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Aims:Lactate dehydrogenase (LDH) and platelet count are routinely used to evaluate response to treatment and discontinuation of treatment in thrombotic thrombocytopenic purpura (TTP). This study aimed to evaluate the mean platelet volume (MPV) and platelet distribution width (PDW) in immune TTP (iTTP) as markers of treatment response.Methods:This retrospective, multicenter study included patients diagnosed with iTTP with severe ADAMTS13 deficiency. We studied the correlations of MPV and PDW values with platelet count, LDH, total bilirubin hematocrit and mean corpuscular volume, which are used to evaluate the response to total plasma exchange (TPE) or relapse in iTTP. The study variables were recorded at the time of diagnosis, 1st week of TPE treatment, and the time of the last TPE. The correlation analyses were performed between the values before the initial TPE, and after the first week and last TPE.Results:The study included 28 patients, 20 females with iTTP [median age (minimum-maximum): 45 (23-74) years]. MPV correlated positively with LDH (r=0.533, p=0.002) and negatively with hematocrit (r=-0.445, p=0.002) and platelet count (r=-0.560, p=0.002). PDW also correlated positively with LDH (r=0.339, p=0.008) and negatively with hematocrit (r=-0.244, p=0.032) and platelet count (r=-0.285, p=0.022).Conclusions:The results showed that MPV and PDW correlated with LDH and platelet count, which are currently used to evaluate the response to treatment in iTTP. Changes in MPV and PDW may serve as a surrogate of treatment response in these patients as an indicator of response to plasmapheresis.

Abstract Background Neoadjuvant treatment is the standard treatment in locally advanced ESCC. However, the optimal chemotherapy regimen is not known. Method This is a retrospective observational cohort study conducted with propensity score matching. Patients with resectable ESCC from 13 tertiary centers from Türkiye were screened between January 2011 and December 2021. We compared the efficacy and safety of neoadjuvant chemoradiotherapy with the CF and the CROSS regimens in patients with ESCC. Results Three hundred and sixty‐two patients were screened. Patients who received induction chemotherapy (n = 72) and CROSS‐ineligible (n = 31) were excluded. Two hundred and fifty nine patients received neoadjuvant chemoradiotherapy. After propensity score matching (n = 97 in both groups), the mPFS was 18.4 months (95% CI, 9.3–27.4) and 25.7 months (95% CI, 15.6–35.7; p = 0.974), and the mOS was 35.2 months (95% CI, 18.9–51.5) and 39.6 months (95% CI 20.1–59.2; p = 0.534), in the CF and the CROSS groups, respectively. There was no difference between subgroups regarding PFS and OS. Compared with the CF group, the CROSS group had a higher incidence of neutropenia (34.0% vs. 62.9%, p

Abstract Introduction Resistance to immune checkpoint inhibitors (ICI) is a significant issue in metastatic renal cell carcinoma (mRCC), as it is in the majority of cancer types. An important deficiency in immunooncology today is the lack of a predictive factor to identify this patient group. Myeloid-derived suppressor cells (MDSC) are a type of cell that contributes to immunotherapy resistance by inhibiting T cell activity. While it accumulates in the tumor microenvironment and blood, it can also accumulate in lymphoid organs such as the spleen and cause splenomegaly. Therefore we aimed to evaluate the effect of increase in splenic volume, which can be considered as an indirect indicator of increased MDSC cells, on survival outcomes in mRCC patients. Methods We analyzed 45 patients with mRCC who received nivolumab as a second-line or subsequent therapy. Splenic volume was analyzed from baseline imaging before starting nivolumab and from control imaging performed within the first 6 months of treatment initiation. Additionally, we analyzed how patients’ body mass index (BMI), IMDC risk score, ECOG performance status, nephrectomy status, neutrophil-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR) and sites of metastasis. Results Median splenic volume change was 10% (ranging from − 22% to + 117%) during follow-up. Change in splenic volume was found to be associated with overall survival (OS) and progression-free survival (PFS) (p = 0.025, 0.04). The median PFS in patients with increased splenic volume was 5 months, while it was 17 months in patients without increased splenic volume. (HR 2.1, 95% CI (1–4), p = 0.04). The median OS in patients with increased splenic volume was 9 months, while it was 35 months in patients without increased splenic volume (HR 2.7, 95% CI (1.1–6.2), p = 0.025). In four patients with decreased splenic volume, neither PFS nor OS could reach the median value. Log-rank p value in respectively (0.015, 0.035), The group in which an increase in volume was accompanied by a high NLR had the shortest survival rate. Basal splenic volume was analyzed separately. However, neither PFS nor OS differed significantly. Conclusion Our findings suggest that the change in splenic volume throughout immunotherapy regimens may be utilized to predict PFS and OS in mRCC patients undergoing treatment.

