Browsing by Author "Miskioglu, M"
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Item Evaluation of reticulocyte parameters in iron deficiency, vitamin B12 deficiency and β-thalassemia minor patientsCeylan, C; Miskioglu, M; Çolak, H; Kiliççiogly, B; Özdemir, EThe aim of this study was to test the clinical utility of reticulocyte parameters in differential diagnosis in iron deficiency anemia (IDA), vitamin B-12 deficiency (B12) and beta-thalassemia minor (TM). We analyzed the percentage of reticulocyte, absolute reticulocyte count, mean content hemoglobin of reticulocyte (CHr), mean corpuscular volume of reticulocyte (MCVr), corpuscular hemoglobin concentration mean of reticulocyte (CHCMr), MCVr/MCV ratio, CHr/CH ratio and CHCMr/CHCM ratio in healthy donors (n = 34), iron deficiency (IDA) (n = 41), vitamin B-12 deficiency (B12) (n = 22), and TM (n = 34). This study demonstrates that the cutoff value of CHr was 25.7 as indicative of IDA (85.4% sensitivity, 97.1% specificity). CHr and MCVr may be useful for TM (cutoff value <= 24.8 for CHr) and B12 (> 102.1, cutoff value for MCVr), respectively. Sensitivity and specificity of these parameters were 90.9, 86.4% and 97.1, 82.4%, respectively. CHCMr is useful to differentiate IDA and TM from B12. While CHr was low value in microcytic groups (mean 21.8 +/- 3.3 for IDA, 21.0 +/- 2.9 for TM), it was high in B12 (mean 32.1 +/- 5.7). However, that of CHr/CH ratio was only significantly in IDA group compared with the control (P < 0.05, mean 0.98). Therefore, there are limitations regarding CHr and CHr/CH ratio differential diagnosis in microcytic and macrocytic groups. CHr, MCVr, and CHCMr are not sufficiently sensitive and specific to differentiate TM from IDA. We conclude that measurement of reticulocyte count and parameters may be a very useful implement in the diagnosis of IDA and TM.Item Relationship of Tumor-Associated Macrophage Population Detected by CD68 PG-M1, CD68 KP1, and CD163 with Latent EBV Infection and Prognosis in Classical Hodgkin LymphomaMavili, HS; Isisag, A; Tan, A; Miskioglu, M; Saka Baraz, L; Nese, NObjective: To evaluate the quantity of tumor-associated macrophages (TAMs) in cases of Hodgkin Lymphoma of classical type (cHL), and to reveal possible associations between TAM intensity and latent Epstein-Barr virus (EBV) infection, overall survival, progression-free survival, prognostic indices, and clinicopathological parameters. Materials and Methods: A total 46 cases of cHL with complete clinical records were selected and re-evaluated histopathologically. Staining for CD68 (PG-M1; KP1 clones) and CD163 was evaluated and the cut-off values were defined. Also, all cases were evaluated using the chromogen in situ hybridization (CISH) method with EBER (Epstein-Barr virus-encoded RNA) probes for the presence of possible EBV infection. Results: It was found that high expression levels of PG-M1 and high International Prognostic Scores (IPS) were associated with shortened overall survival (p=0.047, p=0.013). Cases with 2 or less areas of nodal region involvement were observed to have longer progression-free survival period (p=0.043). Higher expression levels of CD68 PG-M1, CD68 KP1, and CD163 were found to show significant associations with the presence of some clinical parameters such as the presence of B symptoms, spleen involvement, and the presence of EBV infection. Conclusions: Our findings suggest that increase of PG-M1+ TAM is associated with shortened overall survival, while higher expressions of all immunohistochemical markers are statistically significantly associated with the presence of EBV infection and clinical parameters mentioned above. These findings indicate that highlighting the TAM rate via macrophage markers in cases of cHL could be helpful in determining the prognostic risk groups and the relevant results should be mentioned in pathology reports.Item Treatment of inflammatory bowel disease by leukocytapheresisGerçeker, E; Yüceyar, H; Kasap, E; Demirci, U; Ekti, BC; Aydogdu, I; Miskioglu, MStudies about leukocytapheresis have emerged with the need of search for alternatives to conventional treatment in inflammatory bowel diseases (IBD). Leukocytapheresis is a novel non-pharmacologic approach for active ulcerative colitis (UC) and Crohn's disease (CD), in which leukocytes are mechanically removed from the circulatory system. Patients with active IBD treated with leukocytapheresis using a Cellsorba E column between 2012 and 2015, were enrolled in Turkey. In our experience, the results of leukocytapheresis therapy in 6 patients with CD and 20 patients with active UC were overviewed. Leukocytapheresis (10 sessions for remission induction therapy, 6 sessions for maintenance therapy) was applied to the patients with their concomitant medications. Intensive leukocytapheresis (>= 4 leukocytapheresis sessions within the first 2 weeks) was used in 30% patients with active severe UC. The overall clinical remission rate in patients with UC was 80%, and the mucosal healing rate was 65%. Patients were followed for an average of 24 months. It was observed that clinical remission has continued in 65% of patients with UC. Mild relapse was observed