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Öğe Acute Lymphoblastic Leukemia; Prognostic Factors' Perspective(Akad Doktorlar Yayinevi, 2010) Tekgunduz, Emre; Demir, Muzaffer; Akpinar, SevalAcute lymphoblastic leukemia represents a biologically and clinically heterogeneous group of diseases with different outcomes among patients subgroups. Identification of prognostic factors is critical in selecting therapy for subgroups of patients to achieve a high cure rate with minimal toxicity. Another important goal of risk stratification is to define patients with a very high risk of relaps, who may benefit from up-front allogeneic hematopoietic stem cell transplantation following first complete remission. Clinical parameters, immunophenotype, cytogenetics, treatment response, minimal residual disease are among currently used factors in risk stratification of acute lymphoblastic leukemia patients. But there are emerging new parameters like global gene expression profiling, host pharmacodynamics-pharmacogenetics and treatment protocols which may have an impact on risk-adapted treatment in the near future. In the present review we will discuss a variety of prognostic factors and their impact on clinical outcome of children and adults with acute lymphoblastic leukemia.Öğe Amifostine Treatment of a Patient with Refractory Acute Myeloid Leukemia(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2009) Tekgunduz, Emre; Erikci, Alev Akyol; Ozturk, AhmetThe prognosis for the majority of acute myeloid leukemia (AML) patients without a donor is dismal whether conventional salvage chemotherapy regimens or investigational strategies are used, and most of these patients will eventually die of their disease. There is no standard chemotherapy regimen that provides durable complete remission in patients with refractory AML. Beneficial effects of amifostine, either alone or in combination with conventional chemotherapy, was demonstrated in patients with myelodysplastic syndrome and poor prognosis AML. Here we report our second experience with AML patients who were successfully treated with an amifostine containing noncytotoxic drug combination. The beneficial effects of amifostine are not limited to cytoprotectivity which enables dose-escalation for many chemotherapeutic agents, at least in some refractory AML it can also be used as a bridge to hematopoietic stem cell transplantation.Öğe BETA-GLOBIN GENE MUTATIONS AND MICRO-HAPLOTYPE POLYMOPHISMS OF BETA-THALASSEMIA PATIENTS IN TRAKYA POPULATION(John Wiley & Sons Inc, 2009) Gurkan, Hakan; Turgut, Burhan; Tozkir, Hilmi; Bozkurt, Gokay; Tekgunduz, Emre[Abstract Not Available]Öğe CD30 positive T-cell lymphoproliferative disorder: A case report(Springer, 2007) Puyan, Fulya Oz; Tekgunduz, Emre; Ilgili, Aysegul; Pamuk, Gulsum; Yalcin, Omer; Dogan, Oner[Abstract Not Available]Öğe Differences in platelet-leukocyte aggregates among subtypes of acute cerebral ischemia(Elsevier, 2011) Turgut, Burhan; Turgut, Nilda; Celik, Yahya; Tekgunduz, Emre; Pamuk, Gulsum Emel; Demir, MuzafferBackground: Acute cerebral ischemia is caused by different pathophysiological mechanisms. The role of platelets and other blood cells can be different among the stroke subtypes. Methods: Seventy-two patients with acute ischemic cerebrovascular disease, including 31 patients with large vessel disease, 21 patients with cardioembolic disease, and 20 patients with small vessel disease, were evaluated. P-selectin (CD62P) expression and platelet leukocyte aggregates were measured with flow cytometry at the acute phase after the ischemic event. Markers were also measured in 37 control subjects. In all subjects, the serum high-sensitivity C-reactive protein (CRP) was also measured. Results: The platelet-monocyte aggregates (PMA) and platelet-granulocyte aggregates (PGA) in the large vessel disease group were higher than in control group (P=0.002, and P < 0.0001, respectively). The PMA and PGA in the small vessel disease group were also higher than in the control group (P=0.004 and P < 0.0001, respectively). In contrast, in the cardioembolic disease group, the PMA and PGA were not significantly different from the control group. CD62P expression was higher in all of the patient groups relative to the control group (P < 0.05 for all comparisons). Serum CRP levels were also higher in all of the patient groups than in the control group (P < 0.0001 for all comparisons). Conclusions: In contrast to large vessel and small vessel disease, it seems that platelet-leukocyte association does not play a crucial role in the pathogenesis of cardioembolic stroke. (C) 2011 Elsevier B.V. All rights reserved.