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Introduction: Mucormycosis is an aggressive-progressive invasive fungal infection caused by mold fungi in the division of mucorales of the zygomycetes class with high mortality, and is the most common fungal infection in patients with hematologic malignancies. Methods: This study retrospectively evaluated patients with mucormycosis diagnosis between January 2015 and December 2019, including demographic features, hematologic diseases and comorbidities, radiological evaluations, symptoms and signs, treatments, and outcomes. Results: Maxillofacial 9/19 (47.37%) of patients and 10/19 (59.9%) rhinoorbital mucor. Hematologic malignancy was observed in 15 (78.95%) patients, whereas others had additional pre-disposing factors, such as diabetes mellitus and chronic renal failure. The most common find-ings were persistent fever, mucopurulent nasal flux, and periorbital edema. Endoscopic sinus surgery + medication was administered in 12/19 (62.2%) patients and antifungal therapy in 7/19 (37.8%). In addition, 15/19 (79.95%) patients died and 4/19 recovered with sequela. Conclusion: The first large-scale mucormycosis study from our country will guide in determining the treatment algorithm. Effective and early surgery and antifungal application reduce mortality in mucormycosis by early diagnosis and multidisciplinary approach, without bone destruction in the paranasal sinus computed tomography with recurrent fever and earlystage sinusitis finding by performing a biopsy. Amaç: Mukormikoz, yüksek mortaliteye sahip zigomiset sınıfının mucorales bölümünde yer alan, küf mantarlarının neden olduğu agresif ilerleyen invaziv bir mantar enfeksiyonudur. Hematolojik maligniteli hastalarda en sık görülen mantar enfeksiyonu olarak karşımıza çıkmaktadır. Yöntemler: Çalışmamızda Ocak 2015-Aralık 2019 tarihleri arasında mukormikoz tanısı alan hastalar retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, hematolojik hastalıkları ve komorbiditeleri, radyolojik değerlendirmeleri, semptom ve bulguları, tedavileri ve sonuçları değerlendirildi. Bulgular: Olgularımız 9/19 (%47,37) maksillofasiyal ve 10/19 (%59,9) rinoorbital mukor hastalarıydı. Hastaların 15’inde (%78,95) sadece hematolojik malignite varken, diğerlerinde diabetes mellitus ve kronik böbrek yetmezliği gibi ek predispozan faktörler vardı. En sık görülen bulgular inatçı ateş, mukopürülan burun akısı ve periorbital ödemdi. Hastaların 12/19’u (%62,2) endoskopik sinüs cerrahisi + antifungal tedavi ve 7/19’u (%37,8) sadece antifungal tedavi gördü. Hastaların 15/19’u (%79,95) öldü ve bunların 4/19’u sekel ile iyileşti. Sonuç: Ülkemizden ilk büyük ölçekli mukormikoz çalışması, tedavi algoritmasının belirlenmesi açısından yol gösterici olacaktır. Erken tanı ve multidisipliner yaklaşımla, etkili ve erken cerrahi ve antifungal uygulama ve biyopsi ile, mukormikozda mortalitenin, tekrarlayan ateş ile paranazal sinüs bilgisayarlı tomografide kemik destrüksiyonu olmaksızın, azaltılabileceğini düşünmekteyiz. WOS:000721618600001

Previous studies reported that COVID-19 patients with cancer had higher rates of severe events such as intensive care unit (ICU) admission, mechanical ventilation (MV) assistance, and death during the COVID-19 course compared to the general population. However, no randomized study compared the clinical course of COVID-19 in patients with hematologic cancers to patients with solid cancers. Thus, in this study, we intend to reveal the outcome of COVID-19 in hematologic cancer patients and compare their outcomes with COVID-19 patients with solid cancers. The data of 926 laboratory-confirmed COVID-19 patients, including 463 hematologic cancer patients and an age-gender paired cohort of 463 solid cancer patients, were investigated retrospectively. The frequencies of severe and critical disease, hospital and ICU admission, MV assistance were significantly higher in hematologic cancer patients compared with the solid cancer patients (p = 0.001, p = 0.045, p = 0.001, and p = 0.001, respectively). The hospital stay was longer in patients with hematologic cancers (p = 0.001); however, the median ICU stay was 6 days in both groups. The case fatality rate (CFR) was 14.9% in patients with hematologic cancers, and it was 4.8% in patients with solid cancers, and there was a statistically significant difference regarding CFR between groups (p = 0.001). Our study revealed that COVID-19 patients with hematologic cancers have a more aggressive course of COVID-19 and have higher CFR compared to COVID-19 patients with solid cancers and support the increased susceptibility of patients with hematologic cancers during the outbreak.

Background: Aspergillus species meet the most important group of invasive fungal diseases (IFD) in immunosuppressed patients. Galactomannan is a polysaccharide antigen located in the wall structure of Aspergillus. The most commonly used method for antigen detection is enzymelinked immunoassay (ELISA). Aspergillus galactomannan Lateral Flow Assay (LFA) constitutes one of the new methods in the diagnosis of invasive aspergillosis (IA). The goal of this study is to demonstrate efficacy of LFA in our patients and to compare it to synchronous ELISA results. Methods: Galactomannan antigen was examined using both LFA and ELISA in serum samples taken from patients who were followed up in our hematology clinic. All patients are classified in subgroups as "proven", "probable", and “possible" patients according to the last EORTC / MSG guideline. Patients who met the “proven" IA criteria were included in the study as the gold standard. Results: A total of 87 patients were included in the study. Majority of patients had acute myeloid leukemia (AML) (56.3%). Eleven (12.6%) were in "proven" IA group. LFA test showed a superior diagnostic performance compared to ELISA (LFAAUC = 0.934 vs ELISAAUC = 0.545; p

Introduction:Multiple myeloma (MM) constitutes approximately 10% of hematological malignan-cies with abnormal proliferation of plasma cells, which causes an abnormal increase of monoclonal immunoglobulin light chains. We aim to examine our young myeloma cases’ data and compare light chain disease with other subtypes, which are known to have a worse prognosis in all age groups.Methods:Fifty-five MM patients diagnosed and treated between January 2010 and 2020 under 60 years old, were analyzed retrospectively. Their demographic data, laboratory, treatment subtypes, MM subtypes, CRAB findings (hypercalcemia, renal failure, anemia, and presence of lytic bone lesions), treatment, and responses to the first-line treatment were analyzed. The patients were divided into two groups, the light chain and other myeloma subgroups, and compared statistically.Results:Seventeen patients were female (30.9%), and 38 were male (69.1%). The median age was 54 (range: 34-59) years. The median duration of follow-up was 30 (range: 3-108) months. The MM sub-types examined were: immunoglobulin G (IgG)/Kappa 13 (23.6%), kappa light chain 10 (18.2%), lambda light chain 10 (18.2%), IgG/Lambda 9 (16.4%), IgA/Lambda 8 (14.5%), and IgA/Kappa 5 (9.1%). There was no significant difference between the two groups except for albumin and calcium values. In the other myeloma subtype group, albumin and calcium values were significantly lower (p

