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Publication Metadata only A case of secondary hemophagocytic lymphohistiocytosis (HLH) following incomplete kawasaki's disease (KD). Importance of distinguishing recurrent kd from HLH(2014) Kebudi, R.; Dindar, A.; Gürakan, F.; Devecioğlu, O.; Sözmen, Banu Oflaz; Faculty Member; School of Medicine; 198711N/APublication Metadata only A comparison of capillary and venous blood sampling methods for the use in haemorheology studies(Ios Press, 2011) Simmonds, Michael J.; Meiselman, Herbert J.; Marshall-Gradisnik, Sonya M.; N/A; Başkurt, Oğuz Kerim; Faculty Member; School of Medicine; N/AThere is accumulating evidence that exercise may improve disturbed haemorheological parameters that are typically observed in various chronic diseases, thus there is a growing interest in exploring the influence of various exercise models for the improvement of haemorheology. Blood sampling using venipuncture, however, can be limiting during exercise and/or in field settings. The purpose of the present study was to investigate whether venous and capillary blood samples yield comparable red blood cell (RBC) deformability and aggregation indices. Twelve healthy volunteers (6 males and 6 females; age 30 +/- 9 yrs; body mass index 24.9 +/- 2.8 kgm(-2)) provided blood samples that were collected simultaneously from: i) a prominent forearm vein by venipuncture; ii) the earlobe using a lancet; iii) the middle finger using a lancet. Haematocrit, RBC deformability (Rheoscan-D, Sewon Meditech Inc., Korea) and RBC aggregation (Myrenne GmbH, Roetgen, Germany) were measured for each sample. Haematocrit and RBC deformability were not different between the three sampling sites, and the group averages of RBC aggregation parameters were not different between the three sampling methods. The time course of RBC aggregation was slower when using blood sampled from the earlobe, and there was stronger agreement between RBC aggregation parameters measured using venous and capillary finger samples compared with venous and earlobe. It is suggested that capillary blood sampling from the finger may provide a reliable alternative to venous blood sampling in clinical and field settings.Publication Open Access A multi-center study on the efficacy of eltrombopag in management of refractory chronic immune thrombocytopenia: a real-life experience(Galenos Yayınevi, 2019) Çekdemir, Demet; Güvenç, Serkan; Özdemirkıran, Füsun; Eser, Ali; Toptaş, Tayfur; Özkocaman, Vildan; Haydaroğlu Şahin, Handan; Ermiş Turak, Esra; Esen, Ramazan; Cömert, Melda; Sadri, Sevil; Aslaner, Müzeyyen; Uncu Ulu, Bahar; Karakuş, Abdullah; Selim Bapur, Derya; Alacacıoğlu, İnci; Aydın, Demet; Tekinalp, Atakan; Namdaroğlu, Sinem; Ceran, Funda; Tarkun, Pınar; Kiper, Demet; Çetiner, Mustafa; Yenerel, Mustafa; Demir, Ahmet Muzaffer; Yılmaz, Güven; Terzi, Hatice; Atilla, Erden; Malkan, Ümit Yavuz; Acar, Kadir; Öztürk, Erman; Tombak, Anıl; Sunu, Cenk; Salim, Ozan; Alayvaz, Nevin; Sayan, Özkan; Ozan, Ülkü; Ayer, Mesut; Gökgöz, Zafer; Andıç, Neslihan; Kızılkılıç, Ebru; Noyan, Figen; Özen, Mehmet; Pepedil Tanrıkulu, Funda; Alanoğlu, Güçhan; Özkan, Hasan Atilla; Aslan, Vahap; Çetin, Güven; Akyol Erikçi, Alev; Deveci, Burak; Ersoy Dursun, Fadime; Dermenci, Hasan; Aytan, Pelin; Gündüz, Mehmet; Karakuş, Volkan; Özlü, Can; Demircioğlu, Sinan; Akay Yanar, Olga Meltem; Özatlı, Düzgün; Ündar, Levent; Tiftik, Eyüp Naci; Türköz Sucak, Ayhan Gülsan; Haznedaroğlu, İbrahim; Özcan, Muhit; Şencan, Mehmet; Tombuloğlu, Murat; Özet, Gülsüm; Bilgir, Oktay; Turgut, Burhan; Özcan, Mehmet Ali; Bahriye Payzın, Kadriye; Sönmez, Mehmet; Ayyıldız, Orhan; Dal, Mehmet Sinan; Ertop, Şehmus; Turgut, Mehmet; Soysal, Teoman; Kaya, Emin; Ünal, Ali; Pehlivan, Mustafa; Atagündüz, Işık; Tuğlular Fıratlı, Tülin; Saydam, Güray; Diz Küçükkaya, Reyhan; N/A; Çetiner, Mustafa; Öztürk, Erman; Faculty Member; Doctor; School of MedicineObjective: the aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results: