Fakülteler / Faculties
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Item QTc Prolongation During Peripheral Stem Cell Apheresis in Healthy Volunteers(2017) Korur, Asli; Kozanoglu, Ilknur; Buyukkurt, Nurhilal; Yeral, Mahmut; Kandemir, Fatih; Gereklioglu, Cigdem; Sariturk, Cagla; Asma, Suheyl; Solmaz, Soner; Boga, Can; Ozdogu, Hakan; 0000-0002-5086-5593; 0000-0001-5335-7976; 0000-0002-8902-1283; 0000-0002-5268-1210; 0000-0002-9580-628X; 0000-0002-4130-1059; 0000-0002-0895-4787; 0000-0002-9680-1958; 27543914; AAD-5616-2021; AAI-7831-2021; AAD-5542-2021; AAD-6222-2021; AAE-1241-2021; ABC-4148-2020; AAS-7129-2021; AAE-1457-2021Background and aim: Today, voluntary donation of peripheral blood stem cells by healthy donors for allogeneic hemopoietic cell transplantation is common worldwide. Such donations are associated with small but measurable risks of morbidity and mortality. Most complications are associated with citrate infusion during cell collection. We studied the effects of citrate infusion on the QTc and other vital parameters during and after peripheral stem cell apheresis in volunteers. Method: To ensure that donors were healthy, screening included taking a detailed medical history, physical examination, and laboratory measurements of plasma calcium and magnesium. Corrected QT (QTc) values were assessed using a 12-lead electrocardiographic platform that derived QTc values automatically. Results: In all, 141 apheresis procedures were performed. The mean QTc values at baseline, at 2 and 4 h during the procedure, and at 30 min after the procedure, were 347.6 +/- 59.5, 349.9 +/- 52.8, 391.8 +/- 54.0, and 404.8 +/- 59.2 ms, respectively. The baseline and 2 h QTcs did not differ significantly, but the baseline QTc did differ significantly from the 4 h and 30 min after the procedure values. The plasma levels of calcium and magnesium did not significantly differ before and after the procedure. Conclusion: QTc prolongation may develop during leukopheresis, particularly if the procedure takes more than 2 h. Thus, to enhance donor safety, QTc measurement should be standard for all donors. In addition, any family history of sudden death should be noted, to prevent the development of possible fatal arrhythmia in susceptible donors.Item Second Malignancies İn Philadelphia-Positive and -Negative Myeloproliferative Neoplasms: A Single Center Study(2016) Solmaz, Soner; Korur, Asli; Gereklioglu, Cigdem; Asma, Suheyl; Buyukkurt, Nurhilal; Kasar, Mutlu; Yeral, Mahmut; Kozanoglu, Ilknur; Boga, Can; Ozdogu, Hakan; https://orcid.org/0000-0002-5086-5593; https://orcid.org/0000-0002-0895-4787; https://orcid.org/0000-0003-3856-7005; https://orcid.org/0000-0002-9580-628X; https://orcid.org/0000-0002-8902-1283; AAD-5616-2021; AAE-1457-2021; AAL-3906-2021; ABC-4148-2020; AAD-6222-2021; AAD-5542-2021Introduction: Leukemic transformation (LT) of both Philadelphia (Ph) -positive and -negative myeloprolifetarive neoplasms (MPNs) is a well-known subject. However sufficient data are not available in literature from Turkey about the frequency of second malignancies (SMs) except IT in patients with MPNs. In this study, it was aimed to investigate the frequency of SMs in Ph-positive or -negative MPN cases. Materials and Methods: A total of 438 patients diagnosed with classical MPN according to WHO 2008 diagnostic criteria were included in the study. Results: SMs were detected in 15 out of 438 patients (3.4%). In this study, cancer incidence rate was found higher (1149.8/100.000 person-years for males and 540.8/100.000 person-years for females with MPNs) compared with Turkey data. Conclusion: SM frequency is significantly higher than normal population in patients with MPNs. Therefore these patients should be carefully examined for SM symptoms and signs.Item East Mediterranean Region Sickle Cell Disease Mortality Trial: Retrospective Multicenter Cohort Analysis of 735 Patients(2016) Karacaoglu, Pelin