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Öğe Anaplastic Multiple Myeloma with Multiple Genetic Anomalies(Coll Physicians & Surgeons Pakistan, 2022) Demircioglu, Sinan; Tekinalp, Atakan; Ceneli, Ozcan[Abstract Not Availabe]Öğe Bing-Neel syndrome: A case reports(Sage Publications Ltd, 2021) Demircioglu, Sinan; Oltulu, Pembe; Emlik, Ganime D.; Tekinalp, Atakan; Ceneli, OzcanIntroduction Bing-Neel syndrome (BNS) is a rare complication of of Waldenstrom macroglobulinemia (WM) identified by involvement of central nervous system (CNS) lymphoplasmacytic cells. Case report We present a patient who was diagnosed with Bing-Neel syndrome four years after the diagnosis of Waldenstrom macroglobulinemia. Management & outcome The patient was admitted with neurological symptoms. There were lesions associated with WM involvement on brain imaging. The diagnosis was made by brain biopsy. High dose methotrexate treatment was given. Discussion CNS infiltrating agents such as fludarabine, methotrexate and cytarabine are often used in BNS treatment. Ibrutinib, which is a new bruton tyrosine kinase inhibitor, has recently started to be used in BNS treatment, as it has been shown to be effective and penetrate the CNS.Öğe Chronic Myeloid Leukemia After Chemoradiotherapy in a Patient with Non-Small Cell Lung Cancer(Akad Doktorlar Yayinevi, 2017) Demircioglu, Sinan; Korkmaz, Levent; Yilmaz, Seda; Bektas, Ozlen; Ceneli, Ozcan; Artac, Mehmet[Abstract Not Availabe]Öğe The Effects of Genetic Characteristics on the Survival in Myelodysplastic Syndrome Myelodisplastik Sendromda Genetik Ozelliklerin Sagkalim Uzerine Etkisi(Bezmialem Vakif Univ, 2022) Tekinalp, Atakan; Demircioglu, Sinan; Celik, Ahmet Faruk; Ceneli, OzcanObjective: This study aimed to evaluate the effects of genetic characteristics on the survival in patients with myelodysplastic syndrome (MDS). Methods: This retrospective study reviewed the data on epidemiological features, main laboratory tests, International Prognostic Scoring System (IPSS) and revised-IPSS risk categories, genetic anomalies, genetic risk categories, and survival in patients who are diagnosed with MDS in our center. According to the IPSS risk categories, patients were classified into three groups as follows: low risk, intermediate-1, and intermediate-2 risk and high risk. The groups were compared using the ANOVA and Kruskal-Wallis tests. Results: The study reviewed the data of 99 patients. The mean age was 66 +/- 11.6 years. A genetic anomaly was detected in 30.3%, of which the most common was del20q (26.7%). The median survival was 61 months [95% confidence interval (CI): 50.9-71] in the study population. The 5-year survival rate was calculated as 64%, 41%, and 33% in low risk, intermediate-1, and intermediate-2 risk and high risk groups, respectively. The predicted median survival rate was 96 months (95% CI: 47.7-144.2), 56 months (95% CI: 34.1-77.8), and 18 months (95% CI: 15.1-20.8), respectively, which indicate a significant difference (log-rank chi-square: 6.6; p=0.035). The risk for mortality was 3.3-folds higher in the intermediate-2 and high risk group compared to the low risk group (RR: 3.3; 95% CI: 1.2-8.6; p=0.017). Conclusion: Our study supports that risk groups that are determined by several parameters, including genetic characteristics, provide predictive information about survival in MDS.Öğe The Effects of Genetic Characteristics on the Survival in Myelodysplastic Syndrome Myelodisplastik Sendromda Genetik Ozelliklerin Sagkalim Uzerine Etkisi(Bezmialem Vakif Univ, 2022) Tekinalp, Atakan; Demircioglu, Sinan; Celik, Ahmet Faruk; Ceneli, OzcanObjective: This study aimed to evaluate the effects of genetic characteristics on the survival in patients with myelodysplastic syndrome (MDS). Methods: This retrospective study reviewed the data on epidemiological features, main laboratory tests, International Prognostic Scoring System (IPSS) and revised-IPSS risk categories, genetic anomalies, genetic risk categories, and survival in patients who are diagnosed with MDS in our center. According to the IPSS risk categories, patients were classified into