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Acute Promyelocytic Leukemia Diagnosed at the End of First Trimester with a Successful Outcome
(Kare Publ, 2018) Baysal, Mehmet; Umit, Elif G.; Ozdover, Ali Caner; Sutcu, Havva; Cilingir, Isil Uzun; Kirkizlar, Onur; Sayin, Cenk
The treatment and management of patients with acute promyelocytic leukemia (APL) diagnosed in pregnancy can involve a wide range of difficulties and limitations. Thus, these cases are each unique and present challenges to physicians. The aim of this study was to present the case of a 24-year-old patient who was diagnosed with APL in the 14th week of pregnancy who was treated successfully with all-trans retinoic acid and chemotherapy.
Akış Sitometrisi Verilerinin Geriye Dönük Taranması: Tek merkez deneyimi
(2015) Asoğlu, Veysi; Demir, Ahmet Muzaffer; Varım, Ceyhun; Baysal, Mehmet; Pamuk, Gülsüm Emel; Uyanık, Mehmet Şevki; Maden, Muhammet
Amaç: Akış sitometrisi (AS) çeşitli hücrelerin bir süspansiyon halinde bir akış kanalı boyunca tek tek geçmesi vebu esnada hücre büyüklük ve içeriğine göre sınıflandırılması esasına dayanan florokromojenik-lazer tabanlı bir tanıyöntemidir. Hematolojik malignitelerin tanısı AS cihazının en fazla kullanım alanıdır. Mevcut çalışmada hastanemizAS laboratuvarına gönderilen örneklerin yıllara göre dağılımlarını, istek yapan bilim dalının dağılımını, gönderininyapıldığı örnek tipini ve tanı-izlemde ASnin yerini değerlendirmeyi hedefledik. Yöntem ve Gereçler: Trakya Üniversitesi Tıp Fakültesi AS Laboratuvarına 01.01.2002 ile 01.01.2014 tarihleriarasında gönderilerek değerlendirilen AS testleri geriye dönük olarak değerlendirildi. Elde edilen parametreler ta- nımlayıcı istatistik çerçevesinde değerlendirildi.Sonuç: Bu zaman zarfında toplam 4874 adet test değerlendirildi (Ortalama: 406 test/yıl). Örneklerin %18,7si çocukyaştaki hastalardan (n=964) gönderilmişken, % 81,3ü (n=3910) erişkin hastalarından gönderilmişti. Gönderilen ör- neklerin %35,3ü (n=1725) kemik iliği, %58,2si periferik kan (n=2828), %6,5i (n=321) diğer vücut dokularındangönderilmişti. Örneklerin %20,2sinin (n=989) tanısında AS inceleme başrol oynamıştı. Örneklerin %18,5i (n=880)hastalıkların tedaviye yanıtlarının değerlendirilmesinde kullanıldı. Tanısı ASyle konulan hastaların %34,6sı akutmyeloid lösemi, %32si kronik B-lenfoproliferatif hastalıklar, %19,5i akut lenfositer lösemi, %10,2si myelodisp- lastik sendrom, %3,2si kronik myeloid lösemi, %0,3ü Burkitt lösemi/lenfoma, %0,1i T-lenfoproliferatif hastalıkve %0,1i bifenotipik lösemiydi.Tartışma: Tek merkez verilerinin değerlendirildiği bu çalışma tanı konulması istenilen hastalıkların ülkemizdekisıklıklarını göstermesi açısından önemli veriler sunmaktadır. Yıllara göre dağılım ise merkezimizin deneyim artı- şını ve hastaların merkezimize ulaşımının kolaylaşması olarak değerlendirilebilir. Hastane verilerine dayalı geriyedönük çalışmaların yararları arasında hastalık sıklık verilerinin saptanmasında dolaylı bir yöntem olması sayılabilir.
