Impact of Hemoglobin, Leucocyte and Thrombocyte Levels at Diagnosis on the Survival Outcomes of Chronic Myeloid Leukemia Patients

Background:Since the development of tyrosine kinase inhibitors (TKIs), the prognosis for chronic myeloid leukemia (CML) has significantly improved. Several predicted prognostic scores and indicators at diagnosis have been used to predict the prognosis of chronic phase chronic myeloid leukemia (CML-CP) during the TKI period. When CML patients are first diagnosed, hemogram parameter aberrations are rather prevalent in clinical practice, although it is still unknown how those parameters affect the prognosis. This study aims to evaluate the hemogram parameters at diagnosis on the survival outcomes of CML-CP patients. Materials and Methods:One hundred thirty-seven patients who were diagnosed with CML-CP and received treatment were assessed between the years 2006 and 2020. Results:There were 65 (47.4%) males and 72 (52.6%) females with a median age of 50 (range: 18-78) years at diagnosis. Median hemoglobin level was 12.1 gr/dL (4.3-17.4), leucocyte count was 66.2 ×109 /L (7.5-520.2), and thrombocyte count was 362 ×109 /L (18-3.496) for all patients. The median progression-free survival (PFS) was 16.7 months 16.7 (2.0-106.4) and the median overall survival (OS) was 63.8 months (0.43-166.2) for all patients. Conclusion:This study is valuable in terms of predicting the prognosis of CML patients with hemoglobin, leukocyte, and platelet values at the time of diagnosis. While emphasizing the importance of platelet count at the time of diagnosis, similar to the previously defined risk scores, it showed that leukocyte and hemoglobin values at the time of diagnosis did not have a statistically significant effect on OS and PFS

Retrospective Evaluation of Patients Diagnosed with Diffuse Large B Cell Lymphoma (DLBCL)

Aim: Diffuse Large B Cell Lymphoma (DLBCL) is the most common NHL and %80 of all NHLs. Although it has some subtypes with heterogenous characteristic for prognosis, in area of rituximab monoclonal anti-body, improvement in overall survival (OS) was achieved. We evaluated response of treatment, epidemiologic features, OS and progression-free survival (PFS) of our patients with DLBCL for 5-years retrospectively.Materials and Methods: We investigated 160 patients from three centers in Turkey. Demografic features, stages, risk groups, the type of first-line therapy and its reason, duration of remission, relapse status and adverse events were collected. Package for the Social Sciences (SPSS) 22.0 program were used for statistical analysis. Dates of survival and significancies were obtained by Kaplan-Meier analysis and long-rank test, respectively. Analyses with p values below 0.05 were recognized as statistically significant.Results: Mean age of patients at the time of diagnoses was 60.75 ± 13.95. Number of patients with only nodal involved and extranodal involved were 109 (%68,1) and 51 (%31,9), respectively. Frequency of relaps after the first therapy was significancy superior in males than females. Althought there was no significant differencies between stage and OS, and response to treatment (p=0,140 ve p=0,378), significant difference was obtained between stage and PFS (p=0,038). In additon there wasn’t significant differencies between OS and PFS among patients with nodal and extranodal involved. Otherwise patients with advance age adjuested international prognostic index (aaIPI) scores had significancy inferior rate of response of first treatment (p=0,031).Conclusion: We demosrated the characteristics of patients with DLBCL as a general population and other else results related risk factors were similary with literatures

Have COVID-19 pandemic restrictions impacted the functioning of the hematology clinic?