Kardas; Asma, Suheyl; Korur, Asli; Solmaz, Soner; Buyukkurt, Nurhilal Turgut; Gereklioglu, Cigdem; Kasar, Mutlu; Ozbalci, Demircan; Unal, Selma; Kaya, Hasan; Gurkan, Emel; Yeral, Mahmut; Sariturk, Cagla; Boga, Can; Ozdogu, Hakan; https://orcid.org/0000-0002-7459-7167; https://orcid.org/0000-0001-5335-7976; https://orcid.org/0000-0002-0895-4787; https://orcid.org/0000-0003-3856-7005; https://orcid.org/0000-0002-9580-628X; https://orcid.org/0000-0002-4130-1059; https://orcid.org/0000-0002-8902-1283; 27068408; HKF-1250-2023; AAI-7831-2021; AAL-6544-2020; AAE-1457-2021; AAL-3906-2021; ABC-4148-2020; AAS-7129-2021; AAD-6222-2021; AAD-5542-2021Sickle cell disease (SCD), one of the most common genetic disorders worldwide, is characterized by hemolytic anemia and tissue damage from the rigid red blood cells. Although hydroxyurea and transfusion therapy are administered to treat the accompanying tissue injury, whether either one prolongs the lifespan of patients with SCD is unknown. SCD-related mortality data are available, but there are few studies on mortality-related factors based on evaluations of surviving patients. In addition, ethnic variability in patient registries has complicated detailed analyses. The aim of this study was to investigate mortality and mortality-related factors among an ethnically homogeneous population of patients with SCD. The 735 patients (102 children and 633 adults) included in this retrospective cohort study were of Eti-Turk origin and selected from 1367 patients seen at 5 regional hospitals. A central population management system was used to control for records of patient mortality. Data reliability was checked by a data supervision group. Mortality-related factors and predictors were identified in univariate and multivariate analyses using a Cox regression model with stepwise forward selection. The study group included patients with homozygous hemoglobin S (Hgb S) disease (67 %), Hb S-beta(0) thalassemia (17 %), Hgb S-beta(+) thalassemia (15 %), and Hb S-alpha thalassemia (1 %). They were followed for a median of 66 +/- 44 (3-148) months. Overall mortality at 5 years was 6.1 %. Of the 45 patients who died, 44 (6 %) were adults and 1 (0.1 %) was a child. The mean age at death was 34.1 +/- 10 (18-54) years for males, 40.1 +/- 15 (17-64) years for females, and 36.6 +/- 13 (17-64) years overall. Hydroxyurea was found to have a notable positive effect on mortality (p = 0.009). Mortality was also significantly related to hypertension and renal damage in a univariate analysis (p = 0.015 and p = 0.000, respectively). Acute chest syndrome, splenic sequestration, and prolonged painful-crisis-related multiorgan failure were the most common causes of mortality. In a multivariate analysis of laboratory values, only an elevated white blood cell count was related to mortality (p = 0.009). These data show that despite recent progress in the treatment of SCD, disease-related factors continue to result in mortality in young adult patients. Our results highlight the importance of evaluating curative treatment options for patients who have an appropriate stem cell donor in addition to improving patient care and patient education.Item Granulocyte-Colony Stimulating Factor Administration Among Hemoglobin S Trait Donors: A Single Center Experience from The Eastern Mediterranean Region(2018) Gereklioglu, Cigdem; Asma, Suheyl; Korur, Asli; Tepebasi, Songul; Aytan, Pelin; Yeral, Mahmut; Kozanoglu, Ilknur; Boga, Can; Ozdogu, Hakan; https://orcid.org/0000-0001-5335-7976; https://orcid.org/0000-0002-5086-5593; https://orcid.org/0000-0002-2553-7715; https://orcid.org/0000-0002-9580-628X; https://orcid.org/0000-0002-5268-1210; https://orcid.org/0000-0002-8902-1283; 28699692; AAI-7831-2021; AAD-5616-2021; AAE-3833-2019; ABC-4148-2020; AAE-1241-2021; AAD-6222-2021; AAD-5542-2021Background and Objective: Assessment of Hemoglobin S trait donors has gained importance together with the increased allogeneic