Öğe Effectiveness of Defibrotide in the Prevention of VOD Among Patients Receiving Allogeneic Hematopoetic Cell Transplantation: A Retrospective Single Center Experience(Amer Soc Hematology, 2012) Tekgunduz, Emre; Akpinar, Seval; Bozdag, Sinem Civriz; Tetik, Aysegul; Kocubaba, Serife; Cinarsoy, Murat; Durgun, Gamze[Abstract Not Available]Öğe Hospital-acquired pneumonia in patients receiving immunosuppressive therapy(Galenos Publ House, 2010) Edis, Ebru Cakir; Hatipoglu, Osman Nuri; Yilmam, Ilker; Eker, Alper; Tansel, Ozlem; Sut, Necdet; Tekgunduz, EmreObjective: The aims of this study were to determine the clinical success rates, effect of neutropenia on treatment success rates, risk factors related to mortality, and survival in patients who developed hospital-acquired pneumonia (HAP) while receiving immunosuppressive therapy. Materials and Methods: Forty-three adult patients receiving immunosuppressive therapy who developed HAP were included in this prospective study. Transplantation patients and human immunodeficiency virus (HIV)-positive patients were not included. Antibiotic treatment was managed by a multidisciplinary team. The Kaplan Meier method was used for the survival analysis and Cox regression was used for the identification of mortality-related independent risk factors. The relationship between neutropenia and the clinical success rate was determined using the chi-square test. Results: Although anti-pseudomonal antibiotics were started empirically in 40 of the 43 patients (93%) at the beginning of the treatment, the most frequently isolated pathogens were Acinetobacter spp. and Escherichia coli. The success rate at the end of the treatment was 65.1%. The survival rates for the 3(rd), 14(th), 42(nd), and 365(th) days were 97%, 86%, 58%, and 19%, respectively. Elevated levels of urea [Hazard Ratio=1.01 (95% Cl: 1.00-1.02)] and blood glucose [HR=1.01 (95% Cl: 1.00-1.02)] were found to be independent risk factors affecting survival. The treatment success rate was higher in patients without neutropenia (n=23) than in those with neutropenia (n=20) (p=0.05). Conclusion: The treatment success rate was low in patients who developed HAP while receiving immunosuppressive therapy. (Turk J Hematol 2010; 27: 20-4)Öğe Incidence of anti-heparin/platelet factor 4 antibodies and heparin-induced thrombocytopenia in medical patients(Galenos Yayincilik, 2009) Demir, Muzaffer; Tekgunduz, Emre; Edis, Mustafa; Duran, Enver; Kurum, Turan; Yigitbasi, Omer; Yuksel, MahmutObjective: Heparin-induced thrombocytopenia (HIT) is a life threatening complication of heparin therapy, causing thrombosis. The aim of our study was to find out the frequencies of HIT antibody seroconversion and clinical HIT in Turkish medical patients on different forms of heparins. Materials and Methods: Our study included 61 patients who were an unfractionated heparin (UFH) (n: 37) and low molecular weight heparin (LMWH) (n: 24) therapies. The frequency of HIT antibody formation was determined by means of antigenic (ELISA), and functional assays (serotonin release assay-SRA). Results: The seroconversion rates in UFH and LMWH groups were found to be 18.9% and 4.1% (ELISA), and 8.1% and 4.1% (SRA), respectively. One patient (2.1%) on UFH therapy developed deep vein thrombosis. No thromboembolic event was observed in patients taking LMWH. Conclusion: Seroconversion rates by means of antigenic and functional assays and clinical HIT were more common in patients on UFH than patients on LMWH therapy. (Turk J Hematol 2009; 26: 171-5)Öğe Intensive Care BleedinQ Disorders and Treatment(Galenos Yayincilik, 2005) Tekgunduz, Emre; Soysal, TeomanUncontrollable hemorrhage is a significant cause of perioperative and critical care mortality, and is the second leading cause of death from trauma. Unexpected bleeding is a common diagnostic problem in the intensive care unit and patients with coagulopathy have a higher mortality rate than those without. A brief