Objective: Achieving an early molecular response (EMR) is crucial for improving the prognosis of patients with chronic myeloid leukemia (CML). The halving time (HT) and reduction ratio (RR) of BCR: : ABL1 transcript levels have recently emerged as additional prognostic indexes besides the BCR: : ABL1 International Scale (IS). We aimed to investigate the prognostic role of BCR: : ABL1 transcript levels, HT, and RR on molecular response kinetics at 3 months in patients with newly diagnosed chronic-phase (CP)-CML. Materials and Methods: Forty patients with CP-CML who received first-line imatinib treatment were included in this study. BCR: : ABL1 transcript levels and molecular responses at baseline and at 3, 6, 12, and 24 months of treatment were evaluated retrospectively. Major molecular response (MMR) at 12 months and event-free survival (EFS) were determined as primary endpoints and the effects of treatment kinetics on these parameters were examined. Results: Of the 40 patients, BCR: : ABL1 IS was ≤10% at 3 months in 72.5%, representing EMR. The rate of event occurrence was 45.5% in patients with BCR: : ABL1 IS of >10%, whereas it was 6.9% in those with BCR: : ABL1 IS of ≤10% (p=0.004). MMR was detected in 62.1% of the patients with EMR and in 9.1% of those without EMR (p=0.003). The cut-off value for achieving MMR was 24 days for HT and 0.04 for RR. Deep molecular response (DMR) at 24 months was associated with HT of ≤24 days and RR of ≤0.04. EFS was found to be significantly better in the group with BCR: : ABL1 IS of ≤10% and HT of ≤24 days (p=0.001) and in the group with BCR: : ABL1 IS of ≤10% and RR of ≤0.04 (p=0.007) compared to others. Conclusion: Our findings revealed that MMR could be predicted via EMR as well as by HT and RR. Additionally, HT of ≤24 days and RR of ≤0.04 were more important than BCR: : ABL1 IS of ≤10% in achieving DMR at 24 months, and the combination of BCR: : ABL1 IS of ≤10% with both HT of ≤24 days and RR of ≤0.04 has the best predictive value for EFS.

Background: The transmembrane receptor tyrosine kinase-like orphan receptor 1 (ROR1) has acted on the causation and sustentation of mature B cell lymphomagenesis for chronic lymphocytic leukemia (CLL) cells. The aim of this study was to show whether there is a relationship between the level of ROR1 surface expression in CLL cells and disease findings. Materials and Methods: The level of ROR1 cell surface expression was determined in accordance with the flow cytometric analysis of CLL patients at the first diagnosis time. 2 groups were formed according to the high and low ROR1 levels. The cut-off point to the ROR1 level was calculated for advanced-stage disease by using receiver operating characteristic (ROC) curves. A two-sided p-value

Objective: This study aimed to retrospectively evaluate the efficacy, safety, and survival outcome of single-agent ibrutinib therapy in chronic lymphocytic leukemia patients. Materials and Methods: A total of 136 patients (mean age +- standard deviation: 64.6+-10.3 years, 66.9% males) who had received at least one dose of ibrutinib were included in this retrospective multicenter, noninterventional hospital-registry study conducted at 33 centers across Turkey. Data on patient demographics, baseline characteristics, laboratory findings, and leukemia-cell cytogenetics were retrieved. Treatment response, survival outcome including overall survival (OS) and progression-free survival (PFS), and safety data were analyzed. Results: Overall, 36.7% of patients were categorized as Eastern Cooperative Oncology Group (ECOG) class 2-3, while 44.9% were in Rai stage 4. Fluorescence in situ hybridization revealed the presence of del(17p) in 39.8% of the patients. Patients received a median of 2.0 (range: 0-7) lines of pre-ibrutinib therapy. Median duration of therapy was 8.8 months (range: 0.4-58.0 months). The 1-year PFS and OS rates were 82.2% and 84.6%, respectively, while median PFS time was 30.0 (standard error, 95% confidence interval: 5.1, 20.0-40.0) months and median OS time was 37.9 (3.2, 31.5-44.2) months. Treatment response (complete or partial response), PFS time, and OS time were better with 0-2 lines versus 3-7 lines of prior therapy (p

Recent advances in hematology analyzers have enabled to improve the reliability in the results and also provided additional hematological parameters. In the present study, we aimed to determine the reference ranges for automated erythrocyte and reticulocyte parameters in healthy individuals on Sysmex XN 1000 hematology analyzer.

This study aimed to assess the efficacy and safety of FOLFIRI and paclitaxel in patients with advanced gastric cancer (AGC) who were previously treated with first-line modified docetaxel, cisplatin, 5-fluorouracil (mDCF), or 5-fluorouracil, oxaliplatin, docetaxel (FLOT). Patients who received a triplet regimen in the first line setting and were treated with FOLFIRI or paclitaxel in the second-line treatment were included. The study included 198 patients, with 115 receiving FOLFIRI and 83 receiving paclitaxel. The median age was 58 (range = 24–69). The median progression-free survival (mPFS) was 5.2 [95% confidence interval (CI) = 4.4–5.5] months in the FOLFIRI arm, and 4.1 (95% CI = 3.3–4.6) months in the paclitaxel arm (p =.007). The median overall survival (mOS) was 9.4 (95% CI = 7.4–10.5) months in the FOLFIRI arm and 7.2 (95% CI = 5.6–8.3) months in the paclitaxel arm (p =.008). Grade 3–4 neuropathy was higher in patients receiving paclitaxel compared to those receiving FOLFIRI (p =.04). Grade 3–4 diarrhea was 8% in the FOLFIRI arm and 2.4% in the paclitaxel arm (p =.02). Beyond progression with docetaxel-based triplet chemotherapy, FOLFIRI may be preferred as a second-line treatment over paclitaxel due to its longer mPFS and mOS. [ABSTRACT FROM AUTHOR]