Objective: Pomalidomide is a new generation thalidomide analogue. Effectiveness as a single agent or combination with low dose dexamethasone has been in the treatment of relapse/refractory Multiple Myeloma (MM). The aim of the present study was to share the experience of different oncology centres with pomalidomide treatment in patients with relapsed/refractory MM. Materials and Methods: Seventy-three patients from 16 centres were enrolled into the study. The patients were followed for a median of 6 months. Relapsed/refractory MM patients who received at least one line of treatment before pomalidomide were included into the study. ISS, R-ISS and Eastern Cooperative Oncology Group (ECOG) scores of the patients and treatment-related side effects were evaluated. Results: As a result of the median follow-up for 6 months, 36% (26/72) of the patients presented progression. The estimated median PFS was found 29 months. The Cox regression analysis revealed that ECOG affected PFS only, myeloma subtype; ISS and R-ISS scores did not affect PFS. The most common side effects with pomalidomide treatment in our population include neutropenia, infections, anaemia and thrombocytopenia. Conclusion: In our study, it was statistically shown that the ECOG score was effective in survival in relapsed / refractory MM patients treated by pomalidomide. Therefore, we recommend evaluation of the ECOG score for each patient before treatment in eligible cases.

Introduction:Chronic myeloid leukaemia (CML) is a myeloproliferative neoplasm characterised by the overproduction of haematopoietic cells in the granulocytic series, involving translocation of chromosomes 9 and 22. The first tyrosine kinase inhibitor, imatinib, used in the treatment of CML, represents one of the most successful targeted therapies marking a new era in the treatment of CML. Many scoring systems such as the Hasford and Sokal systems have been developed to stratify CML patients into risk categories, and to predict patient outcome. We aimed to evaluate the relationship between blood lymphocyte count (BLC) at diagnosis and molecular response to imatinib therapy as a prognostic factor.Methods:A total of 108 chronic phase CML patients diagnosed between January 2010 and January 2020 were evaluated. Patient characteristics, laboratory results, BLC and response to treatment were recorded.Results:The median BLC was 4,665/mm3 and patients were divided into two groups according to the median BLC as ≤4,665/mm³ and >4,665/mm³. The responses at 3, 6, 12 month and the final status of patients, namely achievement of major molecular response or not, did not differ between the two groups of patients.Conclusion:The introduction of new therapeutic options in CML necessitates improvement in existing risk scoring systems. No direct relationship was found between the initial BLC and imatinib response in CML. However this is the first study exploring the role of BLC at diagnosis in CML patients receiving imatinib, and further studies that look into lymphocyte subgroups as well as bone marrow lymphocyte count at diagnosis might allow a more precise evaluation about the contribution of lymphocyte count to risk assessment in CML patients.

Introduction In this study, we aim to report the outcome of COVID-19 in chronic myeloid leukemia (CML) patients receiving tyrosine kinase inhibitor (TKI). Method The data of 16 laboratory-confirmed COVID-19 patients with CML receiving TKI and age, gender, and comorbid disease matched COVID-19 patients without cancer at a 3/1 ratio (n = 48), diagnosed between March 11, 2020 and May 22, 2020 and included in the Republic of Turkey, Ministry of Health database, were analyzed retrospectively. Results The rates of intensive care unit (ICU) admission, and mechanical ventilation (MV) support were lower in CML patients compared to the control group, however, these differences did not achieve statistical significance (p = 0.1, and p = 0.2, respectively). The length of hospital stay was shorter in CML patients compared with the control group; however, it was not statistically significant (p = 0.8). The case fatality rate (CFR) in COVID-19 patients with CML was 6.3%, and it was 12.8% in the control group. Although the CFR in CML patients with COVID-19 was lower compared to the control group, this difference did not achieve statistical significance (p = 0.5). When CML patients were divided into 3 groups according to the TKI, no significant difference was observed regarding the rate of ICU admission, MV support, CFR, the length of stay in both hospital and ICU (all p > 0.05). Conclusion This study highlights that large scale prospective and randomized studies should be conducted in order to investigate the role of TKIs in the treatment of COVID-19.

Objective: We aimed to investigate whether the severity of fatigue and the incidences of depression and anxiety of patients with beta thalassemia minor (BTm) are different from healthy individuals using the Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS). Subjects and Methods: BTm patients who were followed at the University of Health Sciences Istanbul Training and Research Hospital Hematology Clinic between 2016 and 2017 and who had normal biochemical parameters, thyroid function tests and C-reactive protein levels, and did not use any medications, consume alcohol or tobacco, have any chronic diseases or sleep disturbances were included in the study. Healthy control subjects who were matched with age, sex, marital status, educational status, and body mass index (BMI) were also included for comparison. Results: Thirty-nine BTm patients and 25 healthy controls were included in the study. The BTm and the control groups were comparable in terms of gender, age, BMI, educational status and marital status (p = 0.368, 0.755, 0.851, 0.785, and 0.709, respectively). FSS score was ≥4 in 23 (59.0%) BTm subjects and in 15 (60%) control subjects (p = 1.0). HADS anxiety score was ≥10 in 20 (51.3%) BTm subjects and in 5 (20.0%) control subjects (p = 0.018), and HADS depression score was ≥7 in 20 (51.3%) BTm subjects and in 6 (24.0%) healthy control subjects (p = 0.039).There was no correlation of hemoglobin with FSS score (p = 0.526, r = –0.105), HADS anxiety score (p = 0.703, r = –0.063), or HADS depression score (p = 0.718, r = –0.06) in the BTm group. Conclusion: We found that both depression and anxiety were higher in BTm patients than in healthy individuals, but this difference was not feasible for fatigue.