but very directed history, pyhsical examination, and screening hemostatic investigations will help the physician to make a decision between systemic coagulopathy and local hemostatic failure. In this review we first presented clinical evaluation of the bleeding patient and interpretation of common tests of hemostasis and coagulation. Thereafter clinical approach to and management of the common bleeding disorders in critically ill patients were discussed. In this context disseminated intravascular coagulation, hemorrhagic complications of anticoagulant treatment, coagulopathy of liver, renal, and infectious diseases, perioperative bleeding and bleeding due to massive blood transfusions, and hereditary coagulation disorders were reviewed.Öğe A Multicenter Experience of Thrombotic Microangiopathies in Turkey: The Turkish Hematology Research and Education Group (ThREG)-TMA01 Study(Amer Soc Hematology, 2016) Tekgunduz, Emre; Yilmaz, Mehmet; Erkurt, Mehmet Ali; Kiki, Ilhami; Kaya, Ali Hakan; Kaynar, Leylagul; Alacacioglu, Inci[Abstract Not Available]Öğe Positive Mixed lymphocyte Culture Test Result Due to HLA-DP Mismatch(Galenos Publ House, 2011) Ayna, Tulay Kilicaslan; Tozkir, Hilmi; Ciftci, Hayriye Senturk; Gurkan, Hakan; Tekgunduz, Emre; Algunes, Cetin; Gurtekin, MehmetGraft Versus Host Disease (GVHD) remains a major cause of morbidity and mortality in allogeneic stem cell transplantation (SCT). The MLC assay has been generally accepted as a standard test for determining HLA-D region compatibility. In this study, the MLC test has been carried out on the related recipient-donor couple who were prepared for allogeneic SCT and were found to be matched for HLA-A, -B, -Cw, DR, DO but not for -DP. The result of the MLC test was positive. We observed that HLA-DP mismatch was responsible for the increased proliferation values in MLC test.Öğe Sticky Platelet Syndrome in Patients with Uninduced Venous Thrombosis(Galenos Yayincilik, 2013) Tekgunduz, Emre; Demir, Muzaffer; Erikci, Alev Akyol; Akpinar, Seval; Ozturk, Erman; Kirkizlar, OnurObjective: Sticky platelet syndrome (SPS) is a common autosomal dominant inherited platelet disorder. SPS is characterized by platelet hyperreactivity and is associated with arterial and venous thrombosis. The aim of this study was to determine the role of SPS in patients with uninduced venous thrombosis. Material and Methods: The study included 28 patients (15 male and 13 female) with uninduced venous thrombosis. SPS was defined according to Mammen's aggregation method, which is described in detail elsewhere. Results: According to the defined ranges for platelet hyperreactivity, 3 (50%) patients, 2 (33%), and 1 (17%) (n =6 [21%]) with a confirmed diagnosis were classified as type II, I, and III SPS, respectively. In 1 patient SPS was the only hereditary abnormality noted. The other 5 patients carried other inherited coagulation defects, in addition to SPS. Conclusion: The present findings indicate that the prevalence of SPS was 21% in the patients with uninduced venous thrombosis. We therefore suggest that SPS should be considered in the differential diagnosis of such cases.Öğe Testicular Plasmacytoma: Case Report(Ortadogu Ad Pres & Publ Co, 2010) Tekgunduz, Emre; Ozturk, Erman; Pamuk, Guelsuem E.; Turgut, Burhan; Puyan, Fulya Oe.; Demir, MuzafferTesticular plasmacytomas are rare tumors presenting in most cases with painless testicular swelling. Testicular involvement may occur as a first manifestation of plasma cell disorder or following diagnosis of systemic plasma cell myeloma. We report a case of a 49-year-old man who was found to have IgG-lambda type multiple myeloma and spinal cord compression at Th 7-9 level. After spinal radiotherapy, he was treated with VAD chemotherapy. just before the second cycle of VAD he admitted with left testicular swelling. Surgical orchiectomy of his left testis was performed. Histological and immunohistochemical studies of surgical material established massive interstitial plasma cell infiltration with strong anti-IgG and anti-lambda antisera staining. Soon after the surgery he died of worsening renal failure and progressive myeloma. We present here a fatal case with an aggressive form of plasma cell myeloma with widespread bone disease along with extramedullary involvement of testis.
