Gilteritinib (XOSPATA (R)) in Turkey: Early access program results

Background And Objectives: Gilteritinib (XOSPATA (R), Astellas) is a type I oral FLT3 inhibitor, a tyrosine kinase AXL inhibitor, involved in both c-Kit and FMS-like tyrosine kinase 3 (FLT3) resistance. In the phase 3 ADMIRAL trial, gilteritinib was compared with the standard of care in (R/R) acute myeloid leukemia (AML) patients who harbored any FLT3 mutation and showed superior efficacy with regard to response and survival. Objectives: This research aimed to investigate the real-life efficacy and safety of gilteritinib in FLT3-positive R/R AML patients who were treated as a part of an early access program held in Turkey in April 2020 (NCT03409081). Results: The research included 17 R/R AML patients who had received gilteritinib from seven centers. The overall response rate was 100%. The most common adverse events were anemia and hypokalemia (7 patients, 41.2%). Grade 4 thrombocytopenia was observed in one patient only (5.9%), leading to permanent treatment discontinuation. Patients with peripheral edema had a 10.47 (95% CI: 1.64-66.82) times higher risk of death than those without peripheral edema (p<0.05). Conclusion: This research showed that patients with febrile neutropenia and peripheral edema were at a high risk of death when compared to patients without febrile neutropenia and peripheral edema

Comparison of Voice Quality and Cost Effectiveness of Endoscopic Cordectomy Using Microdissection Electrodes with Laser Cordectomy and Radiotherapy

Objective: To compare the acoustic parameters and the cost effectiveness achieved after endoscopic cordectomy using radiofrequency microdissection electrodes (ECRM) with those of transoral laser cordectomy and radiotherapy.Methods: The study included 81 disease-free patients previously treated for early larynx carcinoma (30 with ECRM, 27 with transoral laser cordectomy, 24 with primary radiotherapy). Post-treatment voice analysis was performed in all patients. Additionally, the cost effectiveness of all treatment procedures was calculated.Results: The GRBAS (G: Grade, R: Roughness, B: Breathiness, A: Asthenia, and S: Strain) scale showed a significant difference between the groups (p0.05 for all). Percent jitter, percent shimmer and fundamental frequency (F0) were significantly different in the radiotherapy group than the ECRM and the transoral laser cordectomy groups (p0.05). The mean cost of the ECRM technique was statistically lower than the other treatment techniques (p<0.05). Moreover, the length of hospital stay after ECRM was statistically significantly shorter than was after laser cordectomy (p<0.05).Conclusion: Objective and perceptive voice analysis after ECRM showed comparable results with transoral laser cordectomy, but poorer results than radiotherapy. Cost effectiveness of ECRM was found to be better than the other two treatment techniques

Glofitamab in relapsed/refractory diffuse large B cell lymphoma: Real world data

Abstract INTRODUCT ̇ION Glofitamab is a T-cell-engaging bispecific antibody connecting CD20 on B cells and CD3 on T cells. Although, most of the patients with B-cell non-Hodgkin lymphoma (BNHL) achieve complete response (CR) following firstline treatment with rituximab and chemotherapy, about 40% of patients with diffuse large B-cell lymphoma (DLBCL) is refractory or relapse (R/R). Autologous stem-cell transplantation (ASCT) can cure some of these patients but many patients cannot undergo this procedure. CAR-T therapies are a significant advance but not available in many countries like Turkey. In Phase II expansion study, the overall response rate (ORR) was 51.6% and complete remission (CR) rate was 39.4% in R/R DLBCL patients (Dickinson er al. JCO 2022). In this retrospective study, we aimed to report the outcomes of patients who used glofitamab via compessionate use in Turkey

Polatuzumab vedotin, rituximab, and bendamustine combination in relapsed or refractory diffuse large B-cell lymphoma: A real-world data from Turkey

Polatuzumab vedotin (Pola) with bendamustine and rituximab (BR) is a promising option for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We analyzed the data of 71 R/R DLBCL patients who had been treated with Pola-BR in the named patient program from March 2018 to April 2021 from 32 centers in Turkey. All patients received up to six cycles of Pola 1.8 mg/kg, rituximab 375 mg/m2 on day 1, and bendamustine 90 mg/m2 on days 1–2 of each cycle. Median age at Pola-BR initiation was 55 (19–84). The overall response rate was 47.9%, including 32.4% CR rate when a median of 3 cycles was applied. With a median follow-up of 5 months, the median OS was 5 months. Grade 3–4 neutropenia and thrombocytopenia were the most common hematological toxicities. The real-world data from our cohort showed the Pola-BR is an effective option with a manageable toxicity profile

