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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 The Association of Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios and Hematological Parameters with Diagnosis, Stages, Extrapulmonary Involvement, Pulmonary Hypertension, Response to Treatment, and Prognosis in Patients with Sarcoidosis(Hindawi Ltd, 2020) Korkmaz, Celalettin; Demircioglu, SinanSarcoidosis is a rare disease characterized by granulomatous inflammation in affected organs, primarily in lungs. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are easy and practical methods providing valuable information in diagnosis, severity, and prognosis of various diseases. Here, we aimed to investigate the association between NLR, PLR, and hematological parameters in sarcoidosis. The study was performed with 75 sarcoidosis patients and 92 controls. Patients' NLR, PLR, and hematological parameters were compared with those of controls. Additionally, while differences between NLR and PLR were investigated in sarcoidosis patients, differences of extrapulmonary involvement, pulmonary hypertension (PH), and spontaneous remission between those with and without responses to treatment concerning stages were also assessed. NLR and PLR were significantly higher in sarcoidosis patients than controls. For NLR, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were found as 68, 61, 58, and 70% respectively, while sensitivity, specificity, PPV, and NPV for PLR were found as 72, 67, 63, and 74%, respectively. In sarcoidosis patients, NLR and PLR were significantly higher at stage-2 and -3 than at stage -1 and -4. There was a significant weak positive correlation between C-reactive protein (CRP) and NLR and PLR. Mean platelet volume (MPV), hemoglobin (Hgb), and mean corpuscular volume (MCV) were lower among patients than controls. A positive moderate correlation was detected between NLR and CD4/CD8 in blood, while there was a strong positive correlation between CD4/CD8 in bronchoalveolar lavage (BAL) and positive moderate correlation between PLR and CD4/CD8 in BAL. High NLR and PLR values were not significantly associated with pulmonary PH, spontaneous remission, response to treatment, and prognosis. The increase in PLR and NLR may be a guide for diagnoses of both sarcoidosis and lung parenchymal involvement. To use these entities as markers, our findings should be supported with prospective studies with larger samples.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 Determinants of recurrence in ITP treatment(E-Century Publishing Corp, 2020) Demircioglu, Sinan; Gurbuz, Ali FuatObjective: Immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia. Two-thirds of the cases respond to first-line therapy with corticosteroids. However, there is a 50% relapse rate six months after the treatment. Information predicting recurrence at the time of the diagnosis is limited. This study aimed to investigate the relationship of mean platelet volume (MPV) and the neutrophil/lymphocyte ratio (NLR) at the time of the diagnosis with ITP recurrence. Methods: The study included 171 adult primary ITP patients who received corticosteroids and/or intravenous immunoglobulin (IVIG) as first-line therapy. The relationship between the demographic characteristics of the patients and the laboratory values at the time of the diagnosis with the frequency of recurrence was evaluated. Results: A total of 126 (73.7%) female and 45 (26.3%) male patients with a mean age of 38.54 +/- 17.41 years were included in the study. 89 (52%) patients had a recurrence after first-line therapy. No relationship was found between the frequency of recurrence and age, gender, the presence of comorbid diseases, bleeding status, type of the first-line treatment, CRP, and MPV values. However, there was a statistically significant relationship between NLR increase and the frequency of recurrence (P=0.049). Conclusion: In this study, an association was found between the NLR levels and the rate of recurrence in ITP patients receivingfirst-line treatment. Further studies with larger sample sizes are needed to support this finding.