Amaç: Çalışmamızın amacı, kısıtlamaların uygulandığı COVID-19 pandemi sürecinde hematoloji klinik işleyişinin değerlendirilmesidir. Hastalar ve Yöntem: Pandeminin ilk döneminde sokağa çıkma kısıtlamalarının uygulandığı 13.03.2020-15.05.2020 ile bu tarih aralığına karşılık gelen 2019 döneminde Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi ve İstanbul Medipol Üniversitesi Tıp Fakültesi Erişkin Hematoloji kliniklerine yatışı yapılan hastalar retrospektif olarak değerlendirildi. Bulgular: Her iki dönemde de yatan hasta sayısı 266 idi. 65 yaş üstü hasta oranı anlamlı olmamakla birlikte 2020’de daha düşük saptandı (%33.1’e kaşın %40.6, p= 0.72). Pandemi döneminde 2019’a göre tanısal amaçlı yatışı yapılan hasta sayısı anlamlı olarak yüksek (OR: 2,1, %95 GA: 1.35-3.26, p< 0.001); herhangi bir enfeksiyon nedeniyle yatış oranı ise düşük (OR: 0,44, %95 GA: 0.27-0.71, p< 0.001) bulundu. Tanısal amaçlı yatış yapılan hastalarda 2020 yılında hem erkek hasta oranı yüksek (OR: 0.4, %95 GA: 0.18-0.92, p= 0.031) hem de yatış süresi daha uzun (medyan 7’ye 14 gün, p= 0.007) bulundu. Kemoterapi, destek ve mobilizasyon amaçlı yatışlar arasında fark saptanmadı. Replasman ihtiyacı nedeniyle yatışı yapılan hasta oranı yine pandemic döneminde yüksek iken (OR: 4.7, %95 GA: 1.7-12.6, p< 0.001), tüm hastalar değerlendirildiğinde kan ürünü kullanımı sıklığı iki yıl arasında farklı değildi. Sonuç: Çalışmamız, kısıtlamalar sürecinde hematoloji hasta yönetiminin önemini ve işlevselliğinin değişmediğini vurgulamaktadır.Objective: The aim of our study is to assess the clinical functioning of hematology during the COVID-19 pandemic when lockdown restrictions are enforced. Patients and Methods: Patients who were admitted to Necmettin Erbakan University Meram Medical Faculty and Istanbul Medipol University Medical Faculty Adult Hematology clinics between March 13, 2020, and May 15, 2020, when lockdown restrictions were enforced in the first phase of the pandemic were evaluated retrospectively by comparing them with those who were admitted to same clinics between March 13, 2019, and May 15, 2019. Results: The number of inpatients during both periods was 266. It was determined that during the period of the pandemic, the number of patients hospitalized for diagnostic purposes was significantly higher compared to 2019 (OR: 2.1, 95% CI: 1.35-3.26, p< 0.001), whereas the rate of hospitalization due to any infection was significantly lower (OR: 0.44, 95% CI: 0.27-0.71, p<0.001). Of the patients who were hospitalized for diagnostic purposes in 2020, both the rate of male patients was higher (OR: 0.4, 95% CI: 0.18-0.92, p= 0.031) and the duration of hospitalization was longer (7 vs. 14 days; p= 0.007) found. While the rate of patients hospitalized due to the need for replacement was also higher during the period of pandemic (OR: 4.7, 95% CI; 1.7-12.6, p< 0.001), when all patients were assessed, the frequency of blood product use was not different between two years. Conclusion: Our study highlights the cruciality and functionality of hematology patient management during the period of lockdown restrictions

A Real-Life Turkish Experience of Ruxolitinib in Polycythemia Vera

Introduction:Ruxolitinib is a small -molecule inhibitor of the JAK1/2 pathway. This study aimed to reveal the results and side-effect profile of the use of ruxolitinib as a treatment option in polycythemia vera (PV).Methods:A total of 34 patients with PV from 18 different centers were included in the study. The evaluation of the response under treatment with ruxolitinib was determined as a reduction in spleen volume (splenomegaly size: ≥35%) by imaging and control of hematocrit levels (≤45%) compared to baseline.Results:While the number of patients in which a reduction in spleen volume and hematocrit control was achieved was 19 (55.9%) at 3 months of treatment, it was 21 (61.8%) at 6 months. Additionally, while the number of side effects was negatively correlated with the reduction in spleen volume (Spearman’s rho: -0.365, p=0.034), a decrease in the hematocrit level was positively correlated (Spearman’s rho: 0.75, p=0.029). Those without a reduction in spleen volume experienced more constipation (chi-square: 5.988, Fisher’s exact test: p=0.033).Conclusion:This study shed light on the use of ruxolitinib in PV and the importance of splenomegaly on studies planned with larger patient groups

Chronic Myeloid Leukemia After Chemoradiotherapy in a Patient with Non-Small Cell Lung Cancer

WOS:00041958630000

İbrutinib sonrası gelişen dev ekimoz ve hematom: Olgu sunumu

Kronik lenfositik lösemi ve Mantle hücreli lenfoma da yeni bir tedavi seçeneği olan ibrutinib, yüksek etkinliği ile günümüzde sık kullanılmaya başlanmıştır. Hedefe yönelik monoklonal antikorların yan etkileri sitotoksik tedavilere göre daha hafif seviyede görülmektedir. İbrutinibin de ishal, bitkinlik, ateş, bulantı, kanama, sitopeniler, alerjik reaksiyonlar gibi yan etkileri görülmektedir. Kanama %50 den fazla vakada görülmüştür. Çoğunluğu peteşiyal kanamalar olmasına rağmen hayati tehdit eden kanamalara da yol açmaktadır. Bizde ibrutinibin kanamaya eğilimi olan hastalarda dikkatli kullanılmasını vurgulamak amacıyla, ibrutinib sonrası kanama gelişen vakamızı sunduk.Ibrutinib, a novel therapeutic agent with increasing use as a highly effective treatment in Chronic lymphocytic leukemia and Mantle cell lymphoma, is associated with a lower incidence of side effects as compared to cytotoxic agents due to its mechanism of action involving targeted monoclonal- antibodies. However, ibrutinib may also cause side effects such as diarrhea, fatigue, fever, nausea, bleeding, cytopenia, or allergic reactions. Bleeding has been reported to occur in more than 50% of the patients, mostly in the form of petechial bleedings. However, life-threatening bleeding may also occur. Herein, we report a case with bleeding occurring after ibrutinib treatment in order to underscore the importance of careful use of this agent in patients with a predisposition for bleeding