Search

This study aims to evaluate the mean platelet volume (MPV) and neutrophil-lymphocyte ratio (NLR) in gouty arthritis (GA) and rheumatoid arthritis (RA) patients, as well as their relationship with atherosclerotic cardiovascular mortality (ACVM).The study included 122 GA patients (96 males, 26 females; mean age 64.6±13.4 years; range 34 to 82 years), 82 RA patients (40 males, 42 females; mean age 62.1±12.1 years; range 29 to 83 years), and 61 healthy controls (34 males, 27 females; mean age 65.3±4.8 years; range 33 to 80 years). Clinical and ACVM data were obtained from medical charts. Erythrocyte sedimentation rate, C-reactive protein, MPV, and NLR were recorded at the time of diagnosis and one month after therapy.Mean platelet volume in GA (8.49±1.5) and RA (7.98±0.99) groups were significantly lower than in healthy controls (9.8±15) (p0.001). NLR in healthy controls (1.9±0.74) was significantly lower than in GA (3.6±2.3) and RA (3.7±2.5) groups (p0.001). After treatment, MPV did not change significantly in GA and RA groups (p values0.05); however, NLR decreased in both groups (p0.001). Nine GA and 12 RA patients died from ACVM during follow-up. GA patients with ACVM were older and had more frequent hypertension, higher MPV, and higher intercritical CRP level. In multivariate analysis, MPV was an independent poor prognostic factor for ACVM in GA patients.Gouty arthritis and RA patients had significantly lower MPV and significantly higher NLR than controls. MPV might be used as a potential biomarker for the development of ACVM in GA.

Apelin/APJ system regulates angiogenesis and is overexpressed in some malignancies. Apelin can induce lymphangiogenesis and lymph node metastasis.We evaluated apelin levels in multiple myeloma (MM) and non-Hodgkin lymphoma (NHL); and analyzed the association between apelin levels and clinical findings.We included consecutive 29 MM, 31 NHL patients, and 19 healthy controls. Patients' demographic and clinical features, treatment modalities, and responses were recorded from hospital records. Plasma apelin was determined by enzyme-linked immunosorbent assay (ELISA).MM patients had significantly higher plasma apelin level than NHL and healthy control groups (p0.001). Apelin level in NHL group was similar to controls (p0.05). ROC curve analysis showed that the area under the curve value for apelin level in MM was 0.842 ng/ml (95%CI: 0.739-0.945, p0.001). Plasma apelin level ≥ 0.827 ng/ml had 76% sensitivity and 86% specificity for the diagnosis of MM. Multivariate Cox regression analysis showed that MM patients with high apelin level had better prognosis and patients with advanced stage of disease (ISS-3) had significantly poor prognosis when compared to others. In the MM group, apelin level correlated negatively with LDH (r = -0.39, p= 0.038).In MM, plasma apelin level was significantly higher than in NHL and control groups. Apelin could be playing a role in MM pathogenesis; and apelin level could be used as a diagnostic and prognostic biomarker in MM.

Objective/background: Myelodysplastic syndromes (MDSs) are a group of monoclonal hematopoietic diseases consisting of a number of various entities. The presence of differences in chromosomal content of cells within the same individual is known as chromosomal mosaicism. The impact of mosaic pattern on the prognosis of MDS has been unclear. In this study, we aimed to determine the impact of mosaic pattern on the survival of patients with MDS. Methods: We retrospectively evaluated 119 patients diagnosed with MDS at the Trakya University Faculty of Medicine, Department of Hematology. Giemsa–Trypsin–Giemsa banding was used to evaluate chromosomal abnormality.The effect of chromosomal abnormality mosaicism on overall survival and transformation to acute leukemia was evaluated by Kaplan–Meier survival analysis. Results: The mean age at diagnosis was 66.3 years, and the mean disease duration was 24.2 months. Chromosomal abnormality was observed in 32.5% of patients. Patients with chromosomal abnormalities comprising at least 50% metaphases had significantly lower overall survival than patients with abnormality comprising up to 50% of all abnormal metaphases (p = .003). There were no differences in transformation to acute leukemia among patients with higher and lower chromosomal mosaicism (p = .056). Conclusion: The most important outcome of this study was to demonstrate worse overall survival rates in MDS patients with higher abnormal chromosomal mosaicism than patients with lesser abnormal chromosomal mosaicism. Higher levels of abnormal chromosomal mosaicism did not predict transformation to acute leukemia. The cause of worse outcomes of patients with higher abnormal chromosomal mosaicism may be related to clonal mass. Keywords: Chromosomal abnormality, Mosaicism, Myelodysplastic syndrome, Prognosis

