Browsing by Author "Demircioglu, Sinan"

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Acute Hepatitis-A Virus Infection as a Rare Cause of Hemophagocytic Lymphohistiocytosis
(Coll Physicians & Surgeons Pakistan, 2021) Dogan, Ali; Demircioglu, Sinan; Ekinci, Omer
Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder of the mononuclear phagocytic system, characterised by histiocyte and lymphocyte activation. It can be classified as primary and secondary HLH. Primary HLH usually presents in childhood, and is associated with gene mutations. Secondary HLH usually presents in adulthood, and is due to an underlying infection, autoimmune disease or malignancy. We describe a case of HLH secondary to acute hepatitis-A virus infection, which was characterised by persistent fever, pancytopenia, splenomegaly, hyperferritinemia, and hemophagocytosis observed in the bone marrow.
Assessment of the Neutrophil-Lymphocyte Ratio in Classic Hodgkin Lymphoma Patients
(Professional Medical Publications, 2019) Dogan, Ali; Demircioglu, Sinan
Background and Objective: Besides known risk scoring systems, studies have recently been conducted in relation to NLR to estimate the prognosis of HL. Some studies found a relationship of NLR with PFS and OS. Our objective was to investigate whether NLR, as an inexpensive and easily accessible test, is a prognostic marker for cHL, as in several previous studies. Methods: The study included 232 patients in the age range of 18 to 88 years who were diagnosed with classic Hodgkin Lymphoma and received ABVD chemotherapy and/or radiotherapy at Van Yuzuncu Yil University Hematology Clinic from 2000-2018. Analyses were conducted on the disease stage, risk scores, treatment responses and relapse statuses at the time of diagnosis based on the patients' NLR values at the time of diagnosis. Results: The mean age of the patients was 39.27 +/- 15.90, while 38.8% were female and 61.2% were male. The NLR value at the time of diagnosis was significantly related to stage (p:0.013), early-stage risk score (p:0.022) and treatment response (p:0.032). The cutoff value of NLR was found as 4.23. The Hb value at the time of diagnosis was significantly related to stage (p:0.00), early-stage risk score (p:0.007), treatment response (p:0.006) and the latest status of patients (p:0.005). Conclusion: High NLR values were found to be significantly related to disease stage, early-stage risk scoring and response to the treatment. These findings need to be supported by prospective studies with larger samples for these data to be used prognostic scores.
Comparison of the Effects of Oral Iron Treatment Every Day and Every Other Day in Female Patients With Iron Deficiency Anaemia
(Wiley, 2020) Oflas, Nur Duzen; Demircioglu, Sinan; Dogan, Narin Yildirim; Eker, Elife; Kutlucan, Ali; Dogan, Ali; Demir, Cengiz
Background: It is known that daily divided doses and high doses of iron increase hepcidin and reduce iron absorption. Aim: To compare treatments of iron replacement every other day at low doses, once a day and twice a day in terms of their effectiveness and frequencies of side-effects. Methods: For 1 month, Group I received 270 mg ferrous sulphate twice a day (total elemental iron dose: 160 mg/day), Group II received 270 mg ferrous sulphate once a day (total elemental iron dose: 80 mg/day), and Group III received 270 mg ferrous sulphate every other day (total elemental iron dose: 80 mg/every other day). Intragroup and intergroup statistical analyses were carried out. Results: Haemoglobin (Hb) increased significantly in all three groups (P = 0.00). The increase in Hb levels was similar among the groups (P = 0.09). Ferritin significantly increased in all three groups after the treatment (P = 0.00). The increase in ferritin in Group I was significantly higher than those in Groups II and III (P < 0.05). Gastrointestinal tract (GIS) side-effects were also significantly higher in Group I in comparison to the others (P = 0.001). Conclusions: A low dosage of iron treatment every other day may be used in the place of providing iron once or twice every day with similar effectiveness and lower rates of GIS side-effects.
