62 results on '"Antmen B"'
Search Results
2. Prediction of factor VIII inhibitor development in the SIPPET cohort by mutational analysis and factor VIII antigen measurement
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Spena, S., Garagiola, I., Cannavò, A., Mortarino, M., Mannucci, P.M., Rosendaal, F.R., Peyvandi, F., El‐Beshlawy, A., Elalfy, M., Ramanan, V., Eshghi, P., Hanagavadi, S., Varadarajan, R., Karimi, M., Manglani, M.V., Ross, C., Young, G., Seth, T., Apte, S., Nayak, D.M., Santagostino, E., Mancuso, M.E., Sandoval Gonzalez, A.C., Mahlangu, J.N., Bonanad Boix, S., Cerqueira, M., Ewing, N.P., Male, C., Owaidah, T., Soto Arellano, V., Kobrinsky, N.L., Majumdar, S., Perez Garrido, R., Sachdeva, A., Simpson, M., Thomas, M., Zanon, E., Antmen, B., Kavakli, K., Manco‐Johnson, M.J., Martinez, M., Marzouka, E., Mazzucconi, M.G., Neme, D., Palomo Bravo, A., Paredes Aguilera, R., Prezotti, A., Schmitt, K., Wicklund, B.M., and Zulfikar, B.
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- 2018
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3. Timing and severity of inhibitor development in recombinant versus plasma‐derived factor VIII concentrates: a SIPPET analysis
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Peyvandi, F., Cannavò, A., Garagiola, I., Palla, R., Mannucci, P.M., Rosendaal, F.R., El‐Beshlawy, A., Elalfy, M., Ramanan, V., Eshghi, P., Hanagavadi, S., Varadarajan, R., Karimi, M., Manglani, M.V., Ross, C., Young, G., Seth, T., Apte, S., Nayak, D.M., Santagostino, E., Elisa Mancuso, M., Sandoval Gonzalez, A.C., Mahlangu, J.N., Bonanad Boix, S., Cerqueira, M., Ewing, N.P., Male, C., Owaidah, T., Soto Arellano, V., Kobrinsky, N.L., Majumdar, S., Perez Garrido, R., Sachdeva, A., Simpson, M., Thomas, M., Zanon, E., Antmen, B., Kavakl, K., Manco‐Johnson, M.J., Martinez, M., Marzouka, E., Mazzucconi, M.G., Neme, D., Palomo Bravo, A., Paredes Aguilera, R., Prezotti, A., Schmitt, K., Wicklund, B.M., and Zulfikar, B.
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- 2018
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4. PHARMACOKINETIC-GUIDED PROPHYLAXIS BASED ON BAYESIAN MODEL WITH MYPKFIT (R) IN HEMOPHILIA A: TURKISH EXPERIENCE
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Zulfikar, B., Albayrak, D., Sasmaz, I., Celkan, T., Ozbek, N. Y., Turkkan, E., Canbolat, A., Karaman, S., Yagci, M., Evim, M., Ozdemir, G. N., Aytac, S., Koc, B., Albayrak, C., Balkan, C., Gulen, H., Ay, Y., Okan, V., Aksu, S., Ileri, T., Andic, N., Oymak, Y., Patiroglu, T., Sahin, F., Erduran, E., Kavakli, K., Kaya, Z., Yilmaz, B., Antmen, B., Soker, M., Zengin, E., Kupesiz, A., Oren, H., and Umit, E.
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- 2020
5. PRO45 NATIONAL BURDEN OF HEMOPHILIA A IN TURKEY
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Malhan, S., primary, Oksuz, E., additional, Antmen, B., additional, Ar, C., additional, Balkan, C., additional, and Kavakli, K., additional
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- 2019
- Full Text
- View/download PDF
6. A single center experience in Turkey in the molecular diagnosis of Hemophilia B
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Keskin, E. Y., Atik, T., Ozkinay, F., Isik, E., Akgun, B., Kavakli, K., Sahin, F., Evim, M. S., Albayrak, C., Kinturp, G. T., Antmen, B., and Onay, H.
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- 2019
7. Pharmacokinetic-guided prophylaxis based on bayesian model with myPKFiT (R) in hemophilia A: Turkish experience
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Balkan, C., Albayrak, C., Ozbek, N. Y., Kaya, Z., Sasmaz, I., Celkan, T., Yagci, M., Karaman, S., Erduran, E., Sahin, F., Ozdemir, G. N., Patiroglu, T., Oymak, Y., Turkkan, E., Evim, M. S., Gulen, H., Ay, Y., Okan, V., Aksu, S., Ileri, T., Salcioglu, Z., Andic, N., Yilmaz, B., Antmen, B., Albayrak, D., Oren, H., Kupesiz, A., Zengin, E., Soker, M., Ar, C., and Kavakli, K.
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- 2019
8. The use of port-a-cath in children with hemophilia in Cukurova region
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Sasmaz, H. I., Antmen, B., Karagun, B. S., Leblebisatan, G., and Çukurova Üniversitesi
- Abstract
WOS: 000457408400176 …
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- 2019
9. Deferasirox in children with transfusion-dependent thalassemia or sickle
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Antmen, B, Karakas, Z, Yesilipek, MA, Kupesiz, OA, Sasmaz, I, Uygun, V, Kurtoglu, E, Oktay, G, Aydogan, G, Akin, M, Salcioglu, Z, Vergin, C, Kazanci, EG, Unal, S, Caliskan, U, Aral, YZ, Turkkan, E, Gunes, AM, Tunc, B, Gumruk, F, Ayhan, AC, Soker, M, Koc, A, Oymak, Y, Ertem, M, Timur, C, Yildirmak, Y, Irken, G, Apak, H, Biner, B, Eren, TG, Balci, YI, Kocak, U, Karasu, G, Akkaynak, D, and Patiroglu, T
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hemoglobinopathy ,iron chelation ,iron overload ,pediatric ,transfusion - Abstract
Objectives To evaluate the long-term efficacy and safety of deferasirox therapy in a large observational cohort of children with transfusion-dependent thalassemia (TDT) and sickle cell anemia (SCA) in Turkey. Methods This was a multicenter, prospective cohort study including TDT and SCA patients aged 2-18 years with iron overload (>= 100 mL/kg of pRBC or a serum ferritin [SF] level >1000 mu g/L) receiving deferasirox. Patients were followed for up to 3 years according to standard practice. Results A total of 439 patients were evaluated (415 [94.5%] TDT, 143 [32.6%] between 2 and 6 years). Serum ferritin levels consistently and significantly decreased across 3 years of deferasirox therapy from a median of 1775.5 to 1250.5 mu g/L (P < 0.001). Serum ferritin decreases were noted in TDT (1804.9 to 1241 mu g/L), SCA (1655.5 to 1260 mu g/L), and across age groups of 2-6 years (1971.5 to 1499 mu g/L), 7-12 years (1688.5 to 1159.8 mu g/L), and 13-18 years (1496.5 to 1107 mu g/L). Serum ferritin decreases were also noted for all deferasirox dose groups but only significant in patients with doses >= 30 mg/kg/d (n = 120, -579.6 median reduction, P < 0.001). Only 9 (2%) patients had adverse events suspected to be related to deferasirox. Serum creatinine slightly increased but remained within the normal range. Conclusions Deferasirox has long-term efficacy and safety in children with TDT and SCA, although higher doses (>= 30 mg/kg/d) may be required to achieve iron balance. C1 [Antmen, Bulent] Acibadem Hosp, Adana, Turkey. [Karakas, Zeynep] Istanbul Univ, Med Fac, Istanbul, Turkey. [Yesilipek, Mehmet Akif; Kupesiz, Osman Alphan] Akdeniz Univ, Med Fac, Antalya, Turkey. [Sasmaz, Ilgen] Cukurova Univ, Med Fac, Adana, Turkey. [Uygun, Vedat; Kurtoglu, Erdal] Antalya Training & Res Hosp, Antalya, Turkey. [Oktay, Gonul] Antakya State Hosp, Antakya, Turkey. [Aydogan, Gonul; Salcioglu, Zafer] Kanuni Sultan Suleyman Training & Res Hosp, Istanbul, Turkey. [Akin, Mehmet] Denizli State Hosp, Denizli, Turkey. [Vergin, Canan] Dr Behcet Uz Child Dis Surg Training & Res Hosp, Izmir, Turkey. [Kazanci, Elif Guler] Dortcelik Child Dis Hosp, Bursa, Turkey. [Unal, Selma] Mersin Univ, Med Fac, Mersin, Turkey. [Caliskan, Umran] Necmettin Erbakan Univ, Meram Med Fac, Konya, Turkey. [Aral, Yusuf Ziya] Adnan Menderes Univ, Med Fac, Aydin, Turkey. [Turkkan, Emine] Okmeydani Training & Res Hosp, Istanbul, Turkey. [Gunes, Adalet Meral] Uludag Univ, Med Fac, Bursa, Turkey. [Tunc, Bahattin] Hematol Oncol Training & Res Hosp, Ankara Child Hlth & Dis, Ankara, Turkey. [Gumruk, Fatma] Hacettepe Univ, Med Fac, Ankara, Turkey. [Ayhan, Aylin Canbolat; Timur, Cetin] Goztepe Training & Res Hosp, Istanbul, Turkey. [Soker, Murat] Dicle Univ, Med Fac, Diyarbakir, Turkey. [Koc, Ahmet; Oymak, Yesim] Harran Univ, Med Fac, Sanliurfa, Turkey. [Ertem, Mehmet] Ankara Univ, Fac Med, Ankara, Turkey. [Yildirmak, Yildiz] Sisli Etfal Training & Res Hosp, Istanbul, Turkey. [Irken, Gulersu] Dokuz Eylul Univ, Med Fac, Izmir, Turkey. [Apak, Hilmi] Istanbul Univ, Cerrahpasa Med Fac, Istanbul, Turkey. [Biner, Betul; Eren, Tugba Gurleyen] Trakya Univ, Med Fac, Edirne, Turkey. [Balci, Yasemin Isik] Pamukkale Univ, Med Fac, Denizli, Turkey. [Kocak, Ulker] Gazi Univ, Med Fac, Ankara, Turkey. [Karasu, Gulsun] Istanbul Zeynep Kamil Women & Childrens Dis Raini, Istanbul, Turkey. [Akkaynak, Diyar] Novartis Saglik Gida & Tarim Urunleri San & Tic A, Istanbul, Turkey. [Patiroglu, Turkan] Erciyes Univ, Med Fac, Kayseri, Turkey.
