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Öğe 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, MuhammetAmaç: 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.Öğe Clinical Features and Treatment Strategies of Primary Central Nervous System Lymphoma: a Multicenter Retrospective Study(Trakya Üniversitesi, 2015) Demirci, Koray; Pamuk, Gülsüm Emel; Erkurt, Mehmet Ali; Kılıç, Oğuz; Şıvgın, Serdar; Maden, Muhammet; Kuku, İrfanAims: Primary central nervous system lymphoma is a rare, highly malignant disease with poor prognosis. Thecurrent knowledge about the disease is mostly gathered from prospective clinical trials and the optimal treatment modality is still a matter of debate. In this study it is aimed to acquire more information about the clinical features of the disease and the responses to different treatment modalities.Methods: The archives in Trakya University Hospital, İnönü University Turgut Özal Medical Center, PamukkaleUniversity Hospital and Erciyes University Hospital researched retrospectively. Demographic, treatment and survival data were retrieved and their statistical analysis was performed. As descriptive statistics number and percentages, arithmetic mean ± standard deviation, median (maximum-minimum) were used. Survival analysis was performed using Kaplan- Meier method.Results: Median age of patients at diagnosis was 53 and out of 28 patients 15 (53.6 %) of them were male. As the symptoms of the disease 18 (66.7%) patients presented headache, 15 (53.8%) presented focal deficit. As initial treatment 26 (92.9%) patients received chemotherapy, while 19 (67.9%) patients were treated with surgical resection and the median overall survival time was 7 months. Conclusion: Achieving complete remission as response to the initial treatment is associated with an improvedoverall survival. Other survival analysis to compare the impact of all initial treatment methods on overall survival resulted statistically insignificantÖğe Decreased dickkopf-1 levels in chronic lymphocytic leukemia and increased osteopontin levels in non-Hodgkin's lymphoma at initial diagnosis: Could they be playing roles in pathogenesis?(Maney Publishing, 2015) Pamuk, Gulsum Emel; Uyanik, Mehmet Sevki; Pamuk, Omer Nuri; Maden, Muhammet; Tapan, UmitAims: We determined plasma levels of dickkopf-1 (DKK-1) and osteopontin (OPN) which have roles in the Wnt pathway in chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL) patients and in healthy controls. We also tested whether DKK-1 and OPN levels could be of clinical or prognostic significance in CLL and NHL. Methods: We included 36 CLL, 24 NHL patients, and 21 healthy controls. Patients' clinical and demographic features, treatment modalities, and response to treatment were recorded. DKK-1 and OPN levels in plasma obtained at initial diagnosis were determined with enzyme-linked immunosorbent assay. Results: CLL patients had significantly lower DKK-1 levels than NHL and control groups (P levels, respectively, 0.048 and 0.017). OPN level was significantly higher in NHL group than in CLL and control groups (P values, 0.017 and <0.001). CLL patients with early and late Rai stages of disease had similar DKK-1 and OPN levels. After a median follow-up of 48 months, 13 CLL patients died. Univariate analysis showed that advanced Rai stages and older age were significantly poor prognostic factors. DKK-1 level in CLL patients who have died was significantly lower than those who were alive (P = 0.035). NHL patients with extranodal involvement had significantly higher OPN levels than those with no involvement (P = 0.04). Conclusions: Our results demonstrated that the Wnt pathway inhibitor DKK-1 was decreased in CLL. OPN was increased in NHL and associated with extranodal involvement. In order to reveal the pathogenic and clinical roles of DKK-1 and OPN in CLL and NHL, larger studies need to be conducted.