Browsing by Subject "etoposide"
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Item Effect of chemotherapy on pulmonary epithelial permeability in lung cancer(2000) Sayit E.; Aktoǧu S.; Ertay T.; Çapa G.; Erkmen G.; Özbilek E.; Büyükşirin M.; Durak H.The aim of this study is to investigate the effect of one-course chemotherapy on the pulmonary epithelial permeability. Eighteen patients (18 male; mean age: 59 ± 10 years) with lung cancer (11 non-small cell, 7 small cell) inhaled 40 mCi (1,480 MBq) 99mTc-diethylenetriaminepentaacetic acid (DTPA). Thirty images of 1-min duration were acquired from posterior projection. The first 7 min of the decay-corrected time activity curves were used to calculate lung clearance half-time. Clearance half-times of 99mTc-DTPA from the peripheral regions of the lungs were 42 ± 19 min before and 56 ± 34 min after chemotherapy (p = 0.009); from the central regions, clearance half-times were 112 ± 94 min before and 160 ± 125 min after chemotherapy (p = 0.005). This decrease in clearance rate might be related to decreasing mucociliary clearance rate due to the toxic effect of the chemotherapy regimen on cilia movement and/or mucus structure. 99mTc-DTPA radioaerosol study can be used to monitor the toxic effects of chemotherapy on the pulmonary epithelium and possibly on mucociliary function. (C) 2000 Elsevier Science Inc.Item Factors influencing engraftment in autologous peripheral hematopoetic stem cell transplantation (PBSCT)(2007) Ergene U.; Çaǧirgan S.; Pehlivan M.; Yilmaz M.; Tombuloǧlu M.Autologous peripheral blood stem cells transplantation (PBSCT) is a therapeutic option which can be used in various hematological neoplastic disorders; and it can prolong disease free survival and total survival and at times it may be curative. In this study, we investigated variables influencing PBSCT in 91 patients who had undergone PBSCT between 1998 and 2002 in our center, retrospectively. PBSC collection was performed after mobilization with G-CSF or chemotherapy plus growth factor. Only high dose chemotherapy was used for conditioning regimes. The median number of CD34+ was 11.5 × 106/kg. Posttransplant neutrophil engraftment (>500/μL) was requiring a median of 10 days, it was 13 days for platelet engraftment (>20,000/μL). For neutrophil and platelet engraftment, we investigated; sex, age, diagnosis and CD34+ cells, the time interval between diagnosis and transplantation, number of apheresis, conditioning regime, growth factor initiation day as independent variables. In univariate analysis CD34+ cell number (>10 × 106/kg), time interval more than one year between diagnosis and transplantation and BEAM conditioning was found to be significant for neutrophil engraftment. But in multivariate analysis none of them was found to be significant. For platelet engraftment in univariate analysis CD34+ cell number (>7 × 106/kg), primary diagnosis of multiple myeloma initiation day of growth factor (>2 day) was found to be significant. In multivariate analyses only CD34+ cell count was found to be significant (p = 0.005). In conclusion, as in previous studies we found that the only predictor of engraftment kinetics was CD34+ cell count. © 2006.Item Delayed renal excretion of methotrexate after a severe anaphylactic reaction to methotrexate in a child with osteosarcoma(2009) Ozguven A.A.; Uysal K.; Gunes D.; Koroglu T.; Gurcu O.; Olgun N.Although methotrexate is an agent widely used in the practice of pediatric oncology, allergic reactions to methotrexate are most unusual. Most of these reactions typically occur after repeated administration. Here, we report a severe anaphylactoid reaction to the first dose of high-dose methotrexate infusion in a child with osteosarcoma who has also experienced a delayed excretion of methotrexate. Clinicians must be aware of the possibility of a systemic, near-fatal anaphylactic reactions with methotrexate and patients who experience severe anaphylactic reactions should be followed carefully because of the possibility of delayed methotrexate excretion. © 2009 Lippincott Williams & Wilkins Inc.