Introduction: The current study aims to evaluate the OX40, TIM-3, LAG-3, and PD-L1 targeted pathways in the regulation of T-cell activity in sarcoma patients to determine their relationship with overall survival (OS). Method: This study included one hundred and eleven patients with bone and soft tissue sarcoma diagnosed in two centers between 2010 and 2020. OX40, LAG-3, TIM-3 and PD-L1 expression levels were evaluated immunohistochemically from pathology preparations. Results: PD-L1 staining was detected in tumor cells, OX40, LAG-3, TIM-3 staining was detected in inflammatory cells in tumor tissue. In univariate analysis, no significant relationship was found between OX40, TIM-3, LAG-3, and PD-L1 staining and overall survival (respectively: p = 0.12, p = 0.49, p = 0.31, p = 0.95). When grade and stage at diagnosis, which were found to be significant in univariate analysis, along with OX-40, TIM-3, LAG-3, and PD-L1, were evaluated in multivariate analysis, a positive effect of OX-40 staining on overall survival was determined (p = 0.009). Considering the correlation between PDL-1 and OX40, TIM-3, and LAG-3 staining, a significant positive correlation was found between PDL-1 and TIM-3 and LAG-3 staining (respectively; p = 0.002, p = 0.001). Conclusions: There was no significant relationship between the PDL-1 staining percentage of tumor cells and OX40, TIM-3, and LAG-3 staining in inflammatory cells with the OS of sarcoma patients. However, detecting a significant positive correlation between PDL-1 staining and TIM-3 and LAG-3 staining also holds promise for finding effective targetable combination therapies that can prolong survival in sarcoma patients in the future. [ABSTRACT FROM AUTHOR]

Objective: Autologous hematopoetic stem cell transplantation (aHSCT) after high dose chemotherapy is a standard treatment for multiple myeloma (MM) patients. The successful aHSCT depends on collection of sufficient numbers of hematopoietic progenitor stem cells and sustained engraftment following infusion. The aim of the present study is to determine the the impact of bone marrow fibrosis (BMF) on the clinical outcomes of MM patients who underwent aHSCT. Methodology: Retrospectively, bone marrow trephine biopsy analyzed in 73 MM patients who were treated with hematopoietic stem cell transplantation (aHSCT) following bortezomib based induction regimen. The BM biopsy samples of all patients were re-evaluated by a single pathologists The patients divided into 4 groups according to fibrosis degree and the correlations in initial characteristic features, therapeutic response, survival, mobilization and engraftment outcomes were reviewed between the groups. Results: Comparative analyses revealed that the median apheresis number was found statistically different according to groups (p=0.04). No significance was detected between the fibrozis grade and the number of peripheral blood CD34+ cell collection results and recovery time of neutrophils and platelets. Overall survival and progression free survival were found similar in groups, however relapse of disease was statistically different in patients with fibrosis (p=0.01). Conclusion: After induction treatment, a regression was observed in fibrosis grade of patients who had fibrosis at the time of diagnosis. Therefore we suggest to evaluate fibrosis status in all MM patients during each histopathological examination. Difficulties may be experienced during stem cell collection in transplant eligible MM patients with fibrosis at diagnosis. Therefore, we recommend that clinicians should be more careful in these patients during the induction treatment and stem cell mobilization.

Aims: Lactate dehydrogenase (LDH) and platelet count are routinely used to evaluate response to treatment and discontinuation of treatment in thrombotic thrombocytopenic purpura (TTP). This study aimed to evaluate the mean platelet volume (MPV) and platelet distribution width (PDW) in immune TTP (iTTP) as markers of treatment response. Methods: This retrospective, multicenter study included patients diagnosed with iTTP with severe ADAMTS13 deficiency. We studied the correlations of MPV and PDW values with platelet count, LDH, total bilirubin hematocrit and mean corpuscular volume, which are used to evaluate the response to total plasma exchange (TPE) or relapse in iTTP. The study variables were recorded at the time of diagnosis, 1st week of TPE treatment, and the time of the last TPE. The correlation analyses were performed between the values before the initial TPE, and after the first week and last TPE. Results: The study included 28 patients, 20 females with iTTP [median age (minimum-maximum): 45 (23-74) years]. MPV correlated positively with LDH (r=0.533, p=0.002) and negatively with hematocrit (r=-0.445, p=0.002) and platelet count (r=-0.560, p=0.002). PDW also correlated positively with LDH (r=0.339, p=0.008) and negatively with hematocrit (r=-0.244, p=0.032) and platelet count (r=-0.285, p=0.022). Conclusions: The results showed that MPV and PDW correlated with LDH and platelet count, which are currently used to evaluate the response to treatment in iTTP. Changes in MPV and PDW may serve as a surrogate of treatment response in these patients as an indicator of response to plasmapheresis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Economic & Social Research / ESAM Ekonomik ve Sosyal Araştırmalar Dergisi is the property of Ekonomik ve Sosyal Arastirmalar Merkezi (Journal of Economic & Social Research) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Classical serum sickness is a type III immune complex-mediated hypersensitivity disease caused by immunization of the host by non-human serum proteins. Anti-thymocyte globulin is one of the agents mostly responsible. Prophylactic steroids are used in the treatment protocol of aplastic anemia in addition to anti-thymocyte globulin. A 33-year-old female patient diagnosed with aplastic anemia developed severe serum sickness with anti-thymocyte globulin, despite the administration of a prophylactic dose of methylprednisolone. The patient responded dramatically to a single dose of pulse steroid therapy. There are reports that high-dose steroids (1-2 mg/kg/day to 500-1000 mg/day methylprednisolone) and/or therapeutic plasma exchange are beneficial treatment options. Our report shows the benefit of a single pulse dose of steroid and gradual tapering of the dose in this case. [ABSTRACT FROM AUTHOR]