in 3 patients with UC during follow up period. In 5 patients with CD significant clinical remission was achieved except only one patient. Surgical needs were disappeared in 3 patients with obstructive type Crohn's disease, Adverse events were seen in only 4.3% of 416 sessions. Any concomitant medications did not increase the incidence of adverse events. Our results indicate that leukocytapheresis is efficacious in improving remission rates with excellent tolerability and safety in patients with IBD. (C) 2017 Elsevier Ltd. All rights reserved.Item Cutaneous Anaplastic Large-Cell Lymphoma with Dramatic Response to Brentuximab VedotinSahin, M; Miskioglu, M; Inanir, I; Akar, H; Nese, N; Temiz, P; Aydogdu, IItem Acral Amelanotic Verrucous Melanoma: Dermoscopic FindingsGencoglan, G; Inanir, I; Miskioglu, M; Temiz, PThe authors have indicated no significant interest with commercial supporters.Item Evaluation of sequential effect of isotretinoin on the haematological parameters in patients with acne vulgarisGencoglan, G; Inanir, I; Miskioglu, M; Gunduz, KPurpose: Isotretinoin is the most effective drug for acne with some side effects. Few studies exist regarding the effects of isotretinoin on haematological parameters with different results. Mostly, baseline values with a single value during or at the end of the treatment were compared. In this study, we aimed to determine the differences in haematological parameters during isotretinoin treatment until reaching the cumulative dose of 120mg/kg.Materials and methods: The study included 118 patients with moderate-to-severe acne vulgaris. Patients with preexisting liver disease, anaemia, iron deficiency, abnormal liver function tests, thrombocytopenia/thrombocytosis or hyperlipidaemia were excluded. Laboratory monitoring for haematological parameters was performed at baseline and monthly during treatment. Parameters at the baseline, at the first and second months and at the end of the therapy were taken into account.Results: According to general linear model analysis, platelets and plateletcrit increased at the first month of the treatment and then decreased to baseline. White blood cells and neutrophils decreased at the first month, then increased to baseline value at the second month, and were found to be decreased again at the end of the treatment. Mean corpuscle volume was found to be increased at the end of the treatment. Other parameters in CBC did not show statistically significant differences.Conclusions: Although some changes occur in haematological parameters during isotretinoin therapy, all of these changes remain within the normal range. Evaluating the spot values at any time during treatment may cause misinterpretations.Item Primary cutaneous anaplastic CD30+ large-cell lymphoma that completely regressed after incisional skin biopsyGencoglan, G; Ozturk, F; Inanir, I; Miskioglu, M; Temiz, P; Gunduz, KWe describe a 48-year-old woman with three erythematous nodules localized on the left forearm, with 2 months evolution. Histological and immunohistochemical examination revealed a CD30(+) large-cell lymphoma. Systemic involvement was not detected. The tumor regressed spontaneously within a week, after the incisional skin biopsy. In control skin biopsy, there was not any histological feature of lymphoma. No reactivation or any symptom of systemic disease was observed during the 10-month follow-up period.Item Severe hypoglycemia due to insulin auto-antibodies of newly diagnosed multiple myeloma: A case reportGuney, SC; Miskioglu, M; Engurulu, SF; Cavdar, GG; Akcura, C; Alkan, S; Ozdemir, N; Hekimsoy, ZObjectiveInsulin autoimmune syndrome (IAS) is a rare condition that can be overlooked in the differential diagnosis of hypoglycemia. Hematologic malignancies such as multiple myeloma (MM) have been associated with IAS. Very few cases of IAS due to multiple myeloma have been reported in the literature. We wanted to present our case who applied to our clinic with severe hypoglycemia and was diagnosed with multiple myeloma-associated IAS.Case presentationAn 83-year-old male patient was admitted to our clinic with recurrent severe hypoglycemia episodes. When the patient's plasma glucose was 37 mg/dL, insulin level was high (2266 mu IU/ml), C-peptide level was relatively normal (3.44 ng/ml); cortisol and ACTH levels were also normal. No pathologic finding was detected in the abdominal MRI and Ga-68 PET/CT. Anti-insulin antibody (IAA) was tested for IAS, and the antibody level was found to be 95.9%. The patient was evaluated in terms of possible conditions that may lead to IAS. Hematology consultation was made due to the fact that the patient had anemia, chronic renal failure, and albumin/globuline discordance, and he was diagnosed with IgG kappa multiple myeloma. Bortezomib and dexamethasone treatment was initiated. A decrease in hypoglycemic symptoms was observed with chemotherapy.ConclusionIAS should be considered in the differential diagnosis of recurrent hypoglycemia cases of unknown cause. It should be kept in mind that IAS may develop due to multiple myeloma, especially in patients with advanced age and anemia.Item 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.