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 Efficacy of convalescent plasma therapy in severe COVID-19 patients(Pergamon-Elsevier Science Ltd, 2021) Cizmecioglu, Hilal Akay; Goktepe, Mevlut Hakan; Demircioglu, Sinan; Tekinalp, Atakan; Cizmecioglu, Ahmet; Tuna, Ali Kursat; Ozer, HuseyinIntroduction: The use of convalescent plasma (CP) transfusions is very valuable in the current COVID-19 outbreak, given that there are no specific preventive and therapeutic options. Materials and methods: 50 patients with severe COVID-19 disease treated with convalescent plasma transfusion were included in the study. The efficacy of CP and in which situations it was effective were investigated. Conclusion: 80 % of the patients recovered, and 20 % died in our study. The mean age of the patients who died was found to be higher than the patients who recovered. CRP, ferritin, D-dimer, neutrophil, MPV, and NLR counts were found to be higher, and lymphocyte and platelet counts were lower in the deceased group after CP. It was determined that patients who received CP within the first five days were hospitalized for a shorter period. Discussion: Administration of CP transfusion within the first five days in severe COVID-19 patients has been shown to reduce hospital stay length.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 Heparin-induced thrombocytopenia in a hemodialysis patient treated with fondaparinux: Nephrologists between two fires(Wiley-Blackwell, 2013) Solak, Yalcin; Demircioglu, Sinan; Polat, Ilker; Biyik, Zeynep; Gaipov, Abduzhappar; Acar, Kadir; Turk, SuleymanHeparin-induced thrombocytopenia (HIT) is caused by heparin exposure and presents with reduced platelet count. Patients undergoing hemodialysis (HD) treatment have increased risk of developing HIT due to prolonged exposure to unfractionated heparin or low-molecular weight heparin. We report a 79-year-old male patient with end-stage renal disease who developed type-II HIT during maintenance HD. Platelet count of the patient decreased gradually and antiplatelet factor IV antibody was found to be positive. The patient was treated with fondaparinux and continued heparin-free HD. Unfortunately, despite favorable initial response without any thrombotic episodes, the patient died due to severe sepsis complicated by gastrointestinal hemorrhage.Öğe Imaging Features of Breast Plasmacytoma(Galenos Publ House, 2022) Babaoglu, Seyma; Poyraz, Necdet; Kaya, Bugra; Findik, Siddika; Demircioglu, Sinan[Abstract Not Availabe]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 Prognostic Significance of Flow Cytometric Immunophenotyping in Patients with Acute Myeloid Leukemia(Galenos Publ House, 2022) Demircioglu, Sinan; Ekinci, Omer; Dogan, Ali; Ulas, TurgayObjective: Chromosomal abnormalities are one of the most important prognostic factors in acute myeloid leukemia (AML). However, not all patients may have such informative chromosomal abnormalities. Although there are many studies on the prognostic value of immunophenotyping in AML, it is still not used as a prognostic marker. In this study, we aimed to investigate the effects of CD13, CD33, CD34, CD117, MPO and HLADR expressions on prognosis of non-acute promyelocytic leukemia AML.Methods: One hundred thirteen patients diagnosed as having non -acute promyelocytic leukemia AML and followed up between 2010 and 2018 were included in this study. The associations of CD13, CD33, CD34, CD117, MPO and HLA DR expressions with chemotherapy response, progression free survival (PFS) and overall survival (OS) were statistically analyzed.Results: It was seen that response to chemotherapy was achieved in 67.3% of the patients. Median PFS duration was 9 months and median OS duration was found as 13 months. Of the immunophenotypic characteristics, only MPO expression was determined to be an independent risk factor for PFS and OS.Conclusion: Immunophenotypic features may be helpful in the diagnosis of AML as well as give an idea about prognosis. In this study, MPO expression was shown to be an independent risk factor for PFS and OS in our own patient population.Öğe Prognostic Significance of Flow Cytometric Immunophenotyping in Patients with Acute Myeloid Leukemia(Galenos Publ House, 2022) Demircioglu, Sinan; Ekinci, Omer; Dogan, Ali; Ulas, TurgayObjective: Chromosomal abnormalities are one of the most important prognostic factors in acute myeloid leukemia (AML). However, not all patients may have such informative chromosomal abnormalities. Although there are many studies on the prognostic value of immunophenotyping in AML, it is still not used as a prognostic marker. In this study, we aimed to investigate the effects of CD13, CD33, CD34, CD117, MPO and HLADR expressions on prognosis of non-acute promyelocytic leukemia AML.Methods: One hundred thirteen patients diagnosed as having non -acute promyelocytic leukemia AML and followed up between 2010 and 2018 were included in this study. The associations of CD13, CD33, CD34, CD117, MPO and HLA DR expressions with chemotherapy response, progression free survival (PFS) and overall survival (OS) were statistically analyzed.Results: It was seen that response to chemotherapy was achieved in 67.3% of the patients. Median PFS duration was 9 months and median OS duration was found as 13 months. Of the immunophenotypic characteristics, only MPO expression was determined to be an independent risk factor for PFS and OS.Conclusion: Immunophenotypic features may be helpful in the diagnosis of AML as well as give an idea about prognosis. In this study, MPO expression was shown to be an independent risk factor for PFS and OS in our own patient population.