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Konvansiyonel Tedavilere ve Splenektomiye Refrakter Primer Myelofibrozisli Olguda Ruxolitinib Deneyimi

A 67-year-old male patient who was diagnosed with primary myelofibrosis 4 years ago did not respond to conventional therapies. The splenomegaly progressively increased, which caused spleen infarctions and led to the decision to perform a splenectomy procedure. After splenectomy, the patient started treatment with ruxolitinib. In the first month of ruxolitinib treatment, the patient became transfusion-free and all constitutional symptoms disappeared. However, in the sixth month of ruxolitinib treatment, the disease transformed to acute myeloblastic leukemia, and the patient died 1 month later. This is the first case report that shows the effects of ruxolitinib in a splenectomized patient

Kronik miyeloid lösemi tedavi dozunda Nilotinib’in gonadotoksik etkilerinin fare modelinde gösterilmesi

Objective: Tyrosine kinase inhibitors may have deleterious effects on spermatogenesis or folliculogenesis, resulting in male or female subfertility. The aim of this study is to determine the effect of nilotinib, which is used routinely to treat chronic myeloid leukemia, on spermatogenesis and folliculogenesis by using histopathological parameters. Materials and Methods: Ten male and ten female mice were orally treated with nilotinib at 20 mg/kg body weight dissolved in drinking water daily for 2 months. Results: When compared with the control group, a statistically significant decrease was demonstrated in the total follicle numbers of the female mice in the nilotinib group (268±110 vs. 170±60; p=0.03). Active spermatogenesis was observed in each tubule sample taken from the mice in the control and nilotinib groups. Spermatogenic activity was similar in the two groups. Conclusion: We have demonstrated that even though spermatogenesis is preserved, folliculogenesis is inhibited by the usage of a continuous nilotinib treatment dose in chronic myeloid leukemia

Blood donors and factors impacting the blood donation decision: Motives for donating blood in Turkish sample

Background: Donations in Turkey are insufficient to cover the high transfusion needs arising from large numbers of thalassemia and sickle cell anemia patients and increasing demands for blood due to advanced surgery and cancer treatment. The most acceptable means to get blood is voluntary blood donation and the blood donor system in Turkey mostly depends on a combination of voluntary and involuntary donors. The main aim of this study is to explore the motivations of Turkish voluntary blood donors toward blood donation and to determine predictors of blood donation motivation. Materials and methods: A cross-sectional sample survey of active blood donors in Ankara, Turkey was conducted. The sample consisted of 189 male volunteer blood donor adults. Donors filled in a self-administered questionnaire including the measures of demographic information, empathetic concern, altruism, social responsibility and blood donation motivation questionnaire during donation. Results: Factor analysis of Blood Donation Motivation Measure with varimax rotation revealed a three-factor solution named as ‘‘values and moral duty’’, ‘‘positive feelings and esteem’’ and ‘‘self-benefit and external reasons’’. The results with regression analyses showed that only social responsibility had an significant effect independent of age, income, and education on blood donation motivation. Conclusion: These result reflects that blood donation motivation not only linked to a high degree of altruistic reasons, but also to a combination of some self-regarding motives. Additionally, feelings of empathy or altruism may be less strong at the time the decision to help, other factors may have a larger influence on helping decisions

CD38 expression and variation as a prognostic factor chronic lymphocytic leukemia

Background: In this study, we aimed to determine a cutoff level for CD38 that would aid us in identifying chronic lymphocytic leukemia patients in need of early therapy and predicting patients at sufficiently low risk who would likely exhibit a rapid improvement; we also aimed to find out if CD38 expression would show variability during disease course and determine the extent of CD38 expression. Methods: 124 patients were diagnosed with CLL. CD38 and ZAP-70 expression levels were measured with four color flowcytometry. Time from diagnosis to initial therapy was calculated for all patients. CD38 expression was studied for a second time during follow-up in 50 patients. Results: For cutoff levels of 7%, 20%, and 30%, CD38 expressions were 61.3%, 25%, and 24.2%, respectively. At all three cutoff levels there were significant correlations with all parameters except age between CD38+ vs. CD38- groups (p < 0.001). The comparative rates of starting therapy for cutoff levels of 7%, 20%, and 30% in CD38+ and CD38- groups were 77.5% vs. 6.25%; 100% vs. 30.7%, and 100% vs. 31.5%, respectively (p < 0.001). Multiple Cox Proportional Hazards Regression analysis: for a cutoff level of 7%, survival was affected by STAGE, ZAP70, and CD38. Conclusions: A CD38 cutoff level of 7% determined by standardized laboratory techniques is an important prognostic marker. However, the number and frequency of repeat measurements of CD38 expression, and cutoff level of CD38 expression that significantly predict disease prognosis should be further determined by future cohort studies

Is mean platelet volume associated with the angiographic severity of coronary artery disease?

