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Sarcoidosis is a rare disease characterized by granulomatous inflammation in affected organs, primarily in lungs. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are easy and practical methods providing valuable information in diagnosis, severity, and prognosis of various diseases. Here, we aimed to investigate the association between NLR, PLR, and hematological parameters in sarcoidosis. The study was performed with 75 sarcoidosis patients and 92 controls. Patients’ NLR, PLR, and hematological parameters were compared with those of controls. Additionally, while differences between NLR and PLR were investigated in sarcoidosis patients, differences of extrapulmonary involvement, pulmonary hypertension (PH), and spontaneous remission between those with and without responses to treatment concerning stages were also assessed. NLR and PLR were significantly higher in sarcoidosis patients than controls. For NLR, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were found as 68, 61, 58, and 70% respectively, while sensitivity, specificity, PPV, and NPV for PLR were found as 72, 67, 63, and 74%, respectively. In sarcoidosis patients, NLR and PLR were significantly higher at stage-2 and -3 than at stage -1 and -4. There was a significant weak positive correlation between C-reactive protein (CRP) and NLR and PLR. Mean platelet volume (MPV), hemoglobin (Hgb), and mean corpuscular volume (MCV) were lower among patients than controls. A positive moderate correlation was detected between NLR and CD4/CD8 in blood, while there was a strong positive correlation between CD4/CD8 in bronchoalveolar lavage (BAL) and positive moderate correlation between PLR and CD4/CD8 in BAL. High NLR and PLR values were not significantly associated with pulmonary PH, spontaneous remission, response to treatment, and prognosis. The increase in PLR and NLR may be a guide for diagnoses of both sarcoidosis and lung parenchymal involvement. To use these entities as markers, our findings should be supported with prospective studies with larger samples.

Some rare malignant diseases exhibit clinical features and bone marrow aspirate morphology similar to that of acute leukemia. For instance, rhabdomyosarcoma, neuroblastoma, medulloblastoma, anaplastic oligodendroglioma, small cell carcinoma, Ewings sarcoma and neuroendocrine tumors have been reported to display an acute leukemia-like morphology in bone marrow aspirates after metastasizing to the bone marrow. Rhabdomyosarcoma (RMS), a malignant tumour of mesenchymal origin which can occur at various sites in the body, is one of the most common soft tissue sarcomas in both children and adolescents, but is rare in adults with a prevalence of less than 1 %. Bone marrow metastases associated with this condition may be readily confused with acute leukemia or lymphoma. Diagnostic confirmation requires immunohistochemical and flowcytometric examinations. In patients with positive CD56 and negative CD45, rhabdomyosarcoma should be included in the differential diagnosis. Here, we report an unusual case of RMS confined to the bone marrow in an older adult. [Med-Science 2018; 7(4.000): 946-8]

Objective: We present data of patients with relapsed/ refractory T cell lymphomas treated with brentuximab vedotin (BV) in real-world practice. Material and Method: This study is an observational, multi-center, retrospective study. The data of patients (n=17) treated with BV alone from January 2014 until July 2020 in thirteen centers from Turkey were collected. Results: Bv was given as salvage chemotherapy to 17 patients with median age of 53. Nine (52.9%) patients had diagnosis of peripheral T cell lymphoma, not otherwise specified; 8 (47.1%) patients had anaplastic large T cell lymphoma. The median follow-up of the cohort was 20 months. Nine (52.9%) patients had complete response, 5 (29.5%) had partial response, 3 (17.6%) had progressive disease. The safety results aligned with the established profile of BV, included 2 pneumonia and 1 thrombocytopenia with grade 4. The median progression free survival of the cohort was 10 months. BV cycle and response to BV therapy were found to have an effect on the univariate analysis. Conclusion: In patients with relapsed/ refractory T cell lymphomas, BV seems to have convincing antitumor activity with favorable safety profile.

