TR-Dizin İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4808
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Item Non-Hematologic Malignancies Metastasing to the Bone Marrow: A Record-Based Descriptive Study From A Tertiary Center(2019) Aytan, Pelin; Kocer, Nazim Emrah; Yeral, Mahmut; Gereklioglu, Cigdem; Kasar, Mutlu; Buyukkurt, Nur Hilal; Asma, Suheyl; Ozdogu, Hakan; Boga, CanThe aim of this study is to assess the cases of nonhematologic maiignancies that had bone marrow (BM) metastasis with respect to hematologic abnormalities, radiologic findings and pathologic findings. All of the patients with BM investigation were retrospectively evaluated. The patients with BM metastasis by a non-hematologic malignancy were assessed. Data regarding patient characteristics including peripheral blood evaluation findings, imaging findings, BM evaluation results and survival were obtained from patient files and computer based electronic database. 30 cases were detected among 1831 BM aspirations and biopsies. The most common malignancies were breast (36.7%), prostate (13.3%), gastric(13.3%) and lung (13.3%) adenocarcinomas. 90.9% and 75% of the cases had positive radiologic findings with PET/CT and CT respectively. 43.3% of the patients died during the study period and the median time from BM assessment to death was 2 months. Anemia, thrombocytopenia and leukopenia were present in 90%, 73.3% and 20% respectively. Lactate dehydrogenase and alkaline phosphatase were elevated in 90% and 80% respectively. In 76.2% a leukoerythroblastic blood picture was present. All the cases were diagnosed with biopsy and aspiration detected infiltration in 40% and in 4 metastatic patients (13.3%) the aspiration was false negative. In 46.7% the aspiration resulted with dry tap. Grade 3 fibrosis was present in 76.7%. BM assessment is a minimally invasive technique and provides very beneficial clinical data, however, because the survival is very short after BM assessment and the PET/CT has a considerable sensitivity it is not necessary to confirm BM metastasis in patients whose tumor stage is already known.Item Use of Mesenchymal Cells to Modulate Immune Suppression and Immune Reconstruction in a Patient with Aplastic Anemia Complicated by Invasive Sino-Orbital Aspergillosis(2014) Ozdogu, Hakan; Yeral, Mahmut; Boga, Can; Kozanoglu, IlknurCultured human bone marrow mesenchymal cells (MSCs) have immunomodulatory and tissue regenerative properties. This report summarizes the result of post-transplant treatment with MSCs of a 26-year-old patient with aplastic anemia complicated by invasive sino-orbital aspergillosis. The patient was treated with MSCs to benefit from the dual effects of MSCs in immune reconstitution: suppression against alloreactive T cells and facilitation of the re-engraftment process. The patient did not develop acute or chronic graft-versus-host disease. The aspergillus infection healed completely. The engraftment failure was also ended without any complications. During his last visit in his fourth year after transplantation, the patient was in hematological remission. Human bone marrow-derived MSCs seem to have an important role in preventing or overcoming immunological complications in patients who undergo stem cell transplantation.Item Tunnelled Central Venous Catheter-Related Problems in the Early Phase of Haematopoietic Stem Cell Transplantation and Effects on Transplant Outcome(2015) Yeral, Mahmut; Boga, Can; Oguzkurt, Levent; Aliskan, Hikmet Eda; Ozdogu, Hakan; Demiroglu, Yusuf Ziya; 25805675Objective: Haematopoietic stem cell recipients need central venous catheters (CVCs) for easy administration of intravenous fluid, medications, apheresis, or dialysis procedures. However, CVCs may lead to infectious or non-infectious complications such as thrombosis. The effect of these complications on transplantation outcome is not clear. This manuscript presents the complication rates of double-lumen tunnelled CVCs and their effect on transplantation outcome. Materials and Methods: Data from 111 consecutive patients, of whom 75 received autologous and 36 received allogeneic peripheral blood stem cell transplantations, were collected retrospectively. The data were validated by the Record Inspection Group of the related JACIE-accredited transplantation centre. Results: Thrombosis developed in 2.7% of recipients (0.9 per 1000 catheter days). Catheter-related infection was identified in 14 (12.6%) patients (3.6 per 1000 catheter days). Coagulase-negative Staphylococcus was the most common causative agent. Engraftment time, rate