three groups as follows: low risk, intermediate-1, and intermediate-2 risk and high risk. The groups were compared using the ANOVA and Kruskal-Wallis tests. Results: The study reviewed the data of 99 patients. The mean age was 66 +/- 11.6 years. A genetic anomaly was detected in 30.3%, of which the most common was del20q (26.7%). The median survival was 61 months [95% confidence interval (CI): 50.9-71] in the study population. The 5-year survival rate was calculated as 64%, 41%, and 33% in low risk, intermediate-1, and intermediate-2 risk and high risk groups, respectively. The predicted median survival rate was 96 months (95% CI: 47.7-144.2), 56 months (95% CI: 34.1-77.8), and 18 months (95% CI: 15.1-20.8), respectively, which indicate a significant difference (log-rank chi-square: 6.6; p=0.035). The risk for mortality was 3.3-folds higher in the intermediate-2 and high risk group compared to the low risk group (RR: 3.3; 95% CI: 1.2-8.6; p=0.017). Conclusion: Our study supports that risk groups that are determined by several parameters, including genetic characteristics, provide predictive information about survival in MDS.Öğe Expansion of a Myeloma-associated Lesion from Orbita to the Cerebrum(Galenos Yayincilik, 2018) Demircioglu, Sinan; Aydogdu, Demet; Ceneli, Ozcan[Abstract Not Availabe]Öğe Ibrutinib and panitumumab used in combination safely in a patient with metachronous colorectal cancer and chronic lymphocytic leukemia(Lippincott Williams & Wilkins, 2022) Korkmaz, Mustafa; Eryilmaz, Melek Karakurt; Karaagac, Mustafa; Araz, Murat; Ceneli, Ozcan; Artac, MehmetIbrutinib is a Bruton tyrosine kinase inhibitor used in the treatment of chronic lymphocytic leukemia (CLL). Panitumumab, an mAb for epidermal growth factor receptor, is used in the treatment of metastatic colorectal cancer (CRC). We wanted to present our case where we used ibrutinib and panitumumab in combination in a patient with metachronous CLL and CRC. A 58-year-old male patient with a diagnosis of CLL was receiving ibrutinib treatment and primary rectal cancer was detected. FOLFOX + panitumumab were started when metastasis was detected in the lung after neoadjuvant chemoradiotherapy for rectal cancer. The patients used ibrutinib and panitumumab in combination. There was no cumulative or unexpected toxicity due to the combination of both antineoplastic agents. The most important point to be considered in the use of combined drugs is the evaluation of drug-drug interactions. Toxic effects of the combination of ibrutinib and cetuximab have been reported in a patient with metastatic CRC. We used ibrutinib together with panitumumab in our case and we did not encounter any cumulative or unexpected side effects during the treatment.Öğe The Long-Term Analysis of Hematological Malignancies: Patients with COVID-19 versus without COVID-19(Doc Design Informatics Co Ltd, 2022) Tekinalp, Atakan; Kars, Taha Ulutan; Dikici, Hatice Zeynep; Demircioglu, Sinan; Ceneli, OzcanObjective: The study aims to determine the frequency and clinical features of COVID-19 during the long-term follow-up of patients with hematological malignancies. Methods: Patients with hematological malignancies followed in our center were evaluated retrospectively. The patients were divided into two groups with having COVID-19 between April 01, 2020, and July 01, 2021: those who had COVID-19 [COVID (+)] and those who didn't have COVID-19 [COVID (-)]. Results: 1258 patients were evaluated. Of these, 288 (22.9%) were found to have had COVID-19. The most common and least common diagnoses in the COVID (+) group were non-Hodgkin lymphoma (NHL) (21.7%) and Hodgkin lymphoma (HL) (6.9%), respectively. The malignancies with the highest and lowest rates of COVID-19 (+) were multiple myeloma (MM) (35.6%) and chronic myeloid leukemia (CML) patients (17.8%), respectively. The median age was higher in COVID (+) chronic lymphocytic leukemia (CLL) patients than in COVID (-) patients (73 vs. 66; p= 0.001). All deaths were due to COVID in COVID (+) patients. The mortality rate for all patients was found to be significantly higher in the COVID (+) group than in the COVID (-) group (22.8% vs. 11.9%; p<0.001). Myelodysplastic syndrome (MDS) (39.5%) and acute leukemia (AL) (35.7%) had the highest mortality rates in the COVID (+) group. The mortality rates in COVID (+) CLL (26% vs. 7%), AL (35.7% vs. 17.7%) and MM (28.6% vs. 9.2%) were significantly higher than in the COVID (-) group. There were no deaths due to COVID-19 in CML patients. 