Öğe Development of Atherosclerotic Cardiovascular Mortality in Gouty Arthritis and Rheumatoid Arthritis Patients: Are They Associated With Mean Platelet Volume and Neutrophil-Lymphocyte Ratio? A Comparative Study(Turkish League Against Rheumatism, 2017) Maden, Muhammet; Pamuk, Gulsum Emel; Pamuk, Omer NuriObjectives: This study aims to evaluate the mean platelet volume (MPV) and neutrophil-lymphocyte ratio (NLR) in gouty arthritis (GA) and rheumatoid arthritis (RA) patients, as well as their relationship with atherosclerotic cardiovascular mortality (ACVM). Patients and methods: The study included 122 GA patients (96 males, 26 females; mean age 64.6 +/- 13.4 years; range 34 to 82 years), 82 RA patients (40 males, 42 females; mean age 62.1 +/- 12.1 years; range 29 to 83 years), and 61 healthy controls (34 males, 27 females; mean age 65.3 +/- 4.8 years; range 33 to 80 years). Clinical and ACVM data were obtained from medical charts. Erythrocyte sedimentation rate, C-reactive protein, MPV, and NLR were recorded at the time of diagnosis and one month after therapy. Results: Mean platelet volume in GA (8.49 +/- 1.5) and RA (7.98 +/- 0.99) groups were significantly lower than in healthy controls (9.8 +/- 15) (p< 0.001). NLR in healthy controls (1.9 +/- 0.74) was significantly lower than in GA (3.6 +/- 2.3) and RA (3.7 +/- 2.5) groups (p< 0.001). After treatment, MPV did not change significantly in GA and RA groups (p values > 0.05); however, NLR decreased in both groups (p< 0.001). Nine GA and 12 RA patients died from ACVM during follow-up. GA patients with ACVM were older and had more frequent hypertension, higher MPV, and higher intercritical CRP level. In multivariate analysis, MPV was an independent poor prognostic factor for ACVM in GA patients. Conclusion: Gouty arthritis and RA patients had significantly lower MPV and significantly higher NLR than controls. MPV might be used as a potential biomarker for the development of ACVM in GA.Öğe Evaluation of Stomach Involvement of Non-Hodgkin's Lymphoma: Single Center Experience(2015) Ümit, Elif Gülsüm; Uyanık, Mehmet Şevki; Emel, Gulsum Pamuk; Demir, Ahmet Muzaffer; Maden, MuhammetIntroduction: Gastrointestinal tract is the most common site of involvement in non-Hodgkin s lymphomas. Appropriate treatment regiments were not defined because of rare involvement. In the present study we aimed to evaluate treatment response of non-Hodgkin s lymphoma patients with stomach involvement. Methodology: 26 patients with stomach involvement were retrospectively analyzed between 01/01/1998 and 01/06/2014. Descriptive statistic was performed to analyze data. Methods: 20 of the patients (76.9%) were composed of primary stomach non-Hodgkin lymphoma, 6 of the patients (23.1%) were composed of patients secondary involvement of the advanced stage disease. All of the patients were subtypes of B cell lymphoma. 3 of the patients (11.5%) was indolent, 22 of the patients (84.6%) was aggressive, and 1 of them (3.8%) was very aggressive. Diffuse large B cell lymphoma was 72.9%; Maltoma was 8.7%, and Mantle cell lymphoma was %3.8. Complete response was achieved at 10 patients, partial response was achieved in 1 patient, and 7 patients were failed to response the treatment. Treatment response and overall survival of low grade and high grade patients, both according to Ann-Arbor and Lugano classification systems were similar. Patients with elevated sedimentation rate had significant lower survival than patients with normal sedimentation rate (p=0.027). Discussion: Together with the data from recent studies, aggressive treatment approach without organ preservation should not be performed on patients without higher inflammatory response and early stage presentation. Sedimentation rate might help to clinicians for the treatment of choice.Öğe General Features of SLE Patients Presenting with Autoimmune Hemolytic Anemia(Wiley, 2016) Elezi, Regaip; Pamuk, Gulsum Emel; Maden, Muhammet; Balci, Mehmet Ali; Pamuk, Omer Nuri[Abstract Not Available]Öğe High apelin levels could be used as a diagnostic marker in multiple myeloma: A comparative study(Ios Press, 2016) Maden, Muhammet; Pamuk, Omer Nuri; Pamuk, Gulsum EmelBACKGROUND: Apelin/APJ system regulates angiogenesis and is overexpressed in some malignancies. Apelin can induce lymphangiogenesis and lymph node metastasis. OBJECTIVE: We evaluated apelin levels in multiple myeloma (MM) and non-Hodgkin lymphoma (NHL); and analyzed the association between apelin levels and clinical findings. METHODS: We included consecutive 29 MM, 31 NHL patients, and 19 healthy controls. Patients' demographic and clinical features, treatment modalities, and responses were recorded from hospital records. Plasma apelin was determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: MM patients had significantly higher plasma apelin level than NHL and healthy control groups (p < 0.001). Apelin level in NHL group was similar to controls (p > 0.05). ROC curve analysis showed that the area under the curve value for apelin level in MM was 0.842 ng/ml (95% CI: 0.739-0.945, p < 0.001). Plasma apelin level >= 0.827 ng/ml had 76% sensitivity and 86% specificity for the diagnosis of MM. Multivariate Cox regression analysis showed that MM patients with high apelin level had better prognosis and patients with advanced stage of disease (ISS-3) had significantly poor prognosis when compared to others. In the MM group, apelin level correlated negatively with LDH (r = -0.39, p = 0.038). CONCLUSIONS: In MM, plasma apelin level was significantly higher than in NHL and control groups. Apelin could be playing a role in MM pathogenesis; and apelin level could be used as a diagnostic and prognostic biomarker in MM.