Clinical Features and Treatment Strategies of Primary Central Nervous System Lymphoma: a Multicenter Retrospective Study

DergiPark: 379015tmsjAims: Primary central nervous system lymphoma is a rare, highly malignant disease with poor prognosis. Thecurrent knowledge about the disease is mostly gathered from prospective clinical trials and the optimal treatment modality is still a matter of debate. In this study it is aimed to acquire more information about the clinical features of the disease and the responses to different treatment modalities.Methods: The archives in Trakya University Hospital, İnönü University Turgut Özal Medical Center, PamukkaleUniversity Hospital and Erciyes University Hospital researched retrospectively. Demographic, treatment and survival data were retrieved and their statistical analysis was performed. As descriptive statistics number and percentages, arithmetic mean ± standard deviation, median (maximum-minimum) were used. Survival analysis was performed using Kaplan- Meier method.Results: Median age of patients at diagnosis was 53 and out of 28 patients 15 (53.6 %) of them were male. As the symptoms of the disease 18 (66.7%) patients presented headache, 15 (53.8%) presented focal deficit. As initial treatment 26 (92.9%) patients received chemotherapy, while 19 (67.9%) patients were treated with surgical resection and the median overall survival time was 7 months. Conclusion: Achieving complete remission as response to the initial treatment is associated with an improvedoverall survival. Other survival analysis to compare the impact of all initial treatment methods on overall survival resulted statistically insignifican

Retrospective Analysis of Flow Cytometry Results: Experience of a single center

Amaç: Akış sitometrisi (AS) çeşitli hücrelerin bir süspansiyon halinde bir akış kanalı boyunca tek tek geçmesi ve bu esnada hücre büyüklük ve içeriğine göre sınıflandırılması esasına dayanan florokromojenik-lazer tabanlı bir tanı yöntemidir. Hematolojik malignitelerin tanısı AS cihazının en fazla kullanım alanıdır. Mevcut çalışmada hastanemiz AS laboratuvarına gönderilen örneklerin yıllara göre dağılımlarını, istek yapan bilim dalının dağılımını, gönderinin yapıldığı örnek tipini ve tanı-izlemde ASnin yerini değerlendirmeyi hedefledik. Yöntem ve Gereçler: Trakya Üniversitesi Tıp Fakültesi AS Laboratuvarına 01.01.2002 ile 01.01.2014 tarihleri arasında gönderilerek değerlendirilen AS testleri geriye dönük olarak değerlendirildi. Elde edilen parametreler ta- nımlayıcı istatistik çerçevesinde değerlendirildi. Sonuç: Bu zaman zarfında toplam 4874 adet test değerlendirildi (Ortalama: 406 test/yıl). Örneklerin %18,7si çocuk yaştaki hastalardan (n=964) gönderilmişken, % 81,3ü (n=3910) erişkin hastalarından gönderilmişti. Gönderilen ör- neklerin %35,3ü (n=1725) kemik iliği, %58,2si periferik kan (n=2828), %6,5i (n=321) diğer vücut dokularından gönderilmişti. Örneklerin %20,2sinin (n=989) tanısında AS inceleme başrol oynamıştı. Örneklerin %18,5i (n=880) hastalıkların tedaviye yanıtlarının değerlendirilmesinde kullanıldı. Tanısı ASyle konulan hastaların %34,6sı akut myeloid lösemi, %32si kronik B-lenfoproliferatif hastalıklar, %19,5i akut lenfositer lösemi, %10,2si myelodisp- lastik sendrom, %3,2si kronik myeloid lösemi, %0,3ü Burkitt lösemi/lenfoma, %0,1i T-lenfoproliferatif hastalık ve %0,1i bifenotipik lösemiydi. Tartışma: Tek merkez verilerinin değerlendirildiği bu çalışma tanı konulması istenilen hastalıkların ülkemizdeki sıklıklarını göstermesi açısından önemli veriler sunmaktadır. Yıllara göre dağılım ise merkezimizin deneyim artı- şını ve hastaların merkezimize ulaşımının kolaylaşması olarak değerlendirilebilir. Hastane verilerine dayalı geriye dönük çalışmaların yararları arasında hastalık sıklık verilerinin saptanmasında dolaylı bir yöntem olması sayılabilir.Aim: Flow Cytometry (FC) is a flourochromogenic-laser based diagnosis tool that is used to subclassify the cells due to their cell size and cytoplasmic content. Diagnosis of hematological malignancies is one of the most com- monly used field of application. In the present study we aimed to determine the distribution of samples per year, distribution of requesting departments (whether pediatric or adult), sample type (bone marrow, peripheral blood, cerebrospinal fluid or pleural fluid), and the usage of FC during diagnosis/follow up. Material and Methods: FC results were screened retrospectively from 01.01.2002 to 01.01.2014. Descriptive statistics were performed to analysis the results. Results: 4874 samples were revised (with a mean of 406 sample per year). 18.7% of the samples were from pediatric patients, 81.3 % were from adult patient population. %35.3 of the samples (n=1725) were obtained from bone marrow, 58.2 % (n=2828) were obtained from peripheral blood, 6.5 % (n=321) of the samples were obtained from other body fluids. FC was the leading diagnostic tool in 20.2 % (n=989) of the samples. 18.5% (n-880) of the samples were used for follow up of the patients. The distribution of the diagnoses that were established by the use of FC were 34.6 % acute myeloid leukemia, 32 % chronic B-lymphoprolipherative disease, 19.5 % acute lymphoid leukemia, 10.2 % myelodysplastic syndrome, 3.2 % chronic myeloid leukemia, 0.3% Burkitt leukemia/lymphoma, 0.1 % T-lymphoprolipherative disease ve 0.1 % biphenotypic leukemia. Discussion: The present study demonstrated important results about the disease incidence in Turkey. The elevated sample size in following years might be due to increased experience, and easy accessibility of patients to our facility. To be an indirect tool to demonstrate disease distribution is one of the benefits of retrospective analysis of hospital data