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- 2019
10. Circumcision in patients with hemophilia and the other bleeding disorders in southern part of Turkey
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Antmen, B., Sasmaz, I., Karagun, B., Leblebisatan, G., Kilinc, Y., Aridogan, A., and Çukurova Üniversitesi
- Abstract
WOS: 000423774100100 …
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- 2018
11. The surgeries in hemophilia A patients with inhibitors
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Sasmaz, I., Antmen, B., Karagun, B., Leblebisatan, G., Kilinc, Y., Yazicioglu, I., Sizmaz, S., and Çukurova Üniversitesi
- Abstract
WOS: 000423774100149 …
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- 2018
12. The prophylaxis and the treatment of hepatic veno-occlusive disease after pediatric hematopoetic stem cell transplantation: our single-centre experience
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Karagün, B., primary, Antmen, B., additional, Şaşmaz, İ., additional, and Akbaş, T., additional
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- 2019
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13. Haploidentical stem cell transplantation in children; a single center experience of alpha beta T-cell depleted and unmanipulated transplantation with post-transplant cyclophosphamide
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Antmen, B., Sasmaz, I., Karagun, B., Serbest, M., and Çukurova Üniversitesi
- Abstract
43rd Annual Meeting of the European-Society-for-Blood-and-Marrow-Transplantation (EBMT) -- MAR 26-29, 2017 -- Marseille, FRANCE WOS: 000424355301415 … European Soc Blood & Marrow Transplantat
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- 2017
14. Defibrotide for the prevention and treatment of hepatic veno-occlusive disease after hematopoietic stem cell transplantation: a single-center experience
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Antmen, B., Sasmaz, I., Karagun, B., Serbest, M., and Çukurova Üniversitesi
- Abstract
43rd Annual Meeting of the European-Society-for-Blood-and-Marrow-Transplantation (EBMT) -- MAR 26-29, 2017 -- Marseille, FRANCE WOS: 000424355301407 … European Soc Blood & Marrow Transplantat
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- 2017
15. Clinical Presentation and Management of Factor X Deficiency: Case Study
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Antmen, B., Sasmaz, I., Karagun, B., Leblebisatan, G., Kilinc, Y., and Çukurova Üniversitesi
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WOS: 000393554500071 …
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- 2017
16. Rare Congenital Bleeding Disorder; Factor VII Deficiencieny And Experience Of Bleeding Treatments: Case Series Of Cukurova University, Adana, Turkey
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Sasmaz, I., Antmen, B., Karagun, B., Leblebisatan, G., Kilinc, Y., and Çukurova Üniversitesi
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WOS: 000393554500123 …
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- 2017
17. Hematopoietic stem cell transplantation in children with thalassemia major: the experience of single center
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Sasmaz, I., Antmen, B., Karagun, B., Serbest, M., and Çukurova Üniversitesi
- Abstract
43rd Annual Meeting of the European-Society-for-Blood-and-Marrow-Transplantation (EBMT) -- MAR 26-29, 2017 -- Marseille, FRANCE WOS: 000424355301417 … European Soc Blood & Marrow Transplantat
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- 2017
18. Experiences with Use of Port-a-Cath in Children with Hemophilia: Single Center Study
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Sasmaz, I., Antmen, B., Karagun, B., Akgul, E., Kilinc, Y., and Çukurova Üniversitesi
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WOS: 000374485500120 …
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- 2016
19. Posterior reversible encephalopathy syndrome following pediatric allogeneic bone marrow transplantation: a case series and review
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Sasmaz, I., Antmen, B., Karagun, B., Serbest, M., and Çukurova Üniversitesi
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animal structures - Abstract
42nd Annual Meeting of the European-Society-for-Blood-and-Marrow-Transplantation -- APR 03-06, 2016 -- Valencia, SPAIN WOS: 000373357600399 … European Soc Blood & Marrow Transplantat
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- 2016
20. BK virus infections in patients with undergoing allogeneic hematopoietic stem cell transplantation
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Sasmaz, I., Antmen, B., Karagun, B., Serbest, M., and Çukurova Üniversitesi
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animal structures - Abstract
42nd Annual Meeting of the European-Society-for-Blood-and-Marrow-Transplantation -- APR 03-06, 2016 -- Valencia, SPAIN WOS: 000373357600361 … European Soc Blood & Marrow Transplantat
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- 2016
21. Iliopsoas Hemorrhage in Children with Congenital Factor Deficiencies (CFD): Experience from Two Centers in Turkey
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Antmen, B., Sasmaz, I., Karagun, B., Leblebisatan, G., Kilinc, Y., and Çukurova Üniversitesi
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WOS: 000374485500126 …
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- 2016
22. Busulfan pharmacokinetics in Turkish children who underwent hematopoetic stem cell transplantation
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Antmen, B., KARAGUN, BARBAROS ŞAHİN, Ozyurek, E., Fisgin, T., Oktem, M., Sahin, E., Guney, Z., Ucar, G., Serbest, M., and Sasmaz, I.
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- 2015
23. Busulfan pharmacokinetics in Turkish children who underwent hematopoetic stem cell transplantation
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Ozyurek, E., Karagun, B., Antmen, B., Sasmaz, I., Serbest, M., Ucar, G., Guney, Z., and Çukurova Üniversitesi
- Abstract
41st Annual Meeting of the European-Society-for-Blood-and-Marrow-Transplantation -- MAR 22-25, 2015 -- Istanbul, TURKEY WOS: 000351632903196 … European Soc Blood & Marrow Transplantat
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- 2015
24. Clinical presentation and management of rare factor deficiencies: case study
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Antmen, B. A., Sasmaz, I, Karagun, B. S., Leblebisatan, G., Kilinc, Y., and Çukurova Üniversitesi
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WOS: 000356426905368 …
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- 2015
25. OUTCOMES OF A COHORT OF CHILDREN WITH HEMOGLOBINOPATHY RECEIVING ORAL IRON CHELATORS FOR TREATMENT OF TRANSFUSIONAL IRON OVERLOAD IN TURKEY: RESULTS OF 3-YEAR FOLLOW-UP STUDY
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Antmen, B., Karakas, Z., Kupesiz, O. A., Sasmaz, I., Kurtoglu, E., Aydogan, G., Salcioglu, Z., and Çukurova Üniversitesi
- Abstract
20th Congress of European-Hematology-Association -- JUN 11-14, 2015 -- Vienna, AUSTRIA WOS: 000361204902241 …
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- 2015
26. The usage of recombinant activated factor VII (RFVIIA) during major and minor surgeries in severe hemophilia patients with inhibitor
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Antmen, B. A., Sasmaz, I, Karagun, B. S., Leblebisatan, G., Kilinc, Y., Aridogan, A., Yazicioglu, I, and Çukurova Üniversitesi
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WOS: 000356426905140 …
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- 2015
27. CIRCUMCISION AND COMPLICATIONS IN ADOLESCENT AND ADULT PATIENTS WIITH HEMOPHILIA IN SOUTHERN PART OF TURKEY
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Sasmaz, I., Antmen, B., Guvenc, B., Karagun, B., Kilinc, Y., Aridogan, A., and Çukurova Üniversitesi
- Abstract
20th Congress of European-Hematology-Association -- JUN 11-14, 2015 -- Vienna, AUSTRIA WOS: 000361204904224 …
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- 2015
28. MICROPARTICLE PROFILE DURING PAINFUL CRISIS AND NON-CRISIS PERIOD IN SICKLE CELL ANEMIA
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Atmis, A., Sasmaz, I., Antmen, B., Karagun, B., Kilinc, Y., and Çukurova Üniversitesi
- Abstract
20th Congress of European-Hematology-Association -- JUN 11-14, 2015 -- Vienna, AUSTRIA WOS: 000361204905004 …
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- 2015
29. National pediatric hematopoietic stem cell transplantation activity in Turkey
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Kansoy, S., Hazar, V., Kupesiz, A., Uckan, D., Kuskonmaz, B., Tezcan, I., Aksoylar, S., Tezcan, G., Kilic, S. Caki, Ertem, M., Unal, E., Ikinciogullari, A., Uygun, V., Ozturk, G., Erbey, F., Gedikoglu, G., Kurekci, E., Kesik, V., Musa Karakukcu, Albayrak, D., Oniz, H., Azik, F., Tanyeli, A., Anak, S., Kocak, U., Oren, H., Antmen, B., Fisgin, T., Ozyurek, E., Atay, D., Gozmen, S., and Yesilipek, A.
