The High Effect of Chemomobilization with High-Dose Etopside + Granulocyte-Colony Stimulating Factor in Autologous Hematopoietic Peripheral Blood Stem Cell Transplantation: A Single Center Experience

Autologous hematopoietic stem cell transplantation (auto-HSCT) provides hematopoietic support after high-dose chemotherapy and is the standard of care for patients with multiple myeloma (MM), chemo sensitive relapsed high or intermediate grade non-Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL). However, yields of hematopoietic stem cells vary greatly between patients, and the optimal strategy to mobilize hematopoietic stem cells into peripheral blood for collection has not been defined yet. We investigated the efficacy and safety of chemo mobilization with an intermediate dose etoposide (VP-16; 200 mg/m2 on days 1–3) and granulocyte-colony stimulating factor (G-CSF)(5 μg/kg twice daily from day 4 through the final day of collection). We reviewed our institutional experience with 91 patients (71 MM, 12 HL, 8 NHL) mobilized with this regimen. VP-16 + G-CSF resulted in successful mobilization in 95.55% of the patients (on one patient stem cell collection with plerixafor was applied), including 76 patients (83.52%) whose stem cells were collected successfully in a single day. Collection was managed between min. D8 and max. D17. Patient age, gender, exposure to previous irradiation and chemotherapy, previous mobilization attempts, and disease characteristics were not considered during selection. Adverse effects of the regimen included supportive transfusions and fevers requiring hospitalization or intravenous antibiotics. VP-16 and GCSF appears to be a safe and effective mobilization regimen for patients with multiple myeloma, non-Hodgkin’s lymphoma and Hodgkin’s lymphoma undergoing autologous stem cell transplantation, producing excellent stem cell yield with the majority of patients requiring 1 day of apheresis

Gastroenteropancreatic neuroendocrine tumors: 10-year experience in a single center

Neuroendocrine tumors originate from neuroendocrine cells and occur in a wide spectrum from carcinoid tumors to small cell carcinomas. Although the World Health Organization determined clinical and histological features to predict prognosis for such tumors, they may not be valid on an individual basis. This study investigates the clinical, pathologic and prognostic characteristics of gastroenteropancreatic neuroendocrine tumors that presented to the Medical Oncology Outpatient Clinic, A degrees stanbul University, CerrahpaAYa School of Medicine from 1995 to 2006 (n = 86). The mean age of the patients was 52 +/- A 14 and the male-to-female ratio was 0.87. The most common site of involvement was the stomach. Midgut intestinal tumors seemed to have significant female predominance compared to hindgut intestinal tumors (P = 0.016). Most of the patients had metastatic disease with a prevalence of 34.9%. Poorly differentiated tumors and mixed neuroendocrine carcinomas were significantly larger than 2 cm (P = 0.0001). The median survival was 139 months and the highest mortality was for colorectal tumors (36%). While univariate analysis revealed that the number of lymph nodes (P = 0.008), multiple foci (P = 0.034), metastases (P = 0.022) and stage (P = 0.034) correlated significantly with survival, there was no independent variable in the multivariate analysis. Hindgut tumors had significantly more Ki-67, mitosis and necrosis compared to others (P a parts per thousand currency sign 0.05). In this retrospective study, the clinical, pathologic and prognostic characteristics of gastroenteropancreatic tumors from a single center from Turkey were analyzed and compared with the current medical literature

Epidermal Growth Factor Receptor in CRC patients in the Era of the RAS

The aim of this study was to investigate EGFR expression patterns and the effect of EGFR expression on stage, prognosis and response to conventional chemotherapy agents other than monoclonal antibodies in CRC patients. This study included 59 metastatic CRC patients. The expression of EGFR was quantified by immunochemistry in biopsy specimens that were obtained before treatment was initiated. The cases were considered to be positive for EGFR if >1% of the tumor cells had complete circumferential membranous staining. The median age of the patients was 54.6 years, and 59% of the patients were male. Twenty-six patients presented with stage IV disease, and the remaining patients developed distant metastasis during follow-up. Fifty-one patients were treated with regimens containing irinotecan. The numbers of patients with EGFR expression in the primary tumors, the metastatic lymph nodes and the normal colonic tissue were 34 (65.4%), 10 (76.9%) and 34 (65.4%) respectively The initial disease stage and lymph node stage were correlated with EGFR expression (p<0.05). Additionally, EGFR positivity was correlated with a statistically significant reduction in the response rate to chemotherapy, the overall survival (21 vs. 28 months) and the progression-free survival (15 vs. 22 months) in metastatic patiens treated with chemotherapy other than targeted therapies. In conclusion, EGFR expression in correlated with stage in all CRC patients and response to chemotherapy and survival in metastatic CRC patients