Decreased Bone Mineral Density and Associated Factors in Severe Haemophilia a Patients: a Case-Control Study
(Wiley, 2019) Ekinci, Omer; Demircioglu, Sinan; Dogan, Ali; Merter, Mustafa; Yildiz, Saliha; Demir, Cengiz
Introduction Haemophilia patients may exhibit lower levels of bone mineral density (BMD) than the general population for a variety of reasons. Aim We aimed to investigate decreased BMD in people with severe adult haemophilia A (PWH) living in eastern Turkey, and to evaluate the related potential risk factors. Methods The study included 41 PWH and 40 healthy volunteers. Dual-energy x-ray absorptiometry (DXA) was used to measure the BMD. Blood tests and body mass index (BMI) were recorded. The Functional Independence Score in Hemophilia (FISH) test was used to measure functional ability status. Results There was a significant difference between the PWH and control groups with respect to femoral neck and total hip BMD (in g/cm(2)), but the difference for lumbar spine was not significant (P = .017, P < .001, P = .071, respectively). In PWH, patients under 50 years of age, 19.4% were found to have "lower than expected" BMD levels for their age, while 27.8% showed "low normal" levels. In PWH, osteoporosis was found in 60% of the patients over 50 and osteopenia in 20%. Vitamin D insufficiency and deficiency were present in 63.4% of the PWH, significantly higher than the control group (37.5%; P < .001). Conclusion The results indicated that the decrease in BMD was significantly greater in patients with severe haemophilia A than in the normal healthy population. This reduction was correlated with BMI, vitamin D and low functional ability status. However, in multivariate analysis, none of these was a strong independent risk factor.
Determinants of Recurrence in Itp Treatment
(E-century Publishing Corp, 2020) Demircioglu, Sinan; Gurbuz, Ali Fuat
Objective: Immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia. Two-thirds of the cases respond to first-line therapy with corticosteroids. However, there is a 50% relapse rate six months after the treatment. Information predicting recurrence at the time of the diagnosis is limited. This study aimed to investigate the relationship of mean platelet volume (MPV) and the neutrophil/lymphocyte ratio (NLR) at the time of the diagnosis with ITP recurrence. Methods: The study included 171 adult primary ITP patients who received corticosteroids and/or intravenous immunoglobulin (IVIG) as first-line therapy. The relationship between the demographic characteristics of the patients and the laboratory values at the time of the diagnosis with the frequency of recurrence was evaluated. Results: A total of 126 (73.7%) female and 45 (26.3%) male patients with a mean age of 38.54 +/- 17.41 years were included in the study. 89 (52%) patients had a recurrence after first-line therapy. No relationship was found between the frequency of recurrence and age, gender, the presence of comorbid diseases, bleeding status, type of the first-line treatment, CRP, and MPV values. However, there was a statistically significant relationship between NLR increase and the frequency of recurrence (P=0.049). Conclusion: In this study, an association was found between the NLR levels and the rate of recurrence in ITP patients receivingfirst-line treatment. Further studies with larger sample sizes are needed to support this finding.
Diagnostic Importance of Bone Marrow Aspiration Evaluation: a Single-Center Study
(Professional Medical Publications, 2022) Dogan, Ali; Demircioglu, Sinan
Background &Objective: Early diagnosis can be made based on the morphological examination of bone marrow aspiration (BMA) until the bone marrow biopsy (BMB) result is reported. This allows for treatment to be started immediately, especially in hematological malignancies for which urgent treatment is indicated. This study aimed to determine the sensitivity and importance of bone marrow aspiration in the diagnosis of hematological malignancies. Methods: In this study, the data of patients who underwent bone marrow aspiration and bone marrow biopsy in Van Yuzuncu Yil University hospital between 2017 and 2019 were retrospectively analyzed. A total of 500 patients who simultaneously underwent BMA and BMB were included in the study. Data were obtained from electronic medical records. Results: Indication for bone marrow evaluation was abnormalities in complete blood count in 270 (54%) of patients. The diagnosis was made based on the evaluation of BMA in 475 (95%). In 456 (96%) of the 475 patients diagnosed with BMA, the diagnosis was consistent with that of BMB. Agreement of BMB with BMA was 100% in acute and chronic leukemias, while BMA was not sufficient for the diagnosis of lymphoma and solid organ metastasis. Conclusion: Our study showed that the evaluation of BMA was highly sensitive in the diagnosis of hematological malignancies, such as acute leukemias, chronic leukemias, and multiple myeloma.