This is the first case of decitabine plus lenalidomide treatment for a myelodysplastic syndrome (MDS) patient with 5q deletion (del(5q)) and elevated number of blasts. Upon bone marrow aspiration and biopsy with conventional cytogenetical studies she was diagnosed with MDS with del(5q) and refractory anemia with excess blasts (RAEB-1). Decitabine was started at a daily dose of 20 mg/m2 1 - 5 days and lenalidomide was started at daily doses of 10 mg 6 - 20 days a month. After two cycles, her hemoglobin level increased and transfusion dependency ceased. After four cycles, bone marrow aspiration showed blast ratio of < 5%. Decitabine and lenalidomide were applied for three more cycles. Decitabine was terminated after seven cycles and lenalidomide has been continued for 12 months. Latest blood values (February 2020) were as follows: white blood cells (WBCs) of 8,670/mm3, neutrophil count of 3,470/mm3, hemoglobin (Hb) level of 11.7 g/dL and platelet count of 203,000/mm3, and the patient continues to follow-up without treatment. In conclusion, combination of lenalidomide and decitabine seems to be an effective treatment modality without notable side effects in MDS patients with del(5q) and excess blasts. The efficacy of this combination should be validated with studies including large patient groups and with longer follow-up periods.

Introduction: Positron-emission tomography (PET)/computerized tomography (CT) with 18F-fludeoxyglucose (FDG) has been come into use for risk assessment of Hodgkin lymphoma (HL) patients in recent years. The aim of our study is to evaluate the reliability of interim PET results according to Deauville score (DS), and also to compared PET findings with tumor reduction on CT. Methods: Forty-two HL patients (median 39, range 19-75 y, 27 M, 15 F) were retrospectively evaluated with pre, interim and post-treatment PET/CT imaging. PET/CT imaging was obtained 60 min after the intravenous administration of 3.7-5.2 MBq/kg 18F-FDG. Results: The negative predictive value of the interim PET was 89%. Four (10.5%) of the 38 interim PET-negative patients became post-treatment PET-positive. According to CT, 15 patients were in complete remission (CR), 27 (64.6%) patients were in partial remission (PR) or stable disease (SD). Conclusion: The negative predictive value of interim PET was not satisfactory considering the treatment rate of over 80% of HL. Additionally, high rate of interim PET-negative patients’ conversion to PET-positive post-treatment state was considered as unexpected.

Objectives Pregnancy carries a significant risk for coronavirus disease-2019 (COVID-19) due to natural immunosuppression. A previous study from our center has shown that the lactate dehydrogenase (LDH)/lymphocyte ratio (LLR) can be used in the early diagnosis of COVID-19 and predicting mortality. Based on this, we aimed to determine the effect of LLR on early detection of critical pregnant women and mortality in COVID-19. Methods The data of 145 patients who were admitted to our hospital between March and December 2020; diagnosed with COVID-19 and hospitalized, were retrospectively analyzed. Results The median gestation period was 31 weeks (range: 5–41), 30.3% (n: 44) gave birth and 68.3% (n: 99) were pregnant. Median LLR was 0.13 (range: 0.04–0.70). The rate of cough (47% vs. 22.8%; p=0.003) was found to be high in patients with LLR>0.13. The patients were divided into subgroups. The proportion of patients without active complaints was higher in the Q1, followed by the Q4. The proportion of patients with an initial complaint of cough increased as LLR from Q1 to Q4, the distribution of other complaints did not differ between the quartiles. Conclusions The higher rate of cough in the group with high LLR indicates that it may be an important indicator of lung involvement during pregnancy. The highest rate of non-treatment follow-up in the lowest LLR group proved that the LLR value at the time of diagnosis can be used as an important clinical marker in pregnant women.

Pralatrexate is a new generation antifolate treatment agent used for the treatment of relapsed or refractory peripheral T-cell lymphomas. This study aims to determine the general characteristics of the patients receiving pralatrexate therapy in Turkey, contributing to the literature on the effectiveness of pralatrexate therapy in peripheral T-cell lymphomas by determining the response levels of such patients to the therapy. The study also attempts to clinically examine the major side effects observed in patients during treatment with pralatrexate.The study included patients with peripheral T-cell lymphoma followed up in the hematology units of several hospitals in Turkey. Overall, 20 patients aged 18 and over were included in the study.The median age at the time of diagnosis was 58.5 years. PTCL-NOS (Peripheral T-cell lymphoma, not otherwise specified) subtype was in 40% of patients, making the PTCL-NOS the most common subtype in the study. In general, most patients were diagnosed with disease at an advanced stage. Pralatrexate therapy was given to the patients at a median treatment line of 3.5. Pralatrexate dose reduction was required in only 3 patients (15%). Response to pralatrexate therapy with partial remission (PR) and above was observed in 11 (55%) of the patients.Pralatrexate seemed to be a promising novel treatment in relapsed refractory PTCL patients. However, patients receiving pralatrexate should be followed up carefully for skin reactions, mucosal side effects, thrombocytopenia and neutropenia.

The AETHERA trial reported an increased progression-free survival (PFS) when brentuximab vedotin (BV) was used as maintenance therapy in high-risk Hodgkin lymphoma (HL) after autologous stem cell transplantation (ASCT). Thus, we aimed to determine the impact and safety of BV as maintenance after ASCT in real-world patients. Seventy-five patients with relapsed/refractory HL started on BV consolidation therapy after ASCT due to high risk of relapse, between January 2016 and July 2019, from 25 institutions, were included in the study. The median follow-up time was 26 months. The most common high-risk features were primary refractory or relapsed disease

Waldenström’s macroglobulinaemia is a disease in the B lymphoproliferative diseases group with immunoglobin M monoclonality and may present with different clinical manifestations. A 52-year-old male patient presented with complaints of weight loss and shortness of breath. Computed tomography (CT) results revealed a mass with a malignant soft tissue density in the abdomen. In the thoracic images, free fluid of up to 130 mm was found between the pleural leaves on both sides. His biopsies from the abdominal mass and bone marrow were reported to be compatible with a lymphoplasmocytic lymphoma in the presence of plasmoid differentiation B cell neoplasia and a Waldenström clinic. Cyclophosphamide -adriamycin -vincristine -prednisolone regimen was used in the first cycle chemotherapy. Positron emission tomography/ CT imaging, which was performed on the 15th day after the second cycle of chemotherapy, showed that the patient’s tumour was stable in size, but metabolic partial regression was observed. Bortezomib-dexamethasone-rituximab regimen was planned because of the resistant chylothorax. The patient had a dramatic clinical response and the chylothorax regressed completely after the first cure treatment. Chylothorax is a rare clinical presentation with chyle in the pleural area. It has traumatic and non-traumatic causes. Non-traumatic causes are most frequently seen due to malignancies. Waldenström’s macroglobulinaemia has a very rare incidence, and the clinical association between Waldenström’s macroglobulinaemia and chylothorax is very interesting. Standard treatment regimens vary, but the response to treatment also varies. Our case was resistant to the first line treatment, but had a dramatic response to the bortezomib and rituximab-based treatment.