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Transplantation ,surgical procedures, operative ,National Pediatric Hematopoietic ,Activity - Abstract
European Society Blood and Marrow Transplantation
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- 2015
30. OP-02 - The prophylaxis and the treatment of hepatic veno-occlusive disease after pediatric hematopoetic stem cell transplantation: our single-centre experience
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Karagün, B., Antmen, B., Şaşmaz, İ., and Akbaş, T.
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- 2019
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31. PP-101 THE CATARACT FORMATION DUE TO THE USE OF DEFERIPRONE IN A PATIENT WITH THALASSEMIA MAJOR
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Karagün, B. Şahin, primary, Kılınç, Y., additional, Şaşmaz, İ., additional, and Antmen, B., additional
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- 2014
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32. A Randomized Trial of Factor VIII and Neutralizing Antibodies in Hemophilia A
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Kaan Kavakli, Mamta Manglani, Ezio Zanon, Christoph Male, Tarek Owaidah, Johnny Mahlangu, Ramabadran Varadarajan, Veronica Soto Arellano, Flora Peyvandi, Alessandra Nunes Loureiro Prezotti, Monica Martinez, Frits R. Rosendaal, Cecil Ross, Suresh Hanagavadi, Suvankar Majumdar, Bulent Zulfikar, Anupam Sachdeva, Brian M. Wicklund, Amal El-Beshlawy, Marilyn J. Manco-Johnson, M. Cerqueira, Dinesh M Nayak, Pier Mannuccio Mannucci, Santiago Bonanad Boix, Nadia P. Ewing, Klaus Schmitt, Angeles Palomo Bravo, Nathan L Kobrinsky, Maria Elisa Mancuso, Shashikant Apte, Mathew Thomas, Isabella Garagiola, Rogelio Paredes Aguilera, Guy Young, Maria Gabriella Mazzucconi, Esperanza Marzouka, Rosario Perez Garrido, Tulika Seth, Bülent Antmen, Mohsen Saleh Elalfy, Peyman Eshghi, E. Santagostino, Mindy L. Simpson, Vijay Ramanan, Daniela Neme, Mehran Karimi, Adriana C Sandoval Gonzalez, Çukurova Üniversitesi, Ege Üniversitesi, [Peyvandi,F, Mannucci,PM, Santagostino,E, Mancuso,ME] the Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Italy. [Peyvandi,F, and Garagiola,I] Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy. [Zanon,E] Milan, Clinica Medica II, Azienda Ospedaliera di Padova, Centro Emofilia, Padua. Italy. [Mazzucconi,MG] Ematologia, Unità Operativa Diagnostica Speciale e Terapia delle Malattie dell’Emostasi e della Trombosi, Università Sapienza, Policlinico Umberto I, Rome, Italy. [El-Beshlawy,A] The Pediatric Hematology Department, Cairo University Pediatric Hospital, Cairo. [Elalfy,M] Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo. [Ramanan,V] Jehangir Clinical Development Center, Department of Hematology, Jehangir Hospital Premises, India. , [Apte,S] Sahyadri Speciality Hospita, l India. [Hanagavadi,S] Pune, Jagadguru Jayadeva Murugarajendra Medical College, Davangere, India. [Baradajaran,P] Center for Blood Disorders, Chennai, India. [Manglani,MV] Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India. [Ross,C] St. John’s Medical College Hospital, Bangalore India. [Seth,T] India Institute of Medical Sciences, Department of Hematology, India. [Sachdeva,A] Pediatric Hematology Oncology and Bone Marrow Transplantation, Institute for Child Health, Sir Ganga Ram Hospital, India. [Nayak,DM] New Delhi, Melaka-Manipal Medical College, Manipal University, Manipal, India. [Thomas,M] Kerala Institute of Medical Science, Trivandrum, India. [Eshghi,P] The Congenital Pediatric Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [Karimi,M] Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. [Young,G] Children’s Hospital Los Angeles, Los Angeles,California. [Ewing,NP] City of Hope National Medical Center, Duarte, California. [Sandoval Gonzalez, AC] Hospital de Especialidades Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Monterrey, Mexico. [Paredes Aguilera,R] Instituto Nacional de Pediatria, Mexico City, Mexico. [Mahlangu,JN] Faculty of Health Sciences, School of Pathology, University of the Witwatersrand, National Health Laboratory Service and Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg.[Bonanad Boix,S] Hospital Universitario La Fe, Unidad Coagulopatias Congenitas, Valencia, Spain. [Perez Garrido, R] Hospital Universitario Virgen del Rocío, Unidad de Hemofilia, Seville, Spain. [Palomo Bravo,A] Hospital Regional Universitario Carlos Haya, Malaga, Spain. [Cerqueira,M] Centro de Pesquisa Clinica Hemorio–Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil. [Prezotti,A] Centro de Hematologia e Hemoterapia do Espírito Santo, Vitoria, Brazil. [Male,C] Medizinische Universität Wien, Department of Pediatrics, Vienna, Austria. [Schmitt,K] Department of Pediatric and Adolescent Medicine, Kepler University Clinic, Linz, Austria. [Owaidah,T] King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. [Soto Arellano,V] Centro de Hemofílicos del Hospital de Niños Dr. Roberto del Río, Chile. [Marzouka,E] Hospital de Niños Dr. Luis Calvo Mackenna, Centro Hemofílico, Santiago, Chile. [Kobrinsky, NL] Sanford Roger Maris Cancer Center, Fargo, ND. [Majundar,S] University of Mississippi Medical Center, Division of Pediatric Hematology–Oncology, Jackson. [Simpson,M] Rush Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago. [Antmen,B] Cukurova Universitesi, Tip Fakultesi Pediatrik Hematoloji Bilim Dali, Adana, Turkey. [Kabakli,K] Ege Universitesi Tip Fakultesi Cocuk Sagligi ve Hastalikari Anabilim Dali, Pediatrik Hematoloji Bilim Dali, Turkey. [Zulfikar,B] Istanbul Universitesi Cerrahpasa Tip Fakultesi, Pediatrik Hematoloji Bilim Dali, Istanbul,Turkey. [Manco-Johnson,MJ] Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora. [Martinez,M] Hospital de Niños Sor María Ludovica La Plata, Servicio de Hematología, Buenos Aires. [Neme,D] Fundación de la Hemofilia, Buenos Aires.[Wicklund,BM] Children’s Mercy Hospital, Kansas City, MO, The Netherlands. [Rosendaal,FR] he Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
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Male ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings] ,Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings] ,Adulto joven ,030204 cardiovascular system & hematology ,Gastroenterology ,law.invention ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,0302 clinical medicine ,Randomized controlled trial ,Isoantibodies ,law ,Hemorragia ,hemic and lymphatic diseases ,Medicine ,Child ,Masculino ,Adolescente ,Named Groups::Persons::Age Groups::Child::Child, Preschool [Medical Subject Headings] ,biology ,Adulto ,Incidence ,Hemofilia A ,General Medicine ,Middle Aged ,Modelos de riesgos proporcionales ,Humanos ,Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Hemorrhagic Disorders::Hemophilia A [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Routes::Injections::Injections, Subcutaneous [Medical Subject Headings] ,Child, Preschool ,Niño ,Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings] ,Drug Therapy, Combination ,Named Groups::Persons::Age Groups::Infant [Medical Subject Headings] ,Antibody ,Incidencia ,Niño preescolar ,Adult ,medicine.medical_specialty ,Randomization ,Adolescent ,Named Groups::Persons::Age Groups::Adult::Young Adult [Medical Subject Headings] ,Injections, Subcutaneous ,Anciano ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Therapy, Combination [Medical Subject Headings] ,Check Tags::Male [Medical Subject Headings] ,Hemorrhage ,Hemophilia A ,Isoanticuerpos ,Bethesda unit ,Anticuerpos neutralizantes ,Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage [Medical Subject Headings] ,Young Adult ,03 medical and health sciences ,Pharmacotherapy ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings] ,Von Willebrand factor ,Internal medicine ,von Willebrand Factor ,Named Groups::Persons::Age Groups::Adult [Medical Subject Headings] ,Humans ,Factor de von Willebrand ,Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings] ,Named Groups::Persons::Age Groups::Child [Medical Subject Headings] ,Aged ,Proportional Hazards Models ,Emicizumab ,Mediana edad ,Factor VIII ,Dose-Response Relationship, Drug ,business.industry ,Phenomena and Processes::Physiological Phenomena::Pharmacological Phenomena::Dose-Response Relationship, Drug [Medical Subject Headings] ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Globulins::Serum Globulins::Immunoglobulins::Antibodies::Isoantibodies [Medical Subject Headings] ,Infant ,Inyecciones subcutáneas ,Lactante ,Antibodies, Neutralizing ,Relación dosis-respuesta de medicamentos ,Chemicals and Drugs::Biological Factors::Blood Coagulation Factors::von Willebrand Factor [Medical Subject Headings] ,Surgery ,Farmacoterapia combinada ,Chemicals and Drugs::Biological Factors::Blood Coagulation Factors::Factor VIII [Medical Subject Headings] ,biology.protein ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Globulins::Serum Globulins::Immunoglobulins::Antibodies::Antibodies, Neutralizing [Medical Subject Headings] ,business ,030215 immunology - Abstract