of 100-day mortality, and development of grade II-IV graft-versus-host disease were not found to be associated with catheter-related complications. Conclusion: These results indicate that adverse events related with tunnelled CVCs are manageable and have no negative effects on transplant outcome.Item Hematopoietic Stem Cell Transplantation in Adult Sickle Cell Disease: Problems and Solutions(2015) Ozdogdu, Halkan; Boga, Can; 25912490Sickle cell disease-related organ injuries cannot be prevented despite hydroxyurea use, infection prophylaxis, and supportive therapies. As a consequence, disease-related mortality reaches 14% in adolescents and young adults. Hematopoietic stem cell transplantation is a unique curative therapeutic approach for sickle cell disease. Myeloablative allogeneic hematopoietic stem cell transplantation is curative for children with sickle cell disease. Current data indicate that long-term disease-free survival is about 90% and overall survival about 95% after transplantation. However, it is toxic in adults due to organ injuries. In addition, this curative treatment approach has several limitations, such as difficulties to find donors, transplant-related mortality, graft loss, graft-versus-host disease (GVHD), and infertility. Engraftment effectivity and toxicity for transplantations performed with nonmyeloablative reduced-intensity regimens in adults are being investigated in phase 1/2 trials at many centers. Preliminary data indicate that GVHD could be prevented with transplantations performed using reduced-intensity regimens. It is necessary to develop novel regimens to prevent graft loss and reduce the risk of GVHD.Item A Rare Complication Developing After Hematopoietic Stem Cell Transplantation: Wernicke's Encephalopathy(2015) Solmaz, Soner; Gereklioglu, Cigdem; Tan, Meliha; Demir, Senay; Yeral, Mahmut; Korur, Asli; Boga, Can; Ozdogu, Hakan; 25912759Thiamine is a water-soluble vitamin. Thiamine deficiency can present as a central nervous system disorder known as Wernicke's encephalopathy, which classically manifests as confusion, ataxia, and ophthalmoplegia. Wernicke's encephalopathy has rarely been reported following hematopoietic stem cell transplantation. Herein, we report Wernicke's encephalopathy in a patient with acute myeloid leukemia who had been receiving prolonged total parenteral nutrition after haploidentical allogeneic hematopoietic stem cell transplantation. To the best of our knowledge, this is the first case reported from Turkey in the literature.Item Recommendations for Risk Categorization and Prophylaxis of Invasive Fungal Diseases in Hematological Malignancies: A Critical Review of Evidence and Expert Opinion (TEO-4)(2015) Boga, Can; Bolaman, Zahit; Cagirgan, Seckin; Karadogan, Ihsan; Ozcan, Mehmet Ali; Ozkalemkas, Fahir; Saba, Rabin; Sonmez, Mehmet; Senol, Esin; Akan, Hamdi; Akova, Murat; 26316478This is the last of a series of articles on invasive fungal infections prepared by opinion leaders in Turkey. The aim of these articles is to guide clinicians in managing invasive fungal diseases in hematological malignancies and stem cell transplantation based on the available best evidence in this field. The previous articles summarized the diagnosis and treatment of invasive fungal disease and this article aims to explain the risk categorization and guide the antifungal prophylaxis in invasive fungal disease.Item Effect of Hereditary Hemochromatosis Gene H63D and C282Y Mutations on Iron Overload in Sickle Cell Disease Patients(2016) Terzi, Yunus Kasim; Balci, Tugce Bulakbasi; Boga, Can; Koc, Zafer; Celik, Zerrin Yilmaz; Ozdogu, Hakan; Karakus, Sema; Sahin, Feride Iffet; 27095682Objective: Hemochromatosis is an autosomal recessive disease that is one of the most important reasons for iron overload. Sickle cell disease is a hemoglobinopathy that occurs as a result of a homozygous mutation in the hemoglobin gene. Erythrocyte transfusion is frequently used in the treatment of this disease. Iron overload as a result of transfusion is important in the mortality and morbidity of sickle cell anemia patients as well as in other hemoglobinopathies. In this study, the effect of hemochromatosis gene (HFE) p.H63D and p.C282Y mutations on transfusion-related cardiac and liver iron overload in sickle cell disease patients who carry homozygous hemoglobin S mutation has been investigated. Materials and Methods: This is a prospective single-center cross-sectional study in patients with homozygous hemoglobin S mutation between the years 2008 and 2013. The patients were divided into two