Background/Aims: Polycythemia vera (PV) and essential thrombocythemia (ET) are chronic myeloproliferative diseases. Along with the increase in myeloproliferative cell lines, they can cause various clinical outcomes such as arterial and venous thrombosis, pulmonary hypertension, and myocardial infarction. This study was designed to evaluate the cardiac effects of these diseases via electrocardiography and echocardiography. Methods: A total of 50 patients with a diagnosis of PV, 50 patients with a diagnosis of ET, and 50 healthy individuals as a control group were included in this study. Data on patient demographics were recorded in all subjects. All patients and control subjects had electrocardiography (ECG) recordings and routine transthoracic echocardiographic examination. Pulse wave velocity (PWV) was assessed with a Holter blood pressure device. Results: In total, 50 PV patients, 50 ET patients, and 50 control group were included in the study. The demographic characteristics of the PV, ET and control groups were similar. The PR interval was significantly shorter in control subjects than in PV and ET patients (p:0.007, p:0.024). Although the measured values were within normal limits, diastolic posterior wall thickness was significantly lower in the control group compared to PV and ET patients (p:0.019, p:0.009). PWV was significantly higher in ET patients compared to the control group (p:0.012). Conclusion: In this study, evaluating the effects of PV and ET on electrocardiography and transthoracic echocardiography; ECG parameters used to predict ventricular arrhythmias (QT, QTc, Tp-Te, Tp-Te/QT) and Pulmonary Artery Pressure showed no significant change, in opposition to existing literature. Nonetheless, similar to previous publications, PV and ET were found to negatively affect the diastolic function parameters on transthoracic echocardiography. While the aortic stiffness was significantly higher in ET patients compared to the control group, no significant difference was noted between PV patients and control subjects in terms of aortic stiffness.

Background:Since the development of tyrosine kinase inhibitors (TKIs), the prognosis for chronic myeloid leukemia (CML) has significantly improved. Several predicted prognostic scores and indicators at diagnosis have been used to predict the prognosis of chronic phase chronic myeloid leukemia (CML-CP) during the TKI period. When CML patients are first diagnosed, hemogram parameter aberrations are rather prevalent in clinical practice, although it is still unknown how those parameters affect the prognosis. This study aims to evaluate the hemogram parameters at diagnosis on the survival outcomes of CML-CP patients. Materials and Methods:One hundred thirty-seven patients who were diagnosed with CML-CP and received treatment were assessed between the years 2006 and 2020. Results:There were 65 (47.4%) males and 72 (52.6%) females with a median age of 50 (range: 18-78) years at diagnosis. Median hemoglobin level was 12.1 gr/dL (4.3-17.4), leucocyte count was 66.2 ×109 /L (7.5-520.2), and thrombocyte count was 362 ×109 /L (18-3.496) for all patients. The median progression-free survival (PFS) was 16.7 months 16.7 (2.0-106.4) and the median overall survival (OS) was 63.8 months (0.43-166.2) for all patients. Conclusion:This study is valuable in terms of predicting the prognosis of CML patients with hemoglobin, leukocyte, and platelet values at the time of diagnosis. While emphasizing the importance of platelet count at the time of diagnosis, similar to the previously defined risk scores, it showed that leukocyte and hemoglobin values at the time of diagnosis did not have a statistically significant effect on OS and PFS.

Objective: This study aimed to evaluate patients with relapsed/ refractory multiple myeloma (RRMM) who underwent daratumumab (DARA) therapy. Materials and Methods: This multicenter retrospective study included 134 patients who underwent at least two courses of DARA from February 1, 2018, to April 15, 2022. Epidemiological, disease, and treatment characteristics of patients and treatment-related side effects were evaluated. Survival analysis was performed. Results: The median age at the start of DARA was 60 (range: 35-88), with 56 patients (41.8%) being female and 48 (58.2%) being male. The median time to initiation of DARA and the median follow-up time were 41.2 (5.1- 223) and 5.7 (2.1-24.1) months, respectively. The overall response rate after DARA therapy was 75 (55.9%), and very good partial response or better was observed in 48 (35.8%) patients. Overall survival (OS) and progressionfree survival (PFS) for all patients were 11.6 (7.8-15.5) and 8.0 (5.1-10.9) months, respectively. OS was higher for patients undergoing treatment with DARA and bortezomib-dexamethasone (DARA-Vd) compared to those undergoing treatment with DARA and lenalidomide-dexamethasone (DARA-Rd) (16.9 vs. 8.3 months; p=0.014). Among patients undergoing DARA-Rd, PFS was higher in those without extramedullary disease compared to those with extramedullary disease (not achieved vs. 3.7 months; odds ratio: 3.4; p

