Browsing by Author "Bilen, Yusuf"

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    Neutropenia Related to Valacyclovir and Valganciclovir in 2 Renal Transplant Patients and Treatment With Granulocyte Colony Stimulating Factor: A Case Report
    (Başkent Üniversitesi, 2010-06) Cetinkaya, Ramazan; Polat, Kamil Yalcin; Keles, Mustafa; Yildirim, Rahsan; Uyanik, Abdullah; Turkmen, Meral; Bilen, Yusuf; Aydinli, Bulent
    Objectives: Posttransplant leukopenia is frequently observed in renal transplant. Granulocyte colony-stimulating factor controls the production of functional neutrophils and their release into peripheral blood. Granulocyte colony-stimulating factor has been widely and frequently used for many conditions and disorders in the field of hematology and oncology. Materials and Methods: We present the cases of valacyclovir-related and valganciclovir-related neutropenia in 2 renal transplant recipients. Results: Both cases had renal transplants from live donors. The first one was an 18-year-old man. Laboratory investigations revealed his leukocyte count as 1.7 x 109/L. The patient was using mycophenolate mofetil, cyclosporine, and valganciclovir. Mycophenolate mofetil was stopped because he had neutropenia, and later, valganciclovir was also stopped because the neutropenia persisted. Because the neutropenia did not recover after we discontinued valganciclovir, the patient was administered granulocyte colony-stimulating factor. The neutrophil count increased to 2.2 x 109/L (leucocyte count to 6.5 x 109/L) after 24 hours. The second case was a 37-year-old man and was using mycophenolic acid, tacrolimus, and valacyclovir. Laboratory investigations revealed his leukocyte count to be 1.3 x 109/L. Mycophenolic acid and valganciclovir were stopped owing to neutropenia. The patient was administered granulocyte colony-stimulating factor, and the neutrophil count increased to 3.8 x 109/L (leucocyte count to 5.8 x 109/L). The kidney functions did not deteriorate in either patient, and the patients’ kidney functions were similar to baseline levels 12 months after surgery. Conclusions: We conclude that granulocyte colony-stimulating factor can be used safely and effectively in renal transplant patients.
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    Relationship between mannose-binding lectin and febrile neutropenia in acute leukemia patients
    (2020) Akan, Selcuk; Bakanay, Sule Mine; Bilen, Yusuf; Balcan, Baran; Erdem, Fuat
    Aim: Mannose-binding lectin (MBL) is an important component of the natural immune system. Its low levels have been linked to increased frequency of opportunistic infections. This study aimed to determine the association of serum MBL levels and duration of febrile neutropenia (FN) after cytotoxic chemotherapy in patients with acute leukemia. Material and Methods: Seventy patients aged 15-75 years with acute leukemia (40 AML (Acute myeloid leukemia), 30 ALL (Acute lymphoblastic leukemia)), and 30 age-matched healthy subjects were included in this study. Blood MBL levels were measured using ELISA Kit before chemotherapy (MBL1) and at FN (MBL2). Results: The MBL1 levels of the patient group (Median 466 ng/ml; interquartile range (iqr): 4507) were higher than that of the control group (Median 485 ng/ml; iqr: 1872), but this difference was statistically insignificant (p=0.92). During FN, MBL levels of 49 (70%) patients increased and 21 (30%) patients remained at the same level. The MBL2 levels (Median 772 ng/ml; iqr: 5870) of the patients were significantly higher than the MBL1 levels (p< 0.001). Patients with very low (<100 ng/ml) MBL2 levels had significantly longer FN duration than patients with normal (>1000 ng/ml) MBL2 levels (p=0.016). Discussion: Our results suggest that duration of FN is longer when MBL level is low especially less than 100 ng/ml. These patients seem to have the highest risk for infection-related morbidity and mortality and deserve interest for trials of MBL replacement.