groups. The first group (group A, n=31) was receiving chelation therapy and the second group (group B, n=13) was not. Direct and indirect iron loads were analyzed by magnetic resonance imaging and biochemically, respectively. HFE gene mutations were analyzed by polymerase chain reaction-restriction fragment length polymorphism method. Statistical analyses were performed by independent samples t-test. Results: p.H63D mutation was detected in 10 (32.3%) patients in group A and in only 1 patient (7.7%) in group B. When the 2 groups were compared for iron overload, iron deposition in the liver was significantly higher in group B (p=0.046). In addition, in group A, iron deposition was significantly higher in HFE mutation carriers compared to patients without the mutation (p=0.05). Conclusion: Results of this study showed that HFE gene mutations are important in iron deposition in the liver in patients with sickle cell disease.Item A rare hematological complication of visceral leishmaniasis: hemophagocytic syndrome(2016) Solmaz, Soner; Boga, Can; Kozanoglu, Ilknur; Asma, Suheyl; Turunc, Tuba; Demiroglu, Yusuf ZiyaThe term "hemophagocytosis" describes the pathologic finding of activated macrophages, engulfing erythrocytes, leukocytes, platelets and their precursor cells. This phenomenon is an important finding in patients with hemophagocytic syndrome. It is a distinct clinical entity characterized by fever, pancytopenia, splenomegaly and hemophagocytosis in bone marrow, liver and lymph nodes. Hemophagocytic syndrome can be classified according to the underlying etiology into either primary (genetic) or secondary (acquired). Severe infections, malignancies, rheumatologic disorders and some metabolic diseases can lead to secondary hemophagocytic syndrome. Infection-associated hemophagocytic syndrome implicating Leishmania is very rare and often difficult to diagnose. Therefore, we aimed to report a young boy with Visceral Leishmaniasis associated hemophagocytic syndrome.Item Red blood cell alloimmunization in patients with sickle cell disease in Turkey: a single center retrospective cohort study(2016) Solmaz, Soner; Karacaoglu, Pelin; Gereklioglu, Cigdem; Asma, Suheyl; Korur, Asli; Buyukkurt, Nurhilal; Kasar, Mutlu; Yeral, Mahmut; Kozanoglu, Ilknur; Boga, Can; Ozdogu, Hakan; 0000-0002-5086-5593; 0000-0002-8902-1283; 0000-0003-3856-7005; 0000-0002-0895-4787; 0000-0002-5268-1210; 0000-0002-9680-1958; AAD-5616-2021; AAD-5542-2021; AAL-3906-2021; AAE-1457-2021; ABC-4148-2020; AAD-6222-2021; AAE-1241-2021Purpose: We aimed to investigate erythrocyte alloimmunization frequency and related factors in our region where SCD is common Material and Methods: This study was planned as a single center, cross-sectional and retrospective cohort study. A total of 216 patients who had been followed up due to SCD [Hemoglobin (Hb) SS, Hb S-beta thalassemia, Hb S-alpha thalassemia] were included in this study. Patients were divided to two groups according to amount of transfusion. The patients who had received less than 6 transfusions per year and who did not have the history of erythropheresis were allocated to Group 1, and the patients who had received 6 or more simple transfusion per year or who had undergone erythrocyte exchange were allocated to Group 2 Results: Of 216 SCD patients included in the study. Alloimmunization was detected in 67 (31.0%) out of 216 patients who underwent transfusion, and in 17 (30.4%) out of 56 patients in Group 1 and in 50 (31.3%) out of 160 patients in Group 2. When the patients were analyzed according to alloimmunization development, our study revealed that neither SCD complications are a risk factor for alloimmunization nor alloimmunization increases mortality rates Conclusion: High alloimmunization frequency found in our study suggests the insufficient adherence of alloimmunization-prevention policies in RBC transfusions performed except experienced institutions. Therefore alloimmunization may be reduced or prevented through performing extended red cell typing among SCD patientsItem Is the Game Over or Starting Again? The Role of the Transplant Team in Genetic Counseling for Adult Sickle Cell Disease Recipients(2017) Aytan, Pelin; Gereklioglu, Cigdem; Yeral, Mahmut; Korur, Asli; Asma, Suheyl; Kozanoglu, Ilknur; Ozdogu, Hakan; Boga, Can; 0000-0002-5086-5593; 0000-0002-5268-1210; 0000-0001-5335-7976; 0000-0002-8902-1283; 0000-0002-2553-7715; 0000-0002-9680-1958; 0000-0002-9580-628X; 27956368; AAD-5616-2021; AAE-1241-2021; AAL-6544-2020; ABC-4148-2020; AAI-7831-2021; AAD-5542-2021; AAE-3833-2019; AAD-6222-2021