Objective: In recent years, new developments have been incorporated into daily practice in the management of immune thrombotic thrombocytopenic purpura (iTTP). In particular, clinical scoring systems could help clinicians with clinical decision-making and early recognition. However, older patients frequently present with more organ involvement and in unusual ways. The ways in which age could affect these clinical prediction scoring systems remain unclear. We evaluated the use of PLASMIC and French scores in patients over 60 years of age. Materials and Methods: We performed a retrospective crosssectional analysis of patients over 60 years of age with a presumptive diagnosis of iTTP between 2014 and 2022 at 10 centers. We calculated PLASMIC and French scores and compared our data with a singlecenter analysis of younger patients presenting with thrombotic microangiopathy. Results: Our study included 30 patients over 60 years of age and a control group of 28 patients younger than 60 years. The diagnostic sensitivity and specificity of a French score of ≥1 were lower in older patients compared to the control group (78.9% vs. 100% and 18.2% vs. 57.1%, respectively). The diagnostic sensitivity and specificity of a PLASMIC score of ≥5 were 100% vs. 95% and 27.3% vs. 100% for the study group and control group, respectively. Our study showed a higher mortality rate in older patients compared to the control group (30% vs. 7.1%, p=0.043). Conclusion: For a limited number of patients (n=6), our results showed that rituximab can reduce mortality. Given that the reliability of clinical prediction scores for iTTP in older patients may be lower, more caution must be undertaken in interpreting their results.

Aim:In this study, it was aimed to compare serum periostin levels of patients with and without bone marrow fibrosis among newly diagnosed multiple miyeloma (MM) patients.Materials and Methods:Thirty patients who were diagnosed with fibrosis in bone marrow biopsy from 36 MM patients over the age of 18 who were newly diagnosed in our center in line with the recommendations of national and international guidelines and were selected for serum periostin levels were included in the study. The patients were divided into two groups as those with and without fibrosis.Results:While the serum periostin level of the patients with bone marrow fibrosis was 29.22 ng/mL, the serum periostin level of the patients without fibrosis was 17.97 ng/mL, which was statistically significantly higher (p

Introduction:Ruxolitinib is a small -molecule inhibitor of the JAK1/2 pathway. This study aimed to reveal the results and side-effect profile of the use of ruxolitinib as a treatment option in polycythemia vera (PV).Methods:A total of 34 patients with PV from 18 different centers were included in the study. The evaluation of the response under treatment with ruxolitinib was determined as a reduction in spleen volume (splenomegaly size: ≥35%) by imaging and control of hematocrit levels (≤45%) compared to baseline.Results:While the number of patients in which a reduction in spleen volume and hematocrit control was achieved was 19 (55.9%) at 3 months of treatment, it was 21 (61.8%) at 6 months. Additionally, while the number of side effects was negatively correlated with the reduction in spleen volume (Spearman’s rho: -0.365, p=0.034), a decrease in the hematocrit level was positively correlated (Spearman’s rho: 0.75, p=0.029). Those without a reduction in spleen volume experienced more constipation (chi-square: 5.988, Fisher’s exact test: p=0.033).Conclusion:This study shed light on the use of ruxolitinib in PV and the importance of splenomegaly on studies planned with larger patient groups.

