Retrospective Evaluation of Immunomodulatory Agents' Response and Side Effects In Relapsed and Refractory Multiple Myeloma Patients

Objective: In this study, we aimed to determine the most appropriate approaches to shape our daily practice by revealing treatment responses, side effects and side effect management of relapsed and refractory multiple myeloma patients who were treated with immunomodulatory drugs (IMIDs). Method: This study was carried out among patients with multiple myeloma who underwent IMIDs between June 2001 and September 2018. General characteristics, overall survival, response rates, side effects profiles, prophylaxis used to prevent side effects of IMIDs are evaluated. Results: The median age of 85 patients included in the study was 62 (38 – 83). Fifty (58.8%) of the patients were male. The mean follow-up period of the patients was 64 months Overall survival of the patients was 87 months (5.70; 75.83 - 98.18). Of the 85 patients included in the study, 11 received thalidomide, 78 received lenalidomide, and 15 received pomalidomide. While none of the patients receiving thalidomide was discontinued due to side effects, the dose was reduced in 1 (9.1%) patient. In 25 (32.1%) of the patients receiving lenalidomide, the drug was discontinued, while the dose was reduced in 21 (26.9%) patients. In 1 of the patients using pomalidomide, the drug was discontinued, and no dose reduction was made in any of the patients. Conclusion: IMIDs are drugs that are frequently used in RRMM and have a pronounced response. In order to use the drugs effectively, prophylactic approaches to prevent the side effects before they are developed should be determined according to patient characteristics

Depression and anxiety in cancer patients and their relatives.

Purpose: To investigate the depression and anxiety levels and the factors that affect patients receiving chemotherapy and their relatives with the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) scoring system

Prognostic significance of serum galectin-3 levels in patients with hepatocellular cancer and chronic viral hepatitis

Background/Aim: Galectins affect diverse physiological and pathophysiological processes such as development, inflammation, and tumor growth. We aimed to compare serum galectin-3 levels in three patient groups with chronic hepatitis B and C virus (HBV, HCV), cirrhosis secondary to HBV or HCV, and hepatocellular carcinoma (HCC) secondary to HBV or HCV and evaluate the role of galectin-3 during HCC progression. Patients and Methods: Nineteen patients with hepatocellular cancer, 22 patients with cirrhosis, and 24 patients with chronic hepatitis B and C were included in this study. Serum galectin-3 levels in different liver diseases were assessed by enzyme-linked immunosorbent assay. Results: The mean galectin-3 levels were 4.61 ng/mL (±2.32) in HCC patients, 5.68 ng/mL (±2,2) in cirrhotic patients, 1.98 ng/mL (±1.50) in chronic viral hepatitis group. There were no statistical differences between HCC and cirrhotic patients (P = 0.5), but lower in chronic hepatitis group statistically compared with cirrhosis and HCC (P < 0.001, P = 0.002, respectively). In case of cirrhotic patients, galectin-3 levels were significantly higher in patients with cirrhosis secondary to HCV compared with HBV (P = 0.03). When we evaluated galectin-3 levels in HCC patients, it was found to be 3.92 ng/mL in HCC secondary to hepatitis B and 5.37 ng/mL in HCC secondary to hepatitis C. Conclusion: Serum galectin-3 levels in patients with chronic HBV or HCV may guide us about progression to cirrhosis or HCC and prognosis of the disease. Especially, galectin-3 levels may be more pronounced in case of HCV

Oxidative and antioxidative status after anthracyclinebased chemotherapy in breast cancer patients.

Purpose: The present study was undertaken to evaluate the effects of adjuvant anthracycline-based chemotherapy on thiobarbituric acid reactive substances (TBARS) and superoxide dismutase (SOD) levels in patients with breast cancer who had undergone surgery

Plasma levels of thrombin activatable fibrinolysis inhibitor in normal and preeclamptic pregnant women.

To explain the pathogenesis of preeclampsia with coagulation induction or a defective fibrinolysis, various hemostatic parameters were studied and different treatment modalities targeting these parameters were evaluated. Considering the role of TAFI in down-regulation of fibrinolysis, in our study we have investigated whether TAFI contributes to impaired fibrinolysis in patient with preeclampsia

Increased concentration of soluble CD40 ligand in preeclampsia

Preeclampsia has been associated with increased platelet activation detected before disease onset. Platelets are involved in hemostasis and also directly initiate an inflammatory response of the vessel wall. Inappropriate activation of platelets may be involved in pathogenesis in preeclampsia by promoting coagulation and thrombosis, and also as a mediator of inflammation. Platelets may release inflammatory mediators such as soluble CD40 ligand. The plasma level of soluble CD40 ligand was investigated during preeclamptic (n =20) and normal pregnancies (n = 20) to emphasize inflammatory response in preeclampsia. The mean soluble CD40 ligand levels were 1.08 +/- 0.43 ng/mL in patients with preeclampsia and 0.76 +/- 0.24 ng/mL in healthy pregnant women, which was statistically significant (P =. 01). To clarify whether inflammation may cause inappropriate endothelial cell activation or inappropriate endothelial cell activation may start this inflammatory response, future studies are needed in a larger study population

Correlation of Nm23 and P27 Expression in Nodal Diffuse Large B Cell Lymphomas with Clinicopathologic Parameters and the Effect on Prognosis

Objective: Diffuse large B cell lymphoma (DLBCL) is the most common type of adult lymphoma. No certain histopathological parameter was found, except proliferation index, for predicting prognosis. In hematological malignancies, the prognostic effect of Nm23 expression, which shows metastatic potential in solid tumors, has been researched by a few studies. Loss of p27, a negative regulator of the cell cycle, indicates aggressiveness; however, some studies showed that high expression is relevant to poor prognosis. Here, we aimed to investigate whether they can be used as prognostic markers in DLBCLs

Subclinical Hypercortisolism among Polycythemia Vera Patients

Background JAK2V617F, a somatic gain-of-function mutation involving the JAK2 tyrosine kinase gene, occurs in nearly all patients with polycythemia vera (PV). JAK2 is also essential in hypothalamo-pituitary-adrenal (HPA) axis system which is known to play a role in subsequent steroid secretion. The purpose of this study was to determine whether or not PV induces subclinical hypercortisolism (SH)

Unmet clinical needs and challenges in the management of acute leukemia in Turkey: a modified Delphi study

Aim: To determine the unmet needs and challenges in management, diagnosis, treatment, follow-up and patient-physician communication in acute leukemia (AL). Materials ; methods: The study was based on a modified Delphi approach. A questionnaire including the major potential obstacles was circulated twice among 13 hematologists. Results: The obstacles in AL management were limited access to the novel treatments and genetic tests, limited bed capacity, insufficient level of knowledge among allied health personnel, limited availability of psycho-oncological support and low levels of awareness in the population about the importance of stem cell donation. Conclusion: The challenges in the management of AL are critical to guide the efforts to improve the quality of healthcare delivery and the evidence-based decision making at treatment of AL patients