The mean platelet volume may predict the development of isolated bone metastases in patients with breast cancer: a retrospective study of the Young Researchers Committee of the Turkish Oncology Group (TOG)

WOS: 000383306700010PubMed ID: 27685904Purpose: To determine the predictive value of the mean platelet volume (MPV) and the MPV/platelet count ratio on the development of isolated bone metastasis in patients with breast cancer. Methods: A total of 121 previously untreated female patients with isolated bone metastases from breast cancer (group 1) were included in this retrospective cohort study. The patients enrolled in this study had similar age, biological subtypes, and duration of follow-up after diagnosis. Group 1 was compared with both 71 previously untreated women with breast cancer with no metastases at all (group 2) and 39 healthy women (group 3). Demographic data, laboratory tests and histological features of all of the patients in groups 1 and 2 were recorded and the study variables from each of the three groups were compared. Results: In group 1, the cut-off value (9.2 fL) for the MPV was determined and patients were stratified into 4 subgroups. The MPV was higher in group 1 than in either group 2 or group 3. Group 1 patients had a MPV of 8.8 +/- 3.1 fL (mean 5.1, range: 6.1-15.6) and the cut-off value for MPV was 9.2fl. For patients in group 1, the MPV distribution was stratified into 4 groups as follows: group A included MPV values 10.06fL. MPV and the presence of lymphovascular invasion were found to be independent risk factors for the development of isolated bone metastases. Conclusion: We concluded that MPV can be used to predict the development of isolated bone metastases

Association KRAS G13D Tumor Mutated Outcome in Patients with Chemotherapy Refractory Metastatic Colorectal Cancer Treated with Cetuximab

Background/Aims: Cetuximab is currently approved for the treatment of metastatic colorectal cancer (mCR) with KRAS wild-type. Prior few studies demonstrated that G13D mutated tumors could benefit from cetuximab. This study aims to investigate whether KRAS G13D mutated tumors benefit from cetuximab in the chemotherapy refractory patients. Methodology: We retrospectively compared progression-free survival (PFS), overall survival (OS) and response rate (RR) according to KRAS mutation status in 105 patients with mRC treated at the Cerrahpasa Medical School Hospital, between October 2008 and October 2011, with cetuximab alone or in combination with chemotherapy. Results: PFS was significantly longer in patients G13D mutated tumors (6.81 months) than in patients with other KRAS mutated tumors (5 months) (p=0.027). No significant difference in PFS. between patients G13D mutated and KRAS wild-type tumors was detected. No significant difference in OS was detected in patients between G13D mutated tumors and other KRAS mutated tumors. However, patients with KRAS wild-type tumors had significantly longer OS (16.1 months) than patients with mutated tumors (8.9 months) (p=0.025). RR in patients with other KRAS mutated tumors, was significantly worse than those with G13D mutated tumors (p=0.002). Conclusion: Our study demonstrated an association between the presence KRAS G13D mutanted and survival chemotherapy in refractory metastatic colorectal cancer treated with cetuximab

Thymoma with chronic diarrhea

Thymoma associated with hypogammaglobulinemia and profound susceptibility to recurrent and serious infections was first reported by Good in 1954, after whom it was named as Good's syndrome. Chronic diarrhea associated with thymoma is almost always seen in patients with hypogammaglobulinernia. However, chronic diarrhea in a setting of normal gammaglobulins have been rarely reported. We hereby report two cases of thymoma with normal immune functions, presenting with chronic diarrhea as the only symptom of thymic malignancy. We discussed the etiopathogenic relation between thymic pathology and diarrhea and review the cases of thymoma associated with chronic diarrhea in the English literature