peripheral stem cell transplant activity for sickle cell disease in the regions where the disease is prevalent. Outcomes of Granulocyte-Colony Stimulating Factor (G-CSF) administration are obscure for hemoglobin S trait donors. This study aims at investigating the incidence of hemoglobin S carrier status and outcomes of G-CSF administration among donors who live in Eastern Mediterranean region. Material and Method: The cross-sectional, single-center cohort study was performed with 147 donors between January 2013 and March 2017. Prevalence of hemoglobin S trait was estimated and subjects with or without Hemogobin S trait were compared with regard to stem cell characteristics, early and late clinical outcomes after G-CSF administration. Results: Eleven out of 147 donors (7.48%) were found as hemoglobin S trait. G-CSF administration was successfully completed and yielded good harvesting results in hemoglobin S trait donors. No statistically significant difference was found between groups with regard to early and late side effects, stem cell characteristics. Blood pressures and QTc values were within normal ranges in both groups. Groups were similar with regard to CD34 values. Conclusion: 1G-CSF seems safe in hemoglobin S trait donors. Their being eligible as donors would increase the chance of the patients for allogeneic stem cell transplantation in high prevalence regions. Further studies are required to reveal the safety profile of G-SCF in hemoglobin S carriers in different regions.Item Survival Outcomes of Young Multiple Myeloma Patients: A Single Center Experience(2018) Aytan, Pelin; Yeral, Mahmut; Gereklioglu, Cigdem; Korur, Asli; Tanrikulu, Funda; Solmaz, Soner; Buyukkurt, Nurhilal; Kasar, Mutlu; Asma, Suheyl; Boga, Can; Kozanoglu, Ilknur; Ozdogu, Hakan; AAL-3906-2021; 0000-0002-2553-7715; 0000-0002-9580-628X; 0000-0002-5086-5593; 0000-0002-0895-4787; 0000-0003-3856-7005; 0000-0002-9680-1958; 0000-0002-5268-1210; 0000-0002-8902-1283; AAE-3833-2019; ABC-4148-2020; AAD-5616-2021; AAE-1457-2021; AAD-6222-2021; AAE-1241-2021; AAD-5542-2021Item Comparison of the clinical course of COVID-19 infection in sickle cell disease patients with healthcare professionals(2021) Boga, Can; Asma, Suheyl; Leblebisatan, Goksel; Sen, Nazan; Tombak, Anil; Demiroglu, Yusuf Ziya; Yeral, Mahmut; Akin, Sule; Yesilagac, Hasan; Habesoglu, Mehmet Ali; Aribogan, Anis; Kasar, Mutlu; Korur, Asli; Ozdogu, Hakan; 0000-0002-9866-2197; 34032899; AAZ-9711-2021; AAY-2668-2021It is highly expected that COVID-19 infection will have devastating consequences in sickle cell disease (SCD) patients due to endothelial activation and decreased tissue and organ reserve as a result of microvascular ischemia and continuous inflammation. In this study, we aimed to compare the clinical course of COVID-19 in adult SCD patients under the organ injury mitigation and clinical care improvement program (BASCARE) with healthcare professionals without significant comorbid conditions. The study was planned as a retrospective, multicenter and cross-sectional study. Thirty-nine SCD patients, ages 18 to 64 years, and 121 healthcare professionals, ages 21 to 53, were included in the study. The data were collected from the Electronic Health Recording System of PRANA, where SCD patients under the BASCARE program had been registered. The data of other patients were collected from the Electronic Hospital Data Recording System and patient files. In the SCD group, the crude incidence of COVID-19 was 9%, while in healthcare professionals at the same period was 23%. Among the symptoms, besides fever, loss of smell and taste were more prominent in the SCD group than in healthcare professionals. There was a significant difference between the two groups in terms of development of pneumonia, hospitalization, and need for intubation (43 vs 5%, P < 0.00001; 26 vs 7%, P = 0.002; and 10 vs 1%, P = 0.002, respectively). Prophylactic low molecular weight heparin and