Objective: To examine granulocytic and non-granulocytic cells in children with severe congenital neutropenia (SCN) and their nonneutropenic parents. Materials and Methods: Fifteen patients with SCN and 21 nonneutropenic parents were evaluated for a) CD95, CD95 ligand, annexin V, propidium iodide, cell cycle, and lymphocyte subsets by flow cytometry; b) rapid cell senescence (of leukocytes) by senescenceassociated β-galactosidase stain; c) aggregation tests by aggregometer; d) in vitro bleeding time by PFA-100 instrument; e) mepacrine-labeled dense granule number of thrombocytes by fluorescence microscope; and f) hematomorphology by light and electron microscope. HAX1, ELANE, G6PC3, CSF3R, and JAGN1 mutations associated with SCN were studied in patients and several parents. Results: Significant increase in apoptosis and secondary necrosis in monocytes, lymphocytes, and granulocytes of the patients and parents was detected, irrespective of the mutation type. CD95 and CD95 ligand results implied that apoptosis was non-CD95- mediated. Leukocytes of 25%, 12.5%, and 0% of patients, parents, and controls showed rapid cell senescence. The cell cycle analysis testable in four cases showed G1 arrest and apoptosis in lymphocytes of three. The patients had HAX1 (n=6), ELANE (n=2), G6PC3 (n=2), and unidentified (n=5) mutations. The CD3, CD4, and NK lymphocytes were below normal levels in 16.6%, 8.3%, and 36.4% of the patients and in 0%, 0%, and 15.4% of the parents (controls: 0%, 0%, 5.6%). The thrombocytes aggregated at low rates, dense granule number/ thrombocyte ratio was low, and in vitro bleeding time was prolonged in 37.5%-66.6% of patients and 33.3%-63.2% of parents (vs. 0% in controls). Under electron and/or light microscope, the neutrophils, monocytes, lymphocytes, and thrombocytes in the peripheral blood of both patients and parents were dysplastic and the bone marrow of patients revealed increased phagocytic activity, dysmegakaryopoiesis, and necrotic and apoptotic cells. Ultrastructurally, thrombocyte adhesion, aggregation, and release were inadequate. Conclusion: In cases of SCN, patients' pluripotent hematopoietic stem cells and their non-neutropenic parents are both affected irrespective of the genetic defect.

Objective: Atypical chronic lymphocytic leukemia (CLL) is most frequently confused with mantle cell lymphoma (MCL). Several markers may contribute to the diagnosis of CLL. However, there is no consensus on which markers are needed to be used in flow cytometry for the diagnosis of CLL. The aim of the present study was to investigate the role of CD43 and CD200 markers in the differential diagnosis between CLL and MCL. Materials and Methods: To address this issue, 339 consecutive patients with CLL and MCL were included in the flow cytometry lymphoproliferative disease panel for evaluation of CD43 and CD200 expressions, but not in the Matutes scoring system. Results: CD200 was expressed in 97.3% of atypical CLL cases, whereas it was dimly expressed in only 6.1% of MCL cases. CD43 expression was 95.7% in atypical CLL cases. In the MCL cases, its expression rate was 39.4%. Conclusion: CD43 and CD200 were found to be more valuable markers than CD22, CD79b, and FMC7. CD43 and CD200 could also be considered as definitive markers in atypical CLL patients, for whom the Matutes scoring system remains ineffective.

Byline: Hayriye. Sahinli, Nalan. Akyürek, Mukaddes. Yilmaz, Olcay. Kandemir, Ayse. Duran, Sezer. Kulaçoglu, Gökhan. Uçar, Elif. Acar, Ahmet. Özet, Mahmut. Gümüs, Ö. Ç. Öksüzoglu, Nuriye. Özdemir Background: Programmed death-ligand 1 [...]