Autonomic and diastolic dysfunction association with quality of life impairment in cirrhotic patients
(Elsevier, 2020) Baysal, Mehmet; Ortaburun, Yildiz; Soylu, Ali Riza; Yilmaztepe, Mustafa Adem; Baysal, Serap; Umit, Elif; Umit, Hasan
Background and study aims: Cirrhosis is a multisystem disorder characterized by hyperdynamic circulation which can progress to multiple organ dysfunctions. Recent studies have demonstrated autonomic dysfunction and cirrhotic cardiomyopathy including diastolic dysfunction, systolic dysfunction with electrophysiologic abnormalities in patients with cirrhosis. Due to the long and complicated course of the disease, health related quality of life is affected. We aimed to evaluate the frequency of diastolic dysfunction and autonomic dysfunction in cirrhosis, and the effects on health-related quality of life. Patients and methods: Hundred cirrhotic patients were enrolled in the study. According to the Child-Pugh classification 35 patients were of Child A, 36 of Child B and 29 of Child C. The proportion of autonomic dysfunction was 52%, and diastolic dysfunction 51%. Autonomic dysfunction was diagnosed using bedside maneuvers and tests; diastolic dysfunction was diagnosed using the E/A ratio in echocardiographic findings. Health-related quality of life measurements was obtained from an SF-36 questionnaire. Results: Patients with advanced Child-Pugh classifications were found to have significantly lower health-related quality of life values (p < 0.05). Likewise, health-related quality of life values were observed to be significantly lower in patients with autonomic dysfunction (p < 0.05). No significant difference was found in health related quality of life measurements between patients with and without diastolic dysfunction. Conclusion: Our study showed that autonomic dysfunction and diastolic dysfunction are found in patients with cirrhosis. Further studies are needed to assess the effects of autonomic dysfunction and diastolic dysfunction on health-related quality of life. (C) 2020 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.
A case of refractory chronic lymphocytic leukaemia with an unusual course
(All India Inst Medical Sciences, 2019) Umit, Elif G.; Baysal, Mehmet; Ozdover, Ali Caner; Kirkizlar, Onur; Demir, Ahmet Muzaffer
Chronic lymphocytic leukaemia (CLL) is a heterogeneous disease with uncertain course. Treatment should be tailored to the patient's disease as well as the prognostic subgroup. With the increased use of rituximab as well as other selective and non-selective immunomodulatory agents, the incidence of infectious complications and second malignancies has also increased. Progressive multifocal leucoencephalopathy (PML) is a complication of rituximab in HIV-negative patients. A 56-year-old male with CLL had been treated and relapsed four times in 6 years. Rituximab was added to the combination after the second relapse and repeated in the third relapse in combination with bendamustine. In the seventh year of diagnosis, relapse of CLL and an ulcerated tumorous lesion was observed in the left index finger, which progressed in 3 months and was later diagnosed as angiosarcoma. The cancer was treated with local radiotherapy and combination chemotherapy. One year after the last rituximab exposure, progressive muscle weakness developed and polyoma JC virus DNA was observed with increased titres in the cerebrospinal fluid, and the patient was diagnosed as having PML. The patient died 2 months later. Our patient had an unusual course of CLL over 8 years, with relapses, complicated with a secondary malignancy and an infectious complication.
Chronic myeloid leukaemia after chemoradiotherapy for solid malignancies
(Wolters Kluwer Medknow Publications, 2020) Baysal, Mehmet; Ulutas, Gulcin; Gokyer, Ali; Umit, Elif; Atli, Emine Ikbal; Kirkizlar, Onur; Gurkan, Hakan
Haematological malignancies associated with chemoradiotherapy (CRT) are often acute myeloid leukaemias and myelodysplastic syndromes. Chronic myeloid leukaemia (CML) has been reported rarely in these situations. Cytogenetics of CRT-associated CML is not different from de novo CML, and there are not enough data about its prognosis. We report two patients who had CRT because of lung cancer and squamous cell carcinoma of head and neck, who subsequently developed CML.