Prognostic Significance of Flow Cytometric Immunophenotyping in Patients With Acute Myeloid Leukemia
(Galenos Publ House, 2022) Demircioglu, Sinan; Ekinci, Omer; Dogan, Ali; Ulas, Turgay
Objective: Chromosomal abnormalities are one of the most important prognostic factors in acute myeloid leukemia (AML). However, not all patients may have such informative chromosomal abnormalities. Although there are many studies on the prognostic value of immunophenotyping in AML, it is still not used as a prognostic marker. In this study, we aimed to investigate the effects of CD13, CD33, CD34, CD117, MPO and HLADR expressions on prognosis of non-acute promyelocytic leukemia AML.Methods: One hundred thirteen patients diagnosed as having non -acute promyelocytic leukemia AML and followed up between 2010 and 2018 were included in this study. The associations of CD13, CD33, CD34, CD117, MPO and HLA DR expressions with chemotherapy response, progression free survival (PFS) and overall survival (OS) were statistically analyzed.Results: It was seen that response to chemotherapy was achieved in 67.3% of the patients. Median PFS duration was 9 months and median OS duration was found as 13 months. Of the immunophenotypic characteristics, only MPO expression was determined to be an independent risk factor for PFS and OS.Conclusion: Immunophenotypic features may be helpful in the diagnosis of AML as well as give an idea about prognosis. In this study, MPO expression was shown to be an independent risk factor for PFS and OS in our own patient population.
Relapsed/Refractory Thrombotic Thrombocytopenic Purpura Treated With N-Acetylcysteine: a Case Report
(Sage Publications Ltd, 2018) Demircioglu, Sinan; Ekinci, Omer; Dogan, Ali; Demir, Cengiz
Thrombotic thrombocytopenic purpura is a rare condition that presents with microangiopathic haemolytic anaemia, thrombocytopaenia, fever, renal impairment and neurological symptoms. Plasma exchange is a lifesaving treatment for this condition. However, some cases may be non-responsive to plasma exchange, or loss of response may occur. Treatment options for refractory cases include high-dose corticosteroids, rituximab, vincristine, cyclophosphamide, splenectomy, bortezomib and N-acetylcysteine. We present a refractory case of thrombotic thrombocytopenic purpura responding to the last of these therapies.
Renal Involvement in Chronic Lymphocytic Leukemia: a Case Report
(Galenos Publ House, 2020) Demircioglu, Sinan; Ozgokce, Mesut; Dogan, Ali; Bayram, Irfan; Demir, Cengiz
Chronic lymphocytic leukemia (CLL) is a neoplastic condition of B cells that frequently affects the lymph nodes, liver, spleen and bone marrow. The extranodal involvement of CLL is most commonly observed in the skin, whereas gastrointestinal and genitourinary involvement is rare. Renal involvement may not always present with renal failure. In this study, we aimed to present a patient with CLL infiltration in the kidney without renal failure and proteinuria.
Renal Involvement in Diffuse Large B-Cell Lymphoma: a Case Report
(Marmara Univ, Fac Medicine, 2019) Demircioglu, Sinan; Telci, Ufuk; Ozcelik, Mahsun; Dogan, Ali; Bayram, Irfan
Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma. Approximately 40% of cases have extranodal involvement. Renal involvement is rare, however, it is associated with poor prognosis. Furthermore, renal involvement increases the risk of central nervous system (CNS) recurrence. Therefore, it is recommended that CNS prophylaxis should be included in lymphoma treatment in cases of renal involvement.
Use of Eculizumab in Thrombotic Microangiopathy Associated With Hematopoietic Stem Cell Transplantation
(Coll Physicians & Surgeons Pakistan, 2021) Demircioglu, Sinan; Dogan, Ali; Demir, Cengiz
Thrombotic microangiopathy (TMA) associated with hematopoietic stem cell transplantation, remains a difficult complication due to its high mortality rate, lack of standardised diagnostic criteria, and limited treatment options. Although the etiology of the disease is not clear, medications, radiotherapy, graft-versus-host disease (GVHD), angioinvasive fungal, viral infections and complement activation have been implicated. Agents such as therapeutic plasma exchange (TPE), steroids, rituximab, defibrotide, eculizumab are used in its treatment. The use of treatments such as TPE, steroids, defibrotide, and rituximab did not yield satisfactory results in transplant-associated TMA (TA-TMA). Recent studies have reported successful results with eculizumab in the treatment of TA-TMA. As there is no standard dose for eculizumab in the treatment of TA-TMA, doses used in atypical hemolytic uremic syndrome (aHUS) were administered. In this paper, we present a case that was unresponsive to TPE and steroids, but which was successfully treated with eculizumab.