4 research outputs found
Hematopoietik Kök Hücre Nakli Olmuş Hastalarda JC Virüs Pozitifliğinin Gerçek-Zamanlı Polimeraz Zincir Reaksiyonu ile Araştırılması
Pre-transplant sTIM-3 levels may have a predictive impact on transplant outcome in acute leukemia patients
Objectives:T-cell immunoglobulin and mucin domain-containing protein-3
(TIM-3) is considered as a negative regulator of T-cell driven immune
response. This study is planned to investigate the prognostic role of
pre-transplant soluble TIM-3 (sTIM-3) levels in allogeneic hematopoietic
stem cell transplantation (allo-HSCT) recipients.Methods:Pre-transplant
serum sTIM-3 levels were measured in 177 allo-HSCT recipients {[}median
age: 36(16-66) years; male/female: 111/66].Results:Pre-transplant sTIM-3
levels were significantly higher in acute myeloid leukemia (AML)
patients compared to acute lymphoblastic leukemia (ALL) patients (p =
0.01). Pre-transplant sTIM-3 levels were significantly lower in patients
with abnormal cytogenetics (p = 0.017). Pre-transplant sTIM-3 levels
were significantly higher in patients who developed viral hemorrhagic
cystitis (p = 0.034). A positive correlation was demonstrated between
sTIM-3 levels and acute graft versus host disease (GvHD) grade (p =
0.013;r = 0.299). Overall survival (OS) was not statistically different
between low- and high-TIM-3 groups (\%35.2 vs \%20.4;p > 0.05). Primary
diagnosis (p = 0.042), sinusoidal obstruction syndrome (p < 0.001),
acute GvHD (p = 0.001), chronic GvHD (p = 0.009) and post-transplant
relapse (p = 0.003) represented significant impact on
OS.Discussion:Increased sTIM-3 levels in AML patients seem to be
compatible with the previous reports. The inhibitor role of TIM-3 in
cellular immune response may be a possible explanation for the
association of sTIM-3 with viral infections and GvHD. However, the main
challenge remains to be the ambiguous association of pre-transplant
sTIM-3 levels and post-transplant complications, as allo-HSCT recipients
are expected to represent donor genetic features in the post-transplant
setting.Conclusion:Further studies are warranted to clarify the
particular role of sTIM-3 in the allo-HSCT setting
Evolution of clinical characteristics of patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab in turkey: a multicenter retrospective analysis
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare X-linked genetic disorder. On the contrary to its name, it is a multisystemic disease and various symptoms other than hemoglobinuria could be occurred. It could be life threatening especially because of thromboembolic events. In the last decade, a terminal complement inhibition with eculizumab approved with promising results for PNH patients. We conducted this study to evaluate the long term experience of eculizumab therapy from Turkey for the first time. Our cohort included 138 patients with PNH treated with eculizumab between January 2008 and December 2018 at 28 centers in Turkey. Laboratory and clinical findings at the time of diagnosis and after eculizumab therapy were recorded retrospectively. The median age was 39 (range 18-84) years and median granulocyte PNH clone size was 74% (range 3.06-99.84%) at the time of diagnosis. PNH with bone marrow failure syndrome was detected in 49 patients and the rest of 89 patients had classical PNH. Overall 45 patients (32.6%) had a history of any prior thrombotic event before eculizumab therapy and only 2 thrombotic events were reported during the study period. Most common symptoms are fatigue (75.3%), hemoglobinuria (18.1%), abdominal pain (15.2%) and dysphagia (7.9%). Although PNH is commonly related with coombs negativity, we detected coombs positivity in 2.17% of patients. Seven months after the therapy, increased hemoglobin level was seen and remarkably improvement of lactate dehydrogenase level during the treatment was occurred. In addition to previous studies, our real life data support that eculizumab is well tolerated with no serious adverse events and improves the PNH related findings