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 Turkey(A. CARBONE Editore, 2015) Berber I.; Erkurt M.A.; Keklik M.; Dogu M.H.; Terzi H.; Pala C.; Sari H.I.; Sencan M.; Sivgin S.; Hacioglu S.; Altuntas F.; Aydogdu I.; Ilhan O.Introduction: 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 Primary central nervous system lymphoma in daily practice and the role of autologous stem cell transplantation in relapsed disease: A retrospective multicenter study(Elsevier Ltd, 2016) Erkurt M.A.; Berber I.; Tekgündüz E.; Dogu M.H.; Korkmaz S.; Demir C.; Yilmaz M.; Akay O.M.; Pala C.; Bilen Y.; Kaya E.; Sari I.; Sencan M.; Kuku I.; Altuntaş F.; Dal M.S.; Aydogdu I.We 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. © 2016 Elsevier Ltd.Item Boric Acid Reduces the Formation of DNA Double Strand Breaks and Accelerates Wound Healing Process(Humana Press Inc., 2016) Tepedelen B.E.; Soya E.; Korkmaz M.Boron is absorbed by the digestive and respiratory system, and it was considered that it is converted to boric acid (BA), which was distributed to all tissues above 90 %. The biochemical essentiality of boron element is caused by boric acid because it affects the activity of several enzymes involved in the metabolism. DNA damage repair mechanisms and oxidative stress regulation is quite important in the transition stage from normal to cancerous cells; thus, this study was conducted to investigate the protective effect of boric acid on DNA damage and wound healing in human epithelial cell line. For this purpose, the amount of DNA damage occurred with irinotecan (CPT-11), etoposide (ETP), doxorubicin (Doxo), and H2O2 was determined by immunofluorescence through phosphorylation of H2AX(Ser139) and pATM(Ser1981) in the absence and presence of BA. Moreover, the effect of BA on wound healing has been investigated in epithelial cells treated with these agents. Our results demonstrated that H2AX(Ser139) foci numbers were significantly decreased in the presence of BA while wound healing was accelerated by BA compared to that in the control and only drug-treated cells. Eventually, the results indicate that BA reduced the formation of DNA double strand breaks caused by agents as well as improving the wound healing process. Therefore, we suggest that boric acid has important therapeutical effectiveness and may be used in the treatment of inflammatory diseases where oxidative stress and wound healing process plays an important role. © 2016, Springer Science+Business Media New York.Item Comparison of survival with somatostatin analog and chemotherapy and prognostic factors for treatment in 165 advanced neuroendocrine tumor patients with Ki-67 20% or less(Lippincott Williams and Wilkins, 2016) Özaslan E.; Karaca H.; Koca S.; Sevinc A.; Hacioglu B.; Özkan M.; Özcelik M.; Duran A.O.; Hacibekiroglu I.; Yildiz Y.; Tanriverdi O.; Menekse S.; Aksoy A.; Bozkurt O.; Urvay S.; Uysal M.; Demir H.; Ciltas A.; Dane F.The objectives of this study were to compare progression-free survival (PFS) with somatostatin analog (SSA) versus chemotherapy (CTx) in first-line therapy and to determine the patient group in which these treatments were more effective in neuroendocrine tumors (NETs) with a Ki-67 index of 20% or less. Patients who received SSA or CTx and had unresectable locally advanced and metastatic NETs with a Ki-67 index of 20% or less were retrospectively selected from 13 centers in the Turkish database between 2000 and 2015. One hundred and sixty-five patients were enrolled. The median age was 56 years and the male-to-female ratio was 1.09. Seventy-four (45%) patients were of grade 1 NET and 91 (55%) were of grade 2. SSA was given to 104 patients, whereas 61 were treated with CTx. The objective response rate after SSA was 15.4%; another 73.1% had stable disease. The objective response rate after CTx was 36.1%, and 40.9% had stable disease (P=0.008). The median PFS in SSA patients was 21 months (95% confidence interval: 12.4-29.6), and 8 months for CTx (95% confidence interval: 5.5-10.6) (P<0.001). There was no significant difference between PFS of receiving SSA and CTx in pancreatic neuroendocrine tumor (PNET) patients; however, the PFS of receiving SSA was longer in non-PNET patients (P<0.001). SSA was better treatment in advanced NET patients with a Ki-67 index of less than 5%, having a primary resected and a performance status of 0 (P<0.05). SSA may be preferred over CTx in advanced NET patients with low-to-intermediate grade. