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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 Acute Lymphoblastic Leukemia in Routine Practice: A Turkish Multicenter Study(2019) Çiftçiler, Rafiye; Sevindik, Ömür; Tekgündüz, Ali; Erkurt, Mehmet Ali; Vural, Filiz; Turgut, Burhan; Demirkan, FatihObjective: Significant developments occurred in the clinical management of acute lymphoblastic leukemia (ALL) in adults in recent decades. However, treatment results are still not satisfactory, especially in routine practice. The objective of this study was to evaluate the general clinical features, treatment details, and outcomes of a large group of patients followed in multiple centers in Turkey with a diagnosis of ALL. Materials and Methods: A retrospective analysis of the data of patients with ALL was made, the patients having been diagnosed and treated between January 2003 and June 2017 by different protocols in the hematology clinics of ten different centers. A total of 288 patients, aged between 17 and 76 years old, were included in the study. In this retrospective multicenter analysis of patients with ALL, classification of patients was performed based on treatment period, Philadelphia chromosome positivity, treatment regimen, and administration of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Results: The majority of cases were B-cell in origin, while 224 patients had B-ALL and 64 of the patients had T-ALL. Median follow-up duration for all patients was 18.2 months (range: 0.03-161 months). Philadelphia chromosome positivity was determined in 49 patients (21.9%), and 54 patients (18.8%) were receiving allo-HSCT. After induction chemotherapy, 219 patients (76.0%) achieved complete remission, 32 patients (11.2%) were evaluated as treatment refractory, and 37 patients (12.8%) were deceased. Median overall survival was 47.7 months (95% confidence interval: 36.1-59.2) and median disease-free survival was 23.4 months (95% confidence interval: 6.7- 40.0) for all patients. Conclusion: Multicenter studies are extremely important for defining the specific clinical features of a particular disease. The results of this study will make a significant contribution to the literature as they reflect real-life data providing valuable information about the Turkish ALL patient profile.Öğe Acute Lymphoblastic Leukemia in Routine Practice: A Turkish Multicenter Study(2019) Çiftçiler, Rafiye; Sevindik, Ömür; Tekgündüz, Ali; Erkurt, Mehmet Ali; Vural, Filiz; Turgut, Burhan; Payzın, BahriyeObjective: Significant developments occurred in the clinical management of acute lymphoblastic leukemia (ALL) in adults in recent decades. However, treatment results are still not satisfactory, especially in routine practice. the objective of this study was to evaluate the general clinical features, treatment details, and outcomes of a large group of patients followed in multiple centers in Turkey with a diagnosis of ALL. Materials and Methods: A retrospective analysis of the data of patients with ALL was made, the patients having been diagnosed and treated between January 2003 and June 2017 by different protocols in the hematology clinics of ten different centers. A total of 288 patients, aged between 17 and 76 years old, were included in the study. in this retrospective multicenter analysis of patients with ALL, classification of patients was performed based on treatment period, Philadelphia chromosome positivity, treatment regimen, and administration of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Results: the majority of cases were B-cell in origin, while 224 patients had B-ALL and 64 of the patients had T-ALL. Median follow-up duration for all patients was 18.2 months (range: 0.03-161 months). Philadelphia chromosome positivity was determined in 49 patients (21.9%), and 54 patients (18.8%) were receiving allo-HSCT. After induction chemotherapy, 219 patients (76.0%) achieved complete remission, 32 patients (11.2%) were evaluated as treatment refractory, and 37 patients (12.8%) were deceased. Median overall survival was 47.7 months (95% confidence interval: 36.1-59.2) and median disease-free survival was 23.4 months (95% confidence interval: 6.7- 40.0) for all patients. Conclusion: Multicenter studies are extremely important for defining the specific clinical features of a particular disease. the results of this study will make a significant contribution to the literature as they reflect real-life data providing valuable information about the Turkish ALL patient profile.