Öğe The impact of new generic formulations of imatinib mesylate on general quality of life in chronic phase chronic myeloid leukaemia patients(Wiley, 2017) Uyanik, Mehmet S.; Pamuk, Gulsum E.; Maden, Muhammet; Merev, Elif; Cevik, Gokcen; Uyanik, Vesile; Umit, Elif G.Treatment with tyrosine kinase inhibitors (TKIs) has dramatically changed the life expectancy of chronic myeloid leukaemia (CML) patients. Although the impact of first-generation TKIs on quality of life (QoL) was shown in CML, the effects of new generic formulations of imatinib mesylate (IM) are unclear. We evaluated differences in QoL under treatment with first-or second-generation TKIs. Fifty-two patients diagnosed with CP-CML completed the European Organization for Research and Treatment of Cancer Quality of Life Questionaire-C30, Hospital Anxiety and Depression Scale, and General Health Questionnaire. General QoL scores were similar between groups. There was a significant difference in the frequency of diarrhoea between IM group and the group using new generic formulations of IM (P = 0.012). General QoL score tended to be higher in patients with disease duration longer than 3 years (P = 0.052). GHQ, anxiety and depression scores correlated positively with symptom scales and negatively with functional subscales. CML patients using new generic formulations of IM reported a higher frequency of diarrhoea than patients using original IM and second-generation TKIs that could result in more drug discontinuation.Öğe Increased frequency of small fiber neuropathy in chronic lymphocytic leukemia and non-Hodgkin lymphoma patients(Taylor & Francis Ltd, 2015) Pamuk, Gulsum Emel; Maden, Muhammet; Tekatas, Aslan; Pamuk, Omer Nuri[Abstract Not Available]Öğe 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, MuzafferThe 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.Öğe The rapid resolution of pseudohyperphosphatemia in an IGA? multiple myeloma patient after therapy with a bortezomib-containing regimen: Report of the first case(Wolters Kluwer Medknow Publications, 2015) Maden, Muhammet; Pamuk, Gulsum Emel; Asoglu, Veysi; Pamuk, Omer Nuri[Abstract Not Available]Öğe Serum Angiopoietin Levels are Different in Acute and Chronic Myeloid Neoplasms: Angiopoietins do not only Regulate Tumor Angiogenesis(Springer India, 2016) Atesoglu, Elif Birtas; Tarkun, Pinar; Mehtap, Ozgur; Demirsoy, Esra Terzi; Atalay, Figen; Maden, Muhammet; Celebi, KorayMolecular balance between Angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2) has important effects in tumor angiogenesis. Ang-2 was shown to be elevated and proved to be a prognostic factor in acute myeloid leukemia (AML). To date studies revealed increased angiogenesis in bone marrows (BMs) of both myeloproliferative neoplasm (MPN) and AML patients. We conducted this study to demonstrate circulating levels of Ang-1 and Ang-2 in MPN patients since no data exists in literature. Thirty-three newly diagnosed MPN, 27 newly diagnosed AML patients and 25 controls (HC) were enrolled and Angiopoietin levels were determined with ELISA. We found that Ang-1 levels were higher whereas Ang-2 levels were lower in MPN and HC when compared to AML. Our results suggest that though angiogenesis is increased in both AML and MPN, angiopoietin serum level profile of the two diseases are different, and MPN patients have similar Ang-1 and Ang-2 levels as HC. We conclude that, according to our results Ang-1 and Ang-2 do not only regulate tumor angiogenesis and the difference between angiopoietin levels of acute and chronic myeloid neoplasms could be a reflection of other effects of these growth factors on tumor malignancy.Öğe Wernicke's Encephalopathy in an Acute Myeloid Leukemia Patient: A Case Study(Galenos Yayincilik, 2016) Maden, Muhammet; Pamuk, Gulsum; Celik, Yahya; Unlu, Ercument[Abstract Not Available]
