Use of bosutinib in patients with chronic phase CML: A single center experience

Kronik Myeloid Lösemide (KML), etyolojisinde sorumlu tirozin kinaz aktivitesi gösteren bcr-abl füzyon geninin keşfinden sonra, bu aktiviteyi inhibe eden ilaçların keşfiyle, daha uzun sağkalım sürelerine ulaşılabilmiştir. Bu ilaçlarla tedaviye zamanla direnç gelişmesi, ikinci ve üçüncü kuşak ajanların geliştirilmesinin önünü açmıştır. Bu çalışmamızda, merkezimizde ikinci kuşak tirozin kinaz inhibitörü (TKİ) – bosutinib - tedavisi alan hastaların, klinik, laboratuvar, moleküler yanıt, yan etki profili ve mortalite üzerindeki etkilerini değerlendirmeyi amaçladık. KML nedeniyle bosutinib tedavisi başlanan 17 hasta çalışmaya dahil edildi. Hastaların tedaviye kaçıncı sırada başlandığı, klinik, laboratuvar ve moleküler yanıt durumları retrospektif olarak elektronik hasta kayıtlarından tarandı. Elde edilen veriler hastaların ilaç başlanma sırasına göre karşılaştırıldı. İkinci (n=2), üçüncü (n=7) ve dördüncü (n=8) sırada bosutinib başlanan hastaların yaş, cinsiyet, komorbidite sayısı, bosutinib tedavi süresi açısından anlamlı bir fark gözlenmezken KML tanı yaşları arasında anlamlı bir farklılık mevcuttu. Moleküler yanıt ve yan etki profili açısından değerlendirildiğinde, ilacın başlanma sırası ile anlamlı bir farklılık yoktu. Hastaların genel sağkalımı 43,38 ± 4,98 ay (%95 GA: 33,62 – 53,16 ay) olarak gözlemlendi. Bosutinib tedavisinin her yaş grubunda, ilacın her başlanma sırasında kullanımının, stabil moleküler yanıt sağlaması açısından güvenli olduğu gözlemlendi. Yan etki profili açısından kullanımını sınırlayacak bir profile sahip olmaması nedeniyle KML tedavisinde tercih edilebilir bir molekül olarak düşünülmelidir.After the discovery of the bcr-abl fusion gene, which shows the tyrosine kinase activity responsible for its etiology in Chronic Myeloid Leukemia (CML), longer survival times have been achieved with the discovery of drugs that inhibit this activity. The development of resistance to treatment with these drugs over time paved the way for the development of second and third generation agents. In this study, we aimed to evaluate the effects of patients receiving second generation tyrosine kinase inhibitor (TKI) - bosutinib - treatment on clinical, laboratory, molecular response, side effect profile and mortality in our center. Seventeen patients who were started on bosutinib therapy for CML were included in the study. The order in which the treatment was initiated, the clinical, laboratory and molecular response status of the patients were retrospectively scanned from electronic patient records. The data obtained were compared according to the order of initiation of the drugs of the patients. While no significant difference was observed among the second-line (n=2), third-line (n=7) and fourth-line (n=8) bosutinib treated patients in terms of age, gender, number of comorbidities, and duration of bosutinib treatment, there was a significant difference between the ages of CML diagnosis. There was no significant difference with the order of initiation of the drug and molecular response and side effect profile. The overall survival of the patients was 43.38 ± 4.98 months (95% CI: 33.62 – 53.16 months) Conclusion: It was observed that the use of bosutinib treatment was safe in all age groups at each initiation order and provide a stable molecular response. Since it does not have a side-effect profile that would limit its use, it should be considered as a preferred molecule in CML treatment

Retrospective analysis of Turkish AML registry database, on behalf of AML working group of Turkish society of hematology

Abstract Introduction: To investigate the demographics and treatment details of the acute myeloid leukemia (AML) patients who were diagnosed and followed up in Turkey. Methods: Patients who were recorded on the database of Turkish AML Registry project were included in this study retro- spectively if they were diagnosed before 1st of Jan 2022. Demographics, patient, and disease related parameters both at the time of diagnosis and at the follow up and treatment outcomes were presented

A real-life Turkish experience of venetoclax treatment in high-risk myelodysplastic syndrome and acute myeloid leukemia

Venetoclax is a selective B-cell lymphoma 2 (BCL2) inhibitor, which is approved to treat elderly patients with newly diagnosed acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS). A total of 60 patients with a median age of 67 years from different centers were included in the final analysis. Our real-life data support the use of venetoclax in patients with both newly diagnosed and relapsed high-risk MDS and AML. Introduction: Venetoclax is a selective B-cell lymphoma 2 (BCL2) inhibitor, which is approved to treat elderly patients with newly diagnosed acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) in combination with either low-dose cytarabine (ARA-C) or hypomethylating agents. We aimed to collect and share data among the efficacy and safety of venetoclax both as a monotherapy or in combination with other drugs used to treat high-risk MDS or AML. Materials and Methods: A total of 60 patients with a median age of 67 (30-83) years from 14 different centers were included in the final analysis. Thirty (50%) of the patients were women; 6 (10%) of the 60 patients were diagnosed with high-risk MDS and the remaining were diagnosed with AML. Results: The best objective response rate (complete remission [CR], complete remission with incomplete hematological recovery (CRi), morphological leukemia-free state [MLFS], partial response [PR]) was 35% in the entire cohort. Best responses achieved during venetoclax per patient number were as follows: 7 CR, 1 CRi, 8 MLFS, 5 PR, and stable disease. Median overall survival achieved with venetoclax was 5 months in patients who relapsed and not achieved in patients who were initially treated with venetoclax. Nearly all patients (86.7%) had experienced a grade 2 or more hematologic toxicity. Some 36.7% of these patients had received granulocyte colony stimulating factor (GCSF) support. Infection, mainly pneumonia (26.7%), was the leading nonhematologic toxicity, and fatigue, diarrhea, and skin reactions were the others reported. Conclusion: Our real-life data support the use of venetoclax in patients with both newly diagnosed and relapsed high-risk MDS and AML

CD5 as a prognostic marker in patients with diffuse large B-cell lymphoma: a multicenter study

© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL) and comprises a heterogeneous group of disease. While classification of B-cell lymphomas has been evolving to include clonality in a specific manner, morphology, and immunohistochemistry remain the backbone. We aimed to evaluate the value of CD5 expression on disease characteristics as well as prognosis in patients with DLBCL. Data of 131 patients with DLBCL with CD5 positivity and as a comparison arm, data of 129 patients with DLBCL without CD5 positivity were evaluated. Mean age was 59 and 55.7% of the patients were male. Overall survival was 29.8 months. Poor prognostic factors including (high-LDH levels, B symptoms, low ECOG score, high R-IPI and NCCN-IPI score) were observed to be significantly related with CD5 positivity. Mean survival in CD5 positive patients were 29.8 months, which is significantly shorter than the general DLBCL survival worldwide. CD5 expression shall be evaluated in all samples of DLBCL patients due to its possible effects on outcomes

Prospective Real-World Outcomes of Acute Myeloid Leukemia

Prospective real-word outcomes of acute myeloid leukemia</p