Clonal Hematopoiesis in Multiple Myeloma, Relations with Treatment Toxicity
(Cig Media Group, Lp, 2021) Gulsaran, Sedanur Karaman; Umit, Elif Gulsum; Bas, Volkan; Baysal, Mehmet; Puyan, Fulya Oz; Demir, Ahmet Muzaffer
[Abstract Not Available]
Comparison of Clinical Scoring Systems in the Management of Patients with Microangiopathic Hemolytic Anemia and Thrombocytopenia
(Galenos Yayincilik, 2021) Baysal, Mehmet; Umit, Elif; Kirkizlar, Hakki Onur; Demir, Ahmet Muzaffer
Objective: Several clinical scoring systems have been developed for the differential diagnosis of thrombotic microangiopathies (TMAs), all to predict and identify patients with ADAMTS13 deficiency and to start treatment as soon as possible. The first scoring system in this regard was the Bentley score, and the French score and PLASMIC score were developed afterwards. Materials and Methods: We aimed to evaluate the laboratory parameters and clinical features of patients who underwent plasma exchange with a prediagnosis of TTP at our clinic between 2007 and 2019 and whose ADAMTS13 enzyme levels were measured and to compare the findings with the scoring systems. Results: Data of 35 patients were evaluated. Twelve patients were evaluated as high risk according to all three scoring systems. A statistically significant relation was observed between all three scoring systems and ADAMTS13 levels. Conclusion: A moderate correlation was found between all three scoring systems and ADAMTS13 levels. We observed similar potential strength of all three scoring systems to predict TTP among other TMAs and we conclude that they are applicable in daily practice.
Concepts of Double Hit and Triple Hit Disease in Multiple Myeloma, Entity and Prognostic Significance
(Nature Portfolio, 2020) Baysal, Mehmet; Demirci, Ufuk; Umit, Elif; Kirkizlar, Hakki Onur; Atli, Emine Ikbal; Gurkan, Hakan; Gulsaran, Sedanur Karaman
Risk assessment in newly diagnosed multiple myeloma patients (NDMM) is the first and the most crucial determinant of treatment. With the utilization of FISH analysis as a part of routine practice, high risk Multiple Myeloma (MM) is defined as having at least one of the mutations related with poor prognosis including; t(4;14) t(14;16), t(14;20), del 17p, p53 mutation, gain 1q and del 1p. M-Smart MM risk stratification guideline by Mayo Clinic has proposed a concept similar to high grade lymphomas. Having two of the high risk genetic abnormalities were defined as double hit MM and having any three as triple hit MM. Based on these definitions which may bring a much more clinically relatable understanding in MM prognosis, we aimed to assess our database regarding these two concepts and their probable significance in terms of outcome and prognosis. We retrospectively evaluated 159 newly diagnosed multiple myeloma patients and their clinical course. Among these patients; twenty-four patients have one high risk determinant and also seven and two patients were classified as double hit MM and triple hit MM respectively. Overall survival (OS) of the patients with double hit MM was 6 months, 32.0 months for patients with single high risk abnormality and 57.0 months for patients with no high risk abnormality. Univariate analysis showed that Double Hit and Triple Hit MM is a predictive of low OS. Hazard Ratio of patients with one high risk abnormality was 1.42, double-hit MM patients was 5.55, and triple-hit MM patients was 7.3. Despite the development of novel drugs and their effects of prolonging survival, the treatment has not been individualized. Understanding the biology of each patient as a unique process will be the success of the treatment. As it is known that some MM patients harbor high risk genetic abnormalities according to FISH analysis, we can continue the argument that some patients bring an even higher risk and that can be defined as double or triple hit MM.
Could Antinuclear Antibody Positivity Be a Factor Affecting Treatment Response in Immune Thrombocytopenia Patients on Eltrombopag?
(Galenos Yayincilik, 2022) Baysal, Mehmet; Bas, Volkan; Umit, Elif; Kirkizlar, Hakki Onur; Demir, Ahmet Muzaffer
Objective: Eltrombopag remains a prominent option in the treatment of steroid-dependent or steroid-refractory immune thrombocytopenia (ITP) patients. Unfortunately, not all patients respond to eltrombopag. Antinuclear antibody (ANA) positivity can be seen at rates of up to 30% in ITP patients. Despite being widely used, more markers to predict the response to eltrombopag are still needed. In the present study, we aimed to show the association between ANA positivity and eltrombopag response in ITP patients. Materials and Methods: Patients who were diagnosed with ITP in the Trakya University Faculty of Medicine's Department of Hematology and who underwent eltrombopag treatment due to their resistance to steroids and other treatments were included in our study. ANA measurement was performed by indirect fluorescent antibody method and titers of 1:160 and above were considered positive. ANA measurements were made before starting eltrombopag. Results: Forty-five patients were included in our study, 33 being women and 12 men. The mean age of the patients was 45.73 years. There were 14 patients with ANA positivity and 31 patients were found to be ANA-negative. Response rates were higher in ANA-negative patients compared to ANA-positive patients in the 1st and 6th months of eltrombopag treatment (p<0.05). Conclusion: ANA positivity in ITP may indicate unresponsiveness to eltrombopag treatment, a finding that should be further supported by prospective studies involving more patients.