The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion: results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors. / Amaç: bu çalışmanın amacı kronik immün trombositopeni (ITP) hastalarında bir oral trombopoietin reseptör agonisti olan eltrombopagın etkinlik ve güvenirliliğini değerlendirmektir. Gereç ve Yöntemler: elli beş merkezde izlem altındaki toplam 285 kronik ITP hastası (187 kadın, %65,6) bu geriye dönük küme çalışmasına alınmıştır. Tedaviye yanıt trombosit sayısına göre değerlendirilmiş ve tam yanıt (>100.000/mm3), kısmi yanıt (30.000-100.000/mm3 veya tedaviden sonra trombosit sayısının bir kat artmış olması) ve yanıtsızlık (<30.000/mm3) olarak tanımlanmıştır. Hastaların klinik bulguları, tanımlayıcı özellikleri, tedaviye yanıt ve yan etki bilgileri toplanmış ve aralarındaki ilişki incelenmiştir. Bulgular: tanı anında yaş ortalaması 43,9±20,6 (3-95) yıl olan hastalar ortalama 18,0±6,4 (6-28,2) ay izlenmiştir. Tam ve kısmi yanıtı içeren toplam yanıt %86,7 (n=247) bulundu. Sırasıyla 182 (%63,8) ve 65 (%22,8) hastada tam ve parsiyel tedavi yanıtları gözlenmiştir. Otuz sekiz hasta (%13,4) eltrombopag tedavisine yanıt vermemiştir. Altmış yaş üzerindeki hastalarda (n=68) toplam yanıt %89,7 (n=61) bulunurken, bu oran 80 yaş üzerindeki (n=12) hastalarda %83 (n=10) olmuştur. Tedavi öncesi trombosit sayısı göz önüne alındığında, eltrombopag, tedavinin 1., 2., 3., 4. ve 8. haftalarında trombosit sayısını anlamlı şekilde artırmıştır. Kısmi veya tam cevap için gereken süre arttıkça, tedaviye cevap önemli ölçüde azaldığı saptanmıştır. Eltrombopag tedavisinden sonra maksimum trombosit sayısı ne kadar yüksekse, yan etkilerin oluşabilme ihtimalinin o kadar yüksek olabildiği dikkati çekmiştir. En sık görülen yan etkiler baş ağrısı (%21,6), güçsüzlük (%13,7) ve hepatotoksisite (%11,8) ve trombozdur (%5,9). Sonuç: Mevcut çalışmanın sonuçları, eltrombopag tedavisinin kronik ITP’de, yaşlı hastalar dahil olmak üzere, etkili bir tedavi seçeneği olduğunu göstermektedir. Bununla birlikte, hastalar tedavi sırasında yanıt ve yan etkiler açısından yakından izlenmelidir. Hem cevap hem de yan etkiler, takip süresi boyunca değişken olabileceğinden, hastalar özellikle tromboz risk faktörleri açısından dinamik olarak değerlendirilmelidir.Publication Metadata only A novel microfluidics-based point of care technique for viscoelastic hemostatic assay(IOS Press, 2021) Erten, Ahmet Can; Yalçın, Özlem; Torun, Berfin Irmak; Öz, Fatma; Faculty Member; Master Student; Master Student; School of Medicine; Graduate School of Sciences and Engineering; raduate School of Sciences and Engineering; 218440; N/A; N/AN/APublication Metadata only A structured mechanical risk sensitivity assessment system using red cell deformability and fragmentation parameters(Ios Press, 2021) Yalçın, Özlem; Uğurel, Elif; Göktaş, Polat; Göksel, Evrim; Çilek, Neslihan; Atar, Dila; Faculty Member; Researcher; Researcher; PhD Student; PhD Student; Undergraduate Student; School of Medicine; School of Medicine; School of Medicine; Graduate School of Health Sciences; Graduate School of Health Sciences; School of Medicine; 218440; N/A; N/A; N/A; N/A; N/AN/APublication Metadata only Activation of protein kinase a cascade increases deformability of sickle red blood cells(Ios Press, 2021) Connes, Philippe; Boisson, Camille; Renoux, Celine; Gauthier, Alexandra; Fort, Romain; Nader, Elie; Poutrel, Solene; Göksel, Evrim; Yalçın, Özlem; PhD Student; Faculty Member; School of Medicine; School of Medicine; N/A; 218440Publication Metadata only Acute and long-term effects of hyperbaric oxygen therapy on hemorheological parameters in patients with various disorders(Ios Press, 2016) Sinan, Mukaddes; Ertan, Nesrin Zeynep; Mirasoglu, Bengusu; Toklu, Akin Savas; Basaran-Kucukgergin, Canan; Yalçın, Özlem; Başkurt, Oğuz Kerim; Ataç, Nazlı; Faculty Member; Faculty Member; Researcher; School of Medicine; School of Medicine; N/A; Koç University Hospital; 218440; N/A; N/AInhalation