<i>A Ritual of Buddhism in Old Uyghur: Bakcan Olur-</i>

Buddhism has a wide range of rituals, most of which are mentioned with regard to practices carried out around monasteries. The term bakchan is used in Old Uyghur for one of these practices and mostly recommends dwelling in one place for a period of time, such as a residence or place of retreat during the three months of the summer rains. Accordingly, this article will attempt to identify the conceptual area of the term in light of examples from Old Uyghur texts and furthermore determine the protolanguage and the lexical cognates that are the source of the Old Uyghur form, emphasizing these sources' dimensions of shape and meaning. In addition, this article will detail the different spellings of the Old Uyghur term according to different texts and interpret the factors that have affected the different spellings, as well as evaluate the compound verb structures formed by the Old Uyghur word using auxiliary verbs. The ritual appears to have emerged as a result of social pressure, and at its heart lies the principle of do not kill/do no harm, which is seen in all Indian beliefs and Buddhism. The article will separately discuss the effect and contribution of this principle regarding the development of the ritual in particular, as well as the bridge the ritual has created in Buddhism between migratory and permanent settlements. The article will seek out the importance of ritual, especially in terms of its contribution to the Buddhist community and monasticism

Yatırım Araçlarının Enerji Değişimlerinin Faz Düzlemleri Aracılığıyla İncelenmesi

Bu çalışmada, Türkiye'deki insanların son yıllarda artan enflasyonnedeniyle yatırım yapma eğilimi ele alınmaktadır. Araştırma, yatırımaraçlarının ekonomik dönemlere göre değişen davranışlarını anlamak için ikincidereceden faz düzlemlerini kullanmaktadır. Bu düzlemler, enerji değişimlerininve sistemdeki dinamiklerin zaman ekseni boyunca görsel olarak incelenmesineolanak tanır. İki boyutlu faz düzlemi, bir yatay ve bir dikey eksen üzerinden potansiyelve kinetik enerji ilişkisini yansıtır. Potansiyel enerji ivme ve kinetik enerjihızla ilgilidir. Sistemin iki durum arasında hareket ettiği harmonik davranışorijini çevreleyen bir döngü gösterir. Bu döngünün hareketinin orijin etrafındasaat yönünde olması gereklidir. Döngünün yarıçapı büyüdükçe sistem daha fazlaenerjiye sahip olur, bu da incelenen değişkenin hareketlerinin büyüklüğünügösterir. Yatırım araçları olarak dolar, euro,BİST-100 endeksi ve çeşitli kripto paralar incelenmiştir. Dönem olarakise pandemi sürecinin önemli etkisi de düşünülerek2020-2023 yılları baz alınmıştır.Çalışma sonucunda özellikle pandemi sürecinde kripto paraların enerjideğişimlerinin çok daha yüksek olduğu döngülerin genişliğinden görülmektedir. Diğeryatırım araçlarındaki dalgalanmalar ise çok daha küçüktür. Aynı zamanda fazdüzlemleri benzer olan yatırım araçlarının benzer dalgalanmalar içerdiği desöylenebilir. Bu durumda özellikle gümüş ve altın, dolar ve Euro ve kriptoparalar da kendi içlerinde benzer davranışlar göstermektedir. Bu bulgular, yatırımcılarıntercihlerine yönelik bilgiler sunarak, daha bilinçli yatırım kararlarıalınmasına katkıda bulunabilir.</p

Comparison of copper intrauterine device with levonorgestrel-bearing intrauterine system for post-abortion contraception

WOS: 000362674400018PubMed ID: 26180028Aim: The aim of this study was to compare the safety, bleeding pattern, effects, side-effects, complications and 6-month continuity rates of levonorgestrel-bearing intrauterine system (LNG-IUS) with conventional copper intrauterine device (Cu-IUD) inserted immediately after voluntary termination of pregnancy up to 10weeks of gestation. Methods: One hundred women who underwent voluntary pregnancy termination and preferred IUD insertion as a contraceptive method after counseling were enrolled. The patients were randomly allocated to Cu-IUD or LNG-IUS and followed up at 10 days, and at 1, 3 and 6 months. The expulsion rates, continuation rates, side-effects, and bleeding patterns were compared. Results: Fifty women in the Cu-IUD group and 44 women in the LNG-IUS group were followed up. The continuity and expulsion rate for Cu-IUD and LNG-IUS at the end of 6months was 74%, 12%, and 75%, 11.3%, respectively. In LNG-IUS users, the incidence of amenorrhea and the number of spotting days were higher and hemoglobin increased throughout the follow-up period. The side-effects related to both methods were not different from interval insertions. Conclusion: Immediate post-abortion intrauterine contraception with Cu-IUD or LNG-IUS is a safe, reliable method. The incidence of side-effects is similar, and there is only a slightly higher rate of expulsion but an acceptable rate of method continuation