Drug Induced Thrombotic Microangiopathy with Certolizumab Pegol
(2018) Baysal, Mehmet; Ümit, Elif Gülsüm; Sarıtaş, Fatih; Kodal, Nil Su; Demir, Ahmet Muzaffer
Background: Certolizumab pegol is used to treat ankylosing spondylitis, Crohn’s disease, psoriatic arthritis, and rheumatoid arthritis. Unlike other monoclonal antibodies such as infliximab and adalimumab, certolizumab does not contain an Fc fraction and hence does not induce complement activation. In this report, we describe the case of a patient with thrombotic microangiopathy caused due to certolizumab pegol, with a brief description about the pathophysiological approach to thrombotic microangiopathy. Case Report: A-39-year-old man suffering from ankylosing spondylitis for the past 10 years presented with fatigue. He had been on certolizumab pegol treatment for 6 months, starting with 400 and 200 mg every 2 weeks. He had significant nonimmune hemolytic anemia and thrombocytopenia without a disseminated intravascular coagulopathy. Schistocytes were observed in more than 10% of the erythrocytes per field. Plasma exchange along with corticosteroid treatment was started. There was a dramatic improvement within a week, and after 10 sessions of plasma exchange, the patient was discharged on corticosteroids with a tapering plan. ADAMTS13 enzyme activity was determined to be normal. Conclusion: The development of drug-induced thrombotic microangiopathy may be either immune-mediated or dose-dependent toxicity-mediated Anti-drug antibodies and their immunological aspects are still unclear and yet to be elucidated.
Economic analysis of oral posaconazole prophylaxis in acute myeloid leukemia during remission induction in Turkey
(Kare Publ, 2020) Umit, Elif Gulsum; Baysal, Mehmet; Kirkizlar, Hakki Onur; Demir, Ahmet Muzaffer
OBJECTIVE: Invasive fungal infections (IFI) are important and trending causes of mortality in patients with acute leukemia, especially during the remission induction. METHODS: In this study, 225 patients who were diagnosed with acute myeloid leukemia (AML) and undergoing intensive treatment for remission induction were enrolled in a retrospective manner. RESULTS: Within the whole group, which consisted of 225 patients, 90 patients received prophylactic antifungal treatment (PAT) (40%), while 135 patients did not (60%) receive. The mean cost of hospitalization was 9.151,6 (2.872,6-20.483,3) US dollars. Gender distribution and mean ages of groups were similar. One hundred fourteen patients not on PAT (84.4%) and five patients on PAT (5.5%) received intravenous antifungal treatment. Thirty-two of the patients who were not on PAT (23.7%) and 11 of the patients on PAT died during remission induction (12.22%). The mean day of the hospitalization was 22.61 days for the patients on PAT and 33.89 days for the patients who were not on PAT. In patients on PAT, the mean number of transfused platelet units was six (0-9), while 12.51 (4-43) units for patients who were not on PAT. CONCLUSION: In our study, the oral suspension form of posaconazole was observed to be cost-effective to prevent IFI with a significant decrease in mortality during remission induction treatment.
