Browsing by Author "Dogu, MH"
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Item A Real-Life Turkish Experience of Ruxolitinib in Polycythemia VeraSerin, I; Dogu, MH; Ekinci, O; Cagliyan, GA; Bastürk, A; Aras, MR; Demircioglu, S; Turgut, B; Merter, M; Hacioglu, SK; Bagci, M; Albayrak, M; Korkmaz, S; Erkurt, MA; Dal, MS; Dursun, FE; Tombak, A; Aydogdu, I; Ulas, T; Altuntas, FIntroduction: 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.Item The Real-World Experience With Single Agent Ibrutinib in Relapsed/Refractory CLLAkpinar, S; Dogu, MH; Celik, S; Ekinci, O; Hindilerden, IY; Dal, MS; Davulcu, EA; Tekinalp, A; Hindilerden, F; Ozcan, BG; Hacibekiroglu, T; Erkurt, MA; Bagci, M; Namdaroglu, S; Korkmaz, G; Bilgir, O; Cagliyan, GA; Ozturk, HBA; Serin, I; Tiryaki, TO; Ozatli, D; Korkmaz, S; Ulas, T; Eser, B; Turgut, B; Altuntas, FWe 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.Item Nodular lymphocyte predominant Hodgkin's lymphoma in daily practice: A multicenter experienceGemici, A; Aydogdu, I; Terzi, H; Sencan, M; Aslan, A; Kaya, AH; Dal, MS; Akay, MO; Dogu, MH; Ayyildiz, O; Sahin, F; Cagliyan, GA; Yilmaz, M; Gokgoz, Z; Bilen, Y; Demir, C; Sevindik, OG; Korkmaz, S; Eser, B; Altuntas, FNodular 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.Item Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: twenty-four year Turkish experience in cladribine therapyHacioglu, S; Bilen, Y; Eser, A; Sivgin, S; Gurkan, E; Yildirim, R; Aydogdu, I; Dogu, MH; Yilmaz, M; Kayikci, O; Tombak, A; Kuku, I; Celebi, H; Akay, MO; Esen, R; Korkmaz, S; Keskin, AIn this multicenter retrospective analysis, we aimed to present clinical, laboratory and treatment results of 94 patients with Hairy cell leukemia diagnosed in 13 centers between 1990 and 2014. Sixty-six of the patients were males and 28 were females, with a median age of 55. Splenomegaly was present in 93.5% of cases at diagnosis. The laboratory findings that came into prominence were pancytopenia with grade 3 bone marrow fibrosis. Most of the patients with an indication for treatment were treated with cladribine as first-line treatment. Total and complete response of cladribine was 97.3% and 80.7%. The relapse rate after cladribine was 16.6%, and treatment related mortality was 2.5%. Most preferred therapy ( 95%) was again cladribine at second-line, and third line with CR rate of 68.4% and 66.6%, respectively. The 28-month median OS was 91.7% in all patients and 25-month median OS 96% for patients who were given cladribine as first-line therapy. In conclusion, the first multicenter retrospective Turkish study where patients with HCL were followed up for a long period has revealed demographic characteristics of patients with HCL, and confirmed that cladribine treatment might be safe and effective in a relatively large series of the Turkish study population. Copyright (C) 2014 John Wiley & Sons, Ltd.Item Primary central nervous system lymphoma in daily practice and the role of autologous stem cell transplantation in relapsed disease: A retrospective multicenter studyErkurt, MA; Berber, I; Tekgunduz, E; Dogu, MH; Korkmaz, S; Demir, C; Yilmaz, M; Akay, OM; Pala, C; Bilen, Y; Kaya, E; Sari, I; Sencan, M; Kuku, I; Altuntas, F; Dal, MS; Aydogdu, IWe investigated the course of 54 patients presenting with primary central nervous system lymphoma, who were treated in daily practice. The patients were treated with chemotherapy and/or radiotherapy and/or intrathecal chemotherapy. At a median follow-up period of 23 months (range 1-71), median relapse-free survival (RFS) and overall survival (OS) were not reached. Estimated 2-year RFS and OS rates were 42% and 48%, respectively. Ten relapsed PCNSL patients underwent ASCT. Complete remission rate of these patients was 40%, with 20% treatment-related mortality. Estimated 2-year RFS and OS rates were 37% and 40%, respectively. The prognosis of patients with PCNSL, who received off-study treatment, is still dismal. (c) 2016 Elsevier Ltd. All rights reserved.Item HAIRY CELL LEUKEMIA: MULTICENTER RETROSPECTIVE ANALYSIS IN TURKEYHacioglu, S; Bilen, Y; Eser, A; Sivgin, S; Gurkan, E; Yildirim, R; Aydogdu, I; Dogu, MH; Yilmaz, M; Kayikci, O; Tombak, A; Kuku, I; Celebi, H; Akay, MO; Esen, R; Korkmaz, S; Keskin, AItem Real-world data on the effectiveness and safety of Ixazomib-Lenalidomide-Dexamethasone therapy in relapsed/refractory multiple myeloma patients: a multicenter experience in