WOS: 000376443500008, PubMed ID: 27223147, BACKGROUND The development of neutralizing anti-factor VIII alloantibodies (inhibitors) in patients with severe hemophilia A may depend on the concentrate used for replacement therapy. METHODS We conducted a randomized trial to assess the incidence of factor VIII inhibitors among patients treated with plasma-derived factor VIII containing von Willebrand factor or recombinant factor VIII. Patients who met the eligibility criteria (male sex, age = 5 Bethesda units). Inhibitors developed in 29 of the 125 patients treated with plasma-derived factor VIII (20 patients had high-titer inhibitors) and in 47 of the 126 patients treated with recombinant factor VIII (30 patients had high-titer inhibitors). The cumulative incidence of all inhibitors was 26.8% (95% confidence interval [CI], 18.4 to 35.2) with plasma-derived factor VIII and 44.5% (95% CI, 34.7 to 54.3) with recombinant factor VIII; the cumulative incidence of high-titer inhibitors was 18.6% (95% CI, 11.2 to 26.0) and 28.4% (95% CI, 19.6 to 37.2), respectively. In Cox regression models for the primary end point of all inhibitors, recombinant factor VIII was associated with an 87% higher incidence than plasma-derived factor VIII (hazard ratio, 1.87; 95% CI, 1.17 to 2.96). This association did not change in multivariable analysis. For high-titer inhibitors, the hazard ratio was 1.69 (95% CI, 0.96 to 2.98). When the analysis was restricted to recombinant factor VIII products other than second-generation full-length recombinant factor VIII, effect estimates remained similar for all inhibitors (hazard ratio, 1.98; 95% CI, 0.99 to 3.97) and high-titer inhibitors (hazard ratio, 2.59; 95% CI, 1.11 to 6.00). CONCLUSIONS Patients treated with plasma-derived factor VIII containing von Willebrand factor had a lower incidence of inhibitors than those treated with recombinant factor VIII. (Funded by the Angelo Bianchi Bonomi Foundation and others; ClinicalTrials.gov number, NCT01064284; EudraCT number, 2009-011186-88.), Angelo Bianchi Bonomi Foundation, Funded by the Angelo Bianchi Bonomi Foundation and others
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- 2016
33. Changes in hematopoietic stem cell numbers following acute exercise in non-athlete marathon runners.
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Günaştı Ö, Özdemir Ç, Özgünen KT, Çiftdal G, Gezgin E, Eryılmaz SK, Boyraz ÖC, Kılcı A, Adaş Ü, Antmen B, and Kurdak SS
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Purpose: Hematopoietic stem cell (HSC) transplant is one of the curative methods for some patients with hematological malignancies. Granulocyte colony-stimulating factor (G-CSF) is the most common drug used to mobilize CD34
+ cells, generally found in small numbers. Recent evidence showed that exercise causes transient mobilization in HSC. However, the type and intensity of exercise have not been fully revealed. We aimed to detect a significant increase in stem cell levels following 60 min of running at a personalized running pace., Materials/methods: Eighteen runners, 48.2 ± 1.9 years with peak oxygen consumption of 46.2 ± 1.4 ml/kg/min, were enrolled in the study. The cardiopulmonary exercise test was performed to determine the individual running pace, and the participants ran 60-min on a treadmill at an intensity close to their ventilatory threshold (VT). The blood sampling for HSC count was performed before, immediately after, at the 1st, 4th and 24th hour after the 60-min running., Results: The CD34+ HSCs were 13.9 ± 2.3 cells/μl before and significantly increased immediately after to 19.5 ± 3.6 cells/μl (p < 0.05). The consecutive HSC counts were 15.3 ± 2.2, 19.5 ± 4.8 and 15.1 ± 3.4 cells/μl at the 1st, 4th, and 24th hour, respectively., Conclusion: The individual data showed that some runners had higher HSC levels than the transplantation limit before and after the 60-min running trail, which was maintained for 24 h. Pre-running high CD34+ HSCs may reflect an adaptive response to regular exercise, with a 60-min run near the VT further elevating HSCs. Individualized exercise may be a valuable tool to mobilize the CD34+ HSCs in peripheral blood for donors., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.)- Published
- 2024
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34. Ruxolitinib in treatment-naive or corticosteroid-refractory paediatric patients with chronic graft-versus-host disease (REACH5): interim analysis of a single-arm, multicentre, phase 2 study.
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Locatelli F, Antmen B, Kang HJ, Koh K, Takahashi Y, Kupesiz A, Dias Matos MGA, Chopra Y, Bhat S, Im HJ, Güngör T, Lu MY, Stefanelli T, Rosko C, St Pierre A, Burock K, Smith Y, Sinclair K, and Diaz-de-Heredia C
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- Adolescent, Child, Child, Preschool, Female, Humans, Infant, Male, Chronic Disease, Treatment Outcome, Adrenal Cortex Hormones therapeutic use, Graft vs Host Disease drug therapy, Graft vs Host Disease etiology, Hematopoietic Stem Cell Transplantation adverse effects, Nitriles, Pyrazoles therapeutic use, Pyrazoles adverse effects, Pyrimidines therapeutic use
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Background: Chronic graft-versus-host disease (GVHD) is a debilitating, and sometimes life threatening, complication of allogeneic haematopoietic stem-cell transplantation (HSCT). We aimed to investigate the activity, pharmacokinetics, and safety of ruxolitinib added to corticosteroids in paediatric patients (ie, <18 years) with moderate-to-severe chronic GVHD., Methods: In this single-arm, phase 2 study, patients were recruited at 21 hospitals or clinics across 14 countries in Asia, Europe, and Canada. Eligible patients were aged 28 days to younger than 18 years, had undergone allogenic HSCT, and had been diagnosed with treatment-naive or corticosteroid-refractory moderate-to-severe chronic GVHD, per 2014 National Institutes of Health consensus criteria. Patients received oral ruxolitinib dosing on the basis of their age at the start of treatment: those aged 12 years to younger than 18 years received 10 mg twice daily (age ≥12 to <18 years group), those aged 6 years to younger than 12 years (age ≥6 to <12 years group) received 5 mg twice daily, and those aged 2 years to younger than 6 years received 4 mg/m
2 twice daily (age ≥2 to <6 years group). Treatment was to be administered in 28-day cycles for approximately 36 months, alongside supportive treatment per institutional guidelines. The primary activity endpoint was overall response rate at cycle 7 day 1. Activity and safety analyses are reported in the full analysis set, which included all patients who received at least one dose of ruxolitinib. Here we report the prespecified interim analysis, scheduled to occur after all patients had completed 1 year of treatment or discontinued treatment, and the results for the primary endpoint evaluation reported here is to be considered final. This study is registered with ClinicalTrials.gov, NCT03774082, enrolment is complete, and the study is ongoing., Findings: Between May 20, 2020, and Sept 17, 2021, 48 patients were screened, of whom 45 were enrolled and received at least one dose of study drug (median age was 11·0 years [IQR 7·2-14·3], 16 [36%] were female, 29 [64%] were male, 21 [47%] were White, one [2%] was Black or African American, 23 [51%] were Asian, 17 [38%] were treatment-naive, 28 [62%] were corticosteroid-refractory). As of data cutoff (Oct 19, 2022), after a median ruxolitinib exposure of 55·1 weeks (IQR 13·1-75·3), the overall response rate at cycle 7 day 1 was 40·0% (18 of 45; 90% CI 27·7-53·3), with responses seen in seven (41%) of 17 treatment-naive patients and 11 (39%) of 28 corticosteroid-refractory patients. The most common treatment-related adverse events of grade 3 or worse were neutropenia (eight [18%] of 45) and thrombocytopenia (six [13%]). Seven (16%) patients had grade 3 or worse serious treatment-related adverse events; the most common was hyponatraemia (two [4%] of 45). Three (7%) patients died while on-treatment (within 30 days of treatment discontinuation), one due to Aspergillus infection, one due to septic shock, and one due to acute respiratory distress syndrome; none were considered to be related to study drug., Interpretation: Pending final analysis, this study suggests that ruxolitinib is active and well tolerated in both treatment-naive and corticosteroid-refractory patients aged 2 years to younger than 18 years with chronic GVHD, thereby supporting its use in this patient population. The safety profile of ruxolitinib in this patient population is consistent with that of adults. Final analysis of this study will provide further information on the long-term benefits of ruxolitinib in children with chronic GVHD., Funding: Novartis., Competing Interests: Declaration of interests FL has participated in speaker bureaus for Amgen, Bluebird Bio, BMS, Medac Pharma, Miltenyi Biotec, Neovii, Novartis, and SOBI. HJK has received consulting fees from Structure Therapeutics (GPCR) and is on Data Safety Monitoring Boards or advisory boards with Jazz Pharmaceuticals, Novartis, Sanofi, Recordati, and Takeda. CD-d-H has received royalties from Jazz Pharmaceuticals and Vertex; received honoraria from Novartis; received meeting and travel support from Jazz Pharmaceuticals and Novartis; and has participated on a data safety monitoring board for Novartis. TS, CR, ASP, KB, YS, and KS are employees of Novartis. TS, KB, ASP, YS, and KS hold shares in Novartis. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)- Published
- 2024
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35. Fitusiran prophylaxis in people with hemophilia A or B who switched from prior BPA/CFC prophylaxis: the ATLAS-PPX trial.
