Browsing by Author "Esen R."
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Item Environmental radioactivity and high incidence rates of stomach and esophagus cancer in the Van Lake Region: A causal relationship?(Asian Pacific Organization for Cancer Prevention, 2014) Akan Z.; Baskurt B.; Asliyuksek H.; Kam E.; Yilmaz A.; Yuksel M.B.; Biyik R.; Esen R.; Koca D.This study examined the incidence rates of cancer cases (averages for 2006-2010) and relationships with environmental radioactivity levels. Soil and water samples were collected from provincial and district centers of Van city and the outdoor gamma doses were determined using a portable gamma scintillation detector. Gross alpha and beta, (226)Ra, (232)Th, and (40)K activities were measured in both tap water and soil samples. Although high rates of stomach and esophagus cancers have been reported previously in Van the underlying reasons have not hitherto been defined. Incidences of cancers were highest in the Gurpinar (326.0) and Ozalp (377.1) counties (p<0.001). As to the results of the gross alpha and gross beta radioactivity measurements in the drinking water, these two counties also had high beta radionuclide levels: Gurpinar (140 mBq/dm3) and Ozalp (206 mBq/dm3). Even if within the normal range, a relation between the higher rate of the incidence of stomach and esophagus cancers with that of the higher rate of beta radionuclide activity was clear. On Spearman correlation analysis, the relation between higher beta radionuclide levels and cancer incidence was found to be statistically significant (p<0.01). According to the results of the analysis, Van residents receive an average 1.86 mSv/y annual dose from outdoor gamma radiation, ingestion of radionuclides in the drinking water, and indoor 222Rn activity. Moreover, gross alpha and beta activities were found to be extremely high in all of the lakes around the city of Van, Turkey. Further investigations with long-term detailed environmental radiation measurements are needed regarding the relationship between cancer cases and environmental radioactivity in the city of Van.Item Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: Twenty-four year Turkish experience in cladribine therapy(John Wiley and Sons Ltd, 2015) Hacioglu S.; Bilen Y.; Eser A.; Sivgin S.; Gurkan E.; Yildirim R.; Aydogdu I.; Dogu M.H.; Yilmaz M.; Kayikci O.; Tombak A.; Kuku I.; Celebi H.; Akay M.O.; Esen R.; Korkmaz S.; Keskin A.In 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. © 2015 John Wiley & Sons, Ltd.Item Prospective registry of adult patients receiving therapeutic plasma exchange with a presumptive diagnosis of thrombotic microangiopathy (TMA): The Turkish hematology research and education group (ThREG)-TMA02 study(Elsevier Ltd, 2021) Akpınar S.; Tekgunduz E.; Erkurt M.A.; Esen R.; Yılmaz M.; Karakus V.; Vural F.; Gediz F.; Aydogdu I.; Kaynar L.; Korkmaz S.; Goker H.; Kelkitli E.; Ayyıldız O.; Demirkan F.Thrombotic microangiopathy(TMA) is a pathological diagnosis characterized by abnormalities of small vessels leading to microvascular thrombosis of arterioles and capillaries. The current prospective, non-interventional, multicenter (n:18) study aimed to define distribution of different TMA forms in adult Turkish patients who were referred for therapeutic plasma exchange (TPE) for a presumptive diagnosis of TMA. Patients with serum ADAMTS13 activity <5% were diagnosed as acquired thrombotic thrombocytopenic purpura (aTTP). Patients presenting with ADAMTS13 activity 6–10 % / normal renal function and patients with ADAMTS13 activity >10 %, normal renal function and no secondary TMA were treated as unclassified TMA. The study included a total of 97 patients (female: 60; male: 30) with a median age of 48 (18−74). Detailed evaluation at 1 month after hospital admission revealed aTTP, secondary TMA, infection/complement-associated hemolytic uremic syndrome and unclassified TMA in 32 (33 %), 33 (34 %), 26 (27 %) and 6 (6%) patients respectively. As subclassification of various TMAs will