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  1. Article ; Online: Retrospective Analysis of Patients with Immune Thrombocytopenic Purpura

    Nil Guler / Mehmet Turgut / Düzgün Özatlı / Şengül Aksakal

    Journal of Contemporary Medicine, Vol 10, Iss 2, Pp 196-

    2020  Volume 200

    Abstract: Aim: We evaluated the clinical feature and the responses to treatments in patients diagnosed and/or followed as chronic immune thrombocytopenic purpura (ITP). Methods: Medical charts of 150 patients diagnosed and/or followed as ITP at Ondokuz Mayıs ... ...

    Abstract Aim: We evaluated the clinical feature and the responses to treatments in patients diagnosed and/or followed as chronic immune thrombocytopenic purpura (ITP). Methods: Medical charts of 150 patients diagnosed and/or followed as ITP at Ondokuz Mayıs Medical Faculty between 2003 and 2011 were analyzed retrospectively. As first-line treatments, steroids based treatment and IVIg were used as medical therapy. In patients, who had no response to first and second courses treatments, splenectomy was performed. Results: The median follow-up of 150 patients was 15 months (range 2-83 months). Thrombocytopenia was incidentally detected in 51(34%) of the cases. During the study period, 21(14%) the patients were followed up without treatment. First line medical therapy were given to 129(86%) patients. Of them, complete response (CR) were seen in 93(72%) patients, partial response (PR) in 14(11%) patients and none response (NR) in 22 (17%) patients. There was no significant benefit of high dose steroid therapy over the standard dose therapy (p=0.59). Of the 107 patients who had response to the treatment, relapse were observed in 48(45%) within 2,5 years. Of 40 patients, there were CR in 15(38%) patients, PR in 9(22%) patients and NR in 16(40%) patients. Splenectomy was performed in 38 patients. Of the 48 patients, CR was achieved in 32(84%) patients, PR in 2(%5) patients and NR in 4(16%) patients. Relapse was observed in 12(35%) patients. Conclusion: This study showed that steroids based treatment and splenectomy are very effective treatment in ITP patients. Only 13(8.6%) patients in our study needed further treatment.
    Keywords immune thrombocytopenic purpura ; bleeding ; corticosteroid ; splenectomy ; i̇mmün trombositopenik purpura ; kanama ; kortikosteroid ; splenektomi ; Medicine ; R
    Language English
    Publishing date 2020-06-01T00:00:00Z
    Publisher Rabia Yılmaz
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Impact of Fluorescent In Situ Hybridization Aberrations and CLLU1 Expression on the Prognosis of Chronic Lymphocytic Leukemia

    Ümmet Abur / Gönül Oğur / Ömer Salih Akar / Engin Altundağ / Huri Sema Aymelek / Düzgün Özatlı / Mehmet Turgut

    Turkish Journal of Hematology, Vol 35, Iss 1, Pp 61-

    Presentation of 156 Patients from Turkey

    2018  Volume 65

    Abstract: Objective: This study evaluates the impact of CLLU1 expression and fluorescent in situ hybridization (FISH) analysis of a group of Turkish chronic lymphocytic leukemia (CLL) patients. Materials and Methods: A total of 156 CLL patients were analyzed by ... ...

    Abstract Objective: This study evaluates the impact of CLLU1 expression and fluorescent in situ hybridization (FISH) analysis of a group of Turkish chronic lymphocytic leukemia (CLL) patients. Materials and Methods: A total of 156 CLL patients were analyzed by FISH method; 47 of them were also evaluated for CLLU1 expression. Results were correlated with clinical parameters. Results: FISH aberrations were found in 62% of patients. These aberrations were del13q14 (67%), trisomy 12 (27%), del11q22 (19%), del17p (8%), and 14q32 rearrangements (20%). Overall del11q22 and del17p were associated with the highest mortality rates, shortest overall survival (OS), and highest need for medication. Homozygous del13q14, 14q32 rearrangements, and higher CLLU1 expression correlated with shorter OS. Conclusion: Cytogenetics/FISH analysis is still indicated for routine evaluation of CLL. Special consideration is needed for the poor prognostic implications of del11q22, del17p, 14q32 rearrangements, and homozygous del13q14. The impact of CLLU1 expression is not yet clear and it requires more data before becoming routine in genetic testing in CLL patients.
    Keywords Chronic leukemia ; Chronic lymphocytic leukemia ; Cytogenetics/FISH ; CLLU1 ; Internal medicine ; RC31-1245 ; Diseases of the blood and blood-forming organs ; RC633-647.5
    Subject code 616 ; 610
    Language English
    Publishing date 2018-02-01T00:00:00Z
    Publisher Galenos Yayinevi
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: The Relationship of T Helper-2 Pathway Components Interleukin-4, Interleukin-10, Immunoglobulin E, and Eosinophils with Prognostic Markers in Non-Hodgkin Lymphoma