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Kenet G, Nolan B, Zulfikar B, Antmen B, Kampmann P, Matsushita T, You CW, Vilchevska K, Bagot CN, Sharif A, Peyvandi F, Young G, Negrier C, Chi J, Kittner B, Sussebach C, Shammas F, Mei B, Andersson S, and Kavakli K
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- Humans, Male, Adult, Middle Aged, Adolescent, Young Adult, Child, RNA, Small Interfering administration & dosage, RNA, Small Interfering therapeutic use, Blood Coagulation Factors therapeutic use, Blood Coagulation Factors administration & dosage, Aged, Hemophilia B drug therapy, Hemophilia B complications, Hemophilia A drug therapy, Hemophilia A complications, Hemorrhage chemically induced, Hemorrhage prevention & control
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Abstract: Fitusiran, a subcutaneous investigational small interfering RNA therapeutic, targets antithrombin to rebalance hemostasis in people with hemophilia A or B (PwHA/B), irrespective of inhibitor status. This phase 3, open-label study evaluated the efficacy and safety of fitusiran prophylaxis in males aged ≥12 years with hemophilia A or B, with or without inhibitors, who received prior bypassing agent (BPA)/clotting factor concentrate (CFC) prophylaxis. Participants continued their prior BPA/CFC prophylaxis for 6 months before switching to once-monthly 80 mg fitusiran prophylaxis for 7 months (onset and efficacy periods). Primary end point was annualized bleeding rate (ABR) in the BPA/CFC prophylaxis and fitusiran efficacy period. Secondary end points included spontaneous ABR (AsBR) and joint ABR (AjBR). Safety and tolerability were assessed. Of 80 enrolled participants, 65 (inhibitor, n = 19; noninhibitor, n = 46) were eligible for ABR analyses. Observed median ABRs were 6.5 (interquartile range [IQR], 2.2-19.6)/4.4 (IQR, 2.2-8.7) with BPA/CFC prophylaxis vs 0.0 (IQR, 0.0-0.0)/0.0 (IQR, 0.0-2.7) in the corresponding fitusiran efficacy period. Estimated mean ABRs were substantially reduced with fitusiran by 79.7% (P = .0021) and 46.4% (P = .0598) vs BPA/CFC prophylaxis, respectively. Forty-one participants (63.1%) experienced 0 treated bleeds with fitusiran vs 11 (16.9%) with BPAs/CFCs. Median AsBR and AjBR were both 2.2 with BPA/CFC prophylaxis and 0.0 in the fitusiran efficacy period. Two participants (3.0%) experienced suspected or confirmed thromboembolic events with fitusiran. Once-monthly fitusiran prophylaxis significantly reduced bleeding events vs BPA/CFC prophylaxis in PwHA/B, with or without inhibitors, and reported adverse events were generally consistent with previously identified risks of fitusiran. This trial was registered at www.ClinicalTrials.gov as #NCT03549871., (© 2024 American Society of Hematology. Published by Elsevier Inc. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
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- 2024
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36. The Efficacy of Three Different Oral Hygiene Regimens in Preventing Chemotherapy-Induced Oral Mucositis in Pediatric Patients Receiving Hematopoietic Stem Cell Transplantation.
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Aygunes U, Karagun BS, Sasmaz I, and Antmen B
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- Humans, Child, Male, Female, Retrospective Studies, Adolescent, Child, Preschool, Mouthwashes therapeutic use, Hyaluronic Acid therapeutic use, Hyaluronic Acid administration & dosage, Hyaluronic Acid adverse effects, Sodium Bicarbonate therapeutic use, Sodium Bicarbonate administration & dosage, Oral Hygiene, Antineoplastic Agents adverse effects, Hematologic Neoplasms therapy, Lidocaine therapeutic use, Sucralfate therapeutic use, Hematopoietic Stem Cell Transplantation adverse effects, Stomatitis prevention & control, Stomatitis chemically induced, Stomatitis drug therapy
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Background: Oral mucositis is one of the side effects developed post-hematopoietic stem cell transplant. This retrospective study aimed to assess the efficacy of a mouthwash mixture (lidocaine, sodium alginate, sucralfate, pheniramine) versus hyaluronic acid and a solution of sodium bicarbonate in terms of healing time and weight gain in the treatment of oral mucositis in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation with hemato-oncological malignancies., Methods: A total of 171 patients that received chemotherapy for the hematopoietic stem cell transplant were divided into three groups; group 1, treated with a mixed mouthwash of lidocaine, sodium alginate, sucralfate, and pheniramine; group 2, treated with hyaluronic acid; and group 3, treated with an aqueous solution of 5% sodium bicarbonate. Weight and mucositis scale scores derived from medical records of patients., Results: There was a statistically significant difference in the mucositis scale scores between the groups on the transplant day and days 5, 10, 15 and 20 after the transplantation. At these measurement points, Group 2 (receiving hyaluronic acid) had a lower score, and Group 3 (who received sodium bicarbonate) had a higher score, especially on days 5 and 10 after the transplantation., Conclusion: The results suggest that hyaluronic acid is a more effective treatment option than the other oral care solutions that are frequently used for prophylaxis and treatment of oral mucositis., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)
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- 2024
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37. COVID-19 disease in children and adolescents following allogeneic hematopoietic stem cell transplantation: A report from the Turkish pediatric bone marrow transplantation study group.
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Bozkurt C, Hazar V, Malbora B, Küpesiz A, Aygüneş U, Fışgın T, Karakükçü M, Kuşkonmaz B, Kılıç SÇ, Bayırlı D, Arman Bilir Ö, Yalçın K, Gözmen S, Uygun V, Elli M, Sarbay H, Küpesiz FT, Şaşmaz Hİ, Aksoy BA, Yılmaz E, Okur FV, Tekkeşin F, Yenigürbüz FD, Özek G, Atay AA, Bozkaya İO, Çelen S, Öztürkmen S, Güneş AM, Gürsel O, Güler E, Özcan A, Çetinkaya DU, Aydoğdu S, Özbek NY, Karasu G, Sezgin G, Doğru Ö, Albayrak D, Öztürk G, Aksoylar S, Daloğlu H, Odaman Al I, Evim MS, Akbayram S, Öncül Y, Zengin E, Albayrak C, Timur Ç, Kar YD, Çakmaklı HF, Tüfekçi Ö, Töret E, and Antmen B
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- Humans, Child, Male, Female, Retrospective Studies, Adolescent, Turkey epidemiology, Child, Preschool, Risk Factors, SARS-CoV-2, Infant, Transplantation, Homologous, Severity of Illness Index, COVID-19 epidemiology, COVID-19 therapy, COVID-19 mortality, Hematopoietic Stem Cell Transplantation adverse effects
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Background: Data on the risk factors and outcomes for pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited., Objectives: The study aimed to analyze the clinical signs, risk factors, and outcomes for ICU admission and mortality in a large pediatric cohort who underwent allogeneic HSCT prior to COVID-19 infection., Method: In this nationwide study, we retrospectively reviewed the data of 184 pediatric HSCT recipients who had COVID-19 between March 2020 and August 2022., Results: The median time from HSCT to COVID-19 infection was 209.0 days (IQR, 111.7-340.8; range, 0-3845 days). The most common clinical manifestation was fever (58.7%). While most patients (78.8%) had asymptomatic/mild disease, the disease severity was moderate in 9.2% and severe and critical in 4.4% and 7.6%, respectively. The overall mortality was 10.9% (n: 20). Deaths were attributable to COVID-19 in nine (4.9%) patients. Multivariate analysis revealed that lower respiratory tract disease (LRTD) (OR, 23.20, p: .001) and lymphopenia at diagnosis (OR, 5.21, p: .006) were risk factors for ICU admission and that HSCT from a mismatched donor (OR, 54.04, p: .028), multisystem inflammatory syndrome in children (MIS-C) (OR, 31.07, p: .003), and LRTD (OR, 10.11, p: .035) were associated with a higher risk for COVID-19-related mortality., Conclusion: While COVID-19 is mostly asymptomatic or mild in pediatric transplant recipients, it can cause ICU admission in those with LRTD or lymphopenia at diagnosis and may be more fatal in those who are transplanted from a mismatched donor and those who develop MIS-C or LRTD., (© 2024 Wiley Periodicals LLC.)