Hypereosinophilic syndromes (HESs) are a group of disorders characterized by pathological proliferation of eosinophils. Diagnostic criteria include eosinophil count of 1,500/mm3 or higher, presence of organ involvement and exclusion of other causes of eosinophilia for at least 6 months. A 69-year-old male patient was referred to the pandemic clinic with a preliminary diagnosis of coronavirus disease 2019 (COVID-19) with fever and dyspnea. Computed tomography (CT) was compatible with COVID-19, nasopharyngeal swab polymerase chain reaction (PCR) was negative for two times. He had 20,000/mm3 eosinophilia and retrospective examinations showed that he have had eosinophilia for more than 1 year. Platelet-derived growth factor receptor alpha (PDGFRα) resulted positively. After starting parenteral methylprednisolone with a dose of 1 mg/kg, he was discharged with oral maintenance therapy. In outpatient follow-up, it was observed that eosinophilic pneumonia completely regressed. HES may occur with multiple system and organ involvement and findings. In the differential diagnosis of patients presenting with heart failure, pulmonary involvement and eosinophilia, HES must definitely be considered.

Chronic myeloid leukemia (CML) usually present with high leukocyte counts and splenomegaly and isolated thrombocytosis is not a common condition in CML. We present two CML patients presenting with isolated thrombocytosis. Case 1: A 44-year-old male patient having isolated thrombocytosis with no additional features, was investigated with the suspicion of essential thrombocythemia (ET). However, he was found to be positive for BCR/ABL. Afterwords, imatinib with the dosage of 400 mg/day was started and a major molecular response was obtained. Case 2: A 74-year-old woman was referred to our outpatient clinic because of thrombocytosis. Her physical examination was normal without splenomegaly. Further investigations were planned with the doubt of ET, but the patient’s BCR/ABL was positive. She was started imatinib and a major molecular response was obtained. In these cases, we explored the presence of BCR/ABL and found that they were positive. In conclusion, screening for BCR/ABL has a substantial significance in patients with isolated thrombocytosis and not exhibiting CML findings, to provide an effective therapeutic approach for these patients.

Karakus, Volkan/0000-0001-9178-2850; Demirkan, Fatih/0000-0002-1172-8668; Demircioglu, Sinan/0000-0003-1277-5105; Arat, Mutlu/0000-0003-2039-8557; Cagliyan, Gulsum Akgun/0000-0002-2073-1949; Ozturk, Hacer Berna Afacan/0000-0001-9386-7604; WOS: 000473249400014 PubMed: 31036516 Therapeutic plasma exchange (TPE) is used to treat more than 60 diseases worldwide and has drawn growing interest. Little is known about the current situation of TPE activity in Turkey, so we developed a survey to obtain information about this timely topic. We collected data on TPE from 28 apheresis units throughout Turkey. We performed a total of 24,912 TPE procedures with 3203 patients over the past decade. Twenty years ago, the majority of procedures were performed for neurological and hematological disorders, and today, most TPE procedures are done for the same reasons. The only historical change has been an increase in TPE procedures in renal conditions. Currently, renal conditions were more frequently an indication for TPE than rheumatic conditions. Fresh frozen plasma was the most frequently used replacement fluid, followed by 5% albumin, used in 57.9% and 34.6% of procedures, respectively. The most frequently used anticoagulants in TPE were ACD-A and heparin/ACD-A, used with 1671 (52.2%) and 1164 (36.4%) patients, respectively. The frequency of adverse events (AEs) was 12.6%. The most common AEs were hypocalcemia-related symptoms, hypotension, and urticaria. We encountered no severe AEs that led to severe morbidity and mortality. Overall, more than two thirds of the patients showed improvement in the underlying disease. Here, we report on a nationwide survey on TPE activity in Turkey. We conclude that there has been a great increase in apheresis science, and the number of TPE procedures conducted in Turkey has increased steadily over time. Finally, we would like to point out that our past experiences and published international guidelines were the most important tools in gaining expertise regarding TPE.

Aim: Essential thrombocythemia (ET) patients exhibit higher mean platelet volume (MPV) values compared to the healthy individuals. However, the association of degree of bone marrow fibrosis with either MPV or platecrit (PCT) has not been evaluated previously. The aim of this study was to investigate MPV and PCT values as predictive markers for evaluating bone marrow fibrosis (BMF) in ET patients. Methods: We conducted a retrospective cohort study to analyze the data of ET patients, who were followed in out-patient clinic of our hematology department, between January 2015 and December 2016. Patients older than 18 years, who had bone marrow biopsy, CBC, biochemistry tests and an abdominal sonography performed at the time of diagnosis, JAK2 test ordered and were BCR-ABL negative were included in the study. The patients were divided into two groups according to the presence of BMF as “the BMF group” and “the non-BMF group”. The cut-off value for MPV and PCT was determined according to the median value. Fisher’s exact test and χ2 were used for comparative statistical analysis.Results: There were 22 males and 26 females with a median age of 56 years (range, 28–81). The BMF group included 35 (73%) patients while the non-BMF group included 13 (27%) patients. The median MPV was 8.8 fL (6.6-11.5) and median PCT was 0.69% (0.42-2.26), which was considered as the cut-off values for these parameters. There was no significant difference between the groups in patients with MPV ≤8.8 fL and MPV >8.8 fL (p=0.104) and also in patients with PCT ≤0.69% and PCT >0.69% (p=0.616).Conclusion: There is no association between the BMF and MPV and PCT in ET patients. However this is the first study investigating the role of both MPV and PCT in BMF in ET patients.