Objective Introduction: The natural course of hepatitis B virus (HBV) infection is determined by the interaction between viral replication and the host's immune response. HBV persists in the body of all infected patients, even those with evidence of serological recovery. Therefore, individuals with a history of HBV infection receiving immunosuppressive therapy are at risk for HBV reactivation. HBV reactivation can result in increased serum aminotransferase levels, fulminant liver failure, and/or death. HBV reactivation has been described in patients receiving chemotherapy for various hematological and solid tumors. We present our patient with a diagnosis of chronic lymphocytic leukemia (CLL) who was spontaneously reactivated during follow-up without treatment. Case report: A female patient, who had been followed up with the diagnosis of chronic lymphocytic leukemia for 13 years without treatment, presented in August 2022 with complaints of loss of appetite, weight loss, and jaundice in the eye. It was learned in her history that she had not received chemotherapy or radiotherapy before, had no known disease, and did not use any medication. On physical examination, sclera icteric, multiple lymph nodes with a size of 1 cm in the cervical region and splenomegaly were detected.The patient's Rai stage 2, CLL-IPI score of 3, 17p(-), mutation in the IGHV gene was detected. Detection of leukocyte count 157,000/mm3, lymphocyte count 149.660/mm3, hemoglobin 13.5 g/dL, platelet count 117.000/mm3, alanine aminotransferase (ALT) 2045 U/L, aspartate aminotransferase (AST) 2252 U/L, total bilirubin 10.72 mg/dL, direct bilirubin 9.62 mg/dL, protrombin time 18.7 sec, active partial thromboplastin time 30 sec. While IgG was normal, IgA and M were low. HBsAg positive, anti-HBs negative, anti-HBc IgM negative, anti-HBcIgG positive, HBV-DNA 28,000,000 IU/mL were determined to explain liver dysfunction. One year ago, HBsAg was negative, anti-HBs negative, anti-HBc-IgM negative, while anti-HBc-IgG was positive. The patient was accepted as HBV reactivation and tenofovir disoproxil was started. In the first month of treatment, AST-ALT and bilirubin values returned to normal limits. In the 3rd month of the treatment, HBsAg and HBV-DNA became negative and anti-HBs became positive. The patient was followed up without treatment for CLL. Long-term use of tenofovir disoproxil was planned, despite the possibility of spontaneous HBV reactivation again. Methodology detected: Detection of leukocyte count 157,000/mm3, lymphocyte count 149.660/mm3, hemoglobin 13.5 g/dL, platelet count 117.000/mm3, alanine aminotransferase (ALT) 2045 U/L, aspartate aminotransferase (AST) 2252 U/L, total bilirubin 10.72 mg/dL, direct bilirubin 9.62 mg/dL, protrombin time 18.7 sec, active partial thromboplastin time 30 sec. While IgG was normal, IgA and M were low. HBsAg positive, anti-HBs negative, anti-HBc IgM negative, anti-HBcIgG positive, HBV-DNA 28,000,000 IU/mL were determined to explain liver dysfunction. One year ago, HBsAg was negative, anti-HBs negative, anti-HBc-IgM negative, while anti-HBc-IgG was positive. The patient was accepted as HBV reactivation and tenofovir disoproxil was started. In the first month of treatment, AST-ALT and bilirubin values returned to normal limits. In the 3rd month of the treatment, HBsAg and HBV-DNA became negative and anti-HBs became positive. The patient was followed up without treatment for CLL. Long-term use of tenofovir disoproxil was planned, despite the possibility of spontaneous HBV reactivation again. Results: determined to explain liver dysfunction. One year ago, HBsAg was negative, anti-HBs negative, anti-HBc-IgM negative, while anti-HBc-IgG was positive. The patient was accepted as HBV reactivation and tenofovir disoproxil was started. In the first month of treatment, AST-ALT and bilirubin values returned to normal limits. In the 3rd month of the treatment, HBsAg and HBV-DNA became negative and anti-HBs became positive. The patient was followed up without treatment for CLL. Long-term use of tenofovir disoproxil was planned, despite the possibility of spontaneous HBV reactivation again Conclusion: tenofovir disoproxil was planned, despite the possibility of spontaneous HBV reactivation again. Discussion: HBsAg positive individuals are at greater risk for HBV reactivation compared to HBsAg negative individuals. It has been reported that HBV reactivation rate is up to 70% in HBsAg-positive individuals receiving standard chemotherapy.For those with cured infection (defined as HBsAg-negative, anti-HBc-positive, HBV DNA-negative), reactivation ranged from 0.3% to 9.0%.

