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Background: Cytogenetic findings are important prognostic factors in acute myeloid leukemia. Large systematic data about chromosomal characteristics of Turkish AML patients have not been reported to date. Objectives: The karyotypic profiles of 157 adult AML patients were evaluated retrospectively and compared with other reports from different populations. Methods: Cytogenetics analyses were performed on bone marrow samples using G-banding. Patients were categorized according to their cytogenetic results into four groups with the addition of a normal karyotyped group to the favorable, intermediate and adverse groups of European Leukemia Network. Results: Cytogenetic analyses were carried out successfully in 138 patients (88%). Abnormal karyotypes were found in 79 (57.2%) patients of which 13 (9.4%) were in favorable, 37 (26.8%) in intermediate and 29 (21%) in adverse groups. t(8;21) (5%) was the most common favorable abnormality while monosomal karyotypes (15.9%) in adverse group. Conclusion: This single center study is the most comprehensive study about the cytogenetic profile of acute myeloid leukemia in Turkey with comparison of other population-based studies. While there were similarities and differences with different publications, our results did not show a marked tendency to the findings of any specific geographic region. Keywords: Acute myeloid leukemia; cytogenetics; chromosomal abnormalities; adult.

Background: The most frequent cytogenetic aberration is 13q14.3 deletion in Chronic Lymphocytic Leukemia (CLL). HsamiR-15a/hsa-miR-16-1 are tumor suppressor miRNAs encoded from 13q14.3 region. Objectives: The aim of this study was to investigate the 13q14.3 deletion using molecular and cytogenetic techniques and association with miRNA-15a/miRNA-16-1. Materials And Methods: We used peripheral blood samples of 30 CLL patients who were either induced and or non-induced with DSP30+IL-2 to determine 13q14.3 deletion by karyotyping and iFISH. Expression levels of hsa-miR-15a/miR-16-1 were measured using qRT PCR and compared with deletions. Results: 13q14.3 deletion was detected in 8.6% of cases by karyotyping and in 65% by iFISH. Mosaic forms (monoallelic+biallelic) were observed in 50% of cases. Besides determining common chromosome abnormalities such as add(2)(q37), t(2;7) (p11.2;q22), del(6)(q13q21), del(6)(q25), add(9)(q21), del(11)(q23), t(11;14)(q13;q32), del(13)(q11q12), del(13)(q12q14), add(14)(q23), del(14)(q23), t(14;19)(q32;q13.1), del(15)(q23), del(17)(p12), t(18;22)(q21;q11.2), add(21)(p13) and t(17;21)(q11.2;122), we also determined t(1;13)(q32;q34), inv(2)(p25q21), del(13)(q22q32), t(14;19) (q24;q13), dup(17)(q21q23), der(21;21)(p13;p13) which have not been reported previously. Mitotic index data was found statistically significant and DSP30+IL-2 increased mitotic index by 2.5 folds. Association between decreased miR-16-1 expression and deletions was statistically significant. Conclusion: We suggest that cytogenetic and iFISH analyses are complementary and use of DSP30+IL-2 is effective .in CLL. Decreased expression of hsa-miR-16-1 is remarkable. Keywords: CLL; miR-15a/miR-16-1; 13q14.3 deletion.

Umut Yilmaz, Ayse Salihoglu, Teoman Soysal Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, TurkeyCorrespondence: Umut YilmazIstanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Internal Medicine, Division of Hematology, Fatih, Istanbul, TurkeyTel +90 541 797 76 47Email umutyza@hotmail.comAbstract: Follicular lymphoma (FL) is an indolent (low-grade) malignancy of B cells and is among the most common hematological cancers affecting adults. Its clinical presentation, natural course, and severity are highly variable. Management of FL depends on the clinical setting; most patients require multiple lines of treatment. Chemoimmunotherapy is the standard of care for FL patients needing treatment; however, alternative treatments are limited for refractory patients or those unfit for chemoimmunotherapy. Multiple alternatives to chemoimmunotherapy for FL are being developed, with some showing significant promise. Lenalidomide combination with rituximab (LR) is among the most successful and extensively studied novel approaches. LR has been compared head-to-head in clinical trials with rituximab monotherapy and chemoimmunotherapy in the frontline and to lenalidomide or rituximab monotherapy in the relapsed or refractory setting for the treatment of FL. Initial reports of these nine trials have been published in the last decade, and their long-term data will be available in the coming years. LR offered superior efficacy to either lenalidomide or rituximab monotherapy alone. The RELEVANCE trial compared the efficacy of LR with chemoimmunotherapy among 1030 FL patients and demonstrated similar efficacy with a different side effect profile. Myelosuppression, rash, and fatigue were among the significant adverse events. Most patients treated with LR received thromboprophylaxis. This paper aims to summarize and comment on the published evidence regarding LR treatment for FL through a literature review. The clinical trials will be presented in detail, and methodological differences complicating their comparisons will be discussed.Keywords: rituximab, lenalidomide, follicular lymphoma, chemo-free, R2

Objective: Our study was performed on 49 chronic lymphocytic leukemia (CLL) patients followed in the outpatient clinic of the Istanbul University Cerrahpasa Medical Faculty Department of Hematology. We aimed to analyze the relationship between autoimmune phenomena and CLL. Methods: Twenty-five CLL patients with and 24 CLL patients without autoimmune phenomenon were included. Thirty-two of them were male and 17 were female. No statistically significant difference in the median age at diagnosis (60 vs 64) and in the median follow-up time (59 months vs 71 months) was detected. The initial diagnostic parameters were similar. Results: In our autoimmune phenomenon cohort, the most frequent autoimmune disease was autoimmune hemolytic anemia (AIHA) followed by immune thrombocytopenia (ITP) and pure red cell aplasia (PRCA). The direct antiglobulin positivity at the time of diagnosis was increased in the autoimmune phenomenon group (p=0.024). Additionally, the stage of CLL in patients of the autoimmune phenomenon group was more advanced than the other group (p=0.04). Although the number of autoimmune phenomena was not high enough, the CD38 positive cell ratio over 30% in the peripheral blood was more frequent in PRCA group (p=0.008). Conclusion: We could not determine a relationship between autoimmunity in CLL and KIR genotypes. We believe that a new study in a larger cohort with superior technical conditions should be planned to find accurate responses to our study. Istanbul University Scientific Research ProjectsIstanbul University [32784] This study was supported by Istanbul University Scientific Research Projects (Proje No: 32784) .

