Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Buyukkurt, NurhilalSubject: search.filters.subject.Autologous transplantation

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    A Comparison of the BEAM and MITO/MEL Conditioning Regimens for Autologous Hematopoietic Stem Cell Transplantation in Hodgkin Lymphoma: An Analysis of Efficiency and Treatment-Related Toxicity
    (2020) Yeral, Mahmut; Aytan, Pelin; Gungor, Burcu; Boga, Can; Unal, Ali; Koc, Yener; Kaynar, Leylagul; Buyukkurt, Nurhilal; Eser, Bulent; Ozdogu, Hakan; 0000-0002-8902-1283; 0000-0002-0895-4787; 0000-0002-9680-1958; 0000-0002-9580-628X; 32605899; AAD-5542-2021; AAE-1457-2021; AAD-6222-2021
    In this multicenter retrospective study, we compared the efficacy and toxicity of BEAM (BCNU, etoposide, cytarabine, and melphalan) and MITO/MEL (mitoxantrone, melphalan) preparation regimens. The 3-year expected overall survival for the MIT/MEL and BEAM were 86.1% and 91.3%, respectively. The MITO/MEL seems to be as effective as the BEAM but has better tolerability in terms of pulmonary toxicity and may be used as an alternative option. Background: Approximately half of patients with relapsed chemosensitive disease achieve robust responses with BEAM (BCNU, etoposide, cytarabine, and melphalan) and autologous stem cell rescue. The scarcity of comparative studies further limits alternative treatment protocols, such as the MITO/MEL (mitoxantrone, melphalan) protocol. Patients and Methods: In this retrospective multicenter study, we compared the BEAM and MITO/MEL regimens used before autologous hematopoietic stem cell transplantation (ASCT) in terms of efficacy and side effects in patients with Hodgkin lymphoma. Data met international accreditation rules. Before ASCT, 108 patients received the MITO/MEL, and 34 patients received the BEAM. Results: The median follow-up time was 36 months in the MITO/MEL group (range, 3-178) and 23 months in the BEAM group (range, 4-99). After ASCT, the 3-year expected overall survival and disease-free survival rates were 86.1% and 86.1% for the MITO/MEL group and 91.3% and 76.5% for the BEAM group, respectively. Although 50% of patients developed febrile neutropenia attacks in the MITO/MEL group, this rate was 91.1% in the BEAM group. The grade II and higher rates of hepatic, renal, gastrointestinal, and cardiac toxicities were similar in both groups. However, the rate of pulmonary toxicity was determined to be 1.9% in the MITO/MEL group and 29.4% in the BEAM group (P < .001). Conclusion: The MITO/MEL conditioning regimen seems to be as effective as the BEAM regimen but has better tolerability in terms of pulmonary toxicity and may be used as an alternative option if necessary, depending on the comorbidity status of the patient.
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    Effects of bone marrow fibrosis and angiogenetic structure on autologous hematopoietic stem cell engraftment
    (2017) Buyukkurt, Nurhilal; Ozsan, Guner Hayri; Ozkal, Sermin; Seydaoglu, Gulsah; Alacacioglu, Inci; Ozcan, Mehmet Ali; Demirkan, Fatih; Piskin, Ozden; Undar, Bulent; 0000-0002-0895-4787; AAE-1457-2021
    Purpose: Hematopoietic stem cell (HSC) engraftment is influenced by many factors. We investigated the effects of bone marrow fibrosis and angiogenetic structure on engraftment in patients with hematological malignancies. Materials and Methods: Data were collected from 34 patients (20 males and 14 females) who underwent autologous HSC transplantation. Bone marrow myelofibrosis was graded from 0 to 3, angiogenesis was quantified using a stereological method in the most recent bone marrow biopsy before the transplantation. Patients were categorized into two groups according to intensity of angiogenesis parameters. Results: Half of the patients had fibrosis and majority had multiple myeloma (73.5%). Eleven patients had grade 1, six had grade 2 myelofibrosis. The engraftment day (ED) for platelets and erythrocytes was significantly different between the grade 2 fibrosis and non-fibrosis groups. VSD and NVES levels were significantly higher in the grades 1 and 2 fibrosis groups than the no fibrosis group. While the overall survival time was shorter in the grade 2 fibrosis group than the others, the difference was not statistically significant. Conclusion: Bone marrow fibrosis was found to be independent risk factor. It may have a negative effect on platelet and erythrocyte engraftment time of autologous transplantation process but this effect does not influence survival.