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- 2024
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38. Busulfan-Based and Treosulfan-Based Myeloablative Conditioning for Allogeneic Transplantation in Children with Thalassemia Major: a Single-Center Experience From Southern Turkey.
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Aygüneş U, Karagun BS, Ay Tuncel D, Sasmaz HI, and Antmen B
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- Humans, Child, Busulfan adverse effects, Retrospective Studies, Quality of Life, Turkey, Transplantation, Homologous adverse effects, Transplantation Conditioning adverse effects, Vidarabine, beta-Thalassemia diagnosis, beta-Thalassemia therapy, beta-Thalassemia complications, Hematopoietic Stem Cell Transplantation adverse effects, Graft vs Host Disease etiology
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Objectives: Allogeneic hematopoietic stem cell transplant is the only curative treatment for patients with transfusion-dependent thalassemia major. In recent years, a number of novel approaches have improved patient outcomes and quality of life by minimizing the toxicity of conditioning regimens. The objective of this study was to compare the role of treosulfan- and busulfan-based conditioning in transfusion-dependent thalassemia., Materials and Methods: Data were collected retrospectively on 121 children with beta thalassemia major who underwent hematopoietic stem cell transplant using treosulfan-based (n = 37) or busulfan-based (n = 84) conditioning regimens between 2012 and 2022., Results: Two-year overall survival was 87.5% in the busulfan-based conditioning group and 91.1% in the treosulfan-based conditioning group.The group given the busulfan regimen compared with treosulfan regimen had significantly increased number of side effects (58.3% vs 21.6%, respectively; P < .001). When the busulfan-based regimen by level was evaluated, we observed no significant differences between the frequency of side effects according to drug serum levels. In addition, no significant differences were shown between the 2 regimen groups for cumulative incidence of acute and chronic graft-versus-host disease., Conclusions: The safety and effectiveness of a treosulfan-based myeloablative conditioning regimen has been confirmed by ourretrospective investigation of pediatric patients with beta thalassemia.
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- 2023
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39. Pneumatosis cystoides intestinalis mimicking free intraabdominal air following chemotherapy for relapsed acute myeloblastic leukemia in a transplanted neutropenic child: a case report.
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Aygüneş U, Karagün BŞ, Şaşmaz İ, Tutuş K, Özden Ö, and Antmen B
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- Animals, Female, Humans, Child, Child, Preschool, Tissue Donors, Anti-Bacterial Agents, Pneumatosis Cystoides Intestinalis chemically induced, Pneumatosis Cystoides Intestinalis diagnostic imaging, Leukemia, Myeloid, Acute therapy, Hematopoietic Stem Cell Transplantation
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Background: Pneumatosis cystoides intestinalis (PI) is a rare but important condition in which widespread air sacs are found in the submucosa, and subserosa of the bowel wall. Although it has several etiologies, children receiving chemotherapy are at risk for PI. Preferred imaging tools for the diagnosis are abdominal direct radiography and computed tomography. In patients with PI, rupture of intramural air sacs is the source of benign pneumoperitoneum, causing free air without true intestinal perforation. Intestinal perforation or obstruction are indications for surgical intervention., Case: Here, we present a 4-year-old patient diagnosed with acute myeloblastic leukemia (AML), who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a matched sibling donor (MSD) and developed PI after HSCT. The patient was consulted to the pediatric surgery department, and her oral feeding was stopped. Broad spectrum antibiotics (teicoplanin, metronidazol and vancomycin) were initiated. Her fever increased during the 24-hour monitoring, there was no stool passage, CRP ( > 25 mg/dL, normal value < 1 mg/dL) and abdominal distension increased and there was prolonged neutropenia and radiologic investigations could not rule out intestinal perforation, so the patient underwent exploratory laparotomy. No intestinal perforation was found. There was no sign in the intestinal wall and numerous gas-filled cysts of various sizes., Conclusions: PI is an uncommon complication, and direct radiography/computed tomography scans are very helpful in making the diagnosis in suspicious cases. PI, should be kept in mind, especially in transplanted or relapsed leukemia patients receiving intensive chemotherapy.
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- 2023
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40. Central Nervous System Fungal Infections in Children With Leukemia and Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Multicenter Study.
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Karaman S, Kebudi R, Kizilocak H, Karakas Z, Demirag B, Evim MS, Yarali N, Kaya Z, Karagun BS, Aydogdu S, Caliskan U, Ayhan AC, Bahadir A, Cakir B, Guner BT, Albayrak C, Karapinar DY, Kazanci EG, Unal E, Turkkan E, Akici F, Bor O, Vural S, Yilmaz S, Apak H, Baytan B, Tahta NM, Güzelkucuk Z, Kocak U, Antmen B, Tokgöz H, Fisgin T, Özdemir N, Gunes AM, Vergin C, Unuvar A, Ozbek N, Tugcu D, Bay SB, Tanyildiz HG, and Celkan T
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- Child, Humans, Retrospective Studies, Antifungal Agents therapeutic use, Hematopoietic Stem Cell Transplantation adverse effects, Hematopoietic Stem Cell Transplantation methods, Invasive Fungal Infections diagnosis, Invasive Fungal Infections drug therapy, Invasive Fungal Infections etiology, Central Nervous System Fungal Infections diagnosis, Central Nervous System Fungal Infections therapy, Leukemia drug therapy
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Background: Central nervous system fungal infections (CNSFI) are seen in patients with hematologic malignancies and have high morbidity and mortality. Because of their rarity, there is limited data on CNSFI in children with no established treatment protocols or guidelines., Materials and Methods: In this multicenter retrospective study, 51 pediatric patients with leukemia, 6 of whom had undergone bone marrow transplantation, with proven or probable CNSFI were evaluated. Fungal infections were defined as proven or probable based on European Organisation for Research and Treatment of Cancer criteria. Proven CNSFI was diagnosed by appropriate central nervous system (CNS) imaging or tissue sample findings in combination with positive microbiological results of cerebrospinal fluid. A positive culture, microscopic evidence of hyphae, a positive result of the galactomannan assays are defined as positive microbiological evidence. Probable CNSFI was defined as appropriate CNS imaging findings together with proven or probable invasive fungal infections at another focus without CNS when there is no other explanatory condition. Data was collected by using the questionnaire form (Supplemental Digital Content 1, http://links.lww.com/JPHO/A541 )., Results: Seventeen patients had proven, 34 patients had probable CNSFI. Headaches and seizures were the most common clinical findings. The median time between the onset of fever and diagnosis was 5 days. The most common fungal agent identified was Aspergillus . Sixteen patients received single-agent, 35 received combination antifungal therapy. Surgery was performed in 23 patients. Twenty-two patients (43%) died, 29 of the CNSFI episodes recovered with a 20% neurological sequelae., Conclusion: CNSFIs should be considered in the differential diagnosis in patients with leukemia and refractory/recurrent fever, headache, neurologicalocular symptoms, and a radiologic-serological evaluation should be performed immediately. Early diagnosis and prompt management, both medical and surgical, are essential for improving clinical outcomes., Competing Interests: The authors declare no conflict of interest.
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- 2022
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41. Gene therapy in haemophilia: literature review and regional perspectives for Turkey.
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Kavaklı K, Antmen B, Okan V, Şahin F, Aytaç S, Balkan C, Berber E, Kaya Z, Küpesiz A, and Zülfikar B
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Haemophilia is an X-linked lifelong congenital bleeding disorder that is caused by insufficient levels of factor VIII (FVIII; haemophilia A) or factor IX (FIX; haemophilia B) and characterized by spontaneous and trauma-related bleeding episodes. The cornerstone of the treatment, factor replacement, constitutes several difficulties, including frequent injections due to the short half-life of recombinant factors, intravenous administration and the risk of inhibitor development. While extended half-life factors and subcutaneous novel molecules enhanced the quality of life, initial successes with gene therapy offer a significant hope for cure. Although adeno-associated viral (AAV)-based gene therapy is one of the most emerging approaches for treatment of haemophilia, there are still challenges in vector immunogenicity, potency and efficacy, genotoxicity and persistence. As the approval for the first gene therapy product is coming closer, eligibility criteria for patient selection, multidisciplinary approach for optimal delivery and follow-up and development of new pricing policies and reimbursement models should be concerned. Therefore, this review addresses the unmet needs of current haemophilia treatment and explains the rationale and principles of gene therapy. Limitations and challenges are discussed from a global and national perspective and recommendations are provided to adopt the gene therapies faster and more sufficient for the haemophilia patients in developing countries like Turkey., Competing Interests: Competing interests: The authors declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: Project and authors’ coordination was provided by Dr Ayse Ozlem Yilmaz and Feride Uçar at Remedium Consulting Group and was funded by Pfizer., (© The Author(s), 2022.)