    Nil Güler / Engin Kelkitli / Hilmi Atay / Dilek Erdem / Hasan Alaçam / Yüksel Bek / Düzgün Özatlı / Mehmet Turgut / Levent Yıldız / dris Yücel

    Turkish Journal of Hematology, Vol 31, Iss 4, Pp 381-

    A Case-Control Study

    2014  Volume 387

    Abstract: OBJECTIVE: Increased risk for non-Hodgkin lymphoma (NHL) is associated with infections and environmental agents. We hypothesized that these factors chronically trigger the T helper-2 (Th2) pathway and result in lymphoma. We investigated the role of the ... ...

    Abstract OBJECTIVE: Increased risk for non-Hodgkin lymphoma (NHL) is associated with infections and environmental agents. We hypothesized that these factors chronically trigger the T helper-2 (Th2) pathway and result in lymphoma. We investigated the role of the Th2 pathway by exploring the relationships between components of the Th2 pathway, interleukin (IL)-10, IL-4, immunoglobulin E (IgE), and eosinophils, and prognostic markers of NHL. METHODS: Thirty-one NHL patients and 27 healthy controls were enrolled. IL-10, IL-4, IgE, and eosinophils were measured. IL-4 and IL-10 were analyzed with the enzyme amplified sensitivity immunoassay method. RESULTS: High IL-10 levels were correlated with several poor prognostic features, short early survival, and lymphopenia. There was a positive correlation between albumin and IL-4 levels and a negative correlation between IL-10 and albumin. There was no relationship related with eosinophils and IgE. We found remnant increased IL-4, which could be a clue for the triggering of the Th2 pathway in the background. CONCLUSION: There is a need for differently designed studies to detect the place of the Th2 pathway in NHL.
    Keywords Chemokines ; Cytokines ; Lymphocytes ; Non-Hodgkin lymphoma ; Th2 pathway ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Diseases of the blood and blood-forming organs ; RC633-647.5
    Subject code 610
    Publishing date 2014-12-01T00:00:00Z
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Incidence of the JAK2V617F Mutation in Chronic Myeloproliferative Disorders

    Ayse Kevser Demir / Memis Hilmi Atay / Engin Kelkitli / Yasemin Turgut Kurt / Duzgun Ozatli / Mehmet Turgut

    Çağdaş Tıp Dergisi , Vol 3, Iss 2, Pp 101-

    2013  Volume 107

    Abstract: Aim: To determine the frequency of JAK2V617F mutation in BCR/ABL negative chronic myeloproliferative disease (CMD) in the Midle Black Sea region of Turkey, and the effects of this mutation on clinical course of the disease. Method: The study was ... ...