TurkeyBakirtas, M; Dal, MS; Yigenoglu, TN; Giden, AO; Serin, I; Basci, S; Kalpakci, Y; Korkmaz, S; Ekinci, O; Albayrak, M; Basturk, A; Ozatli, D; Dogu, MH; Hacibekiroglu, T; Çakar, MK; Ulas, T; Miskioglu, M; Gulturk, E; Eser, B; Altuntas, FA multicenter, retrospective, observational study was conducted to explore effectiveness and safety of ixazomib plus lenalidomide with dexamethasone (IRd) in relapsed/refractory multiple myeloma (RRMM) patients following at least >= two lines of therapy. Patients' treatment responses, overall response rate, progression-free survival rate, and adverse events were recorded. Mean age of 54 patients was 66.5 +/- 9.1 years. There were 20 patients (37.0%) with progression. Median progression-free survival was 13 months in patients who received a median of three therapy lines in a 7.5-month follow-up period. Overall response rate was 38.5%. Of 54 patients, 19 (40.4%) had at least one adverse event, and nine (19.1%) had an adverse event of at least grade 3 or more. Of 72 adverse events observed in 47 patients, 68% were grade 1 or 2. Treatment was not stopped in any patient due to adverse events. IRd combination therapy was effective and safe in heavily treated RRMM patients.Item CLINICAL CHARACTERISTICS, POST-TREATMENT ASSESSMENT AND PROGNOSTIC FACTORS AFFECTING PATIENT SURVIVAL OF PATIENTS AT 65 YEARS OF AGE OR OLDER WITH HODGKIN LYMPHOMA: A RETROSPECTIVE MULTICENTER STUDY FROM TURKEYBerber, I; Erkurt, MA; Keklik, M; Dogu, MH; Terzi, H; Pala, C; Sari, HI; Sencan, M; Sivgin, S; Hacioglu, S; Altuntas, F; Aydogdu, I; Ilhan, OIntroduction: During the last three decades, major advances have been made in the therapy of Hodgkin's lymphoma. However, despite these advances, Hodgkin's lymphoma has a poor prognosis in the elderly. The proportion of Hodgkin's lymphoma patients aged > 60 ranges in the different reports between 15% and 35%. This study aimed to examine clinical characteristics, treatment outcomes and prognostic factors affecting patient survival in Hodgkin's lymphoma patients aged 65 years or older. Material methods: Hodgkin's lymphoma patients at 65 years of age and older managed within last 5 years in a total of 5 centers in Turkey were retrospectively assessed. Results: The median age of a total of 32 patients was 71 (65-83) years. Elderly patients presented more frequently with B symptoms, elevated sedimentation rate, mixed cellularity histologic subtype and comorbid disease. Less frequent were bulky disease, bone marrow involvement, and the application of autologous stem cell transplantation. The nodular lymphocyte predominant subtype and lymphocyte rich subtype were not observed at all. Eastern Cooperative Oncology Group, ferritin, total protein, and histological type were significant predictors affecting survival (p<0.05). Conclusions: Hodgkin's lymphoma is a more fatal disease in 65 years of age or older, when compared to the young population. Tumor biology, older age itself, and other factors related to comorbidity probably contribute to the worse outcome of elderly patients. Further large-scale studies are needed to better investigate the factors that were significant predictors of patient survival.Item Efficacy and Safety of Ibrutinib Use in Patients with Chronic Lymphocytic Leukemia in Real World Experiences: Results of a Prospective Multicenter StudyTombak, A; Tanrikulu, FP; Durusoy, SS; Gurkan, E; Kaya, E; Umit, EG; Yavasoglu, I; Mehtap, O; Deveci, B; Ozcan, MA; Terzi, H; Okay, M; Sayinalp, N; Yilmaz, M; Okan, V; Kizikli, A; Ozcan, O; Cetin, G; Demircioglu, S; Aydogdu, I; Saydam, G; Davulcu, EA; Ilhan, G; Ucar, MA; Ozet, G; Akpinar, S; Turgut, B; Berber, I; Kurtoglu, E; Sonmez, M; Batur, DS; Yildirim, R; Ozkocaman, V; Gunes, AK; Sahip, B; Ertop, S; Akay, M; Basturk, A; Dogu, MH; Akdeniz, A; Unal, A; Seyhanli, A; Ferhanoglu, BItem Efficacy and Safety of Ibrutinib Therapy in Patients with Chronic Lymphocytic Leukemia: Retrospective Analysis of Real-Life DataTombak, A; Tanrikulu, FP; Durusoy, SS; Dinçyürek, HD; Kaya, E; Ümit, EG; Yavasoglu, I; Mehtap, Ö; Deveci, B; Özcan, MA; Terzi, H; Okay, M; Sayinalp, N; Yilmaz, M; Okan, V; Kizikli, A; Özcan, Ö; Çetin, G; Demircioglu, S; Aydogdu, I; Saydam, G; Davulcu, EA; Ilhan, G; Uçar, MA; Özet, G; Akpinar, S; Turgut, B; Berber, I; Kurtoglu, E; Sönmez, M; Batur, DS; Yildirim, R; Özkocamaz, V; Günes, AK; Sahip, B; Ertop, S; Akay, OM; Bastürk, A; Dogu, MH; Akdeniz, A; Ünal, A; Seyhanli, A; Gürkan, E; Çekdemir, D; Ferhanoglu, BObjective: 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.