Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Bone Marrow Biopsy in Patients With Renal Transplant: Spectrum of Findings and Diagnostic Use(2015) Borcek, Pelin; Ozdemir, B. Handan; Ozkan, Eylem Akar; Taslica, F. Zeynep; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0002-3462-7632; 25894168; X-8540-2019; AAJ-8097-2021Objectives: Renal transplant may be complicated by cytopenia, fever of unknown etiology, or hematolymphoid malignancies. Bone marrow biopsy may be indicated to evaluate these complications. However, to the best of our knowledge, no previous study has systematically documented the characteristics of bone marrow biopsy in these patients. The present study reports the range of bone marrow findings in renal transplant recipients. Materials and Methods: We selected 85 patients who underwent bone marrow biopsy among 1745 renal transplant recipients who had transplant at Baskent University from January 1990 to December 2013. The files of these patients were reviewed for age, sex, age at renal transplant, underlying renal disease, donor type, immunosuppressive therapy, presence or absence of acute humoral or cellular rejection, duration between transplant and bone marrow biopsy, indication for bone marrow biopsy, and histopathologic diagnoses of bone marrow biopsies. Results: The most common cause of renal insufficiency leading to transplant in this patient group was unknown etiology, observed in 24 patients (28.2%). The most common indication for bone marrow biopsy was blood cytopenia, detected in 56 patients (65.9%). Neoplastic involvement of the bone marrow was detected in 6 patients (7.1%), all of which were hematolymphoid malignancies. Corticosteroids were the most commonly used immunosuppressive agents, administered to all patients. Conclusions: Bone marrow biopsy provides important information in renal transplant recipients, especially in cases of neoplastic bone marrow involvement, specific inflammation, and amyloidosis, which are uncommon in this patient group. The overall diagnostic use is related to the individual situation of each patient.Item Effect of Left Ventricular Assist Devices on Red Blood Cell Distribution Width(2015) Ersoy, Ozgur; Gultekin, Bahadir; Ozkan, Murat; Akkaya, Ilknur; Umaroglu, Sevi; Sezgin, Atilla; 26640934; ABA-7388-2021Objectives: Red blood cell distribution width is a measure of the variability in the size of circulating erythrocytes, which is calculated by automated blood cell counters as part of a routine blood cell count analysis. Our aim was to examine whether continuous flow left ventricular assist devices affected red blood cell distribution width. Materials and Methods: Our study included 16 of 24 patients who received a HeartWare HVAD Pump (HeartWare Inc, Framingham, MA, USA) implant (continuous flow left ventricular assist device) between April 2012 and February 2015 at our institution. The mean age of the patients was 46.6 years. We compared patient erythrocyte, leucocyte, and platelet counts, hemoglobin and hematocrit levels, mean corpuscular volume, and red blood cell distribution width values before and 6 months after implant. Results: Hemoglobin level (P=.008), hematocrit level (P=.027), and mean corpuscular volume (P=.003) were significantly decreased; however, we observed no significant change in red blood cell distribution width. Conclusions: Although we did not find significant results in our group of patients with left ventricular assist device implant, a larger group of patients may show more significant results, and an increase in red blood cell distribution width can be used as an indicator of a negative prognosis in these patients.Item Histologic Changes in Bone Marrow Biopsies From Liver Transplant Patients(2016) Borcek, Pelin; Ozdemir, B. Handan; Sercan, Cigdem; Akcay, Eda Yilmaz; Karakus, Sema; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0001-6831-9585; 0000-0001-7615-4581; 0000-0002-3462-7632; 27805526; X-8540-2019; AAK-1960-2021; W-9092-2019; AAJ-8097-2021Objectives: Liver transplant may complicated by various hematologic conditions, resulting in indication for bone marrow biopsy. Immunosuppressive therapies, specific infections, and secondary neoplasms affect bone marrow. In the present study, we evaluated the