Objective: Hemolytic anemia defines a group of anemias occurring due to the shortening of normal red blood cell (RBC) lifespan due to factors extrinsic to RBCs or structural changes in RBCs. As a result of the increase in RBC hemolysis, anemia and associated clinical symptoms become manifest. Hemolytic anemias can be categorized under two broad titles: hereditary and acquired. Here, we present a case diagnosed with pemphigus vulgaris who was determined to have Glucose-6-phosphate dehydrogenase (G6PD) deficiency based on the tests performed subsequent to hemolytic anemia that occurred during dapsone therapy. Case report: 66 year-old female patient presented to the dermatology polyclinic with raised erythema and bullous lesions in a butterfly distribution on the face involving the eyelids. The patient was diagnosed with pemphigus vulgaris based on punch biopsy and, as treatment, was started on 2 × 50 mg dapsone (PO), 1 × 16 mg methylprednisolone (PO) and corticosteroid pomades. Blood parameters at diagnosis were as follows: leukocyte, 8.1 × 109/L (4.4-11); hemoglobin (Hgb), 12.3 gr/dl (12-16); thrombocyte, 270 × 109/L (142-424); MCV, 86 fl (80-100); LDH, 210 U/L (135-214); ALT, 22 U/L (0-33); AST, 16 U/L (0-32); direct bilirubin, 0.5 mg/dl (0-0.3); indirect bilirubin, 0.8 mg/dl (0.1-0.9); creatinine, 0.59 mg/dl (0.5-0.9); folate, 10 ng/ml (5.4-24); vitamin B12, 310 ng/ml (210-910). The patient presented to the dermatology polyclinic 6 days after the onset of treatment due to fatigue, pallor, icterus of the sclerae. The patient was referred to the hematology polyclinic based on the following test results: Hgb, 3.8 gr/dl; leukocyte, 11 × 109/L; thrombocyte, 222 × 109/L; MCV, 108 fl; creatinine, 0.8 gr/dl; LDH, 810 U/L; indirect bilirubin, 6.4 mg/dl; direct bilirubin, 0.8 mg/dl.The patient's history and anamnesis did not include a similar condition that followed medication use or an operation. On physical examination; sclerae were icteric, skin was pale, and there was no organomegaly or peripheral lymphadenopathy. In addition, urine was dark in color. On peripheral blood smear; macrocytosis, anisocytosis-poikilocytosis, polychromasia and Heinz bodies were observed. Corrected reticulocyte was determined as 5.2% (0.5-2%); ANA, anti-dsDNA, direct Coombs (IgG) and indirect Coombs' tests were negative. The haptoglobulin level was determined as 8 mg/dl (30-200) and was below the reference range. As the present hemolytic anemia picture was reasoned to be associated with dapsone, the medication was stopped and 16 mg methylprednisolone was started. No pathological findings were determined on abdominal ultrasonography and lung radiography. Based on the perception that anemia was associated with dapsone, G6PD enzyme levels were examined. The patients' G6PD level was found as 3.52 IU/gHb (7.48-10.20 IU/gHb), and was below the reference. During follow-up, fatigue, subicterus and pallor improved. Hgb levels increased, LDH and indirect bilirubin levels showed a gradual decrease. Blood parameters after 10 days were as follows: Hgb 11,8, gr/dl; leukocyte, 7.6 × 109/L; thrombocyte, 234 × 109/L; MCV, 98 fl; creatinine, 0,6 gr/dl; LDH, 260 U/L; direct bilirubin, 0.42 mg/dl; indirect bilirubin, 0.44 mg/dl. Conclusion: Dapsone is used widely in the treatment of various disorders, most notably, dermatological disorders. In G6PD deficiency, using dapsone is risky and is associated with a high probability of hemolytic anemia occurrence. In this case presentation, we aimed to stress that hemolytic anemia encountered in a patient on dapsone would be linked to G6PD enzyme deficiency.