Serum Angiopoietin Levels are Different in Acute and Chronic Myeloid Neoplasms: Angiopoietins do not only Regulate Tumor Angiogenesis

Molecular balance between Angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2) has important effects in tumor angiogenesis. Ang-2 was shown to be elevated and proved to be a prognostic factor in acute myeloid leukemia (AML). To date studies revealed increased angiogenesis in bone marrows (BMs) of both myeloproliferative neoplasm (MPN) and AML patients. We conducted this study to demonstrate circulating levels of Ang-1 and Ang-2 in MPN patients since no data exists in literature. Thirty-three newly diagnosed MPN, 27 newly diagnosed AML patients and 25 controls (HC) were enrolled and Angiopoietin levels were determined with ELISA. We found that Ang-1 levels were higher whereas Ang-2 levels were lower in MPN and HC when compared to AML. Our results suggest that though angiogenesis is increased in both AML and MPN, angiopoietin serum level profile of the two diseases are different, and MPN patients have similar Ang-1 and Ang-2 levels as HC. We conclude that, according to our results Ang-1 and Ang-2 do not only regulate tumor angiogenesis and the difference between angiopoietin levels of acute and chronic myeloid neoplasms could be a reflection of other effects of these growth factors on tumor malignancy

Could the mosaic pattern of chromosomal abnormality predict overall survival of patients with myelodysplastic syndrome?

Objective/background: Myelodysplastic syndromes (MDSs) are a group of monoclonal hematopoietic diseases consisting of a number of various entities. The presence of differences in chromosomal content of cells within the same individual is known as chromosomal mosaicism. The impact of mosaic pattern on the prognosis of MDS has been unclear. In this study, we aimed to determine the impact of mosaic pattern on the survival of patients with MDS. Methods: We retrospectively evaluated 119 patients diagnosed with MDS at the Trakya University Faculty of Medicine, Department of Hematology. Giemsa–Trypsin–Giemsa banding was used to evaluate chromosomal abnormality.The effect of chromosomal abnormality mosaicism on overall survival and transformation to acute leukemia was evaluated by Kaplan–Meier survival analysis. Results: The mean age at diagnosis was 66.3 years, and the mean disease duration was 24.2 months. Chromosomal abnormality was observed in 32.5% of patients. Patients with chromosomal abnormalities comprising at least 50% metaphases had significantly lower overall survival than patients with abnormality comprising up to 50% of all abnormal metaphases (p = .003). There were no differences in transformation to acute leukemia among patients with higher and lower chromosomal mosaicism (p = .056). Conclusion: The most important outcome of this study was to demonstrate worse overall survival rates in MDS patients with higher abnormal chromosomal mosaicism than patients with lesser abnormal chromosomal mosaicism. Higher levels of abnormal chromosomal mosaicism did not predict transformation to acute leukemia. The cause of worse outcomes of patients with higher abnormal chromosomal mosaicism may be related to clonal mass. Keywords: Chromosomal abnormality, Mosaicism, Myelodysplastic syndrome, Prognosi

2009 H1N1 Influenza and Experience in Three Critical Care Units

Aim: We describe futures of ICU admission, demographic characteristics, treatment and outcome for critically ill patients with laboratory-confirmed and suspected infection with the H1N1 virus admitted to the three different critical care departments in Turkey