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.Item Nodular lymphocyte predominant Hodgkin's lymphoma in daily practice: A multicenter experience(John Wiley and Sons Ltd, 2018) Gemici A.; Aydogdu I.; Terzi H.; Sencan M.; Aslan A.; Kaya A.H.; Dal M.S.; Akay M.O.; Dogu M.H.; Ayyildiz O.; Sahin F.; Cagliyan G.A.; Yilmaz M.; Gokgoz Z.; Bilen Y.; Demir C.; Sevindik O.G.; Korkmaz S.; Eser B.; Altuntas F.Nodular 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 37.5 years (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 46 months. During follow-up, none of the patients died. Seven patients relapsed or progressed after initial therapy at a median of 12 months. 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 46 months 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. Copyright © 2017 John Wiley & Sons, Ltd.Item A Src/Abl kinase inhibitor, bosutinib, downregulates and inhibits PARP enzyme and sensitizes cells to the DNA damaging agents(Turkish Biochemistry Society, 2018) Kirmizibayrak P.B.; Ilhan R.; Yilmaz S.; Gunal S.; Tepedelen B.E.Background: Poly(ADP-ribosyl)ation (PARylation) catalyzed mainly by PARP1 is a highly regulated posttranslational modification associated with several pathways in cellular physiology and genotoxic deoxyribonucleic acid (DNA) damage response. PAR polymers and PARP enzyme function in DNA integrity maintenance and several PARP inhibitors have entered clinical phase studies for cancer therapies. Material and methods: The effect of bosutinib, a dual Src/ Abl kinase inhibitor, on PARylation was fluorometrically measured. The cytotoxic and chemosensitizing effects were assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetra-zolium bromide (MTT) assay. The levels of DNA repair proteins and PARP enzyme were examined by immunoblotting. Results: In this study, bosutinib is characterized as a novel PARP inhibitor. Bosutinib inhibited oxidative stress-induced cellular PARylation and nuclear foci formation by downregulating PARP1 levels. Bosutinib was found to be more cytotoxic on Capan1 cells with BRCA2 mutation. Furthermore by acting as a chemosensitizer, bosutinib enhanced the cytotoxicity of doxorubicin (DOXO) and etoposide (ETP) by decreasing phosphorylation of DNA repair enzymes checkpoint kinase 1 (Chk1) and ataxia-telangiectasia mutated (ATM). Conclusion: By inhibition of both PARP and DNA damage checkpoint kinases, bosutinib increased the phospho-H2AX levels, an early indicator of DNA double strand breaks. © 2018 Turkish Biochemistry Society. All rights reserved.Item Atezolizumab combined with chemotherapy in the first-line treatment of extensive-stage small cell lung cancer: a real-life data of the Turkish Oncology Group(Springer Science and Business Media Deutschland GmbH, 2022) Gürbüz M.; Kutlu Y.; Akkuş E.; Köksoy E.B.; Köse N.; Öven B.B.; Uluç B.O.; Demiray A.G.; Erdem D.; Demir B.; Turhal N.S.; Üskent N.; Akbaş S.; Selçukbiricik F.; İnal A.; Bilici A.; Ölmez Ö.F.; Çabuk D.; Ünal Ç.; Hızal M.; Şendur M.A.N.; Korkmaz M.; Karadurmuş N.; Ertürk İ.; Göksu S.S.; Tatlı A.M.; Güven D.C.; Kılıçkap S.; Paksoy N.; Aydıner A.; Çınkır H.Y.; Özkul Ö.; Öztürk A.; Ballı S.; Kemal Y.; Erdoğan A.P.; Er Ö.; Yumuk P.F.; Demirkazık A.Purpose: Atezolizumab has been shown to be effective and safe in randomized trial in the first-line treatment of extensive-stage small cell lung cancer (SCLC). However, there are limited real-life data on atezolizumab. In this study, we aimed to determine the real-life efficacy and safety of atezolizumab combined with chemotherapy in the first-line treatment of extensive-stage SCLC. Methods: This trial is a retrospective multicenter study of the Turkish