dictate specific therapy, proper diagnosis in a timely manner is of utmost clinical significance. © 2021 Elsevier LtdItem Prospective registry of adult patients receiving therapeutic plasma exchange with a presumptive diagnosis of thrombotic microangiopathy (TMA): The Turkish hematology research and education group (ThREG)-TMA02 study(Elsevier Ltd, 2022) Akpinar S.; Tekgunduz E.; Esen R.; Yilmaz M.; Karakus V.; Vural F.; Gediz F.; Aydogdu I.; Kaynar L.; Goker H.; Kelkitli E.; Ayyildiz O.; Demirkan F.Thrombotic microanjiopathy (TMA) is a pathological diagnosis characterized by abnormalities of small vessels leading to microvascular thrombosis of arterioles and capillaries. The current prospective, non-interventional, multicenter study aimed to define the distribution of different TMA forms in adult Turkish patients who were referred for therapeutic plasma exchange (TPE) for presumptive diagnosis of TMA. Patients with serum ADAMTS13 activity <5% were diagnosed as having acquired thrombotic thrombocytopenic purpura (aTTP). Patients presenting with ADAMTS13 activity 6–10 % / normal renal function and patients with ADAMTS13 activity >10 %, normal renal function and no secondary TMA were treated as unclassified TMA. The study included a total of 80 patients (women: 50; man: 30) with a median age of 48 (20−74). Detailed evaluation at 1 month after hospital admission revealed aTTP, secondary TMA, infection/complement-associated hemolytic uremic syndrome and unclassified TMA in 29 (36.2 %), 22 (27.5 %), 23 (28.8 %) and 6 (7.5 %) patients respectively. As subclassification of various TMAs will dictate specific therapy, proper diagnosis in a timely manner is of utmost clinical significance. © 2022Item Comparison of the efficacy of sunitinib and pazopanib in patients with advanced non-clear renal cell carcinoma(Taylor and Francis Ltd., 2024) Yildirim H.C.; Bayram E.; Chalabiyev E.; Majidova N.; Avci T.; Güzel H.G.; Kapar C.; Uzun M.; Perkin P.; Akgül F.; Yildirim S.S.; Sali S.; Yildiz A.; Kazaz S.N.; Hendem E.; Arcagok M.; Tufan G.; Yildirim U.; Akgul O.F.; Arslan Ç.; Taban H.; Sahin E.; Caglayan M.; Esen R.; Öksüzoğlu B.; Guven D.C.; Kaplan M.A.; Araz M.; Basaran M.; Cubukcu E.; Gokmen E.; Cicin I.; Algin E.; Semiz H.S.; Tural D.; Ozturk B.; Erdogan A.P.; Sari M.; Kara O.; Erman M.Non-clear cell renal cell carcinoma (non-ccRCC) is a highly heterogeneous disease group, accounting for approximately 25% of all RCC cases. Due to its rarity and especially heterogeneity, phase III trial data is limited and treatment options generally follow those of clear cell RCC. In the literature, there exists a number of studies with sunitinib, cabozantinib, and everolimus, but data on the efficacy of pazopanib are limited. Our aim in this study was to compare the efficacy of pazopanib and sunitinib, in a multicenter retrospective cohort of non-ccRCC patients. Our study included patients diagnosed with non-ccRCC who received pazopanib or sunitinib treatment as first-line therapy from 22 tertiary hospitals. We compared the progression-free survival (PFS), overall survival (OS), and response rates of pazopanib and sunitinib treatments. Additionally, we investigated prognostic factors in non-ccRCC. PFS and response rates of sunitinib and pazopanib were found to be similar, while a numerical difference was observed in OS. Being 65 years and older, being in the intermediate or poor risk group according to the International Metastatic Renal Cell Carcinoma Database Consortium, having liver metastases, presence of a sarcomatoid component, and having de novo metastatic disease were found to be significantly associated with shorter PFS. Pazopanib treatment appears to have similar efficacy in the treatment of non-ccRCC compared to sunitinib. Though randomized controlled trials are lacking and will probably be never be available, we suggest that pazopanib could be a preferred agent like sunitinib and cabozantinib. © 2024 Edizioni Scientifiche per l’Informazione su Farmaci e Terapia (Italian Society of Chemotherapy).