Background: Prior speculation suggests that selective 5-hydroxytryptamine-3 receptors and neurokinin-1 receptor antagonists may increase arrhythmia risk and induce electrocardiographic changes. This study examined the effect of anti-emetic medications on arrhythmogenic potential and hemodynamic alterations. Methods: We considered patients aged 18 or above receiving chemotherapy between June 2013 and December 2013. Patients were grouped by anti-emetic medication: intravenous granisetron (Group G), oral aprepitant plus IV granisetron (Group AG), IV palonosetron (Group P), and oral aprepitant plus IV palonosetron (Group AP). We recorded blood pressure and electrocardiography initially and at the thirtieth minute post-medication, focusing on P dispersion, QTc dispersion, and systolic/diastolic blood pressure alterations. Results: The study included 80 patients (20 per group). Baseline systolic/diastolic blood pressure and P dispersion showed no significant variance. However, the baseline QTc dispersion was significantly lower in Groups P and AP than G and AG. The thirtieth-minute systolic/diastolic blood pressures were significantly lower than the baseline for Groups AG and AP, and the heart rates decreased in all groups. Group P showed significantly fewer blood pressure changes. Conclusions: We found no arrhythmogenic potential linked to granisetron, palonosetron, and aprepitant. Hypotension was more frequent at 30 min post-medication in granisetron or aprepitant recipients. Considering no hypotension occurred when using palonosetron alone, this treatment was deemed safer. [ABSTRACT FROM AUTHOR]

We investigated expressions of PD-L1, LAG-3, TIM-3, and OX40L as immune checkpoint proteins, and MSI (repetitive short-DNA-sequences due to defective DNA-repair system) status were analyzed with immunohistochemistry from tissue blocks. Of 83 patients, PD-L1 expression was observed in 18.1% (n = 15) of the patients. None of the patients exhibited LAG-3 expression. TIM-3 expression was 4.9% (n = 4), OX40L was 22.9% (n = 19), and 8.4% (n = 7) of the patients had MSI tumor. A low-to-intermediate positive correlation was observed between PD-L1 and TIM-3 expressions (rho: 0.333, p < 0.01). Although PD-L1 expression was higher in grade 3 NET/NEC, MSI status was prominent in grade 1/2 NET. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Turkish Society for Rheumatology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background This study aimed to evaluate the efficacy and side effects of bortezomib, cyclophosphamide and dexamethasone (VCD) treatment, which is frequently preferred in primary care in patients with multiple myeloma in our country, with two applications per week and one application per week. Methods A total of 141 patients who received VCD in the induction treatment of newly diagnosed multiple myeloma were retrospectively reviewed and analysed. Both treatment groups were evaluated in terms of efficacy and side effects. Results A total of 141 patients with newly diagnosed multiple myeloma who received VCD in induction therapy were included in the study. The median age was 62 years. Among 141 patients included in the study, 57 patients received treatment two days a week and 84 patients received treatment one day a week. Sixty-one (43.3%) patients were female and 80 (56.7%) were male. There was no significant difference between the two groups in terms of post-treatment response rates after 2nd cycle VCD regimen (p=0.378) and 4th cycle VCD regimen (p=0.965). Patients receiving weekly VCD regimen had a significantly higher rate of receiving other regimens, and additional VCD regimen of autologous stem cell transplant (ASCT) was significantly higher in patients who received a VCD regimen twice a week compared to the other group (p<0.001). ASCT was performed in 73% of the patients (n: 103). In 54 patients with ASCT at the end of 4th cycle VCD, there was no significant difference between very good partial response/complete response rates and partial response/sub responses between the two groups according to the 3rd month post-transplant responses (p=0.612). Neuropathy was observed in seven (12.3%) patients receiving twice-weekly VCD regimens, while neuropathy was observed in 16 (19.3%) and neutropenia in two (2.4%) patients receiving weekly VCD regimens. The two groups had no significant difference regarding side effects (p=0.387). Conclusion Our study found no significant difference in the treatment response rates of patients receiving weekly VCD and twice-weekly VCD. The low rates of ASCT in the weekly VCD group were thought to be related to the fact that the patients receiving the weekly regimen were older than the other group and were unsuitable for ASCT due to age. No difference was observed between the two groups regarding the frequency of side effects. [ABSTRACT FROM AUTHOR]