Introduction:We aimed to investigate the association between neutrophil lymphocyte ratio (NLR) and response and loss of response to corticosteroid treatment in immune thrombocytopenia patients (ITP).Methods:We retrospectively analyzed the data of 47 ITP patients treated with corticosteroid therapy at Istanbul Training and Research Hospital Clinic of Hematology between 2007 and 2016. NLR was calculated using complete blood count of patients at the time of diagnosis. The cut-off score for NLR was determined at 2.5 according to median NLR level.Results:Twenty-three (48.9%) patients had NLR

Context The AETHERA trial reported an increased progression-free survival (PFS) when brentuximab vedotin (BV) was used as maintenance therapy in high-risk Hodgkin lymphoma (HL) after autologous stem cell transplantation (ASCT). Objective To determine the impact and safety of BV as maintenance after ASCT in real-world patients. Design Patients with relapsed/refractory HL started on BV consolidation therapy after ASCT due to high risk of relapse, between January 2016 and July 2019, from 25 institutions, were retrospectively analyzed. Setting All patients were followed by the bone marrow transplantation team of their hospital. Patients or Other Participants Seventy-five patients were included in the study. The median follow-up time was 26 months. The most common high-risk features were primary refractory or relapsed disease Interventions BV consolidation was initiated within 6 months of ASCT and administered at a dose of 1.8 mg/kg intravenous infusion over 30 min every 3 weeks for up to 16 cycles in an outpatient setting. Main Outcome Features The primary endpoint of the study was PFS; secondary endpoints were safety and overall survival (OS). Results At the time of analysis, 42 patients completed consolidation courses, and BV was discontinued in 33 patients. Fifty patients had an ongoing response (CR in 41, PR in six, and SD in three patients), 25 had progressed. Ten died in the follow-up, eight with progressive disease and two due to infection while in CR. The 2-years PFS and OS rates were 67.75% (95% CI:0.55–0.77) and 87.61% (95% CI:0.76–0.94), respectively. Seventeen patients (23%) received BV in the pre-ASCT treatment lines, and there was no survival difference between the BV naive and BV exposed groups. The most common adverse events were neutropenia (27%) and peripheral neuropathy (21%). Sixteen patients (21.3%) experienced grade 3 or 4 toxicity. BV was discontinued due to AE in 12 patients. Conclusions Consolidation with BV after ASCT can achieve a 2-year PFS of 67.75% (95% CI: 0.55–0.75) with an acceptable toxicity profile.

Introduction: Passive antibody therapy has been used to immunize vulnerable people against infectious agents. In this study, we aim to investigate the efficacy of convalescent plasma (CP) in the treatment of severe and critically ill patients diagnosed with COVID-19. Method: The data of severe or critically ill COVID-19 patients who received anti-SARS-CoV-2 antibody-containing CP along with the antiviral treatment (n = 888) and an age-gender, comorbidity, and other COVID-19 treatments matched severe or critically ill COVID-19 patients at 1:1 ratio (n = 888) were analyzed retrospectively. Results: Duration in the intensive care unit (ICU), the rate of mechanical ventilation (MV) support and vasopressor support were lower in CP group compared with the control group (p = 0.001, p = 0.02, p = 0.001, respectively). The case fatality rate (CFR) was 24.7 % in the CP group, and it was 27.7 % in the control group. Administration of CP 20 days after the COVID-19 diagnosis or COVID-19 related symptoms were associated with a higher rate of MV support compared with the first 3 interval groups (?5 days, 6-10 days, 11-15 days) (p=0.001). Conclusion: CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients.

Hemolytic anemia is a disease caused by autoantibodies and resulting in various complaints and clinical symptoms. In about half of cases, the cause of autoimmune hemolytic anemia can not be determined. Corticosteroids are the first-line treatment option for warm autoantibody-related hemolytic anemia. In patients who develop steroid side effects or do not respond adequately, other immunosuppressives may be preferred. In case a rapid response is required or fulminant hemolysis occur, human immunoglobulins (IVIGs) may be added to treatment. Finally, plasma exchange (PE) may additionally be utilised. The essence of PE is based on the removal of immune complexes, protein-bound toxins, autoantibodies and high molecular weight solutes and protein-bound solutes. The main clinical aim of the removal of solutes is usually to gain a faster response than immunosuppressive therapy. Studies related to hemolytic anemia and PE are usually based on case reports. Our case report is about a patient with severe IgG subtype hemolytic anemia. The treatment was started with 1 mg/kg methylprednisolone; to which there was no response with weekly rituximab 375 mg/m2 and IVIG administered. Because of unresponsiveness to all of the immunosuppresives, a total of 5 sessions of PE were added to the treatment procedure every other day. After these sessions, the requirement for transfusions has decreased and the patient underwent splenectomy. The patient is currently being followed up only on oral cyclosporine and the last hemoglobin level was 14.7 g /dl. In severe and refractory anemia, especially in the case of cardiovascular imbalance in fulminant hemolysis, PE may be preferred as a third series option after immunosuppressive treatments and play a role as a bridge to splenectomy. WOS:000697004600014 34412947 Q4

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, Janssen Pharmaceutica Turkey, This study was supported by Janssen Pharmaceutica Turkey. The authors would like to thank Prof. Sule Oktay, MD, PhD, and Cala Ayhan, MD, from KAPPA Consultancy Training Research Ltd. (stanbul, Turkey) , who provided editorial support.

Aim: The objective of this article was to compare the efficiency of azacitidine (AZA) and decitabine (DAC) in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) who are not suitable for high-dose chemotherapy. Materials and methods: MDS and AML patients who were treated with hypomethylating agents (HMAs) between January 2005 and 2020 were evaluated retrospectively. Results: No statistically significant difference was found between the patients who received AZA or DAC in AML patients. In MDS group, the rate of patients who achieved remission was statistically significantly higher in patients who received DAC (p = 0,032). Conclusion: The advantage in terms of response for MDS and no survival difference between AZA and DAC for AML and MDS patients will be an important contribution to the literature. First draft submitted: 24 August 2020; Accepted for publication: 6 September 2021; Published online: 12 November 2021 35295753