79.8% of COVID (+) patients were hospitalized, and the mortality rate in these patients was significantly higher than in outpatients (34.6% vs. 2.8%; p<0.001). The patients with the highest need for mechanic ventilation had MDS (44.8%) and AL (36%). Conclusion: Our study provides important data to the literature comparing the effect of SARS-CoV-2 on all hematological malignancies with malignant patients who do not have COVID-19.Öğe Might periostin serve as a marker of bone marrow involvement in patients with diffuse large B-cell lymphoma?(Walter De Gruyter Gmbh, 2022) Tekinalp, Atakan; Kars, Taha Ulutan; Tuna, Ali Kursat; Kilinc, Ibrahim; Demircioglu, Sinan; Ceneli, OzcanObjectives We measured the serum periostin levels in patients with DLBCL and determined whether the levels reflected the clinical findings. Methods This was a case-control study. DLBCL patients diagnosed between March 2021 and October 2021 (n=36) and healthy volunteers (n=36) (Control group) were included. The serum periostin levels of the two groups were compared. Moreover, subgroup analyses were conducted in the patient group. Results The serum periostin level was significantly higher in the patient than the control group (28.8 +/- 3.2 vs. 15.1 +/- 7.5 ng/mL, p=0.017). On subgroup analyses, the median serum periostin level of nine (25%) patients with bone marrow involvement was higher than that of the 27 (75%) lacking bone marrow involvement (12.7 vs. 21.7 ng/mL, p=0.018). On ROC analysis, the optimal periostin cutoff for bone marrow involvement was 17.3 ng/mL (sensitivity 77%, specificity 67%, AUC 0.765; 95% CI; 0.606-0.924, p=0.018). By the disease stage, the periostin level was higher in stage 4 patients than in those of other stages (21.3 vs. 12.0 ng/mL, p=0.029). Conclusions The periostin level correlated with such involvement; periostin may serve as a novel prognostic marker of DLBCL.Öğe Might periostin serve as a marker of bone marrow involvement in patients with diffuse large B-cell lymphoma?(Walter De Gruyter Gmbh, 2022) Tekinalp, Atakan; Kars, Taha Ulutan; Tuna, Ali Kursat; Kilinc, Ibrahim; Demircioglu, Sinan; Ceneli, OzcanObjectives We measured the serum periostin levels in patients with DLBCL and determined whether the levels reflected the clinical findings. Methods This was a case-control study. DLBCL patients diagnosed between March 2021 and October 2021 (n=36) and healthy volunteers (n=36) (Control group) were included. The serum periostin levels of the two groups were compared. Moreover, subgroup analyses were conducted in the patient group. Results The serum periostin level was significantly higher in the patient than the control group (28.8 +/- 3.2 vs. 15.1 +/- 7.5 ng/mL, p=0.017). On subgroup analyses, the median serum periostin level of nine (25%) patients with bone marrow involvement was higher than that of the 27 (75%) lacking bone marrow involvement (12.7 vs. 21.7 ng/mL, p=0.018). On ROC analysis, the optimal periostin cutoff for bone marrow involvement was 17.3 ng/mL (sensitivity 77%, specificity 67%, AUC 0.765; 95% CI; 0.606-0.924, p=0.018). By the disease stage, the periostin level was higher in stage 4 patients than in those of other stages (21.3 vs. 12.0 ng/mL, p=0.029). Conclusions The periostin level correlated with such involvement; periostin may serve as a novel prognostic marker of DLBCL.