Introduction: Niraparib, a strong poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor, contributed significantly to progression-free survival as a maintenance therapy in the platinum-sensitive period in both first-line and recurrent ovarian cancer, regardless of the BRCA mutation. Grade 3–4 anemia, which has a manageable side effect profile, especially hematological, is seen in almost 1 out of every 4 patients. To the best of our knowledge, there has been no reported case of pure red cell aplasia (PRCA) induced by niraparib treatment. Case Report: A 65-year-old woman diagnosed with stage 3 serous carcinoma of the tuba received niraparib front-line maintenance treatment had grade 4 anemia after 3 months of niraparib treatment. She underwent bone marrow aspiration and biopsy because of refractory anemia, which needs red blood cell (RBC) transfusions despite interruption of treatment. Management and Outcome: The patient was treated with 1 mg/kg methyl prednisolone, after histopathological assessment was consistent with PRCA. The hemoglobin count returned to the normal range with steroid treatment. Discussion: In daily practice, it should be kept in mind that in the case of refractory anemia induced by niraparib, the underlying cause might be PRCA and can be improved with steroid administration. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to evaluate the effect of the time duration to reach the lowest prostate-specific antigen (PSA) from the onset of first-line hormonal treatment (time to nadir PSA, TTNpsa) on survival in castration-naive metastatic prostate cancer (CN-MPC) patients. Methods: Eighty patients who had PSA response >80% with first-line hormonal therapy (luteinizing hormone-releasing hormone, LH-RH analog +/- bicalutamide) were included in this study. Results: Under androgen deprivation therapy (ADT), a significant positive correlation was found between TTNpsa, nadir PSA (Npsa) duration, and progression-free survival (PFS) (p < 0.001) and overall survival (OS) (p < 0.001). There was no correlation between TTNpsa and Npsa duration. TTNpsa and Npsa durations were independently correlated with PFS and OS. In patients with TTNpsa value ≥19 weeks, the median PFS was 126 (95% CI, 68–184) weeks compared with TTNpsa <19-week group in which the median PFS was 44 (95% CI, 26–62) weeks (p = 0.033). In patients with TTNpsa value ≥19 weeks, the median OS was 242 (95% CI, 169–315) weeks compared with TTNpsa <19-week group in which the OS was 156 (95% CI, 89–223) weeks (p = 0.018). The median nadir PSA value was 1 ng/mL. The median PFS was significantly longer in the patient group with ≤1 ng/mL (137 weeks, 95% CI, 50–224) compared with the group with >1 ng/mL (41 weeks, 95% CI, 34–48) (p < 0.001). The median OS was significantly longer in the patient group with nadir PSA ≤1 ng/mL (296 weeks, 95% CI, 220–272) compared to the group with >1 ng/mL (131 weeks, 95% CI, 84–178) (p = 0.002). In patients with nadir PSA ≤1 ng/mL (n = 40), there was no relationship between TTNpsa and Npsa duration with both PFS and OS. However, in patients with nadir PSA >1 ng/mL (n = 40) subgroup, there was a significant positive correlation between TTNpsa and PFS, and OS (p < 0.001, P = 0.016, respectively). Conclusion: In CN-MPC who received first-line ADT, especially in the group with the nadir PSA value >1 ng/mL, the duration of TTNpsa was positively correlated with PFS and OS. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to investigate the relationship between the CD56 and CD117 expressions and the clinical and laboratory findings in multiple myeloma (MM) patients. Materials and Methods: Analyses of multiparametric flow cytometry data obtained from the diagnostic bone marrow aspirations of a total of 34 newly diagnosed MM patients were assessed retrospectively. CD56 and CD117 expressions of the patients were compared with their stages and clinical parameters. The staging was performed according to the International Staging System (ISS). Results: Of the patients, 58.8% had ISS stage 1-2 MM while 41.2% had stage 3 MM. The number of CD56-positive patients was 29, whereas the number of CD117-positive patients was 13. There was no statistical difference between the CD56 and CD117 expressions and extramedullary involvement and lytic bone lesions. The median beta-2 microglobulin level was higher in the CD117-negative group (p=0.047). CD56 and CD117 expression levels were found to be lower in advanced-stage patients than in early-stage ones (p=0.026 and p=0.017). The lactate dehydrogenase (LDH) levels were high in advanced-stage patients, and an inverse relationship was found between LDH level and CD117 expression. Conclusion: Our findings that the CD56 and CD117 expression levels are lower in advanced stages than earlier stages and that LDH level and CD117 expression have an inverse relationship in patients with newly diagnosed MM suggest that CD56 and CD117 expressions may be prognostic markers for MM.

Copyright of Gazi Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background The earthquakes in February 2023 in Turkey had a major impact on Turkey’s health system, causing damage to hospitals and health centres in the affected areas. Cancer patients are one of the groups that are highly influenced by the disaster. The aim of this study was to evaluate some of the demographic and clinical characteristics of cancer patients who are getting health care in earthquake-affected areas. Material and Methods Fifty cancer patients who lived in 11 cities of Turkey affected by the earthquake and were admitted to Gazi University Department of Medical Oncology after the earthquake between 15 February 2023 and 15 March 2023 were included in the study. Data such as demographic characteristics, cancer diagnosis, time of cancer treatment, and earthquake history were taken retrospectively from nationally-linked electronic records (E-nabız). Results Breast cancer was the most common diagnosis of these patients. Most of the patients were taking active treatment (60%). Chemotherapy and hormonotherapy were the most common treatment modalities (20% and 18%, respectively). The median delay in the active treatment of 14 cancer patients was 24 days (2-60). Conclusions The earthquake disaster has led to important impacts on cancer patients’ care in most affected areas. The human, financial and medical resources should be improved. Especially if detailed nationally-linked electronic records are provided, cancer patients will not have difficulty seeking health care. This disaster should be an important stimulus for hospitals and healthcare systems to improve the care of patients during disasters. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is the most common cancer in women worldwide. One of the treatment choices used in hormone receptor positive and HER2 expression negative metastatic breast cancer is cyclin dependent kinase 4/6 (CDK) inhibitors. There are differences between the effects and adverse events of all CDK4/6 inhibitors. In this report, we describe a 48-year-old female patient with breast cancer who developed pulmonary infiltrates secondary to drug in the second year of follow-up with Ribociclib therapy. Case Report: The patient who used ribociclib for metastatic breast cancer was admitted to hospital for routine controls. The patient, in the eighth month of ribociclib treatment, had no active complaints. In the patient's imaging, pulmonary infiltrates were detected in the lower lobe of the right lung. Management and Outcome: The drug was continued in the patient who was asymptomatic and had no infectious signs. Pneumonitis, interstitial lung disease, tuberculosis, COVID-19 and other viral agents were excluded in the patient. A minimal increase in pulmonary infiltrates was observed in the follow-up. However, the patient who does not have any complaints is currently continuing ribociclib at 600 mg/day. Discussion: The pulmonary infiltrates that developed in the patient increased with continued use of ribociclib, suggesting that this was due to ribociclib. The Naranjo Adverse Drug Reaction Probability Scale also indicates probable relationship. [ABSTRACT FROM AUTHOR]