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

We evaluated the safety and efficacy of single-agent ibrutinib in 200 patients presenting with relapsed/refractory CLL in real-world settings. With an estimated median OS of 52 months, 146 patients (75%) achieved at least PR; 16 (8.7%) patients discontinued ibrutinib due to adverse events. The results indicate good safety and efficacy for single-agent ibrutinib in R/R CLL in daily practice. Introduction/Background: The emergence of novel agents targeting the B-cell receptor pathway and BCL-2 has significantly changed the therapeutic landscape of CLL. We evaluated the safety and efficacy of single-agent ibrutinib in relapsed/refractory CLL in real-world settings. Patients/Methods: A total of 200 relapsed/refractory CLL patients with a median age of 68 were included in this retrospective, multicenter, non-interventional study. Data of the study were captured from the patient charts of the par ticipating centers. Results: The median for lines of previous chemotherapy was 2 (1-6); 62 (31.8%) patients had del17p and/or p53 mutations (del17p+ /p53mut). Of the study group, 146 (75%) patients achieved at least PR, while 16 (8.7%) patients discontinued ibrutinib due to TEA. The most common drug-related adverse events were neutropenia (n: 31; 17.4%) and thrombocytopenia (n: 40; 22.3%), which were >= grade 3 in 9 (5%) and 5 (3.9%) patients, respectively. Pneumonia (n: 42; 23.7%) was the most common nonhematologic TEA. Atr ial fibrillation (n: 5; 2.8%) and bleeding (n: 11; 6.3%) were relatively rare dur ing the study period. Within a median follow-up period of 17 (1-74) months, 42 (21%) patients died. The estimated median OS of the study cohort was 52 months. Only the response to ibrutinib (CR/PR vs. SD/PD) was significantly associated with OS. Conclusion: Our results indicate good safety and efficacy for single-agent ibrutinib in R/R CLL in daily practice. (C) 2021 Elsevier Inc. All rights reserved.

In this study, we aim to report the outcome of COVID-19 in hematopoietic cell transplant (HCT) recipients. HCT recipients (n = 32) with hematological disease and hospitalized for COVID-19 were included in the study. A cohort of age and comorbid disease-matched hospitalized COVID-19 patients with hematological malignancy but not underwent HCT (n = 465), and another cohort of age and comorbid disease-matched hospitalized COVID-19 patients without cancer (n = 497) were also included in the study for comparison. Case fatality rate (CFR) was 5.6% in patients without cancer, 11.8 in patients with hematological malignancy and 15.6% in HCT recipients. The CFR in HCT recipients who were not receiving immunosuppressive agents at the time of COVID-19 diagnosis was 11.5%, whereas it was 33% in HCT recipients who were receiving an immunosuppressive agent at the time of COVID-19 diagnosis. In conclusion, our study reveals that for the current pandemic, HCT recipients, especially those receiving immunosuppressive drugs, constitute a special population of cancer patients.

Background Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma and may occur with lymph node and/or extranodal involvement. Recurrence in patients with diffuse large B-cell lymphoma usually occurs within the first few years after treatment and may occur in a different area outside the initial localization. Case presentation A female Turkish patient who was diagnosed with nodular sclerosing Hodgkin lymphoma through lymphadenopathy examination reached remission after chemotherapy and radiotherapy. In the 11th year of follow-up and at the age of 45, newly developed multiple lymphadenopathies were diagnosed with a pathological result of diffuse large B-cell lymphoma in her advanced examination. Due to massive splenomegaly and cystic necrotic splenic residues, splenectomy was performed after eight cycles of a first-line chemotherapy regimen and two cycles of high-dose methotrexate treatment for central nervous system prophylaxis. A pericardial mass (maximum standardized uptake value 34.8), which was not present at the time of diagnosis and interim evaluation of positron emission tomography/computed tomography, was detected through chest pain in the third month after the last screening, although a complete response had been obtained. Pathological examination of the pericardial area revealed the pathological result was a recurrence. Conclusions Patients with diffuse large B-cell lymphoma have an aggressive clinical course, but cardiac involvement is very rare. In our patient’s case, pericardial involvement was observed after treatment and scanning revealed that recurrence took place in an area different from the pericardium. Cooperation of clinicians and pathologists and rapid evaluation are very important in cases of diffuse large B-cell lymphoma relapse. Although a tumoral invasion of the pericardium mostly suggests secondary malignancies, it should be kept in mind that recurrence of lymphoma is also possible.

Background COVID-19 (Coronavirus Disease-2019) is a pandemic disease, infecting more than 26.5 million people. Since there is no specific and effective treatment; early diagnosis and optimal isolation of the patient are of vital importance. Real-time polymerase chain reaction-based (RT-PCR) analyses do not achieve sufficient sensitivity in the diagnosis of the disease. Methods The data from 2217 patients diagnosed as COVID-19 between March 2020 and June 2020 and hospitalized or discharged with home isolation were retrospectively analyzed. Demographic data, comorbidities, PCR results, initial computed tomography (CT), laboratory values, Lactate Dehydrogenase (LDH) / Lymphocyte ratio, initial treatments and last status were recorded. The diagnostic sensitivity of LDH / Lymphocyte ratio, which is the main purpose of the study, was analyzed statistically. Results In order to test the effectiveness of LDH / Lymphocyte ratio for COVID-19 for diagnostic purposes, CT results were considered as gold standard. The area under the curve (AUC) was found to be 0.706 (p 0.06) (Sensitivity: 76.4, specificity: 59.60). For the evaluation of LDH / Lymphocyte ratio in terms of survival, AUC was found to be 0.749 (p 0.21) (Sensitivity: 70.59, specificity: 73.88). Conclusion Studies based on radiological findings have demonstrated that CT involvement has higher sensitivity. LDH / Lymphocyte ratio was analyzed in terms of diagnosis and mortality with using specific CT involvement as gold standard method which was found to be a more sensitive due to PCR false negativity; 0.06 and 0.21 were obtained as cut off values for diagnosis and mortality.

Introduction In this study, we aim to report the outcome of COVID‐19 in patients with hematological malignancy in Turkey. Method The data of laboratory‐confirmed 188,897 COVID‐19 patients diagnosed between March 11, 2020 and June 22, 2020 included in the Republic of Turkey, Ministry of Health database were analyzed retrospectively. All of the COVID‐19 patients with hematological malignancy (n=740) were included in the study and an age, gender and comorbidity matched COVID‐19 patients without cancer (n=740) at 1:1 ratio was used for comparison. Results Non Hodgkin lymphoma (30.1%), myelodysplastic syndrome (19.7%), myeloproliferative neoplasm (15.7%), were the most common hematological malignancies. The rates of severe and critical disease were significantly higher in patients with hematological malignancy compared to the patients without cancer (p=0.001). The rates of hospital and intensive care unit (ICU) admission were higher in patients with hematological malignancy compared to the patients without cancer (p=0.023, p=0.001, respectively). The length of hospital stay and ICU stay were similar between groups (p=0.7, p=0.3; retrospectively). The rate of mechanical ventilation (MV) support was higher in patients with hematological malignancy compared to the control group (p=0.001). The case fatality rate (CFR) was 13.8% in patients with hematological malignancy, and it was 6.8% in the control group (p=0.001). Conclusion This study reveals that there is an increased risk of COVID‐19 related serious events (ICU admission, MV support or death) in patients with hematological malignancy compared to COVID‐19 patients without cancer and supports high vulnerability of patients with hematological malignancy in the current pandemic. This article is protected by copyright. All rights reserved.