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 A Real-Life Turkish Experience of Ruxolitinib in Polycythemia Vera(Galenos Publ House, 2023) Serin, Istemi; Dogu, Mehmet Hilmi; Ekinci, Omer; Cagliyan, Gulsum Akgun; Basturk, Abdulkadir; Aras, Merih Reis; Demircioglu, SinanIntroduction: Ruxolitinib is a small -molecule inhibitor of the JAK1/2 pathway. This study aimed to reveal the results and side-effect profile of the use of ruxolitinib as a treatment option in polycythemia vera (PV). Methods: A total of 34 patients with PV from 18 different centers were included in the study. The evaluation of the response under treatment with ruxolitinib was determined as a reduction in spleen volume (splenomegaly size: >= 35%) by imaging and control of hematocrit levels (<= 45%) compared to baseline. Results: While the number of patients in which a reduction in spleen volume and hematocrit control was achieved was 19 (55.9%) at 3 months of treatment, it was 21 (61.8%) at 6 months. Additionally, while the number of side effects was negatively correlated with the reduction in spleen volume (Spearman's rho: -0.365, p=0.034), a decrease in the hematocrit level was positively correlated (Spearman's rho: 0.75, p=0.029). Those without a reduction in spleen volume experienced more constipation (chi-square: 5.988, Fisher's exact test: p=0.033). Conclusion: This study shed light on the use of ruxolitinib in PV and the importance of splenomegaly on studies planned with larger patient groups.Öğe Renal Involvement in Chronic Lymphocytic Leukemia: A Case Report(Galenos Publ House, 2020) Demircioglu, Sinan; Ozgokce, Mesut; Dogan, Ali; Bayram, Irfan; Demir, CengizChronic lymphocytic leukemia (CLL) is a neoplastic condition of B cells that frequently affects the lymph nodes, liver, spleen and bone marrow. The extranodal involvement of CLL is most commonly observed in the skin, whereas gastrointestinal and genitourinary involvement is rare. Renal involvement may not always present with renal failure. In this study, we aimed to present a patient with CLL infiltration in the kidney without renal failure and proteinuria.Öğe Rituximab-induced severe acute thrombocytopenia in a patient with splenic marginal zone lymphoma(Sage Publications Ltd, 2023) Kars, Taha Ulutan; Yorganci, Zahit Furkan; Yaskiran, Osman; Tekinalp, Atakan; Demircioglu, SinanIntroduction Rituximab, which is widely used in the treatment of B-cell lymphoma, is a chimeric monoclonal antibody directed against the CD20 antigen. Rituximab has many side effects, mainly allergic and neurological. Rituximab may cause thrombocytopenia in the long term after administration. Rare cases of rituximab-induced acute thrombocytopenia have been reported in the literature. Case Report A 51-year-old female patient who was newly diagnosed with splenic marginal zone lymphoma received rituximab as first-line therapy. Petechiae occurred in the lower extremities on the day following rituximab administration. The blood test showed a severe drop in the platelet count from 112,000/mu L to 5000/mu L. Blood peripheral smear evaluation confirmed severe thrombocytopenia. Management and outcome There was no change in hemoglobin or white blood cell levels. After the diagnosis of rituximab-induced acute thrombocytopenia, thrombocyte suspension was administered due to the risk of bleeding. Close clinical and laboratory observations were made. The platelet count began to rise gradually in the following period. Before the second week of rituximab administration, the platelet count was 122,000/mu L. No complications developed after premedication and slow rituximab administration, and subsequent treatments were continued in the same way. Discussion Rituximab has widespread use, especially in malignancies and autoimmune diseases. Like many monoclonal antibodies, rituximab has several side effects. Thrombocytopenia is a long-term side effect associated with rituximab, and rituximab-induced severe acute thrombocytopenia has been rarely reported. Therefore, it should be kept in mind that severe acute thrombocytopenia may develop after rituximab administration.