The most common genetic disorder in Philadelphia negative chronic myeloproliferative neoplasms is the JAK2-V617F mutation. In the present study, we aimed to determine risk factors for thrombosis in patients with essential thrombocytosis and polycythemia vera. We screened the medical records of 101 patients. Risk factors which may predict thrombosis were recorded. Venous thrombosis (VT) before diagnosis was significantly higher in JAK2 positive patients. VT after diagnosis was similar in JAK2 positive and negative groups, and was significantly higher in elderly patients. Treatment places importance on the JAK2 mutation under unmodifiable cardiovascular risk factors such as advanced age after diagnosis.

Introduction: Gastrointestinal tract is the most common site of involvement in non-Hodgkin’s lymphomas. Appropriate treatment regiments were not defined because of rare involvement. In the present study we aimed to evaluate treatment response of non-Hodgkin’s lymphoma patients with stomach involvement. Methodology: 26 patients with stomach involvement were retrospectively analyzed between 01/01/1998 and 01/06/2014. Descriptive statistic was performed to analyze data.Results: 20 of the patients (76.9%) were composed of primary stomach non-Hodgkin lymphoma, 6 of the patients (23.1%) were composed of patients secondary involvement of the advanced stage disease. All of the patients were subtypes of B cell lymphoma. 3 of the patients (11.5%) was indolent, 22 of the patients (84.6%) was aggressive, and 1 of them (3.8%) was very aggressive. Diffuse large B cell lymphoma was 72.9%; Maltoma was 8.7%, and Mantle cell lymphoma was %3.8. Complete response was achieved at 10 patients, partial response was achieved in 1 patient, and 7 patients were failed to response the treatment. Treatment response, and overall survival of low grade and high grade patients, both according to Ann-Arbor and Lugano classification systems were similar. Patients with elevated sedimentation rate had significant lower survival than patients with normal sedimentation rate (p=0.027).Discussion: Together with the data from recent studies, aggressive treatment approach without organ preservation should not be performed on patients without higher inflammatory response and early stage presentation. Sedimentation rate might help to clinicians for the treatment of choice.

Aims We determined plasma levels of dickkopf-1 (DKK-1) and osteopontin (OPN) which have roles in the Wnt pathway in chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL) patients and in healthy controls. We also tested whether DKK-1 and OPN levels could be of clinical or prognostic significance in CLL and NHL. Methods We included 36 CLL, 24 NHL patients, and 21 healthy controls. Patients' clinical and demographic features, treatment modalities, and response to treatment were recorded. DKK-1 and OPN levels in plasma obtained at initial diagnosis were determined with enzyme-linked immunosorbent assay. Results CLL patients had significantly lower DKK-1 levels than NHL and control groups (P levels, respectively, 0.048 and 0.017). OPN level was significantly higher in NHL group than in CLL and control groups (P values, 0.017 and

Molecular balance between Angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2) has important effects in tumor angiogenesis. Ang-2 was shown to be elevated and proved to be a prognostic factor in acute myeloid leukemia (AML). To date studies revealed increased angiogenesis in bone marrows (BMs) of both myeloproliferative neoplasm (MPN) and AML patients. We conducted this study to demonstrate circulating levels of Ang-1 and Ang-2 in MPN patients since no data exists in literature. Thirty-three newly diagnosed MPN, 27 newly diagnosed AML patients and 25 controls (HC) were enrolled and Angiopoietin levels were determined with ELISA. We found that Ang-1 levels were higher whereas Ang-2 levels were lower in MPN and HC when compared to AML. Our results suggest that though angiogenesis is increased in both AML and MPN, angiopoietin serum level profile of the two diseases are different, and MPN patients have similar Ang-1 and Ang-2 levels as HC. We conclude that, according to our results Ang-1 and Ang-2 do not only regulate tumor angiogenesis and the difference between angiopoietin levels of acute and chronic myeloid neoplasms could be a reflection of other effects of these growth factors on tumor malignancy.