In this study, we aim to report the outcome of COVID-19 in hematopoietic cell transplant (HCT) recipients. HCT recipients (n = 32) with hematological disease and hospitalized for COVID-19 were included in the study. A cohort of age and comorbid disease-matched hospitalized COVID-19 patients with hematological malignancy but not underwent HCT (n = 465), and another cohort of age and comorbid disease-matched hospitalized COVID-19 patients without cancer (n = 497) were also included in the study for comparison. Case fatality rate (CFR) was 5.6% in patients without cancer, 11.8 in patients with hematological malignancy and 15.6% in HCT recipients. The CFR in HCT recipients who were not receiving immunosuppressive agents at the time of COVID-19 diagnosis was 11.5%, whereas it was 33% in HCT recipients who were receiving an immunosuppressive agent at the time of COVID-19 diagnosis. In conclusion, our study reveals that for the current pandemic, HCT recipients, especially those receiving immunosuppressive drugs, constitute a special population of cancer patients.

WOS:000650535000001 PMID: 33988739 The aim of this study is to collect paroxysmal nocturnal hemoglobinuria (PNH) patient data from hematology centers all over Turkey in order to identify clinical features and management of PNH patients. Patients with PNH were evaluated by a retrospective review of medical records from 19 different institutions around Turkey. Patient demographics, medical history, laboratory findings, and PNH-specific information, including symptoms at the diagnosis, complications, erythrocyte, and granulocyte clone size, treatment, and causes of death were recorded. Sixty patients (28 males, 32 females) were identified. The median age was 33 (range; 17-77) years. Forty-six patients were diagnosed as classic PNH and 14 as secondary PNH. Fatigue and abdominal pain were the most frequent presenting symptoms. After eculizumab became available in Turkey, most of the patients (n = 31/46, 67.4%) were switched to eculizumab. Three patients with classic PNH underwent stem cell transplantation. The median survival time was 42 (range; 7-183 months) months. This study is the first and most comprehensive review of PNH cases in Turkey. It provided us useful information to find out the differences between our patients and literature, which may help us understand the disease.

Objective: Chronic antigenic stimulation is frequently blamed in the pathogenesis of extranodal marginal zone lymphomas including splenic marginal zone lymphoma (SMZL). Chronic hepatitis C is frequently observed in SMZL patients in some geographical regions. However, these reports are largely from North America and Europe, and data from other countries are insufficient. In this multicenter study we aimed to identify the clinical characteristics of SMZL patients in Turkey, including viral hepatitis status and treatment details. Materials and Methods: Data were gathered from participating centers from different regions of Turkey using IBM SPSS Statistics 23 for Windows. Hepatitis B virus surface antigen (HBsAg), anti-HBs antibody, anti-HB core antigen antibody (anti-HBcAg), HB viral load, anti-hepatitis C virus (HCV) antibody, HCV viral load results were analyzed. Results: One hundred and four patients were reported. Hepatitis C virus positivity was observed in only one patient. However, hepatitis B virus surface antigen (HBsAg) positivity was observed in 11.2% and HBsAg and/or anti-HB core antigen antibody (anti-HBcAg) positivities were seen in 34.2% of the patients. The median age was 60 years (range=35-87). Median follow-up duration was 21.2 months (range=00.2-212; 23.2 months for surviving patients). Median overall survival was not reached. Estimated 3-year and 10-year survival rates were 84.8% and 68.9%, respectively. Older age, no splenectomy during follow-up, platelet count of, Amaç: Splenik marjinal zon lenfoma’yı da (SMZL) içeren ekstranodal marjinal zon lenfomaların patogenezinde, kronik antijenik stimülasyon sorumlu olan mekanizmadır. Bazı coğrafik bölgelerde SMZL hastalarında kronik hepatit C sıklıkla gözlenir. Fakat bu çalışmalar sıklıkla kuzey Amerika ve Avrupa’dandır. Diğer ülkelerden veriler sınırlıdır. Bu çalışma ile Türkiye’deki SMZL hastalarının hepatit serolojisi durumları ve tedavi yöntemlerinin ortaya konulması amaçlanmıştır. Gereç ve Yöntemler: Türkiye’de farklı merkezlerden IBM SPSS Statistics for Windows v23 elektronik tablo kullanılarak veriler toplanmıştır. Hepatit B virüs yüzey antijeni (HBsAg), Anti-HBs antikor, Anti-HB kor antijen antikoru (anti-HBcAg), HB virüs yükü, anti-hepatit C virüs (HCV) antikoru, HCV virüs yükü sonuçları analiz edilmiştir. Bulgular: Yüz dört hastanın verilerine ulaşılmıştır. Hepatit C virüs pozitifliği sadece 1 hastada tespit edilmiştir. Hepatit B virüs yüzey antijeni (HBsAg) pozitifliği %11,2, HBsAg ve/veya hepatit B kor antijen antikoru (anti-HBcAg) pozitifliği %34,2 oranında tespit edilmiştir. Ortanca yaş 60 yıl (35-87) olarak saptanmıştır. Ortanca izlem süresi 21,2 (0,2-212) ay (yaşayan hastalar için 23,2 ay) olarak bulunmuştur. Ortanca genel sağkalım (GS) süresine ulaşılamamıştır. Tahmini 3-yıl ve 10-yıl GS oranları %84,8 ve %68,9 olarak bulunmuştur. İleri yaş, splenektomi yapılmaması

We hereby report our multicentre, retrospective experience with CLARA in patients with fludarabine/cytarabine/G-CSF (FLAG) refractory AML. The study included all consecutive R/R AML patients, who received CLARA salvage during October 2010–October 2015 period. All patients were unresponsive to FLAG salvage chemotherapy regimen and did not undergo previous allo-HCT. A total of 40 patients were included. Following CLARA 5 (12.5%) patients experienced induction mortality and 10 (25%) patients achieved CR. 25 (62.5%) patients were unresponsive to CLARA. 7 (17.5%) out of 10 patients in CR received allo-HCT. Median overall survival of patients who achieved CR after CLARA was 24.5 months (8.5–54.5) and 3 months (2.5–5), in patients who underwent and didn’t allo-HCT, respectively. Our results indicate that CLARA may be good alternative even in FLAG refractory AML patients and can be used as a bridge to allo-HCT, who have a suitable donor and able to tolerate the procedure. © 2017 Edizioni Scientifiche per l'Informazione su Farmaci e Terapia.