salicylate were used more in the SCD group than in healthcare professionals group (41 vs 9% and 28 vs 1%; P < 0.0001 for both). The 3-month mortality rate was demonstrated as 5% in the SCD group, while 0 in the healthcare professionals group. One patient in the SCD group became continously dependent on respiratory support. The cause of death was acute chest syndrome in the first case, hepatic necrosis and multi-organ failure in the second case. In conclusion, these observations supported the expectation that the course of COVID-19 in SCD patients will get worse. The BASCARE program applied in SCD patients could not change the poor outcome.Item Factors Associated With Overall Survival in Acute Myeloid Leukemia Patients Before and After Hematopoietic Stem Cell Transplant(2021) Aytan, Pelin; Yeral, Mahmut; Korur, Asli; Gereklioglu, Cigdem; Kasar, Mutlu; Buyukkurt, Nur Hilal; Asma, Suheyl; Kazanoglu, Ilknur; Ozdogdu, Hakan; Boga, Can; 0000-0002-5086-5593; 0000-0001-5335-7976; 0000-0002-5268-1210; 0000-0002-9580-628X; 31424361; AAD-5616-2021; AAI-7831-2021; AAE-1241-2021Objectives: Our aim was to identify factors associated with overall survival and the efficacy of postrelapse treatment protocols and to determine whether pretransplant consolidation therapy and minimal residual disease status pose a survival benefit. Materials and Methods: Patients with acute myeloid leukemia who underwent stem cell transplant between 2007 and 2018 were enrolled retrospectively. The effects of pretransplant cytogenetic and minimal residual disease status, pretransplant consolidation therapies, development of graft-versus-host disease, postrelapse treatment protocols, and type of conditioning regimens on overall survival were analyzed. Results: In 76 study patients, the cumulative overall 1- and 5-year relapse probabilities were 67.8% and 58.7%, respectively. Overall survival rates at 3 and 5 years in patients with and without relapse were 23.5% and 0% and 95.9% and 91.1% (P<.001), respectively. Although mean postrelapse overall survival was better with intensive salvage plus donor lymphocyte infusion, no significant differences were shown versus other therapies (intensive salvage, nonintensive salvage, intensive salvage or nonintensive salvage plus donor lymphocyte infusion, or supportive therapy). Twenty-three patients (30.3%) died during the study period with a median survival of 9.6 months. Patients with favorable, intermediate, and unfavorable cytogenetic status showed overall survival of 46.6 +/- 10.4, 54.6 +/- 4.4, and 36.9 +/- 5.9 months (P=.807). Patients with and without minimal residual disease and patients who received or did not receive consolidation therapy had similar overall survival. Relapse was an independent predictor of overall survival (increased mortality risk of 26.22). Patients who developed graft-versus-host disease showed decreased relapse. Conclusions: Relapse is the most important predictor of overall survival and is associated with poor prognosis. Pretransplant minimal residual status and cytogenetic status showed no effect on relapse rates and overall survival, and consolidation therapy did not improve outcomes.Item Excellent outcomes of allogeneic transplantation from peripheral blood of HLA-matched related donors for adult sickle cell disease with ATLG and posttransplant cyclophosphamide-containing regimen: an update work(2020) Ozdogu, Hakan; Boga, Can; Yeral, Mahmut; Kozaoglu, Ilknur; Gereklioglu, Cigdem; Aytan, Pelin; Kasar, Mutlu; Asma, Suheyl; Buyukkurt, Nurhilal; Korur, Asli; Sariturk, Cagla; 0000-0002-0895-4787; 0000-0001-5335-7976; 0000-0002-5086-5593; 0000-0003-3856-7005; 0000-0002-8902-1283; 0000-0002-5268-1210; 0000-0002-9580-628X; 0000-0002-9680-1958; 31992850; AAL-6544-2020; AAE-1457-2021; AAS-7129-2021; ABC-4148-2020; AAI-7831-2021; AAD-5616-2021; AAL-3906-2021; AAD-5542-2021; AAE-1241-2021; AAD-6222-2021Item Significance of Lymphocyte Count, Monocyte Count, and