    Abstract Aim: To determine the frequency of JAK2V617F mutation in BCR/ABL negative chronic myeloproliferative disease (CMD) in the Midle Black Sea region of Turkey, and the effects of this mutation on clinical course of the disease. Method: The study was conducted with 52 patients diagnosed to CMD: twenty-eight polycythemia vera, twenty-one essential thrombocythemia, and three primer myelofibrosis. Age, gender, hemoglobin, hematocrit, platelet and leukocyte values were recorded. The presence of hepatomegaly, splenomegaly, hemorrhage and thrombosis were evaluated.JAK2V617F mutation analyzes were evaluated from the peripheral blood granulocytes by Real Time-PCR Melting Curve. Results: The frequency of JAK2V617F mutation in polycythemia vera, essential thrombocythemia, and primer myelofibrosis were 86% (24/28), 48 (10/21) and 33% (1/3), respectively. There was no significant difference between JAK2V617F mutation and CMD onset age (p>0.05). When the patients divided according to the presence of JAK2V617F mutation, there were higher average level of leukocyte, hemoglobin and hematocrit values in patients with the mutation in polycythemia vera and essential thrombocythemia, but the difference was not statistically significant (p>0.05). The incidence of hepatomegaly were higher in JAK2V617F mutation positive polycythemia vera patients (p=0.030). Average platelet count at diagnosis in essential thrombocythemia patients with JAK2V617F mutation was lower, however, this difference was not statistically significant (p=0.397). Conclusion: The discovery of JAK2V617F mutation provided new information about the molecular basis of BCR/ABL negative CMD. The presence of this mutation affects the clinical features of CMD. In our knowledge, the present study is the first to evaluate the frequency of JAK2V617F mutation on CMD patients in our region, and our results are in concordance with the literature. Further studies with large cohort will be necessitated to better elucidate the effect of JAK2V617F mutation on CMD and confirm these findings. [J Contemp Med 2013; 3(2.000): 101-107]
    Keywords JAK2V617F mutation ; polycythemia vera ; essential thrombocythemia ; primer myelofibrosis ; chronic myeloproliferative disorders ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2013-06-01T00:00:00Z
    Publisher Scopemed
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia

    Demet Çekdemir / Serkan Güvenç / Füsun Özdemirkıran / Ali Eser / Tayfur Toptaş / Vildan Özkocaman / Handan Haydaroğlu Şahin / Esra Ermiş Turak / Ramazan Esen / Melda Cömert / Sevil Sadri / Müzeyyen Aslaner / Bahar Uncu Ulu / Abdullah Karakuş / Derya Selim Batut / İnci Alacacıoğlu / Demet Aydın / Atakan Tekinalp / Sinem Namdaroğlu /
    Funda Ceran / Pınar Tarkun / Demet Kiper / Mustafa Çetiner / Mustafa Yenerel / Ahmet Muzaffer Demir / Güven Yılmaz / Hatice Terzi / Erden Atilla / Ümit Yavuz Malkan / Kadir Acar / Erman Öztürk / Anıl Tombak / Cenk Sunu / Ozan Salim / Nevin Alayvaz / Özkan Sayan / Ülkü Ozan / Mesut Ayer / Zafer Gökgöz / Neslihan Andıç / Ebru Kızılkılıç / Figen Noyan / Mehmet Özen / Funda Pepedil Tanrıkulu / Güçhan Alanoğlu / Hasan Atilla Özkan / Vahap Aslan / Güven Çetin / Alev Akyol Erikçi / Burak Deveci / Fadime Ersoy Dursun / Hasan Dermenci / Pelin Aytan / Mehmet Gündüz / Volkan Karakuş / Can Özlü / Sinan Demircioğlu / Olga Meltem Akay Yanar / Düzgün Özatlı / Levent Ündar / Eyüp Naci Tiftik / Ayhan Gülsan Türköz Sucak / İbrahim Haznedaroğlu / Muhit Özcan / Mehmet Şencan / Murat Tombuloğlu / Gülsüm Özet / Oktay Bilgir / Burhan Turgut / Mehmet Ali Özcan / Kadriye Bahriye Payzın / Mehmet Sönmez / Orhan Ayyıldız / Mehmet Sinan Dal / Şehmus Ertop / Mehmet Turgut / Teoman Soysal / Emin Kaya / Ali Ünal / Mustafa Pehlivan / Işık Atagündüz / Tülin Tuğlular Fıratlı / Güray Saydam / Reyhan Diz Küçükkaya

    Turkish Journal of Hematology, Vol 36, Iss 4, Pp 230-

    A Real-Life Experience

    2019  Volume 237

    Abstract: Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients ( ... ...

    Abstract Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results: The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion: Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors.
    Keywords thrombocytopenia ; immune thrombocytopenic ; eltrombopag ; Internal medicine ; RC31-1245 ; Diseases of the blood and blood-forming organs ; RC633-647.5
    Subject code 610
    Language English
    Publishing date 2019-12-01T00:00:00Z
    Publisher Galenos Yayinevi
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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