Objectives: We analyzed the impact of some clinical and disease-specific factors on the long-term outcomes of SARS-CoV-2 infection in patients with solid tumors. Methods: Total of 739 patients with known solid malignancy and infected by SARS-CoV-2 before the beginning of vaccination were examined. Results: Seventy-six cancer patients died from COVID-19 infection-related effects such as mostly pulmonary and cardiovascular system disorders after a median 16-month follow-up (67.1% and 14.5%; respectively). Compared with survivors (n = 468), non-survivors due to COVID-19 infection related effects (n = 76) were more likely to be aged = 65 years and diagnosis with lung cancer (p = 0.01). Also, female patients were at decreased risk of mortality [OR: 0.34 (95% CI: 0.18-0.65)]. Furthermore, patients with tumor stage IV, active/stable/progressive disease and patients receiving active anticancer therapy were at increased risk of mortality (p = 0.01). Conclusions: The patients with aged = 65 years, diagnosed with lung cancer, receiving active anticancer therapy, with active/stable/progressive and advanced cancer stage were at increased risk of mortality from COVID-19 infection in long-term follow-up. [ABSTRACT FROM AUTHOR]

Objective:There is an increase in the incidence of cancer, and consequently in mortality rates, both in the world and in Turkey. The increase in the incidence and mortality rate of cancer are more prominent in our country as well as in other developing countries. The aim of this workshop was to determine the current status on prevention, screening, early diagnosis and treatment of cancer in our country, to identify related shortcomings, specify solutions and to share these with health system operators, and to aid in implementation of these systems. Developments on palliative care were also evaluated.Materials and Methods:The current situation in the practice of clinical oncology, related drawbacks, problems encountered during multidisciplinary approach and their solutions were discussed under several sub-headings during a 3-day meeting organized by the Turkish Ministry of Health (Türkiye Cumhuriyeti Sağlık Bakanlığı- TCSB) with participation of 16 scientists from Turkey and 6 from abroad, and the conclusions were reported.Results:It is expected that the newly established Turkish Health Institutes Association (Türkiye Sağlık Enstitüleri Başkanlığı-TÜSEB) and the National Cancer Institute (Ulusal Kanser Enstitüsü) will provide a new framework in the field of oncology. The current positive findings include the increase in the number of scientists who carry out successful trials in oncology both in Turkey and abroad, the implementation of the national cancer registry program by the Cancer Control Department and the breast cancer registry program by the Turkish Federation of Breast Diseases Societies (Türkiye Meme Hastalıkları Dernekleri Federasyonu-TMHDF), and introduction of Cancer Early Diagnosis, Screening, and Training Centers (Kanser Erken Tanı, Tarama ve Eğitim Merkezi-KETEM) for the application of community-based cancer screening programs. In addition to these, obvious shortcomings related to education, implementation, management and research issues were also determined, and policy and project proposals to address these issues were presented. Collaboration with relevant organizations in the implementation of these studies was supported.Conclusion:Both the incidence and mortality rates of cancer are increasing in Turkey. The widespread deficiencies in population-based screening and in effective treatment lead to an increase in delay in diagnosis and mortality. Despite improvements in data recording, screening and treatment over the last 10 years, extensive, organized, population-based screening programs and fully equipped early diagnosis and treatment centers are required. Enhancement of basic cancer epidemiologic, translational, genetic and molecular research studies is essential in our country. Improvements on pain treatment and palliative care of patients with chronic and terminal cancer are also required.

Copyright of TESAM Academy Journal is the property of Tesam Academy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE The aim of the study is to compare treatment outcomes of the patients with federation of gynecology and obstetrics stages III and IV ovarian carcinomas, who underwent interval debulking surgery after neoadjuvant chemotherapy (NACT), and patients who underwent adjuvant chemotherapy after primary debulking surgery (PDS). METHODS Patients from four centers (n=183) were retrospectively evaluated. Of the patients, 91 (50%) were in the PDS group and 92 (50%) in the NACT group. RESULTS In the NACT group patients have advanced age, poor performance status, high levels of CA125, and advanced disease stage compared with the PDS group (p<0.050). Of the patients receiving NACT, 14 (15%) had a complete response, and 68 (74%) had a partial response. The R0 rate was higher in the PDS group (p=0.018). In univariate analysis, poor prognostic factors affecting OS were NACT in the treatment protocol (p<0.001), poor performance status (p<0.001), advanced age (<70 vs. =70, p=0.002), advanced clinical stage (p=0.042), and localization of the tumor with the largest diameter outside the omentum and ovary at the time of diagnosis (p=0.029). In the multivariate analysis, the presence of NACT (HR: 2.30, 95% CI: 1.25-4.23, p=0.007) and poor performance (HR: 2.52, 95% CI: 1.18-5.10, p=0.017) were independent poor prognostic factors for OS. CONCLUSION In the study, OS was better in the PDS group than in the NACT group. This result was thought to be associated with the NACT group having more disadvantageous characteristics (advanced age, poor performance, high CA125 level, advanced stage, etc.). [ABSTRACT FROM AUTHOR]