Lymphocyte-To-Monocyte Ratio in Predicting Molecular Response in Patients with Chronic Myeloid Leukemia: a Single-Centre Experience(2020) Pepedil-Tanrikulu, Funda; Buyukkurt, Nurhilal; Korur, Asli; Sariturk, Cagla; Aytan, Pelin; Boga, Can; Ozdogu, Hakan; Kozanoglu, Ilknur; 0000-0002-5268-1210; 0000-0002-0895-4787; 0000-0002-8902-1283; 0000-0002-5086-5593; 0000-0002-9680-1958; 32162884; AAE-1241-2021; AAD-6222-2021; AAE-1457-2021; AAD-5542-2021; AAD-5616-2021Background: Chronic myeloid leukemia (CML) is a disease resulting from BCR-ABL gene fusion. It is possible to monitor treatment by molecular testing for BCR-ABL. The lymphocyte-to-monocyte ratio (LMR) is a commonly used marker associated with prognosis in various neoplasms. This study was performed to evaluate the relevance of absolute lymphocyte count (ALC), absolute monocyte count (AMC), and LMR in predicting molecular response status in patients with chronic phase CML. Methods: Samples submitted to our hematology laboratory for BCR-ABL testing between April 2012 and October 2018 were retrospectively reviewed. Concurrent hemogram testing together with the results of quantitative reverse transcriptase-polymerase chain reaction were noted. Data were grouped according to molecular response status and the ALC, AMC, and LMR were compared among patient groups. Results: A total of 224 samples from 95 patients were included in the study. Analysis revealed differences between groups when newly diagnosed patients were compared with patients undergoing treatment, regardless of response status. However, analyzing the groups according to molecular response status failed to reveal differences in ALC, AMC, or LMR. Conclusions: ALC, AMC, and LMR are not potential biomarkers for predicting molecular response status in patients with chronic phase CML.Item Role of prophylactic and therapeutic red blood cell exchange in pregnancy with sickle cell disease: Maternal and perinatal outcomes(2020) Baran, Safak Yilmaz; Kozanoglu, Ilknur; Korur, Asli; Durdag, Gulsen Dogan; Kalayaci, Hakan; Alemdaroglu, Songul; Asma, Suheyl; Kilicdag, Esra Bulgan; Boga, Can; 0000-0002-0942-9108; 0000-0002-5086-5593; 0000-0002-5268-1210; 0000-0003-4335-6659; 0000-0001-5335-7976; 0000-0002-5064-5267; 0000-0002-8902-1283; 0000-0001-5874-7324; 0000-0002-9680-1958; 32797735; ABF-6439-2020; AAK-8872-2021; AAD-5616-2021; AAD-6222-2021; AAE-1241-2021; AAI-8400-2021; AAI-7831-2021; AAI-9594-2021; AAD-5542-2021Background and Aim The incidence of fetomaternal complications during pregnancy is high for women with sickle cell disease (SCD), which is the most common hematologic genetic disorder worldwide. Prophylactic red blood cell exchange (pRBCX) has been shown to be efficient, safe, and feasible for preventing complications. The aim of this study was to observe maternal, perinatal, and neonatal outcomes of pregnancies in which pRBCX was. Method This was a single-center, retrospective, cross-sectional study, which recruited 46 consecutive adult pregnant women with SCD between January 2012 and June 2019. Obstetric features, SCD-related complications, and fetomaternal outcomes were compared between the 27 patients who received prophylactic exchange and the 19 who did not (therapeutic exchange was performed in 7 and was not performed in 12 cases). Results Painful crises, preeclampsia, and preterm birth rates were significantly higher in the group that did not receive prophylactic exchange (control group;P= .001,P= .024, andP= .027, respectively). There was one maternal mortality in the control group (P= .41). Incidence of adverse fetal or maternal complications was significantly higher in the control group (P= .044 andP= .007, respectively). Conclusions Our center's experience over a 7.5-year period, as described above, demonstrates that pRBCX in SCD affects the course of pregnancy positively by ameliorating negative fetomaternal outcomes.
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