Öğe Outcome of Thrombotic Thrombocytopenic Purpura Patients: A Single-Center Experience(Galenos Yayincilik, 2019) Ceneli, Ozcan; Yilmaz, Seda; Karaselek, Mehmet Ali; Camli, Kazim[Abstract Not Availabe]Öğe Pneumonitis associated with bortezomib in a patient with multiple myeloma(Sage Publications Ltd, 2023) Kars, Taha Ulutan; Yaskiran, Osman; Ceneli, OzcanIntroduction Bortezomib, which is widely used in the treatment of multiple myeloma (MM), is a proteasome inhibitor and acts by inducing apoptosis. Bortezomib has many side effects, mainly hematological, neurological, and gastrointestinal. A few cases of bortezomib-induced pneumonitis (BIP) have been reported in the literature. Case Report A 51-year-old male patient who was newly diagnosed with MM received bortezomib, cyclophosphamide, and dexamethasone as first-line therapy. In the first cycle, the patient developed dyspnea, tachypnea, and hypoxia after the fourth day of administration of bortezomib monotherapy according to the treatment protocol. Management and outcome Infection and pulmonary involvement of MM were excluded after radiological evaluations, and a diagnosis of BIP was made. Clinical control was achieved quickly with steroid therapy and oxygen support, and radiological findings improved with treatment. Due to this rare side effect of bortezomib, the treatment regimen containing bortezomib was changed. The patient is still receiving treatment that does not contain bortezomib and does not have any pulmonary problems. Discussion In cancer patients receiving treatment, infection and metastasis should be quickly ruled out when pulmonary problems occur, and drug-induced pneumonitis should be considered. This diagnosis, which often responds dramatically to steroids, has the potential to have serious consequences when not considered. In this case, we present bortezomib-associated pneumonitis, a rare side effect of bortezomib. The most important feature of this case is the development of this side effect at the beginning of the treatment, unlike other cases reported in the literature.Öğe Prostate Involvement in a Patient with Follicular Lymphoma(Galenos Yayincilik, 2017) Yilmaz, Seda; Demircioglu, Sinan; Bektas, Ozlen; Ceneli, Ozcan; Findik, Sidika[Abstract Not Availabe]Öğe Thrombotic Thrombocytopenic Purpura in a Patient with Klinefelter Syndrome(Aves, 2018) Demircioglu, Sinan; Yilmaz, Seda; Bektas, Ozlen; Ceneli, OzcanThrombotic thrombocytopenic purpura is a rare disease associated with microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological disorders, and renal insufficiency pentad. It is a fatal hematologic emergency if left untreated. If plasma exchange is feasible, treatment is easy and comfortable. It should be kept in mind that such as in our patient may be acquired at all congenital illnesses.Öğe Treatment with doxorubicin-based protocol in cardiac involvement diffuse large B-cell lymphoma: A case report(Sage Publications Ltd, 2022) Tekinalp, Atakan; Kars, Taha U.; Dikici, Hatice Z.; Yilmaz, Pinar D.; Demircioglu, Sinan; Ceneli, OzcanIntroduction Cardiac involvement in diffuse large B-cell lymphoma is a rare entity in non-Hodgkin lymphomas. Symptoms are usually related to heart failure. Patients who are severely symptomatic due to cardiac mass could be considered treatment as soon as possible. In this report, we present a patient diagnosed with diffuse large B-cell lymphoma with cardiac involvement. Case Report A 61-year-old female patient was admitted to our unit with gastric biopsy diffuse large B-cell lymphoma. Computerized tomography of the chest and positron emission tomography/computed tomography demonstrated a neoplastic mass in the intra-atrial septum extended to inferior vena cava (5 x 4 cm in size and standardized uptake value maximum 24.6). She was in stage III and in the high-risk group. Because of pronounced heart failure findings associated with the mass-specific chemotherapy was planned early. Management & Outcome Although a fraction of ejection was 60% by echocardiography before the treatment, she had a cardiac risk for doxorubicin due to being over 60 years old and hypertension. Complete remission was achieved after three cycles of rituximab-cyclophosphamide-doxorubicin-vincristine and methylprednisolone protocol including doxorubicin. Treatment was completed with six cycles and she was followed up for three months. Discussion Because of the cardiotoxicity of doxorubicin-based protocols, patients should be evaluated according to cardiac functions before and during the chemotherapy.