The prognosis of metastatic melanoma is poor. Pre-targeted treatment era, the combination of interferon-α (IF-α) plus chemotherapy had been used and have generally short response duration. Herein, we present a metastatic melanoma case that achieved long-term durable complete response (CR) IF-α plus chemotherapy and IF-α maintenance therapy and had lower Regulatory T (Treg) cells. A fifty-year old woman was admitted to the hospital with metastatic melanoma. Lactate dehydrogenase (LDH) level was 660 U/L. The percentage of CD4+CD25+ Treg cells was 2.4% in CD4+ lymphocytes. The IF-α plus chemotherapy and IF-α maintenance were administered. After six courses of chemotherapy, CR was achieved. Vitiligo and hypothyroidism occurred. The patient has remained in CR for approximately 7 years until second pleural metastases were detected and death. The patient has positive prognostic factors such as induction of autoimmunity, small tumor volume, mild elevated LDH level, and lower Treg cell percentage. She survived long term with CR after IF-α treatment with concurrent chemotherapy and maintenance. IF-α plus chemotherapy may be a treatment option for metastatic melanoma in selected cases who cannot reach new targeted drugs.

OBJECTIVE: The plasminogen activator system consists of the serine protease urokinase plasminogen activator (uPA), two endogenous inhibitors of PAI-1 (plasminogen activator inhibitor-1) as well as the PAI-2 and uPA receptor (uPAR or CD87). The aim of this study was to determine the significance of flow cytometry and CD87, CD45 and CD56 expressions in the diagnosis, follow-up and prognosis of multiple myeloma (MM). METHODS: Twenty-nine MM patients were included in the study. Bone marrow samples were used for flow cytometry. A panel of CD87, CD45, CD56, CD10, CD19, CD20, CD38, and CD138 was tested by flow cytometry. RESULTS: CD87 was negative in 8 (27.5%) cases, dim positive in 9 (31.1%) and bright positive in 12 (41.4%). CD87 expression was significantly higher in CD45 (-) cases. CONCLUSION: Flow cytometry has a significant role in the diagnosis and prognosis of MM. Further clinical studies including large numbers of patients are needed to determine the prognostic role of CD87 in MM.

OBJECTIVE: The increased risk for thrombosis is known as hypercoagulability or thrombophilia. In our study, we aimed to compare the frequency of the identified defects for thrombophilia in patients with central venous thrombosis and under the age of 50 years, with the findings in the current literature. METHODS: Forty-three patients (16-50 years old) were retrospectively evaluated. Thrombophilia investigation included determinations of protein C, protein S, antithrombin, and activated protein C resistance, factor V Leiden (FVL), prothrombin 20210A (PT 20210) and methylene tetrahydrofolate reductase (MTHFR) C677T mutations, antiphospholipid antibodies (APA), factor VIII levels, and homocysteine levels. RESULTS: We detected a single thrombophilic defect in 67.4%, two defects in 27.9% and three defects in 4.7% of our patients. The most common thrombophilic defect was mutation in the MTHFR gene (41.8%), and this was followed by the FVL mutation (34.9%). CONCLUSION: Since the prevalence of individual thrombophilic defects varies in each population, ethnic group and geographical location, screening for thrombophilic defects in patients presenting with cerebral venous thrombosis should primarily investigate the most frequent thrombophilia risk factors.

Although pulmonary complications developing secondary to lung infections and involvement in ribs occur frequently in multiple myeloma (MM), involvement of the lung parenchyma is quite rare. In clinical studies, the involvement of lung parenchyma has been found to be associated with unfavorable prognosis. Here, a MM case in whom involvement of lung parenchyma was accompanied by unfavorable prognostic cytogenetic markers is presented. A 62-year-old male presented with complaint of cough, and heterogeneous hypodense mass was detected in thorax computerized tomography. The patient underwent bronchoscopic biopsy. Pathological examination revealed diffuse plasma cell infiltration staining with kappa immunohistochemically. In bone marrow biopsy, plasma cell infiltration was observed. In conventional cytogenetic examination, hypodiploidy was established. In cytogenetic examination carried out with fluorescence in situ hybridization, deletion (13q) was determined. In conclusion, in patients diagnosed with MM and presenting with pulmonary mass lesion, lung involvement associated with plasma cell infiltration should also be considered in the differential diagnosis. As overall survival is low in these cases, more aggressive treatment approaches such as high-dose treatment should be immediately considered.