Objective:Chromosomal abnormalities are one of the most important prognostic factors in acute myeloid leukemia (AML). However, not all patients may have such informative chromosomal abnormalities. Although there are many studies on the prognostic value of immunophenotyping in AML, it is still not used as a prognostic marker. In this study, we aimed to investigate the effects of CD13, CD33, CD34, CD117, MPO and HLADR expressions on prognosis of non-acute promyelocytic leukemia AML.Methods:One hundred thirteen patients diagnosed as having non- acute promyelocytic leukemia AML and followed up between 2010 and 2018 were included in this study. The associations of CD13, CD33, CD34, CD117, MPO and HLA DR expressions with chemotherapy response, progression free survival (PFS) and overall survival (OS) were statistically analyzed.Results:It was seen that response to chemotherapy was achieved in 67.3% of the patients. Median PFS duration was 9 months and median OS duration was found as 13 months. Of the immunophenotypic characteristics, only MPO expression was determined to be an independent risk factor for PFS and OS.Conclusion:Immunophenotypic features may be helpful in the diagnosis of AML as well as give an idea about prognosis. In this study, MPO expression was shown to be an independent risk factor for PFS and OS in our own patient population.

Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARSCoV- 2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixtynine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.

Objective:This study aimed to evaluate the effects of genetic characteristics on the survival in patients with myelodysplastic syndrome (MDS).Methods:This retrospective study reviewed the data on epidemiological features, main laboratory tests, International Prognostic Scoring System (IPSS) and revised-IPSS risk categories, genetic anomalies, genetic risk categories, and survival in patients who are diagnosed with MDS in our center. According to the IPSS risk categories, patients were classified into three groups as follows: “low risk,” “intermediate-1,” and “intermediate-2 risk and high risk.” The groups were compared using the ANOVA and Kruskal-Wallis tests.Results:The study reviewed the data of 99 patients. The mean age was 66±11.6 years. A genetic anomaly was detected in 30.3%, of which the most common was del20q (26.7%). The median survival was 61 months [95% confidence interval (CI): 50.9-71] in the study population. The 5-year survival rate was calculated as 64%, 41%, and 33% in “low risk,” “intermediate-1,” and “intermediate-2 risk and high risk” groups, respectively. The predicted median survival rate was 96 months (95% CI: 47.7-144.2), 56 months (95% CI: 34.1-77.8), and 18 months (95% CI: 15.1-20.8), respectively, which indicate a significant difference (log-rank chi-square: 6.6; p=0.035). The risk for mortality was 3.3-folds higher in the “intermediate-2 and high risk” group compared to the “low risk” group (RR: 3.3; 95% CI: 1.2-8.6; p=0.017).Conclusion:Our study supports that risk groups that are determined by several parameters, including genetic characteristics, provide predictive information about survival in MDS.

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

Aim:Autologous hematopoietic stem cell transplantation is the most frequently used treatment method in the treatment of lymphoma and myeloma patients. To apply this treatment method, first of all, a sufficient number of stem cells must be collected from the patient. With the development of apheresis methods and safe, effective mobilization methods, it is now possible to collect stem cells in an outpatient manner. In our study, we aimed to compare the efficacy and safety of outpatient based mobilization versus inpatient based mobilization of hematopoietic stem cells with granulocyte-colony stimulating factor (G-CSF) alone in patients with myeloma and lymphoma.Materials and Methods:A total of 89 patients, including 54 patients who underwent outpatient and 35 patients who underwent inpatient based mobilization of stem cells with G-CSF alone were included in the study. Outpatient and inpatient based mobilization groups were compared in terms of efficacy and safety. Statistical analyses were performed with Jamovi 1.2.27 software. The Mann-Whitney U and chi-square tests were used to examine the differences. MANCOVA was used for univariate and multivariate statistical analysis of factors influencing mobilization.Results:Three leukaphereses resulted in the collection of a mean 9.73x106/kg (4.5-16.5) CD34+ cells in the outpatient based mobilization group and a mean 11.8x106/kg (3.56-59) CD34+ cells in the inpatient based mobilization group (p=0.14). Life-threatening side effects were not observed in any of the patients. Grade 1, 2 side effects were observed and there was no significant statistical difference between the two groups.Conclusion:In this study, we found no significant difference in terms of efficacy and safety between the outpatient and the inpatient based mobilization group patients with myeloma and lymphoma who were mobilized with G-CSF. The results of our study show that outpatient based mobilization can be effectively and safely performed with g-csf, especially in patients who need autologous transplantation and avoid hospitalization, as in the current Coronavirus disease-2019 pandemic.

