Eltrombopag for the treatment of immune thrombocytopenia: The aegean region of Turkey experience

Objective: Immune thrombocytopenia (ITP) is an immune-mediated disease characterized by transient or persistent decrease of the platelet count to less than 100x109/L. Although it is included in a benign disease group, bleeding complications may be mortal. With a better understanding of the pathophysiology of the disease, thrombopoietin receptor agonists, which came into use in recent years, seem to be an effective option in the treatment of resistant cases. This study aimed to retrospectively assess the efficacy, long-term safety, and tolerability of eltrombopag in Turkish patients with chronic ITP in the Aegean region of Turkey. Materials and Methods: Retrospective data of 40 patients with refractory ITP who were treated with eltrombopag in the Aegean region were examined and evaluated. Results: The total rate of response was 87%, and the median duration of response defined as the number of the platelets being over 50x109/L was 19.5 (interquartile range: 5-60) days. In one patient, venous sinus thrombosis was observed with no other additional risk factors due to or related to thrombosis. Another patient with complete response and irregular follow-up for 12 months was lost due to sudden death as the result of probable acute myocardial infarction. Conclusion: Although the responses to eltrombopag were satisfactory, patients need to be monitored closely for overshooting platelet counts as well as thromboembolic events. © 2015 Turkish Society of Hematology. All rights reserved

Ida-FLAG chemotherapy in the refractory-relapsed hematologic malignancies [Refrakter-relapsli hematolojik maligniteli olgularda Ida-FLAG kemoterapisi]

Ida-FLAG chemotherapy, which consists of fludarabine, high dose cytosine arabinoside, idarubucine, and G-CSF, is accepted as an efficient chemotherapeutical regimen in the refractory and/or relapsed AML, ALL, and relapsed malign lymphomas. In this report, the result of the patients who have recieved Ida-FLAG regimen in our center, have been evaluated retrospectively. Total 10 patients were included and mean age was 41.1±11.2 years. Seven of them were relapsed or refractory AML, 2 of them relapsed ALL and one patient was transformed low grade lymphoma. All of the patients had recieved multiple chemotherapy regimens before. All patients died bacaues of febrile neutropenia, hemorrhage and bone marrow failure. In the literature, Ida-FLAG results are better and the mortality is less. In our patients, the mortality was high, most probably because of very bad prognosis patient selection. With our results, it can be suggested that, Ida-FLAG is not a good choice in the selected patient group of relapsed-refractory, multiple chemotherapy administered patients

Fast neighbor lists for adaptive-resolution particle simulations

Particle methods provide a simple yet powerful framework for simulating both discrete and continuous systems either deterministically or stochastically. The inherent adaptivity of particle methods is particularly appealing when simulating multiscale models or systems that develop a wide spectrum of length scales. Evaluating particle–particle interactions using neighbor-finding algorithms such as cell lists or Verlet lists, however, quickly becomes inefficient in adaptive-resolution simulations where the interaction cutoff radius is a function of space. We present a novel adaptive-resolution cell list algorithm and the associated data structures that provide efficient access to the interaction partners of a particle, independent of the (potentially continuous) spectrum of cutoff radii present in a simulation. We characterize the computational cost of the proposed algorithm for a wide range of resolution spans and particle numbers, showing that the present algorithm outperforms conventional uniform-resolution cell lists in most adaptive-resolution settings

Incidence of aplastic anemia in Turkey: A hospital-based prospective multicentre study

PubMedID: 9444948The incidence of aplastic anemia among hospitalized adult patients was prospectively determined in this first study in Turkey. New cases of aplastic anemia among patients 14 years and older who were admitted to the study centers were included in a 3 year survey. Seventy-three patients fulfilled the diagnostic criteria, yielding a mean annual incidence rate of 1.14 cases in 103 admissions. The male-to-female ratio of the cases (1.6:1) differed from the almost equal ratio of the larger population of Turkey. The median age was 30 years and females were younger at diagnosis. The age distribution of the cases was different from that of the population; showing two incidence peaks in both sexes. The majority of the patients (89%) had severe disease.TAG-0755 Materials Research SocietyAcknowledgements-The authorsa re gratefult o Professor N. Akman,P rofessoYr . Aydm,P rofessoSr . DtindarP, rofessor B. Ferhanoglu,A ssociateP rofessor0 . Gzcebe, Associate Professor0 . Gzdemir,P rofessorK . Gzerkana nd Associate ProfessorT . Soysal for providingp atientst o the studya nd ProfessorH asanY azrci for his valuables uggestionfso r the studya nda lso Mrs GtinseliD um,M S Figen Aydogana ndM S NurcanG edik for their secretariaal ssistanceTs.h e studyw as supportedb y TL&ITAK (The Scientific and Technical Research Council of Turkey), grant no: TAG-075