Öğe Acute Lymphoblastic Leukemia in Routine Practice: A Turkish Multicenter Study(Galenos Yayincilik, 2019) Ciftciler, Rafiye; Sevindik, Omur Gokmen; Tekgunduz, Ali Irfan Emre; Erkurt, Mehmet Ali; Vural, Filiz; Turgut, Burhan; Kaynar, Leylagul; Payzn, Bahriye; Dogu, Mehmet Hilmi; Karakus, Volkan; Altuntas, Fevzi; Buyukasik, Yahya; Demirkan, FatihObjective: Significant developments occurred in the clinical management of acute lymphoblastic leukemia (ALL) in adults in recent decades. However, treatment results are still not satisfactory, especially in routine practice. The objective of this study was to evaluate the general clinical features, treatment details, and outcomes of a large group of patients followed in multiple centers in Turkey with a diagnosis of ALL. Materials and Methods: A retrospective analysis of the data of patients with ALL was made, the patients having been diagnosed and treated between January 2003 and June 2017 by different protocols in the hematology clinics of ten different centers. A total of 288 patients, aged between 17 and 76 years old, were included in the study. In this retrospective multicenter analysis of patients with ALL, classification of patients was performed based on treatment period, Philadelphia chromosome positivity, treatment regimen, and administration of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Results: The majority of cases were B-cell in origin, while 224 patients had B-ALL and 64 of the patients had T-ALL. Median follow-up duration for all patients was 18.2 months (range: 0.03-161 months). Philadelphia chromosome positivity was determined in 49 patients (21.9%), and 54 patients (18.8%) were receiving allo-HSCT. After induction chemotherapy, 219 patients (76.0%) achieved complete remission, 32 patients (11.2%) were evaluated as treatment refractory, and 37 patients (12.8%) were deceased. Median overall survival was 47.7 months (95% confidence interval: 36.1-59.2) and median disease-free survival was 23.4 months (95% confidence interval: 6.7-40.0) for all patients. Conclusion: Multicenter studies are extremely important for defining the specific clinical features of a particular disease. The results of this study will make a significant contribution to the literature as they reflect real-life data providing valuable information about the Turkish ALL patient profile.Öğe Akraba dışı allojenik kök hücre nakli ile başarıyla tedavi edilen primer ileal miyeloid sarkom(2019) Patır, Püsem; Çağlıyan, Gülsüm Akgün; Soyer, Nur; Özsan, Nazan; Vural, FilizMiyeloid sarkom, granülositik sarkom veya kloroma olarak da adlandırılan olgunlaşmamış miyeloid hücre proliferasyonunun ekstramedüller tutulumudur. Miyeloid sarkom olgularının sadece %6,5’i gastrointestinal sistemden köken alır. Burada, hastalığın anlaşılmasını arttırmak ve bireyselleştirilmiş tedaviler için bir referans sağlamak amacıyla gastrointestinal sistemden köken alan bir primer myeloid sarkom olgusu sunulmuştur.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 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 Allogeneic stem cell transplantation for acquired pure red cell aplasia(Wiley, 2019) Halkes, Constantijn; de Wreede, Liesbeth C.; Knol, Cora; Simand, Celestine; Aljurf, Mahmoud; Tbakhi, Abdelghani; Vazquez, Lourdes; Bloor, Adrian; Wagner-Drouet, Eva; Vural, Filiz; Bodova, Ivana; Isaksson, Cecilia; Diaz, Miguel Angel; Gruhn, Bernd; Snowden, John; Arat, Mutlu; Bazarbachi, Ali; Spilleboudt, Chloe; Kulagin, Alexander; Marsh, Judith C. W.; Passweg, Jakob; Risitano, Antonio M.; Peffault de Latour, Regis; Dufour, CarloÖğe Amyloid deposition in knee and ankle joints in the course of multiple myeloma(Elsevier France-Editions Scientifiques Medicales Elsevier, 2007) Sahin, Fahri; Soyer, Nur Akad; Saydam, Güray; Vural, Filiz; Tombuloglu, Murat; Argin, Mehmet; Ertan, YesimÖğe 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 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 Carfilzomib experience in relapsed/refractory multiple myeloma: a single-center experience(2018) Uysal, Ayşe; Soyer, Nur Akad; Özkan, Melda; Şahin, Fahri; Vural, Filiz; Töbü, Mahmut; 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 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 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 Chronic myelogenous leukemia exhibiting trisomy 14 due to a Robertsonian translocation with philadelphia chromosome(Informa Healthcare, 2008) Durmaz, Burak; Karaca, Emin; Vural, Filiz; Cogulu, Ozgur; Alpman, Asude; Tombuloglu, Murat; Özkınay, FerdaÖğe 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 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 Cutaneous graft-versus-host disease after hematopoietic stem cell transplantation; a single institution experience(Nature Publishing Group, 2018) Atilla, Fatos Dilan; Bulbul, Hale; Soyer, Nur; Turk, Bengu Gerceker; Acar, Ayda; Tombuloglu, Murat; Vural, Filiz[No Abstract Available]
