TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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Item An Approach to Pediatric or Mentally Deficient Donors from a Bioethical Perspective: Considerations and Recommendations on Behalf of the Donor Research Team of the Turkish Society of Hematology (DART)(2022) Keles, Sukru; Boga, Can; Tekkesin, Funda; Ozen, Ilknur Nizam; Kozanoglu, Ilknur; 35699265; GXH-4007-2022Item Is Sickle Cell Trait Really Innocent?(2021) Yeral, Mahmut; Boga, Can; 0000-0002-9580-628X; 33053967Item The Clinicopathologic Features and the Factors Associated with the Survival in Light -Chain Amyloidosis Patients: A Single Center Descriptive Study(2020) Aytan, Pelin; Yeral, Mahmut; Gereklioglu, Cigdem; Kasar, Mutlu; Korur, Asli; Buyukkurt, Nurhilal; Asma, Suheyl; Kozanoglu, Ilknur; Ozdogu, Hakan; Boga, Can; 0000-0002-5086-5593; 0000-0003-3856-7005; 0000-0002-0895-4787; 0000-0002-8902-1283; 0000-0002-5268-1210; 0000-0002-9680-1958; AAD-6222-2021; AAD-5616-2021; AAL-3906-2021; AAE-1457-2021; AAD-5542-2021; AAE-1241-2021Objective: To present the clinicopathologic features and assess the factors related to the survival in light- chain amyloidosis (AL) patients. Method: All the patients with AL diagnosis being followed-up in the hematology department were recruited in the study. Clinicopathologic data were obtained. Factors related with overall survival (OS) including systemic inflammatory response markers were analyzed. Results: In 16 AL patients, the estimated OS was 58.6 +/- 10.8 months, with a-5-year- survival rate of 52.1%. While, 43.8% of the patients died during the study period. Gastrointestinal and respiratory complaints were the most frequent symptoms. Myocardial and renal biopsies were amyloid positive in 31.3% and 25% of the patients respectively. Myeloma was diagnosed in 18.8% and amyloid was positive in 31.3% of the bone marrow biopsies. There was no difference between surviving and deceased patients with respect to laboratory findings including systemic inflammatory markers. Only immunoglobulin M was significantly lower in the deceased patients and IgM was found to be the only factor independently associated with OS. Lower IgM levels were associated with decreased OS. An IgM value of 75.4 mg/dL was found as a cut-off value with a sensitivity and specificity of 71.4% and 66.7% respectively for the prediction of survival status. Conclusion: AL is a rare, progressive, systemic disease with a wide spectrum of clinical presentations. The disease most commonly presents with gastrointestinal and respiratory complaints. IgM level seems to be an independent predictor of survival and may be used as a prognostic marker.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.