Potential involvement of calcineurin in regulating the state of differentiation and apoptosis of HL-60 cells during methylprednisolone-treatment

To evaluate the role of calcineurin (protein phosphatase type 2B, PP2B) in methylprednisolone-induced differentiation and apoptosis of leukaemic cells, we have investigated the induction of apoptosis, calcineurin specific protein phosphatase activity and expression of regulatory and catalytic subunits of calcineurin and calmodulin after induction of HL-60 leukaemic cells with methylprednisolone. The cells underwent differentiation and apoptosis within 72 hours time period after methylprednisolone added to cell culture media. Before apoptosis occurred, the specific calcineurin enzyme activity revealed gradual increase during the differentiation process. However, immunoblots of catalytic and regulatory subunits of calcineurin showed no amplification in the amount of these cellular signaling mediators during methylprednisolone-induced differentiation and apoptosis but calmodulin expression gradually increased during the process. Significant increase in the specific calcineurin enzyme activity during differentiation and apoptosis might be crucial to the posttranslational modifications of calcineurin during methylprednisolone-induced differentiation

The coincidence of hematological and colorectal malignancies: Report of 4 cases [Kolorektal ve hematolojik malignitelerin birlikteligi: 4 Olgu sunumu]

The coincidence of hematological and other system malignancies is not rare. Particularly, in the older ages, a second malignancy is much more prevelant. Recently, the coincidence of colorectal carcinoma and leukemia is detected more frequently. In certain studies, DCC gene inactivation is pointed in the pathophysiology. In this report, a 56-year old patient with colorectal carcinoma and AML M4, 76-year old colorectal carcinoma with AML M5, 75-year old myelofibrosis patient with colorectal carcinoma and, 56-year oold CML patient with colorectal carcinoma are discussed

Molecular evaluation of t(14;18)(bcl-2/IgH) translocation in follicular lymphoma at diagnosis using paraffin-embedded tissue sections [Foliküler lenfoma Tani{dotless}si{dotless}nda Parafine-Gömülü Dokular kullani{dotless}larak t(14;18)(bcl-2/IgH) translokasyonun moleküler yöntemler ile Degerlendirilmesi]

Objective: Follicular lymphoma (FL) is one of the most common lymphomas, and is characterized by t(14;18) (q32;q21) in more than 80% of patients. The aim of this study was to determine the rate of t(14;18) positivity based on the detection of mbr or mcr in paraffin-embedded tissue samples. Material and Methods: The study included 32 paraffin-embedded tissue samples collected from 32 consecutive FL patients that were diagnosed and followed-up at our hospital between 1999 and 2006. The MBR breakpoint was identified based on real-time PCR using a LightCycler v.2.0 t(14;18) Quantification Kit (MBR), multiplex PCR, and seminested PCR. To identify the mcr breakpoint, real-time PCR was performed using specific primers and the FastStart DNA Master SYBR Green I Kit. To detect t(14;18) via fluorescence in situ hybridization (FISH) nuclei from paraffin-embedded tissue sections were extracted and used together with LSI IgH (immunoglobulin heavy chain) (spectrum green)/bcl-2 (B-cell leukemia-lymphoma 2) (spectrum orange) probes. Results: The DNA and nuclei isolation success rate for B5 formalin-fixed, paraffin-embedded tissue sections (n = 12) was 42% and 33%, respectively, versus 95% and 60%, respectively, for 20 tissue sections fixed in formalin only. In all, 24 paraffin-embedded tissue sections were analyzed and mbr positivity was observed in the DNA of 82.14% via seminested PCR, in 53.57% via multiplex PCR, and in 28.57% via real-time PCR. We did not detect mcr rearrangement in any of the samples. In all, 15 of 16 patients (93.75%) whose nuclei were successfully isolated were observed to be t(14;18) positive via the FISH method. Conclusion: Semi-nested PCR and FISH facilitated the genetic characterization of FL tumors. As such, FISH and PCR complement each other and are both essential for detecting t(14;18) translocation