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Öğe Akış Sitometrisi Verilerinin Geriye Dönük Taranması: Tek merkez deneyimi(2015) Uyanık, Mehmet Şevki; Baysal, Mehmet; Asoğlu, Veysi; Maden, Muhammet; Ümit, Elif Gülsüm; Pamuk, Gülsüm Emel; Varım, CeyhunAmaç: Akış sitometrisi (AS) çeşitli hücrelerin bir süspansiyon halinde bir akış kanalı boyunca tek tek geçmesi ve bu esnada hücre büyüklük ve içeriğine göre sınıflandırılması esasına dayanan florokromojenik-lazer tabanlı bir tanı yöntemidir. Hematolojik malignitelerin tanısı AS cihazının en fazla kullanım alanıdır. Mevcut çalışmada hastanemiz AS laboratuvarına gönderilen örneklerin yıllara göre dağılımlarını, istek yapan bilim dalının dağılımını, gönderinin yapıldığı örnek tipini ve tanı-izlemde ASnin yerini değerlendirmeyi hedefledik. Yöntem ve Gereçler: Trakya Üniversitesi Tıp Fakültesi AS Laboratuvarına 01.01.2002 ile 01.01.2014 tarihleri arasında gönderilerek değerlendirilen AS testleri geriye dönük olarak değerlendirildi. Elde edilen parametreler ta- nımlayıcı istatistik çerçevesinde değerlendirildi. Sonuç: Bu zaman zarfında toplam 4874 adet test değerlendirildi (Ortalama: 406 test/yıl). Örneklerin %18,7si çocuk yaştaki hastalardan (n=964) gönderilmişken, % 81,3ü (n=3910) erişkin hastalarından gönderilmişti. Gönderilen ör- neklerin %35,3ü (n=1725) kemik iliği, %58,2si periferik kan (n=2828), %6,5i (n=321) diğer vücut dokularından gönderilmişti. Örneklerin %20,2sinin (n=989) tanısında AS inceleme başrol oynamıştı. Örneklerin %18,5i (n=880) hastalıkların tedaviye yanıtlarının değerlendirilmesinde kullanıldı. Tanısı ASyle konulan hastaların %34,6sı akut myeloid lösemi, %32si kronik B-lenfoproliferatif hastalıklar, %19,5i akut lenfositer lösemi, %10,2si myelodisp- lastik sendrom, %3,2si kronik myeloid lösemi, %0,3ü Burkitt lösemi/lenfoma, %0,1i T-lenfoproliferatif hastalık ve %0,1i bifenotipik lösemiydi. Tartışma: Tek merkez verilerinin değerlendirildiği bu çalışma tanı konulması istenilen hastalıkların ülkemizdeki sıklıklarını göstermesi açısından önemli veriler sunmaktadır. Yıllara göre dağılım ise merkezimizin deneyim artı- şını ve hastaların merkezimize ulaşımının kolaylaşması olarak değerlendirilebilir. Hastane verilerine dayalı geriye dönük çalışmaların yararları arasında hastalık sıklık verilerinin saptanmasında dolaylı bir yöntem olması sayılabilir.Öğe Efficacy and Safety of Ibrutinib Therapy in Patients with Chronic Lymphocytic Leukemia: Retrospective Analysis of Real-Life Data(Galenos Yayincilik, 2021) Tombak, Anıl; Pepedil Tanrıkulu, Funda; Durusoy, Salih Sertaç; Dinçyürek, Hüseyin Derya; Kaya, Emin; Ümit, Elif Gülsüm; Ferhanoğlu, Burhan; Akpınar, Seval; Turgut, BurhanObjective: 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<0.001, p=0.001, and p<0.001, respectively), with ECOG class 0-1 versus class 2-3 (p=0.006, p=0.011, and p=0.001, respectively), and with Rai stage 0-2 versus 3-4 (p=0.002, p=0.001, and p=0.002, respectively). No significant difference was noted in treatment response rates or survival outcome with respect to the presence of comorbidity, bulky disease, or del(17p). While 176 adverse events (AEs) were reported in 74 (54.4%) patients, 46 of those 176 AEs were grade 3-4, including pneumonia (n=12), neutropenia (n=11), anemia (n=5), thrombocytopenia (n=5), and fever (n=5). Conclusion: This real-life analysis confirms the favorable efficacy and safety profile of long-term ibrutinib treatment while emphasizing the potential adverse impacts of poorer ECOG performance status, heavy treatment prior to ibrutinib, and advanced Rai stage on patient compliance, treatment response, and survival outcomes.Öğe Efficacy and Safety of Ibrutinib Use in Patients with Chronic Lymphocytic Leukemia in Real World Experiences: Results of a Prospective Multicenter Study(Amer Soc Hematology, 2019) Tombak, Anıl; Pepedil Tanrıkulu, Funda; Durusoy, Salih Sertaç; Gürkan, Emel; Kaya, Emin; Ümit, Elif Gülsüm; Ferhanoğlu, Burhan; Akpınar, Seval[No Abstract Available]Öğe Immune Thrombotic Thrombocytopenic Purpura in Elderly Patients: The Roles of PLASMIC and French Scores(2023) Baysal, Mehmet; Hindilerden, Fehmi; Ümit, Elif Gülsüm; Demir, Ahmet Muzaffer; Karadağ, Fatma Keklik; Saydam, Güray; Akpınar, SevalObjective: 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 cross- sectional 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 single- center 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.