WOS: 000425633300017, PubMed ID: 28707314, Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is a rare subtype of Hodgkin's lymphoma. In this study, we aimed to investigate the clinical features and therapeutic outcomes of patients with NLPHL who were diagnosed at different institutes in Turkey. We retrospectively reviewed the records of the patients diagnosed with NLPHL. Adult patients who were diagnosed after 2005 with histological confirmation were selected for the study. Forty-three patients were included in the study. Median age of patients was 37.5years (18-70) at the time of diagnosis. About 60.5% patients were diagnosed as stage I and II NLPHL, and remaining 39.5% had stage III and IV disease. Median follow-up was 46months. During follow-up, none of the patients died. Seven patients relapsed or progressed after initial therapy at a median of 12months. Five of 7 relapsed/refractory patients (71.4%) were salvaged with chemotherapy only (DHAP, ICE), and the remaining 2 (28.6%) were salvaged with chemoimmunotherapy. All of relapsed/refractory patients were able to achieve complete remission after salvage therapy. Lactate dehydrogenase levels were significantly higher in patients with progressive disease compared with nonprogressive disease. Our study showed an excellent outcome with all patients alive at last contact with a median follow up of 46months despite a wide range of different therapeutic approaches. All relapsed and refractory patients were successfully salvaged despite a low frequency of patients received immunotherapy in conjunction with chemotherapy. Our results suggest that immunotherapy may be reserved for further relapses.

We aimed to investigate the role of bone marrow infiltration pattern (BMIP) and bone marrow reticulin fibrosis (BMRF) in determining treatment demand in patients with diagnosis of chronic lymphocytic leukemia (CLL). We retrospectively evaluated the data of 65 patients, who were followed with the diagnosis of CLL at Istanbul Training and Research Hospital, Department of Hematology, between July 2007 and June 2016. The median age of the patients was 64 years (range, 32–83). Twenty-three (35.4%) patients were female, and 42 (64.6%) were male. Early/mild grade BMRF was observed in 46 (70.8%) patients and advanced grade BMRF in 19 (29.2%) patients. Eleven (23.9%) of 46 patients with early/mild grade BMRF and 10 (52.9%) of 19 patients with advanced grade BMRF required treatment during follow-up (p = 0.04). According to the BMIP, 14 (21.5%) patients had diffuse and 51 (78.5%) patients had non-diffuse BMIP. Eleven (78.6%) of 14 patients with diffuse BMIP and 10 (19.6%) of 51 patients with non-diffuse BMIP required treatment during follow-up (p

Introduction: Plateletpheresis is a procedure included in donor apheresis in which the donor blood is passed through an extraction machine, the platelets are extracted, and the remainder is returned into the circulation. Donor selection is important because donors are the only source for meeting blood product needs. In our study we aimed to evaluate deferral reasons in applications for plateletpheresis donation and reveal determine the preventable ones among them. Materials And Methods: The persons who were admitted to our Blood Center to be plateletpheresis donors during the period of six month, after a demand/request for platelet suspension was issued by the clinics. Their eligibility for being plateletapeheresis donors was decided. Results: A total of 1098 persons have applied to be plateletpheresis donors; 1045 were male and 53 female. A total of 787 persons were found to be eligible for being plateletpheresis donors; 772 were male and 15 female. 891 units of apheresis platelets were obtained from apheresis donors, including double units collected from 104 of them. Applications of 311 persons were deferred due to various reasons. The most common reason for donor deferral was inappropriate vascular access in 80 persons (25.7%, 69 males, 11 females). This is followed by abnormal laboratory values in 57 persons (18.3%) and drug use (most commonly analgesics) in 46 persons (14.7%). Discussion: During the assessment of blood product donors, proper selection of the candidates should be considered very carefully in order to not to harm the donor but to supply the demand of the recipient properly. When the deferral reasons were evaluated, improvement of in-hospital technical reasons and education sessions for people in order to increase the social awareness may substantially decrease the deferral rates.

61st Annual Meeting and Exposition of the American-Society-of-Hematology (ASH) -- DEC 07-10, 2019 -- Orlando, FL, Kaynar, Leylagul/0000-0002-2035-9462; Erkurt, Mehmet Ali/0000-0002-3285-417X, WOS:000577164605146, [No Abstract Available], Amer Soc Hematol

WOS: 000482629200004, PubMed ID: 31131598, Objective: Significant developments occurred in the clinical management of acute lymphoblastic leukemia (ALL) in adults in recent decades. However, treatment results are still not satisfactory, especially in routine practice. The objective of this study was to evaluate the general clinical features, treatment details, and outcomes of a large group of patients followed in multiple centers in Turkey with a diagnosis of ALL. Materials and Methods: A retrospective analysis of the data of patients with ALL was made, the patients having been diagnosed and treated between January 2003 and June 2017 by different protocols in the hematology clinics of ten different centers. A total of 288 patients, aged between 17 and 76 years old, were included in the study. In this retrospective multicenter analysis of patients with ALL, classification of patients was performed based on treatment period, Philadelphia chromosome positivity, treatment regimen, and administration of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Results: The majority of cases were B-cell in origin, while 224 patients had B-ALL and 64 of the patients had T-ALL. Median follow-up duration for all patients was 18.2 months (range: 0.03-161 months). Philadelphia chromosome positivity was determined in 49 patients (21.9%), and 54 patients (18.8%) were receiving allo-HSCT. After induction chemotherapy, 219 patients (76.0%) achieved complete remission, 32 patients (11.2%) were evaluated as treatment refractory, and 37 patients (12.8%) were deceased. Median overall survival was 47.7 months (95% confidence interval: 36.1-59.2) and median disease-free survival was 23.4 months (95% confidence interval: 6.7-40.0) for all patients. Conclusion: Multicenter studies are extremely important for defining the specific clinical features of a particular disease. The results of this study will make a significant contribution to the literature as they reflect real-life data providing valuable information about the Turkish ALL patient profile.