of 100% oxygen in a hyperbaric chamber has been accepted as a useful treatment for patients with various pathologies who suffer from hypoxia. The oxidative effects of hyperbaric oxygen (HBO) on RBCs have been investigated in animals but there is not enough data on hemorheological parameters in patients following HBO treatment (HBOT). In this study, we investigated the effect of HBO on hemorheological and haematological parameters during treatment. Red blood cell (RBC) deformability and aggregation, blood and plasma viscosity and superoxide dismutase activity were investigated in patients who underwent HBOT. Hematological parameters were determined by an electronic hematology analyzer. A Laser-assisted Optical Rotational Cell Analyzer (LORCA) was used to measure RBC deformability. RBC aggregation was measured for cells in autologous plasma and for cells resuspended in PBS containing Dextran70 (3%) by using a Myrenne Aggregometer. A Wells-Brookfield cone/plate rotational viscometer was used for viscosity measurements. According to our results, a significant decrement of the hematocrit and the RBC count was observed after the 20th session of HBOT compared to the baseline, but none of the hemorheological parameters changed significantly. Our results showed that HBOT did not cause any significant changes in hemorheological parameters, thereby not representing any problems for the patients.Publication Metadata only Adult philadelphia chromosome-positive acute lymphoblastic leukemia in daily practice: a multicenter experience(Elsevier, 2016) Tekgunduz, Emre; Goker, Hakan; Kaynar, Leylagul; Sari, Ismail; Pala, Cigdem; Dogu, Mehmet Hilmi; Turgut, Burhan; Korkmaz, Serdal; Tetik, Aysegul; Buyukasik, Yahya; Hacioglu, Sibel Kabukcu; Bozdag, Sinem Civriz; Ozdemir, Evren; Altuntas, Fevzi; N/A; Öztürk, Erman; Doctor; N/A; Koç University Hospital; N/AIn this retrospective, multicenter study, we evaluated the real-life outcomes of adult Philadelphia-positive acute lymphoblastic leukemia patients. The best results in terms of survival are achieved in patients who were treated with tyrosine kinase inhibitors during induction and received allogeneic hematopoietic cell transplantation as part of consolidation. Background: The prognosis of Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) is generally poor. Currently, allogeneic hematopoietic cell transplantation (allo-HCT) is the only accepted therapy with curative potential. Patients and Methods: Herein, we report our multicenter, retrospective experience with 46 (23 female; 23 male) Ph+ ALL patients, who were treated off-study between 2005 and 2012. Results: The median age of the patients was 46 years (range, 19-73 years). During induction, 30 (65%), 13 (28%), and 3 (7%) patients received tyrosine kinase inhibitors (TKIs) concurrent with chemotherapy (TKIs/chemotherapy), chemotherapy only, and TKIs only, respectively. Following induction, rates of complete remission (CR) of the study population were 85% (n = 39). CR rate in patients receiving TKIs during induction (n = 33) was significantly higher compared with patients who received chemotherapy only (n = 13; P = .011). Taking TKIs during induction significantly reduced induction mortality (3.3% vs. 38%; P = .01). Allo-HCT was performed subsequently in 21 (46%) patients. More patients who received TKIs with or without chemotherapy (19/33; 58%) during induction were able to undergo to allo-HCT compared with patients who received chemotherapy only (2/13; 15%; P = .005). Median overall survival of patients who were treated with TKIs during induction and received allo-HCT (not reached; NR) was significantly prolonged compared with patients who received allo-HCT but without TKIs during induction (23.2 months) and to the rest of the cohort (21.2 months; P = .019). Conclusions: Current state-of-the art management of Ph+ ALL in real-life seems to be incorporation of TKIs to chemotherapy regimens and proceeding to allo-HCT, whenever