Treatment with tyrosine kinase inhibitors (TKIs) has dramatically changed the life expectancy of chronic myeloid leukaemia (CML) patients. Although the impact of first-generation TKIs on quality of life (QoL) was shown in CML, the effects of new generic formulations of imatinib mesylate (IM) are unclear. We evaluated differences in QoL under treatment with first- or second-generation TKIs. Fifty-two patients diagnosed with CP-CML completed the European Organization for Research and Treatment of Cancer Quality of Life Questionaire-C30, Hospital Anxiety and Depression Scale, and General Health Questionnaire. General QoL scores were similar between groups. There was a significant difference in the frequency of diarrhoea between IM group and the group using new generic formulations of IM (P = 0.012). General QoL score tended to be higher in patients with disease duration longer than 3 years (P = 0.052). GHQ, anxiety and depression scores correlated positively with symptom scales and negatively with functional subscales.CML patients using new generic formulations of IM reported a higher frequency of diarrhoea than patients using original IM and second-generation TKIs that could result in more drug discontinuation.

Background The association between lymphoproliferative diseases, like chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL), and autoimmunity is well-known. The risk of development of lymphoproliferative diseases, primarily lymphomas, is higher in autoimmune diseases, like systemic lupus erythematosus (SLE), Sjogren9s syndrome (SS) and rheumatoid arthritis (RA). Until now, various studies evaluated markers of autoimmunity, like antinuclear antibody (ANA). Objectives We evaluated the frequency of some autoantibodies in CLL and NHL; and investigated their association with clinical findings. Methods Onehundred-and-ninetynine NHL patients (113 males, 86 females, mean age: 55.1+16.4) and 64 CLL patients were included into the study (36 males, 27 females, mean gae: 62.4+12.4). Blood samples were taken from the patients at the time of diagnosis. ANA, ANCA tests and ENA profile when deemed necessary were assessed by the immunofluorescence method by same technician. Rheumatoid factor (RF), anti-CCP were evaluated by the nephelometry method. The demographic and clinical features and outcome of patients were obtained from medical charts. In addition, the frequency of CLL and NHL in our RA and SLE cohort were evaluated. Results In NHL group, ANA was positive in 44 (22.1%); RF in 13 (6.5%); anti-CCP in 3 (1.5%); and ANCA in one patient. In CLL group, ANA was positive in 20 patients (31.7%), and RF in 7 (11.1%) patients; ANCA was positive in 3 patients; and anti-CCP was positive in 2 patients. Our NHL group included 3 RA (1.5% 3/199), one SLE (0.5%, 1/199) and one SS (0.5%, 1/199) patients. Our CLL patients included one RA (1.6%, 1/63), one SS (1.6%, 1/63) and one ANCA-associated vasculitis (1.6%, 1/63). In NHL patients, the frequencies of ANA positivity (29.1% vs. 16.8%) and RF positivity (11.6% vs. 2.7%) were higher in female patients (p values, 0.039 and 0.011). In CLL group, there was a trend to more frequent ANA positivity (40.7% vs. 25%); and less frequent RF positivity (3.7% vs. 16.7%) in female patients (p values>0.05). ANA positivity in NHL patients was at least at a titer of at least 1/100 in 25 cases; in 19 patients, it was positive at higher titers. In CLL patients, on the other hand, ANA was positive at a 1/100 titer in 11 cases; in 9 cases, it was positive at a higher titer. The frequencies of ANA and RF positivity were most common in subtypes of marginal zone lymphoma (30.8% vs. 23.1%). The mean age in NHL group was also significantly higher in RF- positive patients than in other patients (64.3±12.5 vs. 54.4±16.5, p=0.036). In CLL patients, the frequency of lymphadenopathy was significantly higher in RF-positive (15.6% vs. 0%, p=0.05) and ANA-positive (42.2% vs 5.6%, p=0.005) groups than in others. Conclusions ANA was the most commonly encountered autoantibody in both CLL and NHL patients. RF positivity was more frequent in CLL. RF and ANA were associated with the presence of lympadenopathy. The most common autoimmune disease in patients with lymphoproliferative diseases was RA. Disclosure of Interest None declared