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    Chronic Myeloid Leukemia After Chemoradiotherapy in a Patient with Non-Small Cell Lung Cancer
    (2017) Demircioğlu, Sinan; Korkmaz, Levent; Yılmaz, Seda; Bektaş, Özlen; Çeneli, Özcan; Artaç, Mehmet
    Chronic myeloid leukemia(CML) is a myeloproliferative disease characterized by uncontrolled proliferation of mature and maturing granulocytes. Chronic myeloid leukemia accounts for approximately 15 to 20 percent of leukemias in adults. The incidence is 1-2/10000 per year.1-2 There is only one risk factor, which is ionized radiation.3 There are some publitions in the literature about CML development after chemotherapy and/or radiotherapy. Here we presented a case that CML occured after chemotherapy concurrent with radiotherapy in non-small cell lung cancer patient. Sixty year old man who has diagnosed inoperable lung adenocarcinoma in 2013. Carboplatin concurrent with radiotherapy was administered to him. After 2 years follow-up with no progression of disease, the level of leucocyte was started to increase. White blood cell level was 41700/ul, haemoglobin level was 14.3 g/dl and platelet level was 239000/ul. Peripheral blood smear suggested chronic myeloid leukemia. Bone marrow aspiration and biopsy was performed. The biopsy was supported chronic phase chronic myeloid leukemia. Cytogenetic analysis showed %95 translocation (9;22) in 20 metaphasis. BCR-ABL was detected as 60% IS. Sokal, Hasford and EUTOS risk score was calculated high. Imatinib therapy was started as 400 mg/day. Hematologic response was seen 2 weeks after imatinib treatment. After 3, 6, 12 months, BCR-ABL was detected as 27% IS, 1% IS, and 0.4 IS, respectively. The patient is still being followed as remission for both lung cancer and CML.
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    İbrutinib sonrası gelişen dev ekimoz ve hematom: Olgu sunumu
    (2017) Demircioğlu, Sinan; Çipil, Handan; Çeneli, Özcan; Uğur Bilgin, Aynur
    Kronik lenfositik lösemi ve Mantle hücreli lenfoma da yeni bir tedavi seçeneği olan ibrutinib, yüksek etkinliği ile günümüzde sık kullanılmaya başlanmıştır. Hedefe yönelik monoklonal antikorların yan etkileri sitotoksik tedavilere göre daha hafif seviyede görülmektedir. İbrutinibin de ishal, bitkinlik, ateş, bulantı, kanama, sitopeniler, alerjik reaksiyonlar gibi yan etkileri görülmektedir. Kanama %50 den fazla vakada görülmüştür. Çoğunluğu peteşiyal kanamalar olmasına rağmen hayati tehdit eden kanamalara da yol açmaktadır. Bizde ibrutinibin kanamaya eğilimi olan hastalarda dikkatli kullanılmasını vurgulamak amacıyla, ibrutinib sonrası kanama gelişen vakamızı sunduk.
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    Prostate Involvement in a Patient with Follicular Lymphoma
    (2017) Demircioğlu, Sinan; Çeneli, Özcan; Fındık, Sıdıka; Yılmaz, Seda; Bektaş, Özlen
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    Survivin Expression May Affect The Neoadjuvantchemotherapy Response İn Breast Cancer Patients
    (2017) Er, Zehra; Peştereli, Hatice Elif; Tavlı, Lema; Bozcuk, Hakan; Erdoğan, Gülgün; Esen, Hacı Hasan; Artaç, Mehmet; Korkmaz, Levent; Gündüz, Şeyda; Karaağaç, Mustafa; Demircioğlu, Sinan
    To investigate whether there is a predictive effect of NF-kappaB, survivin, and Ki-67 expressions on pathological response and disease relapse in breast cancer (BC) patients. Ki-67, survivin and NF-kappaB expressions were analyzed in the pathology specimens of breast biopsy before and after neoadjuvant chemotherapy (NeoCT) in BC patients (n52). Event -free survival (EFS) (defined as recurrence or metastasis free) analyze was performed. The median overall survival was 43.5 months and the median EFS was 51 months (95% CI: 33.3-68.9) in all patients. The expression percentages of NF-kappaB, survivin, and Ki-67 significantly decreased after NeoCT (p>0.001). Survivin expression level before NeoCT was significantly higher in patients who did not respond to NeoCT than both partial-responders and complete-responders (p0.038, p0.010, respectively). Type of NeoCT was the only independent factor on pathological response status (p0.007). Addition of taxanes to NeoCT improved pathological complete response rates about six times. However, no predictor was found to be a prognostic factor for EFS in multivariate analyze. Higher survivin expression level before NeoCT may be associated with poor pathological response to NeoCT. These findings must be tested with prospective clinical trials.
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    Testicular Involvement in Relapsed Hodgkin Lymphoma
    (2016) Demircioğlu, Sinan; Baştürk, Abdukadir; Uğur Bilgin, Aynur
    Dear Editor, Malignant lymphoma of the testis generates 5% of all testicular malignancy and 1% of all lymphomas (1). Testicular involvement is an extremely rare presentation of Hodgkin’s lymphoma (HL); to date, testicular involvement has been reported in 5 patients with HL. We have examined a patient with testicular involvement of HL who relapsed 11 years after treatment. Written informed consent was obtained from patient. A 40-year-old male patient was admitted to hospital in June 2014 with complaints of fever, weight loss and night sweats for 2 months. We found that he had been diagnosed as mixed cellularity classical HL (stage 2A) in 2003 and achieved complete remission after 3 cycles of Adriamycin (Doxorubicin, Koçak; Tekirdağ, Turkey), bleomycin (Blemisin, Koçak; Tekirdağ, Turkey), vinblastine (Vinko, Koçak; Tekirdağ, Turkey), dacarbazine (Dakarbaz, Koçak; Tekirdağ, Turkey) (ABVD) chemotherapy and involved field radiotherapy. He was followed without any therapy for 11 years. On admission, physical examination was unremarkable except for millimeter cervical lymph nodes. The following measurements were recorded: erythrocyte sedimentation rate of 97 mm/h, lactate dehydrogenase level 247 U/L and beta2-microglobulin of 2.14 mg/L. 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET-CT) (Siemens; Munich, Germany) revealed multiple cervical, mediastinal and abdominal lymph nodes with increased FDG uptake.