Aim: Diffuse Large B Cell Lymphoma (DLBCL) is the most common NHL and %80 of all NHLs. Although it has some subtypes with heterogenous characteristic for prognosis, in area of rituximab monoclonal anti-body, improvement in overall survival (OS) was achieved. We evaluated response of treatment, epidemiologic features, OS and progression-free survival (PFS) of our patients with DLBCL for 5-years retrospectively.Materials and Methods: We investigated 160 patients from three centers in Turkey. Demografic features, stages, risk groups, the type of first-line therapy and its reason, duration of remission, relapse status and adverse events were collected. Package for the Social Sciences (SPSS) 22.0 program were used for statistical analysis. Dates of survival and significancies were obtained by Kaplan-Meier analysis and long-rank test, respectively. Analyses with p values below 0.05 were recognized as statistically significant.Results: Mean age of patients at the time of diagnoses was 60.75 ± 13.95. Number of patients with only nodal involved and extranodal involved were 109 (%68,1) and 51 (%31,9), respectively. Frequency of relaps after the first therapy was significancy superior in males than females. Althought there was no significant differencies between stage and OS, and response to treatment (p=0,140 ve p=0,378), significant difference was obtained between stage and PFS (p=0,038). In additon there wasn’t significant differencies between OS and PFS among patients with nodal and extranodal involved. Otherwise patients with advance age adjuested international prognostic index (aaIPI) scores had significancy inferior rate of response of first treatment (p=0,031).Conclusion: We demosrated the characteristics of patients with DLBCL as a general population and other else results related risk factors were similary with literatures.

Chronic lymphocytic leukemia (CLL) is a neoplastic condition of B cells that frequently affects the lymph nodes, liver, spleen and bone marrow. The extranodal involvement of CLL is most commonly observed in the skin, whereas gastrointestinal and genitourinary involvement is rare. Renal involvement may not always present with renal failure. In this study, we aimed to present a patient with CLL infiltration in the kidney without renal failure and proteinuria

INTRODUCTION: Extramedullary myeloma (EMM) is defined by the presence of plasma cells outside the bone marrow in a patient with multiple myeloma (MM). More using sensitive imaging techniques, EMM may be found in up to 30% of MM patients across the overall disease course. We also aimed to investigate the frequency of EMM in MM patients in our clinic. METHODS: Patients diagnosed with multiple myeloma in our clinic between January 2010 and August 2018 were examined retrospectively and the frequency of extramedullary myeloma was determined. EMM was divided into two groups as those with and without EMM. Factors that could be effective on these two groups were analyzed. RESULTS: Of the 67 patients who were taken to work, 37 were male, 30 were female and the mean age was 59.9 +- 11.2. Extramedullary myeloma was detected in 31 patients (46.3%). Of these patients, 28 (41.8%) patients are associated bone plasmacytoma, 4 (6%) patients are showed extramedullary disease. The most common bone-related plasmacytoma is the vertebrae, while extramedullary disease is most commonly seen in the lung. DISCUSSION AND CONCLUSION: Extramedullary myeloma ratios were higher in our patient population than in the literature.

Mucormycosis is a rare, emerging fungal infection, with high morbidity and mortality. Rhino-orbito-cerebral form is common. In the treatment of this form, it is recommended to apply amphotericin B and surgery together. However, despite these treatments, mortality is very high. We present a case of mucormycosis which we treated successfully with surgery for three times and simultaneously intravenous and nasal amphotericin B liopozomal application in our patient with acute lymphoblastic leukemia.