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- 2022
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42. The Prophylaxis of Hepatic Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome With Defibrotide After Hematopoietic Stem Cell Transplantation in Children: Single Center Experience.
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Karagun BS, Akbas T, Erbey F, Sasmaz İ, and Antmen B
- Subjects
- Adolescent, Adult, Allografts, Child, Child, Preschool, Female, Humans, Incidence, Infant, Male, Polydeoxyribonucleotides adverse effects, Retrospective Studies, United States, Hematopoietic Stem Cell Transplantation, Hepatic Veno-Occlusive Disease epidemiology, Hepatic Veno-Occlusive Disease etiology, Hepatic Veno-Occlusive Disease prevention & control, Polydeoxyribonucleotides administration & dosage, Transplantation Conditioning
- Abstract
Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is one of the most severe and life-threatening complications after hematopoietic stem cell transplantation (HSCT). Defibrotide (DF) is approved for adult and pediatric patients with VOD/SOS with renal or pulmonary dysfunction after HSCT in the United States, and for severe VOD/SOS post-HSCT in patients above 1 month of age in the European Union. Several studies have examined whether DF prophylaxis can reduce the incidence of VOD/SOS in high-risk patients. A total of 334 pediatric allogeneic HSCT were included in this study. All patients received DF at the dose of 25 mg/kg/d, from the first day of the conditioning regimen to the 30th day after transplantation for VOD/SOS prophylaxis. Seventeen patients (5.08%) developed VOD/SOS; 4 of these had moderate, while 13 had mild VOD/SOS. None of the patients were developed severe or very severe VOD/SOS. In conclusion, we showed that prophylactic intervention with DF lowered the incidence of VOD/SOS in high-risk pediatric patients., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2022
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43. Different Kinetics and Risk Factors for Isolated Extramedullary Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Children with Acute Leukemia.
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Hazar V, Öztürk G, Yalçın K, Uygun V, Aksoylar S, Küpesiz A, Ok Bozkaya İ, Karagün BŞ, Bozkurt C, İleri T, Atay D, Koçak Ü, Karasu GT, Yeşilipek A, Gökçe M, Kansoy S, Kintrup GT, Karakükcü M, Okur FV, Ertem M, Kaya Z, Gürsel O, Yaman Y, Özbek N, Antmen B, Tüfekçi Ö, Albayrak C, Adaklı Aksoy B, Sezgin G, Albayrak D, Evim MS, Zengin E, and Pekpak E
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- Child, Humans, Kinetics, Recurrence, Retrospective Studies, Risk Factors, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute therapy
- Abstract
Relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the most frequent cause of post-transplantation mortality. Isolated extramedullary (EM) relapse (iEMR) after HSCT is relatively rare and not well characterized, particularly in pediatric patients. We retrospectively analyzed 1527 consecutive pediatric patients with acute leukemia after allo-HSCT to study the incidence, risk factors, and outcome of iEMR compared with systemic relapse. The 5-year cumulative incidence of systemic relapse (either bone marrow [BM] only or BM combined with EMR) was 24.8%, and that of iEMR was 5.5%. The onset of relapse after allo-HSCT was significantly longer in EM sites than in BM sites (7.19 and 5.58 months, respectively; P = .013). Complete response (CR) 2+/active disease at transplantation (hazard ratio [HR], 3.1; P < .001) and prior EM disease (HR, 2.3; P = .007) were independent risk factors for iEMR. Chronic graft-versus-host disease reduced the risk of systemic relapse (HR, 0.5; P = .043) but did not protect against iEMR. The prognosis of patients who developed iEMR remained poor but was slightly better than that of patients who developed systemic relapse (3-year overall survival, 16.5% versus 15.3%; P = .089). Patients experiencing their first systemic relapse continued to have further systemic relapse, but only a minority progressed to iEMR, whereas those experiencing their iEMR at first relapse developed further systemic relapse and iEMR at approximately similar frequencies. A second iEMR was more common after a first iEMR than after a first systemic relapse (58.8% versus 13.0%; P = .001) and was associated with poor outcome. iEMR has a poor prognosis, particularly after a second relapse, and effective strategies are needed to improve outcomes., (Copyright © 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
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- 2021
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44. Risk Assessment for BK Virus-Associated Hemorrhagic Cystitis After Pediatric Hematopoietic Stem Cell Transplant: A Single-Center Retrospective Cross-Sectional Study.
- Author
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Karagun BS, Aygunes U, Eken A, Akbas T, Melek E, and Antmen B
- Abstract
Objectives: BK virus-associated hemorrhagic cystitis is a common complication of allogeneic hematopoietic stem cell transplant. It is known to be associated with cyclophosphamide therapy and the intensity of the conditioning regimen as well as infection with the BK virus. Data are limited for BK virus-associated hemorrhagic cystitis in pediatric recipients of allogeneic hematopoietic stem cell transplant. Therefore, we aimed to identify the risk factors and etiology of BK virus-associated hemorrhagic cystitis and determine the factors that may improve the treatment efficacy., Materials and Methods: Data from recipients of allogeneic hematopoietic stem cell transplant were retrospectively analyzed. These data included information about age, sex, underlying disease, the details of ablative conditioning, graft-versus-host disease prophylaxis, donor type, stem cell source, history of acute graft-versus-host disease, and cytomegalovirus reactivation., Results: A total of 50 patients developed BK virusassociated hemorrhagic cystitis among 334 patients. Symptoms associated with BK virus-associated hemorrhagic cystitis manifested an average of 45.3 days after transplant. Most of the patients had grade 2 and grade 3 hemorrhagic cystitis. Risk factor analysis revealed that haploidentical donor type, treatment with busulfan and cyclophosphamide as part of conditioning regimen, and history of total body irradiation increased the risk of BK virus-associated hemorrhagic cystitis in the pediatric recipient population., Conclusions: We found that, despite current conditioning regimens, BK virus-associated infection still leads to a considerable incidence rate of hemorrhagic cystitis in pediatric recipients of allogeneic hematopoietic stem cell transplant. Patients with a haploidentical donor and a history of busulfan and cyclophosphamide treatment or total body irradiation had a higher risk of BK virus-associated hemorrhagic cystitis. Thus, we suggest that patients with these factors should be followed closely after allogeneic hematopoietic stem cell transplant.
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- 2021
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45. Cost of hemophilia A in Turkey: an economic disease burden analysis.
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Malhan S, Öksüz E, Antmen B, Ar MC, Balkan C, and Kavaklı K
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- Health Care Costs, Health Expenditures, Humans, Turkey epidemiology, Cost of Illness, Hemophilia A drug therapy, Hemophilia A epidemiology
- Abstract
Objective: Hemophilia A is the second most common bleeding disorder causing patients to have lifelong follow-up and treatment. Despite being a rare disease, hemophilia A has a high economic burden on individuals and the public. The purpose of this study was to estimate the total disease cost of hemophilia A in Turkey., Materials and Methods: Data used in this analysis were collected through literature review, including studies conducted in Turkey in December 2018. A disease burden analysis was performed by modeling hemophilia A-related costs among patients, their relatives, and the social security system. Two expert panels were held to evaluate real-world data sources and to provide further information. All direct medical and non-medical costs were calculated annually from the Social Security Institution of the Republic of Turkey perspective, while indirect costs were estimated from the patient and community perspective., Results: For the calendar year of 2018, the number of hemophilia A patients in Turkey were estimated to be 5,055, with an average weight of 64.7 kg. The average annual direct medical, direct non-medical, and indirect costs of hemophilia A were calculated as €93,268 ($109,286; ₺502,717), €2,533 ($2,968; ₺13,655), and €7,957 ($9,323; ₺42,888) per patient, respectively, with a total annual cost of €103,759 ($121,578; ₺559,259). For the management of patients with inhibitors (4.9%), the average annual total cost was calculated to be €325,439 ($381,330; ₺1,754,117) per patient. The total annual disease burden of hemophilia A in 2018 was estimated to be about €524 million ($614 million; ₺2.82 billion), which corresponded to 1.6% of the total health expenditure in Turkey., Conclusion: The most important reason hemophilia A has a significant economic burden in Turkey is that replacement therapy is expensive. The major cost contributor was identified as factor replacement therapy. With inhibitor development, the average annual cost increased more than 3-fold.
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- 2021
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46. Muscle strength and joint health in children with hemophilia: a cross-sectional study.