The evaluation of risk factors leading to early deaths in patients with acute promyelocytic leukemia: a retrospective study
(Springer, 2022) Baysal, Mehmet; Gursoy, Vildan; Hunutlu, Fazil Cagri; Erkan, Buket; Demirci, Ufuk; Bas, Volkan; Gulsaran, Sedanur Karaman
Acute promyelocytic leukemia (APL) differs from other forms of acute myeloid leukemia (AML), including coagulopathy, hemorrhage, disseminated intravascular coagulation (DIC), and treatment success with all-trans retinoic acid (ATRA). Despite ATRA, early deaths (ED) are still common in APL. Here, we evaluated factors associated with ED and applicability of scoring systems used to diagnose DIC. Ninety-one APL patients (55 females, 36 males, and median age 40 years) were included. ED was defined as deaths attributable to any cause between day of diagnosis and following 30th day. DIC was assessed based on DIC scoring system released by the International Society of Thrombosis and Hemostasis (ISTH) and Chinese Diagnostic Scoring System (CDSS). Patients' median follow-up time was 49.2 months, and ED developed in 14 (15.4% of) cases. Patients succumbing to ED had higher levels of the Eastern Cooperative Oncology Group Performance Status (ECOG PS), lactate dehydrogenase (LDH), and ISTH DIC, and lower fibrinogen levels (p <0.05). In multivariate Cox regression analysis, age >55 and ECOG PS >= 2 rates were revealed to be associated with ED. Based on ISTH and CDSS scores, DIC was reported in 47.3 and 58.2% of the patients, respectively. Despite advances in APL, ED is still a major obstacle. Besides the prompt recognition and correction of coagulopathy, those at high ED risk are recommended to be detected rapidly. Implementation of local treatment plans and creating awareness should be achieved in hematological centers. Common utilization of ATRA and arsenic trioxide (ATO) may be beneficial to overcome ED and coagulopathy in APL patients.
Evaluation of Sarcopenia with F-18 FDG PET/CT and relation with disease outcomes in patients with multiple myeloma
(Wiley, 2020) Umit, Elif G.; Korkmaz, Ulku; Baysal, Mehmet; Karaman Gulsaran, Sedanur; Bas, Volkan; Demirci, Ufuk; Onur Kirkizlar, Hakki
Introduction Multiple myeloma (MM) is a potentially incurable haematological malignancy with devastating manifestations including lytic bone lesions leading to fractures and renal insufficiency. As a disease of patients with a mean age of 66 years, both the disease and the continuous efforts of treatments lead to frailty and devastation. From this stand point, we aimed to evaluate the development of muscle loss in MM patients and also with a new method of sarcopenia evaluation, F-18 FDG PET/CT. While used for bone disease routinely, this method brings a fresh perspective of metabolic quantitation of alteration of muscles which may be regarded as muscle quality. Materials and Methods Data and images of 105 patients with MM both before and after treatment were evaluated in a retrospective manner. Results Both female and male patients were observed to be effected after MM treatment in terms of lumbar and femoral muscle evaluations with CT. Metabolic evaluations confirmed a loss of quality in muscles in terms of metabolic volume and total lesion glycolysis. Conclusion Sarcopenia should be evaluated in every patient and regarded as a treatment target. FDG PET/CT is an easy and handy tool to assess muscle mass and quality as well as MM disease status.
Fusarium Endophthalmitis, Unusual and Challenging Infection in an Acute Leukemia Patient
(Hindawi Ltd, 2018) Baysal, Mehmet; Umit, Elif; Boz, Ibrahim Bekir; Kirkizlar, Onur; Demir, Muzaffer
Invasive fungal infections bring serious mortality and morbidity during the treatment of acute myeloid leukemia. Especially, mold infections are challenging, and each case is unique in feature. These cases are usually fatal, and there is no consensus regarding optimal treatment. AML patients receive antifungal prophylaxis and may further require IFI (invasive fungal infection) treatments, but fusarium mold infections are often unrecognized and could be overlooked. In this case report, we try to emphasize the importance of this infection with a high-risk AML patient.