Oncology Group, which included extensive-stage SCLC patients who received atezolizumab combined with chemotherapy in a first-line treatment. The characteristics of the patients, treatment and response rates, and PFS and OS are presented. Factors associated with PFS and OS were analyzed by univariate and multivariate analysis. Results: A total of 213 patients at the 30 oncology centers were included. The median number of chemotherapy cycle was 5 (1–8) and atezolizumab cycle was 7 (1–32). After median 11.9 months of follow-up, median PFS and OS was 6.8 months (95%CI 5.7–7.8), and 11.9 months (95%CI 11–12.7), respectively. The ORR was 61.9%. ECOG-PS (p = 0.002) and number of metastatic sites (p = 0.001) were associated with PFS and pack-year of smoking (p = 0.05), while ECOG-PS (p = 0.03) and number of metastatic sites (p = 0.001) were associated with OS. Hematological side effects were common and toxicities were manageable. Conclusion: This real-life data confirm the efficacy and safety of atezolizumab in combination with chemotherapy in first-line treatment of extensive-stage SCLC. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Item Intestinal Ewing Sarcoma Misdiagnosed as an Adnexal Mass in a Young Woman(Galenos Publishing House, 2024) Hasdemir P.S.; Aliyeva A.; Mavili S.; Göksel G.Extraosseous Ewing’s sarcoma is an extremely rare tumor. In the literature, intestinal Ewing’s sarcoma was reported in 20 cases, and omental Ewing’s sarcoma was reported in only two cases. In this case report, we report a 23-year-old female who presented with the complaint of diffuse abdominal pain. Abdominal ultrasound and whole-body computed tomography revealed a mass starting from the adnexal area and extending between the intestinal loops. Serum levels of tumor markers were high. The serum levels of carbohydrate antigen-125 (CA-125) and carcinoembryonic antigen-19.9 (CA-19.9) were high (427.5 U/mL and 67.9 U/mL, respectively). Laparotomic exploration was performed with the preliminary diagnosis of an adnexal mass, and a mass originating from the small intestine meso and completely covered by the omentum was excised. Histological evaluation reported intestinal and omental origin of Ewing’s sarcoma. This case highlights the importance of rare extraosseous Ewing’s sarcoma, which should be included in the differential diagnosis of a young female with intra-abdominal mass. © 2024 Galenos Publishing House. All rights reserved.Item Sirolimus is effective and safe in childhood relapsed-refractory autoimmune cytopenias: A multicentre study(John Wiley and Sons Inc, 2024) Acar S.O.; Tahta N.; Al I.O.; Erdem M.; Gözmen S.; Karapınar T.H.; Kılınç B.; Celkan T.; Kirkiz S.; Koçak Ü.; Ören H.; Yıldırım A.T.; Arslantaş E.; Ayhan A.C.; Oymak Y.Autoimmune cytopenias are a heterogeneous group of disorders characterized by immune-mediated destruction of haematopoietic cell lines. Effective and well-tolerated treatment options for relapsed-refractory immune cytopenias are limited. In this study, the aim was to evaluate the efficacy and safety of sirolimus in this disease group within the paediatric age group. The study enrolled patients in the paediatric age group who used sirolimus with a diagnosis of immune cytopenia between December 2010 and December 2020, followed at six centres in Turkey. Of the 17 patients, five (29.4%) were treated for autoimmune haemolytic anaemia (AIHA), six (35.2%) for immune thrombocytopenic purpura (ITP) and six (35.2%) for Evans syndrome (ES). The mean response time was 2.7 months (range, 0–9 months). Complete response (CR) and partial response (PR) were obtained in 13 of 17 patients (76.4%) and nonresponse (NR) in four patients (23.5%). Among the 13 patients who achieved CR, three of them were NR in the follow-up and two of them had remission with low-dose steroid and sirolimus. Thus, overall response rate (ORR) was achieved in 12 of 17 patients (70.5%). In conclusion, sirolimus may be an effective and safe option in paediatric patients with relapsed-refractory immune cytopenia. © 2024 The Scandinavian Foundation for Immunology.