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Tat NM, Tat AM, Can F, Antmen B, and Öner AF
- Subjects
- Adolescent, Ankle Joint, Child, Cross-Sectional Studies, Hemarthrosis diagnosis, Hemarthrosis epidemiology, Hemarthrosis etiology, Humans, Muscle Strength, Hemophilia A complications
- Abstract
Background and Objectives: We aimed to evaluate joint health in children with hemophilia (CwH) and to investigate the effects of hemarthrosis on the musculoskeletal system., Method: Forty-one CwH aged between 6-18 years participated in the study. Joint health status was evaluated according to Hemophilia Joint Health Score (HJHS). Pain intensity level was assessed in resting and in activity using Visual Analog Scale. Range of motion was measured with goniometer and muscle strength was assessed with digital dynamometer. Arthropathic joints were examined in three groups named knee, elbow and ankle., Results: Physical examination revealed arthropathy findings to be found in 29 knee, 19 elbow and 18 ankle joints. The median of flexion angle of the affected side were 120°, 122° and 12° for the knee, elbow and ankle and extension losses of these joints were 5°, 7° and 0, respectively. In CwH having knee and elbow arthropathy, index joint HJHS was found to be significantly higher than those with ankle arthropathy (p < 0.01). The flexor and extensor muscle strength significantly decreased in 11 CwH with unilateral elbow arthropathy compared to the non-arthropatic side (p < 0.05). In 15 CwH with unilateral ankle arthropathy decreased in the extensor muscle strength (plantarflexors) (p < 0.05). Extension loss showed a good correlation with index HJHS of elbow, knee and ankle joints, respectively. (rs= 0.599, 0.576, 0.606, p < 0.01). We observed that the muscle strength of elbow flexors/extensors and ankle extensors were significantly decreased compared to the non-arthropathic side. However this situation was not detected in knee joint despite having highest index HJHS., Conclusion: Our findings indicate that hemarthrosis may cause more muscle strength loss in the upper extremity than the lower extremity. Furthermore, extension loss was found to be an important parameter in physical examination of hemophilic arthropathy. Musculoskeletal system should be evaluated comprehensively at regular intervals and when necessary rehabilitative treatment should be planned.
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- 2020
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47. Parent's report on oral health-related quality of life of children with haemophilia.
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Yazicioglu I, Deveci C, Çiftçi V, Antmen B, and Doğan MC
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- Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Emotions, Female, Humans, Male, Surveys and Questionnaires, Blood Coagulation Disorders, Inherited pathology, Caregivers psychology, Oral Health, Quality of Life
- Abstract
Introduction: Among children with haemophilia and their caregivers; problems arising from the teeth and the surrounding tissues have an important role in the treatment of this disease and it affects the quality of life of children and their parents., Aim: Aim of this study is to evaluate the oral health-related quality of life of children with haemophilia from the perspective of their parents., Methods: Paediatric oral health-related quality of life (POQL) instrument was used in this cross-sectional study for quality of life measurement. The research data collected by the questionnaire form were coded for scale items and personal information questions and transferred to SPSS, a multivariate statistical analysis program for social sciences. SPSS 23.0 (IBM Corp, Armonk, NY) package program was used for statistical analysis of the data., Results: Primary dentition dmft scores of patients with haemophilia are higher than the control group; mean value of haemophilic group is 3.5 vs control group are 2.6, respectively (P = 0.034). In spite of higher dmft scores, the haemophilia and control groups have shown no significant difference in oral health-related quality of life scores; median scores were 63.9 in haemophilic group and 85.3 in control group (P = 0.336), respectively., Conclusion: In spite of lower oral health measures, children with haemophilia and their parents reported no difference in oral health-related quality of life from their healthy counterparts., (© 2019 John Wiley & Sons Ltd.)
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- 2019
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48. Deferasirox in children with transfusion-dependent thalassemia or sickle cell anemia: A large cohort real-life experience from Turkey (REACH-THEM).
- Author
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Antmen B, Karakaş Z, Yeşilipek MA, Küpesiz OA, Şaşmaz İ, Uygun V, Kurtoğlu E, Oktay G, Aydogan G, Akın M, Salcioglu Z, Vergin C, Kazancı EG, Ünal S, Çalışkan Ü, Aral YZ, Türkkan E, Meral Güneş A, Tunç B, Gümrük F, Ayhan AC, Söker M, Koç A, Oymak Y, Ertem M, Timur Ç, Yıldırmak Y, İrken G, Apak H, Biner B, Eren TG, Işık Balcı Y, Koçak Ü, Karasu G, Akkaynak D, and Patıroğlu T
- Subjects
- Adolescent, Anemia, Sickle Cell therapy, Biomarkers, Blood Transfusion, Child, Child, Preschool, Cohort Studies, Deferasirox administration & dosage, Deferasirox adverse effects, Female, Ferritins blood, Ferritins metabolism, Humans, Iron blood, Iron metabolism, Iron Chelating Agents administration & dosage, Iron Chelating Agents adverse effects, Iron Overload metabolism, Male, Thalassemia therapy, Treatment Outcome, Turkey, Anemia, Sickle Cell complications, Deferasirox therapeutic use, Iron Chelating Agents therapeutic use, Iron Overload drug therapy, Iron Overload etiology, Thalassemia complications
- Abstract
Objectives: To evaluate the long-term efficacy and safety of deferasirox therapy in a large observational cohort of children with transfusion-dependent thalassemia (TDT) and sickle cell anemia (SCA) in Turkey., Methods: This was a multicenter, prospective cohort study including TDT and SCA patients aged 2-18 years with iron overload (≥100 mL/kg of pRBC or a serum ferritin [SF] level >1000 μg/L) receiving deferasirox. Patients were followed for up to 3 years according to standard practice., Results: A total of 439 patients were evaluated (415 [94.5%] TDT, 143 [32.6%] between 2 and 6 years). Serum ferritin levels consistently and significantly decreased across 3 years of deferasirox therapy from a median of 1775.5 to 1250.5 μg/L (P < 0.001). Serum ferritin decreases were noted in TDT (1804.9 to 1241 μg/L), SCA (1655.5 to 1260 μg/L), and across age groups of 2-6 years (1971.5 to 1499 μg/L), 7-12 years (1688.5 to 1159.8 μg/L), and 13-18 years (1496.5 to 1107 μg/L). Serum ferritin decreases were also noted for all deferasirox dose groups but only significant in patients with doses ≥30 mg/kg/d (n = 120, -579.6 median reduction, P < 0.001). Only 9 (2%) patients had adverse events suspected to be related to deferasirox. Serum creatinine slightly increased but remained within the normal range., Conclusions: Deferasirox has long-term efficacy and safety in children with TDT and SCA, although higher doses (≥30 mg/kg/d) may be required to achieve iron balance., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2019
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49. Cecum perforation induced by mycophenolate mofetil after hematopoietic stem cell transplantation: A case report and review of literature.
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Karagun BS, Akbas T, Arpaci T, and Antmen B
- Abstract
GI perforation after stem cell transplantation is extremely rare and is associated with poor prognosis. In addition, the clinical limitations of MMF are associated with GI intolerance and hematologic suppression. However, the exact mechanism whereby MMF induces changes in GI mucosa is unknown. Currently, there is no definite method to distinguish between GI toxicity associated with MMF and GVHD. It is important to recognize association between MMF and the histologic changes mimicking GVHD, given that GVHD is a significant differential diagnosis in stem cell transplant patients. MMF-induced colitis and GI perforation are extremely rare but should be considered in patients presenting with diarrhea and abdominal pain. Histology and clinical features are helpful to distinguish this condition from ischemic colitis. Early recognition of GI perforation is necessary for proper diagnosis and subsequent intervention. Emergency medical treatment and laparotomy have been shown to reduce the risk of fatal complications in patients presenting with GI symptoms suspected of GI perforation., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2018
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50. Eye Movement Disorders Following Allogeneic Bone Marrow Transplantation on FK506 (Tacrolimus) and Ganciclovir.
- Author
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Karagun BS, Akbas T, Arpaci T, and Antmen B
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- Adolescent, Antiviral Agents therapeutic use, Blepharoptosis chemically induced, Bone Marrow Transplantation methods, Ganciclovir therapeutic use, Graft vs Host Disease drug therapy, Humans, Immunosuppressive Agents therapeutic use, Male, Ocular Motility Disorders etiology, Tacrolimus adverse effects, Tacrolimus therapeutic use, Transplantation, Homologous, Treatment Outcome, Bone Marrow Transplantation adverse effects, Drug Therapy, Combination adverse effects, Graft vs Host Disease prevention & control, Ocular Motility Disorders chemically induced
- Abstract
FK506 (tacrolimus) is an immunosuppressive drug and more potent than cyclosporine. FK506 is widely used for immunosuppression in the prevention and treatment of graft-versus-host disease after allogeneic bone marrow transplantation and solid organ transplantation. Neurotoxicity is a recognized complication of FK506 therapy, but ptosis and weakness of eye abduction unilaterally has not been reported in association with FK506 administration to date. We discuss a 13-year-old male patient who developed ptosis and weakness of eye abduction unilaterally 90 days after transplantation with bone marrow from an unrelated donor, for acute lymphoblastic leukemia in this case report. FK506 therapy was administered for graft-versus-host disease prophylaxis and CMV infection was treated with ganciclovir. The physical examination findings completely resolved 72 to 96 hours after concomitant FK506 and ganciclovir treatment were terminated.
- Published
- 2018
- Full Text
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