Background: Platelet activation and aggregation play key roles both in the pathogenesis of atherosclerosis and in the developmentof acute thrombotic events. Platelet volume is a marker of platelet activation and function, and is measured usingmean platelet volume (MPV).Aim: To determine the relationship between MPV and angiographic Gensini and SYNTAX scores, which give informationabout the severity and complexity of coronary artery disease (CAD).Methods: This study included 435 consecutive patients undergoing elective coronary angiography. The complete blood countand biochemical examination of blood were obtained after 12 h of fasting. The independent association between MPV andthe severity of CAD was statistically evaluated using PASW Statistics 18 for Windows.Results: Mean age of the study population was 58.4 ± 9.3 years, of whom 196 were female (45.1%) and 239 male (54.9%).Of the patients, 63.2% had CAD, 31.7% had diabetes mellitus, 61.8% had hypertension, 56.6% had hyperlipidaemia, and38.6% were smokers. Mean Gensini score was 20.7 ± 31.1. According to Gensini scores, 160 of the patients (36.8%) hadnormal coronary arteries (Gensini score: 0), 134 of the patients (30.8%) had minimal CAD (Gensini score: 1–19), and 141 ofthem (32.4%) had severe CAD (Gensini score ? 20). Mean MPV values were 8.4 ± 1.0 fL in the group that had no CAD,8.7 ± 1.0 fL in the group with minimal CAD, and 9.3 ± 1.5 fL in the group with severe CAD. According to Spearman correlationanalysis, the positive relationship found between MPV and Gensini score was statistically significant (p < 0.001,r = 0.290). Likewise, SYNTAX score was also associated with MPV (p < 0.001, r = 0.504).Conclusions: We determined a positive correlation between MPV and Gensini and SYNTAX scores. Therefore, this simplehaematology test can be used in determining cardiovascular disease burden besides other risk factors during routine clinicalpractice. For further information about this topic, large-scale studies are needed

Ruxolitinib Treatment in a Patient with Primary Myelofibrosis Resistant to Conventional Therapies and Splenectomy: A Case Report

A 67-year-old male patient who was diagnosed with primary myelofibrosis 4 years ago did not respond to conventional therapies. The splenomegaly progressively increased, which caused spleen infarctions and led to the decision to perform a splenectomy procedure. After splenectomy, the patient started treatment with ruxolitinib. In the first month of ruxolitinib treatment, the patient became transfusion-free and all constitutional symptoms disappeared. However, in the sixth month of ruxolitinib treatment, the disease transformed to acute myeloblastic leukemia, and the patient died 1 month later. This is the first case report that shows the effects of ruxolitinib in a splenectomized patient

Gonadotoxic effects of nilotinib in chronic myeloid leukemia treatment dose in a mouse model

Objective: Tyrosine kinase inhibitors may have deleterious effects on spermatogenesis or folliculogenesis, resulting in male or female subfertility. The aim of this study is to determine the effect of nilotinib, which is used routinely to treat chronic myeloid leukemia, on spermatogenesis and folliculogenesis by using histopathological parameters. Materials and Methods: Ten male and ten female mice were orally treated with nilotinib at 20 mg/kg body weight dissolved in drinking water daily for 2 months Results: When compared with the control group, a statistically significant decrease was demonstrated in the total follicle numbers of the female mice in the nilotinib group (268±110 vs. 170±60; p=0.03). Active spermatogenesis was observed in each tubule sample taken from the mice in the control and nilotinib groups. Spermatogenic activity was similar in the two groups. Conclusion: We have demonstrated that even though spermatogenesis is preserved, folliculogenesis is inhibited by the usage of a continuous nilotinib treatment dose in chronic myeloid leukemia

The effect of nilotinib in chronic myeloid leukemia treatment dose on fertility and teratogenicity in a healthy

20th Congress of European-Hematology-Association -- JUN 11-14, 2015 -- Vienna, AUSTRI

Kan kaybına bağlı hemoglobin düşüklüğü ve hipoksemi durumunda kardiak iskemi belirteci olarak İMA

Objective: Although the mechanism is still not so clear, ischemia modified albumin is produced as a result of the occurrence of changes in metal binding regions on the albumin with the production of reactive oxygen species. But it is not known whether this change is the cause or the result of different states. This study is designed to investigate the correlation between hypohemoglobinemia, hypoxemia due to blood loss and IMA. Methods: The research is carried out with 83 patients (28 Male, 55 Female; mean age: 51±22 year) and 19 subject as control group (7Male, 12 Female; mean age 35±18 year). Patients were divided into three sub-groups according to their hemoglobin levels (<8, 8-10, 10-12 g/dL). Additionally, same patients were divided into second sub-group according to their follow-up status as outpatient (40 male, 15 female, mean age: 48 ± 20 year), postoperative (8 male, 11 female, mean age: 49 ± 24 year) and intensive care unit (6 male, 5 female; mean age: 64±20 year) patients. To determine the IMA levels the measurement method based on albumin cobalt binding assay was used. Results: In IMA levels, no significant difference is found between the mild (Hb: 10-12 g/dL) [(n=47; 0,61±0,23 ABSU)], moderate (Hb: 8-10 g/dL) [(n=26; 0.58±0.24 ABSU)] and severe (Hb: <8 g/dL) [(n=9; 0.62±0.12 ABSU)] anemia groups. However, because of acute blood loss related acute hypoxemia; IMA levels of the postoperative patients are statistically higher as compared to control group. As compared to control groups, no statistically significant difference is observed in the levels of the serum IMA in the outpatient group who had minimally invasive surgery and in the intensive care patient group. Conclusion: Our results suggest that; if mycardial oxygenization is questioned in cases of acute and heavy blood loss, ischemia modified albumin is not a valuable test for the indicator of the myocardial ischemia