Genetic Diagnosis of Hereditary Hemorrhagic Telangiectasia: Four Novel Pathogenic Variations in Turkish Patients
(2020) Baysal, Mehmet; Demir, Selma; Ümit, Elif G.; Gürkan, Hakan; Baş, Volkan; Gülarslan, Sedanur Karaman; Demir, Ahmet Muzaffer
Aims: Hereditary hemorrhagic telangiectasia is an autosomal dominant disorder characterized by telangiectasia, epistaxis, and vascular malformations. Pathogenic mutations were found in ENG, AVCRL1, SMAD4, and GDF genes. In this study, we present our database of patients with hereditary hemorrhagic telangiectasia regarding the phenotype-genotype relations and discuss two novel ENG gene pathogenic variations in two unrelated families. Methods: Next Generation Sequencing analysis was performed on the peripheral blood of nine patients with hereditary hemorrhagic telangiectasia in four unrelated families. All patients were diagnosed with hereditary hemorrhagic telangiectasia according to the Curaçao criteria. Data on treatment and screenings of visceral involvement were recorded from files. Results: We have found a pathogenic variation in either the ENG or ACVRL1 gene in each family. Two novel pathogenic variations in the ENG gene, including NM_000118.3 (ENG): c.416delC (p.P139fs*24) and NM_000118.3(ENG): c.1139dupT (p.Leu380PhefsTer16), were found in the same family. The NM_000020.2(ACVRL1): c.1298C>T (p.Pro433Leu) pathogenic variation in the ACVRL1 gene in our first family and a novel heterozygous likely pathogenic NM_000020.2(ACVRL1): c.95T>C (p.Val32Ala) variation was found in our second family. Seven of the nine patients were treated with thalidomide for controlling bleeding episodes. All patients responded to thalidomide. In one patient, the response to thalidomide was lost and switched to bevacizumab. Conclusion: In hereditary hemorrhagic telangiectasia, certain types of mutations correlate with disease phenotypes and with next generation sequencing methods. New pathogenic variations can be revealed, which might help manage patients with hereditary hemorrhagic telangiectasia
Immune Thrombotic Thrombocytopenic Purpura in Elderly Patients: The Roles of PLASMIC and French Scores
(Galenos Publ House, 2023) Baysal, Mehmet; Hindilerden, Fehmi; Umit, Elif Gulsum; Demir, Ahmet Muzaffer; Karadag, Fatma Keklik; Saydam, Guray; Akpinar, Seval
Objective: In recent years, new developments have been incorporated into daily practice in the management of immune thrombotic thrombocytopenic purpura (iTTP). In particular, clinical scoring systems could help clinicians with clinical decision-making and early recognition. However, older patients frequently present with more organ involvement and in unusual ways. The ways in which age could affect these clinical prediction scoring systems remain unclear. We evaluated the use of PLASMIC and French scores in patients over 60 years of age. Materials and Methods: We performed a retrospective cross-sectional analysis of patients over 60 years of age with a presumptive diagnosis of iTTP between 2014 and 2022 at 10 centers. We calculated PLASMIC and French scores and compared our data with a single-center analysis of younger patients presenting with thrombotic microangiopathy. Results: Our study included 30 patients over 60 years of age and a control group of 28 patients younger than 60 years. The diagnostic sensitivity and specificity of a French score of >= 1 were lower in older patients compared to the control group (78.9% vs. 100% and 18.2% vs. 57.1%, respectively). The diagnostic sensitivity and specificity of a PLASMIC score of >= 5 were 100% vs. 95% and 27.3% vs. 100% for the study group and control group, respectively. Our study showed a higher mortality rate in older patients compared to the control group (30% vs. 7.1%, p=0.043). Conclusion: For a limited number of patients (n=6), our results showed that rituximab can reduce mortality. Given that the reliability of clinical prediction scores for iTTP in older patients may be lower, more caution must be undertaken in interpreting their results.
The Incidence of Venous Thromboembolism and Impact on Survival in Hodgkin Lymphoma
(Cig Media Group, Lp, 2020) Kirkizlar, Onur; Kirkizlar, Tugcan Alp; Umit, Elif Gulsum; Asker, Ismail; Baysal, Mehmet; Bas, Volkan; Gulsaran, Sedanur Karaman
Venous thromboembolic events are associated with high morbidity and mortality in malignancy patients. We should be aware in terms of venous thromboembolism in patients who have involvement of spleen, advanced stage disease, or a central venous line, especially initial high fibrinogen levels, even with a good performance status. Background: Thrombosis increase the acute and long-term morbidity and mortality in malignancy patients. We analyzed venous thromboembolism (VTE) in patients with Hodgkin lymphoma, the impact of VTE on survival, predisposing factors for VTE, and predicting value of Khorana and ThroLy score models. Patients and Methods: We included 150 adult patients with Hodgkin lymphoma between January 2010 and 2018 at our university hospital. Results: VTE was observed in 31 patients (20.7%). The types of VTE were 18 upper and 3 lower extremity deep vein thrombosis and 10 pulmonary embolism (1 with lower extremity deep vein thrombosis). Twenty-nine patients developed VTE during the treatment with a median time of episode as 5 months. In logistic regression analysis, a body mass index of >32 kg/m(2), high fibrinogen levels, initial thrombocytosis and leukocytosis, splenic and extranodal involvement, presence of a central venous line, advanced stage, line of treatment status of thromboprophylaxis, VTE timing, and better Eastern Cooperative Oncology Group performance scores were observed to be related with VTE. Kaplan Meier survival analysis showed a negative impact of VTE on survival. Khorana and ThroLy risk assessment models were found predictive for VTE (P = .000 and P = .003, respectively), although only ThroLy score was associated with the survival. Conclusion: Thromboprophylaxis and precautions for VTE in patients with Hodgkin lymphoma according to validated risk assessment models can improve prognosis and quality of life owing to the impact of VTE on survival in the study. (C) 2020 Elsevier Inc. All rights reserved.
