Tıp Fakültesi / Faculty of Medicine

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

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    Long-term Results of Imatinib Discontinuation in Patients with Chronic-phase Chronic Myeloid Leukemia: A National Multicenter Prospective Study
    (2023) Savas, Emine Merve; Yilmaz, Seda; Dikyar, Ayse Asena Baser; Ozkurt, Zubeyde Nur; Ocal, Ramazan; Can, Ferda; Pepeler, Sezgin; Kaynar, Lale Aydin; Gokcen, Sanem; Yildiz, Abdulkerim; Albayrak, Murat; Karakus, Sema; Ceneli, Ozcan; Yagci, Munci; 37877113
    Objective: The discovery of imatinib was a milestone for chronic myeloid leukemia (CML). As the life expectancy of CML patients has approached that of the general population, research has shifted towards improving quality of life and economic considerations. After 2010, it was shown that some patients could maintain molecular response even after discontinuing imatinib. This national multicenter prospective cohort study aimed to observe the long-term consequences of discontinuing imatinib therapy in adult chronic-phase CML patients. Materials and Methods: We enrolled 41 CML patients from 4 different centers in this non-randomized single-arm trial. Molecular responses of all patients were re-evaluated using real-time polymerase chain reaction at a single center. The median follow-up time after imatinib discontinuation was 48 months (minimum-maximum: 6-81 months). Results: The rate of molecular relapse-free survival at 48 months was 33.2% (confidence interval: 48.2-18.2). Twenty-seven of 41 patients lost their major molecular response, treatment was started again, and deep molecular response was re-achieved with imatinib in all cases. There was no significant relationship between molecular relapse and clinical factors such as duration of treatment or molecular response status. Discontinuing imatinib resulted in savings of approximately 4,392,000 Turkish lira or 245,150 US dollars. Conclusion: Tyrosine kinase inhibitor discontinuation with close molecular monitoring is a safe option and provides important national economic benefits for chronic phase CML patients. This approach should be considered for all eligible patients. This is the first tyrosine kinase inhibitor discontinuation study from Turkiye.
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    Castleman Disease: A Multicenter Case Series from Turkey
    (2022) Gunduz, Eren; Kirkizlar, Hakki Onur; Umit, Elif Gulsum; Gulsaran, Sedanur Karaman; Ozkocaman, Vildan; Ozkalemkas, Fahir; Candar, Omer; Elverdi, Tugrul; Kucukyurt, Selin; Paydas, Semra; Ceneli, Ozcan; Karakus, Sema; Maral, Senem; Ekinci, Omer; Ipek, Yildiz; Kis, Cem; Guven, Zeynep Tugba; Akdeniz, Aydan; Celkan, Tiraje; Kucukdiler, Ayse Hilal Eroglu; Cagliyan, Gulsum Akgun; Sengoz, Ceyda Ozcelik; Karatas, Ayse; Bulduk, Tuba; Ozcan, Alper; Apak, Fatma Burcu Belen; Canbolat, Aylin; Kartal, Ibrahim; Oren, Hale; Toret, Ersin; Ozdemir, Gul Nihal; Ozturk, Sule Mine Bakanay; 35176839
    Objective: Castleman disease (CD) is a rare disease also known as angiofollicular lymph node hyperplasia. The two main histological subtypes are the hyaline vascular and plasma cell variants. It is further classified as unicentric CD (UCD) or multicentric CD (MCD) according to the anatomical distribution of the disease and the number of lymph nodes involved. The aim of this multicenter study was to evaluate all cases of CD identified to date in Turkey to set up a national registry to improve the early recognition, treatment, and follow-up of CD. Materials and Methods: Both adult (n=130) and pediatric (n=10) patients with lymph node or involved field biopsy results reported as CD were included in the study. Patients' demographic information, clinical and laboratory characteristics, imaging study results, treatment strategies, and clinical outcomes were evaluated retrospectively. Results: A total of 140 patients (69 male and 71 female) with a diagnosis of UCD (n=73) or MCD (n=67) were included. The mean age was 39 years in the UCD group and 47 years in the MCD group. Female patients were more common in the UCD group. The most common histological subtype was hyaline vascular for both UCD and MCD patients. Asymptomatic patients were more common in the UCD group. Anemia, elevations of acute phase reactants, and hypoalbuminemia were more common in the MCD group. The most commonly used treatment strategies for UCD were surgical excision, rituximab, and radiotherapy, respectively. All UCD patients were alive at a median of 19.5 months of follow-up. The most commonly used treatment strategies for MCD were methyl prednisolone, R-CHOP, R-CVP, and rituximab. Thirteen MCD patients had died at a median of 34 months of follow-up. Conclusion: This study is important in presenting the patient characteristics and treatment strategies for CD from Turkey, with the potential of increasing awareness about CD. Treatment data may help in making decisions, particularly in countries that do not have access to siltuximab. However, larger prospective studies are needed to make definitive conclusions.