histologic spectrum of bone marrow findings in liver allograft recipients. Materials and Methods: Of 338 patients who received liver transplants and were followed at the Baskent University, Faculty of Medicine, 44 patients underwent bone marrow biopsy. The medical and pathologic information about these patients were evaluated, including age at liver transplant, age at bone marrow biopsy, sex, primary disease, bone marrow histology, and indication for bone marrow biopsy. Results: Of 44 patients who required bone marrow sampling, 30 were male (68.2%), and 14 were female (31.8%). Fifteen patients (34.1%) were in pediatric age group at the time of transplant. The most common cause of liver insufficiency leading to liver transplant was viral hepatitis in 11 patients (25%), followed by cryptogenic cirrhosis in 10 patients (22.8%). The source of the graft liver was a living donor in 40 patients (90.9%). The average age at transplant was 28.8 years, and the mean age at bone marrow sampling was 29.9 years. Nineteen patients (43.2%) required bone marrow sampling within the first year after transplant. The most common histologic findings were hypocellular, and normocellular bone marrow, observed in 18 patients (40.9%) each. Six patients (13.6%) had bone marrow biopsies for staging of posttransplant lympho proliferative disorder. Only 1 patient of the 6 with this disease (16.7%) had malignant infiltration of the bone marrow, which was a case of Burkitt lymphoma developed as posttransplant lymphoproliferative disorder, and this was the only malignant infiltration in this patient group (2.3%). Neither specific infections nor granulomatous inflammation was detected. Conclusions: Bone marrow morphology has a major role in the follow-up of liver transplant patients, who may present with peripheral blood cytopenias. The present study represents the first systematic evaluation of bone marrow findings in liver allograft recipients.Item Chemoradiotherapy-İnduced Hemoglobin Nadir Values And Survival in Patients With Stage III Non-Small Cell Lung Cancer(2018) Topkan, Erkan; Selek, Ugur; Ozdemir, Yurday; Yildirim, Berna A.; Guler, Ozan C.; Mertsoylu, Huseyin; Hahn, Stephen M.; https://orcid.org/0000-0001-8120-7123; https://orcid.org/0000-0002-2218-2074; https://orcid.org/0000-0001-6661-4185; https://orcid.org/0000-0001-6908-3412; https://orcid.org/0000-0002-1932-9784; 29858023; AAG-2213-2021; AAG-5629-2021; V-5717-2017; AAC-5654-2020; M-9530-2014Purpose: We investigated the influence of change in hemoglobin (Hgb) levels during concurrent chemoradiotherapy (C-CRT) on outcomes of non-anemic patients with stage IIIA/B non-small cell lung cancer (NSCLC). Methods: We identified 722 patients with stage IIIA/B NSCLC without anemia at baseline [hemoglobin (Hgb) < 12 g/dL for women or < 13 g/dL for men], either nonsmokers or ex-smokers, who received C-CRT between 2007 and 2012. All patients had received 1 - 3 cycles of platinum-based doublet chemotherapy during radiotherapy to 60 - 66 Gy and had documented Hgb measurements before treatment and at weekly intervals for 6 weeks during the C-CRT. Potential associations were assessed between baseline, nadir, extent of change in Hgb level, and anemia and overall survival (OS), locoregional progression-free survival (LRPFS), and PFS. Results: The median baseline Hgb level was 13.9 g/dL (range 12.0-16.8) and declined to a median 12.4 g/dL (range 7.9-16.1) during treatment. Anemia appeared in 237 patients (32.8%) and was more common among women (44.8% vs. 26.5%, P < 0.001). Neither baseline Hgb level nor change during treatment nor anemia emergence influenced any survival endpoint. Receiver operating curve analysis revealed an Hgb nadir of 11.1 g/dL to be associated with outcomes, in that a nadir Hgb < 11.1 g/dL (in 156 patients) was linked with shorter median OS time (P < 0.001), LRPFS time (P < 0.001), and PFS time (P < 0.001); retained significance for all three endpoints in multivariate analyses; and was more strongly associated with OS in squamous cell carcinoma (P < 0.001) than in adenocarcinoma (P = 0.009). Conclusion: Nadir Hgb < 11.1 g/dL levels during C-CRT were associated with significantly poorer survival times in initially non-anemic patients presenting with locally advanced NSCLC.