possible.Publication Metadata only An evaluation of thrombocytopenia cases in the hematology clinic of the ankara numune training and research hospital(Wolters Kluwer Medknow Publications, 2022) Sarı, Öznur; N/A; Üre, Ümit Barbaros; Doctor; N/A; Koç University Hospital; N/ABackground: Thrombocytopenia is a major disease that requires the referral of outpatient and hospitalized patients to hematology specialists. Objectives: The present study aims to evaluate the laboratory and transfusion statuses of adult patients admitted to our hospital and receiving outpatient/inpatient treatment and diagnosed with thrombocytopenia (< 100 x 109/l). Design: Single-center, retrospective, laboratory-based study. Patients and Methods: In the study, after obtaining permission of the hospital's Non-Invasive Clinical Research Ethics Committee, the information of patients diagnosed with thrombocytopenia (platelet count < 100 x 109/l) and who were examined and treated in the outpatient/inpatient settings between 2008 and 2010 were retrospectively analyzed using patient files and the hospital electronic database. Sample Size: A total of 1020 patients diagnosed with thrombocytopenia. Results: The patients were divided into groups according to the most common diagnoses for diseases associated with thrombocytopenia (hematological malignancy, disseminated intravascular coagulation (DIC)-sepsis, immune thrombocytopenia (ITP), infection, and chronic liver disease (n=708). Chemotherapy-induced, drug-induced, nutritional (B12, folate deficiency, etc.), OKIT, pregnancy-induced thrombocytopenias and other less common causes of thrombocytopenia were evaluated in a separate group (n=312). It was found that female patients were more frequently diagnosed with ITP (71.7 vs. 28.3%). Sex distributions were similar in other groups. The highest mean age (71 years: 50/80) was observed in patients with DIC-sepsis, whereas the lowest mean age was found in patients with ITP (40 years: 30/57) (P < 0.001). It was found that the most frequent need for transfusion developed in patients diagnosed with acute myeloid leukemia, acute lymphoblastic leukemia, and aplastic anemia. Conclusion: In this study, it was determined that the prevalence of thrombocytopenia was highest in patients diagnosed with hematological malignancy, ITP, and DIC-sepsis, respectively. In cases of hematological malignancy, the need for replacement of blood products is considered to be inevitable during the treatment process of the underlying disease compared with other clinical conditions.Publication Metadata only Angiopoietin as a novel prognostic marker in kidney disease(KARGER, 2024) Gaipov, Abduzhappar; Magagnoli, Lorenza; Ciceri, Paola; Cozzolino, Mario; Yıldız, Abdullah Burak; Çöpür, Sidar; Tanrıöver, Cem; Yavuz, Furkan; Vehbi, Sezan; Kanbay, Mehmet; School of MedicineIntroduction: Renal injury is among the leading causes of morbidity and mortality; however, there are no reliable indicators for determining the likelihood of developing chronic kidney disease (CKD), CKD progression, or AKI events. Vascular growth factors called angiopoietins have a role in endothelial function, vascular remodeling, tissue stabilization, and inflammation and have been implicated as prognostic and predictive markers in AKI. Methods: Although the exact mechanism of the relationship between kidney injury and angiopoietins is unknown, this review demonstrates that AKI patients have higher angiopoietin-2 levels and that higher angiopoietin-1 to angiopoietin-2 ratio may potentially be linked with a reduced risk of the CKD progression. Results: This review therefore emphasizes the importance of angiopoietin-2 and proposes that it could be an important predictor of AKI in clinical settings. Conclusion: There is a need for further large-scale randomized clinical trials in order to have a better understanding of the significance of angiopoietin-2 and for the determination of its potential clinical implications.