Objective: Our study was performed on 49 chronic lymphocytic leukemia (CLL) patients followed in the outpatient clinic of the Istanbul University Cerrahpasa Medical Faculty Department of Hematology. We aimed to analyze the relationship between autoimmune phenomena and CLL. Methods: Twenty-five CLL patients with and 24 CLL patients without autoimmune phenomenon were included. Thirty-two of them were male and 17 were female. No statistically significant difference in the median age at diagnosis (60 vs 64) and in the median follow-up time (59 months vs 71 months) was detected. The initial diagnostic parameters were similar. Results: In our autoimmune phenomenon cohort, the most frequent autoimmune disease was autoimmune hemolytic anemia (AIHA) followed by immune thrombocytopenia (ITP) and pure red cell aplasia (PRCA). The direct antiglobulin positivity at the time of diagnosis was increased in the autoimmune phenomenon group (p=0.024). Additionally, the stage of CLL in patients of the autoimmune phenomenon group was more advanced than the other group (p=0.04). Although the number of autoimmune phenomena was not high enough, the CD38 positive cell ratio over 30% in the peripheral blood was more frequent in PRCA group (p=0.008). Conclusion: We could not determine a relationship between autoimmunity in CLL and KIR genotypes. We believe that a new study in a larger cohort with superior technical conditions should be planned to find accurate responses to our study., Amaç: İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Hematoloji Polikliniği’nde takip edilen 49 Kronik Lenfositik Lösemi (KLL) hastası çalışmaya dahil edilmiştir. Çalışmanın amacı, çeşitli otoimmün hastalıklar ile ilişkisi gösterilmiş olan Killer Immunoglobuline Like Receptor (KIR) gen düzeylerini, otoimmün olay gözlenmiş ve gözlenmemiş KLL hasta grupları arasında karşılaştırmaktır. Gereç ve Yöntem: Bu doğrultuda otoimmün olay gözlenmiş olan 25 ve otoimmün olay gözlenmemiş 24 KLL hastası çalışmaya dahil edilmiştir. Hastaların 32’si erkek, 17’si kadındır. Otoimmün hastalık gözlenen grup ile otoimmün olay gözlenmeyen KLL grubu arasında tanı anındaki yaş (60 vs 64) ve ortanca takip süresi (59 ay vs 71 ay), tanı anındaki parametreleri istatistiki olarak benzerdir. Bulgular: Gözlenen en sık otoimmün olay otoimmün hemolitik anemi (OİHA) iken onu immün trombositopeni (İTP) ve saf eritroid aplazi (PRCA) takip etmiştir. Otoimmün olay gözlenmiş hastaların tanı anında direkt antiglobulin testi pozitiflik oranı, otoimmün olay gözlenmemiş KLL hastalarına göre artmış olduğu gözlenmiştir (p=0,024). Ayrıca otoimmün olay gözlenen hastaların tanı anında KLL hastalık evrelerinin daha ileri olduğu görülmüştür (p=0,04). Otoimmün olaylar kendi aralarında değerlendirildiğinde ise, sayı az olmasına karşın, PRCA’da çevresel kanda CD38 pozitif hücre oranının %30’un üstünde olma sıklığının arttığı gözlenmiştir (p=0,008). Sonuç: Çalışmamızda KIR genlerinin otoimmün olaylarla ilişkisi incelendiğinde, otoimmünite gözlenmeyen gruba göre herhangi bir istatistiki fark tespit edilememiştir. Daha iyi teknik şartlarda yeni çalışmalar yapılmasında fayda vardır.

In this report we identified CNV regions unique to adult ITP patients. Despite several studies the genetic background of ITP is still unclear. There are studies on pediatric cases, describing several genes associated with the disease, but the data is still limited. Here, we aimed to identify regions that may play a role in the pathogenesis of adult ITP by SNP array technology. Our findings support the idea that ITP is not only clinically but also genetically heterogeneous and genetic modifiers play an important role in the development of the disease. We believe that this data will provide important bases for the future studies to enlighten ITP pathogenesis.

Karakus, Volkan/0000-0001-9178-2850; Soysal, Teoman/0000-0002-7417-2118; Malkan, Umit Yavuz/0000-0001-5444-4895; Ulu, Bahar Uncu/0000-0002-6230-9519; Demircioglu, Sinan/0000-0003-1277-5105; Sahin, Handan Haydaroglu/0000-0002-3467-8819; Saydam, Guray/0000-0001-8646-1673; Ersoy Dursun, Fadime/0000-0002-3577-188X; Dermenci, Hasan/0000-0002-2244-5006 WOS:000497303100003 PubMed ID: 31327186 Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients (187 women, 65.6 %; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm(3)) and defined as complete (platelet count of >100,000/mm(3)), partial (30,000-100,000/mm(3) or doubling of platelet count after treatment), or unresponsive (