Invasive fungal infection with a rare organism in a patient with acute myeloid leukaemia
(Wolters Kluwer Medknow Publications, 2020) Baysal, Mehmet; Umit, Elif; Ozdover, Ali Caner; Kirkizlar, Onur; Demir, Ahmet Muzaffer
Invasive fungal infections are a major cause for morbidity and mortality in patients with acute myeloid leukaemia (AML). Long duration of hospitalization and increased costs are secondary burdens for patients and caregivers. The clinical manifestations are variable with a spectrum of different organs or systems. Factors related with invasive fungal infections may be categorized as host-related including the underlying disease, treatment and colonization status and pathogen-related including the capacity of the microorganism for defence, growth, tolerance and tissue affinity. The diagnosis of invasive fungal infection is confirmed with histopathological or microbiological demonstration of the microorganism, and commonly treatments are based on probability rather than definitive diagnosis due to patients fragile conditions preventing interventions. We aimed to present the less frequent yet difficult-to-treat organism, Verticillium causing invasive fungal infection in a patient with AML undergoing remission induction therapy.
Is JAK2V617F Mutation the Only Factor for Thrombosis in Philadelphia-Negative Chronic Myeloproliferative Neoplasms?
(Springer India, 2016) Uyanik, Mehmet Sevki; Baysal, Mehmet; Pamuk, Gulsum Emel; Maden, Muhammet; Akker, Mustafa; Umit, Elif Gulsum; Demir, Muzaffer
The most common genetic disorder in Philadelphia negative chronic myeloproliferative neoplasms is the JAK2-V617F mutation. In the present study, we aimed to determine risk factors for thrombosis in patients with essential thrombocytosis and polycythemia vera. We screened the medical records of 101 patients. Risk factors which may predict thrombosis were recorded. Venous thrombosis (VT) before diagnosis was significantly higher in JAK2 positive patients. VT after diagnosis was similar in JAK2 positive and negative groups, and was significantly higher in elderly patients. Treatment places importance on the JAK2 mutation under unmodifiable cardiovascular risk factors such as advanced age after diagnosis.
Late onset left ventricular dysfunction and cardiomyopathy induced with ibrutinib
(Sage Publications Ltd, 2020) Gulsaran, Sedanur K.; Baysal, Mehmet; Demirci, Ufuk; Bas, Volkan; Kirkizlar, Hakki O.; Umit, Elif; Demir, Ahmet M.
Introduction Ibrutinib, an oral inhibitor of Bruton's tyrosine kinase, has altered the treatment perspective of chronic lymphocytic leukemia and showed modest activity against several types of non-Hodgkin's lymphomas. According to phase studies and real-world data, reported serious adverse effects included atrial fibrillation, diarrhea, and bleeding diathesis. However, heart failure was not reported to be a probable adverse effect linked with ibrutinib. Case report In this paper, we present a 66-year-old female chronic lymphocytic leukemia patient who developed significant and symptomatic left ventricular dysfunction at the 13th month of ibrutinib treatment. Management and outcome Following cessation of ibrutinib, ejection fraction and clinical findings of the left ventricular dysfunction alleviated. Discussion Although the use of ibrutinib is generally well tolerated, cardiac functions should be monitored occasionally in all patients.

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