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Öğe A rare case of pulmonary lymphomatoid granulomatosis complicated with venous thrombosis(2022) Maral, Senem; Albayrak, Murat; Afacan Öztürk, Hacer Berna; İncekara, Funda; Yıldız, Abdülkerim; Cömert, Pınar; Albayrak, Aynur; Reis Aras, Merih; Kaya, SadiLymphomatoid granulomatosis (LG) is Epstein-Barr virus associated and aggressive B cell lymphoproliferative disease. The most common sites of involvement are lungs, skin, kidneys, liver and central nervous system. The clinical presentation of pulmonary LG may mimic infectious diseases, malignancies or vasculitis. While treatment approach of low grade disease is watch and wait, patients with advanced stage require aggressive treatment with chemotherapy. Patients with hematological malignancy as well as solid tumors are at increased risk of venous thromboembolic events (VTE). We reported here in a case of pulmonary LG who was complicated with VTE during treatment with chemo-immunotherapy After 4 cycles of R-CHOP, she achieved complete remission for LG and was followed up without relapse for 2 years. She was anticoagulated with Low-Molecular-Weight Heparin (LMWH) during chemotherapy period, and the thrombus improved over the next several weeks. While on this paper written, patient completed her pregnancy successfully under anticoagulation prophylaxis.Öğe Analysis of factors associated with the development of myelofibrosis in polycythemia vera and essential thrombocythemia patients: a single-center experience(2022) Tığlıoğlu, Pınar; Albayrak, Murat; Yıldız, Abdulkerim; Tığlıoğlu, Mesut; Sağlam, Buğra; Aras, Merih Reis; Yılmaz, Fatma; Maral, Senem; Öztürk, Hacer Berna Afacan; Malkan, Ümit YavuzIn some patients with chronic myeloproliferative neoplasms, myelofibrosis (MF) develops as natural evolution of the disease. The aim of this study was to analyze predictive factors that may cause MF in polycythemia vera (PV) and essential thrombocythemia (ET) patients. This retrospective study was conducted on PV and ET patients who attended our hospital between 2008 and 2019. The development of MF during follow-up was recorded, and comparisons were made of the patients who developed MF and those who did not develop MF. Evaluation was made of 126 ET and 105 PV patients. During follow-up period, MF had developed 5.7% of PV and 7.1% of ET patients. It was determined that JAK-2 mutant allele burden, lymphocyte count, vitaminB12 levels, and grade of bone marrow fibrosis at diagnosis had statistically significant impact on the development of MF in all patients. In the logistic-regression analysis, it was found that initial hemoglobin, hematocrit, neutrophil-to-lymphocyte ratio, and monocyte count for PV patients; vitaminB12, the presence of splenomegaly; and BM fibrosis at diagnosis for ET patients have statistically significant effect on MF development. The results of the current study demonstrated that some parameters especially vitamin B12 levels can be used as predictive markers for the development of MF.Öğe Marjinal Zon Lenfoma Tanılı Hastalarda Klinik Özellikler ve Olası Prognostik Faktörler: İki Merkezden Retrospektif Analiz(2022) Tığlıoğlu, Pınar; Tığlıoğlu, Mesut; Yıldız, Abdulkerim; Yıldırım, Murat; Aylı, Meltem; Albayrak, Murat; Afacan, Hacer Berna; Sağlam, Buğra; Maral, Senem; Şahin, OsmanAmaç: Marjinal zon lenfoma tüm Hodgkin dışı lenfomaların %5-17’sini oluşturur ve indolan bir klinik seyir gösterir. Prognoz ve tedavi ihtiyacını öngören parametreler hala belirsizdir. Bu çalışmanın amacı, marjinal zon lenfomada klinik ve laboratuvar parametrelerinin hastalığın seyri ve tedavi endikasyonu üzerine olan etkilerini incelemektir. Hastalar ve Yöntem: 2010-2018 yılları arasında iki merkezin hematoloji bölümlerinde marjinal zon lenfoma tanısı alan hastalar retrospektif olarak incelenmiştir. Tanı anındaki demografik ve hastalık özellikleri ile hematolojik ve biyokimyasal parametreler incelenmiştir. Hastaların klinik seyirleri incelenmiştir. Parametrelerin genel sağkalım ve tedavi ihtiyacı üzerindeki etkisi analiz edilmiştir. Bulgular: 25 (%62.5) kadın ve 15 (%37.5) erkekten oluşan toplam 40 MZL hastası değerlendirildi. Takipte 25 hastanın tedavi ihtiyacı olmuştur ve 15 hasta tedavisiz takip edilmiştir. Tüm marjinal zon lenfoma hastalarının genel sağkalımı 58.4 ay olarak saptanmıştır. Genel sağkalım, nodal marjinal zon lenfomalı hastalarda, ekstranodal ve splenik marjinal zon lenfoma hastalarına göre anlamlı derecede daha yüksek izlenmiştir. Tedavi ihtiyacı olmayan hastaların tanı anındaki trombosit sayısı, tedavi alan hastalardan istatistiksel olarak anlamlı derecede yüksek (p= 0.04) saptanmıştır. Sonuç: Tanı anındaki trombosit sayısının gelecekteki tedavi ihtiyacını belirleyici bir faktör olabilir. Daha geniş çaplı çalışmalara ihtiyaç olmakla beraber, marjinal zon lenfomada tanı anındaki trombosit düzeyi hastalığın seyrini tahmin etmeye yardımcı olabilecek objektif ve basit bir kan testi olarak kullanılabilir.Öğe Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data(2022) Karakuş, Volkan; Maral, Senem; Kaya, Egemen; Gemici, Aliihsan; Dere, Yelda; Sevindik, Ömür GökmenOBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that frequently affects elderly population. With introducing the hypomethylating agents (HMAs) in elderly AML treatment, survival rates and quality of life have improved. However, long-term management in elderly and frail patients is still a challenge. In the present study, we aimed to determine whether HMA maintenance therapy is required until disease progression in frail and elderly AML patients by examining with a real-life data. METHODS: In a multicenter study, we analyzed non-promyelocytic elderly AML patients who were treated with first-line azacitidine or decitabine monotherapy in two different groups, retrospectively. While patients were treated with HMA until progression in the maintenance group, 6+3 cycles of azacitidine or decitabine were administered as a standard care of elderly AML patients in the non-maintenance group. Survival outcomes were compared between the groups. RESULTS: HMA therapy was maintained until progression in 20 patients, and HMA therapy was terminated after 6+3 cycles in 21 patients. Patients received a median of 6 (1–14) HMA cycles during follow-up time. The median 7.5 months of overall survival were observed (2–17 months) in maintenance and 3 months (1–13 months) in non-maintenance groups (p=0.001). CONCLUSION: Despite long-term exposure to HMA may appear as a risk factor for complications and toxicities in elderly and frail AML patients, the maintenance of therapy until disease progression provides a significant survival advantage. Therefore, we suggest that HMA therapy should continue until disease progression regardless the sort of HMA.
