility of allo-HCT, especially in heavily treated patients.Öğe Natural dissemination of hypovirulent Cryphonectria parasitica strain used for biological control of chestnut blight(Tubitak Scientific & Technical Research Council Turkey, 2017) Celiker, Naciye Mukerrem; Kaplan, Cevdet; Onogur, Ersin; Cetinel, Barbaros; Poyraz, Dilek; Uysal, AyseChestnut blight, caused by Cryphonectria parasitica Murr. Barr, is the most serious disease of chestnut trees in Turkey on which several studies related to biological control were conducted. The aim of this study was to determine the cause of the occurrence of healing cankers on untreated chestnut trees and the role of carriers in the spread of hypovirulence by laboratory tests, and to discover the effect of some environmental factors (temperature and relative humidity) on the natural spreading of hypovirulence. The study was carried out in a chestnut grove where biological control studies of the disease had been performed in previous years. Bark samples were collected from healed cankers and 388 possibly hypovirulent isolates were obtained. Two of them that were white converted virulent isolates to hypovirulent ones, but others developed yellowish cream-colored mycelia and did not convert virulent isolates. dsRNA analysis was performed on randomly selected possible hypovirulent isolates collected from healed cankers. After the virus concentration had increased, dsRNA-positive reactions were obtained for 56.73% of the isolates. Thirty-one possible hypovirulent isolates from Formicidae and Gastropoda did not convert virulent isolates to hypovirulent ones. dsRNA analysis was performed on these isolates and 61.29% of them containing dsRNA were observed in the invertebrates collected from cankers that had healed from hypovirulence. It was also observed that there was no significant difference among the date of average temperatures and date of relative humidity from 3 different altitudes. It was determined that the reason for the occurrence of the healed cankers on untreated trees was the natural dissemination of hypovirulence, ants and snails might have played a role in the natural dissemination of hypovirulence, and healed cankers mostly occurred on the western sides of shaded slopes.Öğe Outcome of allogeneic stem cell transplantation for hodgkin and non-hodgkin lymphoma: Single center experince from Turkey(Nature Publishing Group, 2019) Uysal, Ayse; Bulbul, Hale; Soyer, Nur Akad; Tobu, Mahmut; Tombuloglu, Murat; Saydam, Güray; Vural, FilizÖğe Risk factors for amputation in patients with diabetic foot infection: a prospective study(Wiley, 2017) Uysal, Serhat; Arda, Bilgin; Tasbakan, Meltem I.; Cetinkalp, Sevki; Simsir, Ilgin Y.; Ozturk, Anil M.; Uysal, Ayse; Ertam, IlgenThere is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI. The variables were analysed using logistic analysis. A total of 126 cases (332%) underwent amputation. The odds ratios in the amputation model were 309 for osteomyelitis (P < 0001), 490 for arterial stenosis (AS) (P < 0001), 367 for the history of DFI (P = 0001), 247 for ulcer duration >60 days (P = 0001), 310 for ulcer depth > 15 mm (P < 0001) and 1028 for fungal DFI (P = 0015). In this study, the unusual result of well-known literature was fungal DFI as an independent risk factor for amputation in patients with DFI.Öğe The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study(Galenos Yayincilik, 2016) Tombak, Anil; Ucar, Mehmet Ali; Akdeniz, Aydan; Tiftik, Eyup Naci; Sahin, Deniz Goren; Akay, Olga Meltem; Yildirim, Murat; Nevruz, Oral; Kis, Cem; Gurkan, Emel; Solmaz, Serife Medeni; Ozcan, Mehmet Ali; Yildirim, Rahsan; Berber, Ilhami; Erkurt, Mehmet Ali; Tuglular, Tulin Firatli; Tarkun, Pinar; Yavasoglu, Irfan; Dogu, Mehmet Hilmi; Sari, Ismail; Merter, Mustafa; Ozcan, Muhit; Yildizhan, Esra; Kaynar, Leylagul; Mehtap, Ozgur; Uysal, Ayse; Sahin, Fahri; Salim, Ozan; Sungur, Mehmet AliObjective: In this study, we aimed to investigate the efficacy and safety of azacitidine (AZA) in elderly patients with acute myeloid leukemia (AML), including patients with >30% bone marrow (BM) blasts. Materials and Methods: In this retrospective multicenter study, 130 patients of >= 60 years old who were ineligible for intensive chemotherapy or had progressed despite conventional treatment were included. Results: The median age was 73 years and 61.5% of patients had >30% BM blasts. Patients received AZA for a median of four cycles (range: 1-21). Initial overall response [including complete remission (CR)/CR with incomplete recovery/partial remission] was 36.2%. Hematologic improvement (HI) of any kind was documented in 37.7% of all patients. HI was also documented in 27.1% of patients who were unresponsive to treatment. Median overall survival (OS) was 18 months for responders and 12 months for nonresponders (p=0.005). In the unresponsive patient group, any HI improved OS compared to patients without any HI (median OS was 14 months versus 10 months, p=0.068). Eastern Cooperative Oncology Group performance status of <2, increasing number of AZA cycles (>= 5 courses), and any HI predicted better OS. Age, AML type, and BM blast percentage had no impact. Conclusion: We conclude that AZA is effective and well tolerated in elderly comorbid AML patients, irrespective of BM blast count, and HI should be considered a sufficient response to continue treatment with AZA.Öğe Use of Tigecycline for Diabetic Foot Infections(H M P Communications, 2017) Arda, Bilgin; Uysal, Serhat; Tasbakan, Meltem; Simsir, Ilgin Yildirim; Ozturk, Murat; Ertam, Ilgen; Uysal, Ayse; Ulusoy, SercanObjective. The aim of this study is to evaluate tigecycline for diabetic foot infections (DFIs). Materials and Methods. In this prospective observational study, the investigators included patients who had consultation with the Diabetic Foot Council of Ege University Faculty of Medicine (Izmir, Turkey) between March 2013 and July 2015 and who used tigecycline during their treatment. Treatment success was assessed by design-specific criteria for each evaluation. Results. The study included 105 cases. Of those, 37 (35.2%) were women (mean [+/- standard deviation] age, 61.9 +/- 11.9 years). The success rate of tigecycline treatment was 93.3% in mild infections, 56.2% in moderate, 57.7% in severe, and 61.9% in all cases. The authors found a 9-fold decrease (P = .046) in the success of tigecycline treatment among those who developed moderate or severe DFIs and a 6.4-fold decrease (P < .0001) among those who had arterial stenosis. For 33 (71.7%) of 46 (43.8%) patients who experienced a side effect, tigecycline treatment was continued as it could be tolerated. Conclusions. If tigecycline is to be the treatment choice, extra attention must be paid to patients with arterial stenosis, severe DFIs, and side effects. The common disadvantage is the high side effect rate, especially nausea. However, it is generally not necessary to discontinue the medication incases with nausea. Therefore, tigecycline may be used as a choice of therapy in mild DFIs.