Thrombotic thrombocytopenic purpura (TTP) is a rare disease associated with microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological disorders, and renal insufficiency pentad. It is a fatal hematologic emergency if left untreated. If plasma exchange is feasible, treatment is easy and comfortable. It should be kept in mind that such as in our patient may be acquired at all congenital illnesses.

Kronik lenfositik lösemi ve Mantle hücreli lenfoma da yeni bir tedavi seçeneği olan ibrutinib, yüksek etkinliği ile günümüzde sık kullanılmaya başlanmıştır. Hedefe yönelik monoklonal antikorların yan etkileri sitotoksik tedavilere göre daha hafif seviyede görülmektedir. İbrutinibin de ishal, bitkinlik, ateş, bulantı, kanama, sitopeniler, alerjik reaksiyonlar gibi yan etkileri görülmektedir. Kanama %50 den fazla vakada görülmüştür. Çoğunluğu peteşiyal kanamalar olmasına rağmen hayati tehdit eden kanamalara da yol açmaktadır. Bizde ibrutinibin kanamaya eğilimi olan hastalarda dikkatli kullanılmasını vurgulamak amacıyla, ibrutinib sonrası kanama gelişen vakamızı sunduk

Background & Objective: Early diagnosis can be made based on the morphological examination of bone marrow aspiration (BMA) until the bone marrow biopsy (BMB) result is reported. This allows for treatment to be started immediately, especially in hematological malignancies for which urgent treatment is indicated. This study aimed to determine the sensitivity and importance of bone marrow aspiration in the diagnosis of hematological malignancies., Methods: In this study, the data of patients who underwent bone marrow aspiration and bone marrow biopsy in Van Yuzuncu Yil University hospital between 2017 and 2019 were retrospectively analyzed. A total of 500 patients who simultaneously underwent BMA and BMB were included in the study. Data were obtained from electronic medical records., Results: Indication for bone marrow evaluation was abnormalities in complete blood count in 270 (54%) of patients. The diagnosis was made based on the evaluation of BMA in 475 (95%). In 456 (96%) of the 475 patients diagnosed with BMA, the diagnosis was consistent with that of BMB. Agreement of BMB with BMA was 100% in acute and chronic leukemias, while BMA was not sufficient for the diagnosis of lymphoma and solid organ metastasis., Conclusion: Our study showed that the evaluation of BMA was highly sensitive in the diagnosis of hematological malignancies, such as acute leukemias, chronic leukemias, and multiple myeloma., Competing Interests: Conflict of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Background and Objective: Besides known risk scoring systems, studies have recently been conducted in relation to NLR to estimate the prognosis of HL. Some studies found a relationship of NLR with PFS and OS. Our objective was to investigate whether NLR, as an inexpensive and easily accessible test, is a prognostic marker for cHL, as in several previous studies., Methods: The study included 232 patients in the age range of 18 to 88 years who were diagnosed with classic Hodgkin Lymphoma and received ABVD chemotherapy and/or radiotherapy at Van Yuzuncu Yil University Hematology Clinic from 2000-2018. Analyses were conducted on the disease stage, risk scores, treatment responses and relapse statuses at the time of diagnosis based on the patients' NLR values at the time of diagnosis., Results: The mean age of the patients was 39.27 ± 15.90, while 38.8% were female and 61.2% were male. The NLR value at the time of diagnosis was significantly related to stage (p:0.013), early-stage risk score (p:0.022) and treatment response (p:0.032). The cutoff value of NLR was found as 4.23. The Hb value at the time of diagnosis was significantly related to stage (p:0.00), early-stage risk score (p:0.007), treatment response (p:0.006) and the latest status of patients (p:0.005)., Conclusion: High NLR values were found to be significantly related to disease stage, early-stage risk scoring and response to the treatment. These findings need to be supported by prospective studies with larger samples for these data to be used prognostic scores.