Showing papers in "International Journal of Hematology and Oncology in 2015"
TL;DR: ABS is an effective agent in the treatment of chemotherapy related severe oral mucositis in patients with hematological malignancies and further experimental and clinical trials about ABS shall focus on the interrelationships between proteomic content, fibrinogen gamma, and vital erythroid aggregation due to ABS.
Abstract: Oral mucositis, characterized by ulcerative lesions in the oral mucosa of patients undergoing chemotherapy, is currently considered to be the most severe complication of anti-cancer therapy which is affecting 40-80% of those patients. Ankaferd hemostat, (ABS) is the first topical hemostatic agent regarding the red blood cell (RBC)-fibrinogen interactions tested in the clinical trials. ABS also has pleiotropic effects particularly in the tissue healing and has anti-infective properties. The aim of this study is to assess the safety and efficacy of ABS in the management of chemotherapy-induced oral mucositis in adult patients with hematological malignancies. ABS was topically applied to the patients with grade 3-4 mucositis according to the WHO classification. Patients were said to mouthwash and swallow the five milliliters of ABS . Twenty patients with oral mucositis were evaluated. Eleven patients with acute myeloid leukemia, four acute lymphoblastic leukemia, three non-hodgkin lymphoma, one hemophagocytosis with acute myleoid leukemia and one hemophagocytosis were included in study. Median extract amount was calculated as 74.50 ml (30-100 ml) and median healing time was 6.6 days (3-10). Consequently, ABS is an effective agent in the treatment of chemotherapy related severe oral mucositis in patients with hematological malignancies. Further experimental and clinical trials about ABS shall focus on the interrelationships between proteomic content, fibrinogen gamma, and vital erythroid aggregation due to ABS.
13 citations
TL;DR: Low rates of need to switch to second generation TKIs with generic IM and no difference in treatment responses between generic and original molecules that confirms the non-inferiority of generic TKI over original molecules are found.
Abstract: Unsustainable drug prices in chronic myeloid leukemia (CML) and cancer may be causing harm to patients. The aim of this multicenter study is to assess the efficacy of generic imatinib mesylate (IM) over Glivec in terms of hematological, cytogenetic, and molecular responses in CML. The data of 120 CML patients, who were treated with generic or original form of IM, were obtained from six different hematology clinics in Turkey between the years of 2009-2014 and analyzed retrospectively. Initial evaluation revealed that only one patient who was using original molecule switched to second generation tyrosine kinase inhibitor (TKI). In this period, hematological response(HR) was observed in 99.2% of the patients, cytogenetic response (CR) was observed in 88.7% of the patients (47 of 53), and molecular response (MR) was observed in 75% of the patients. Clinicians had a tendency to prefer generic molecules in each sequent visit, and this switch rate was statistically significant (p< 0.001). 11 patients, who were using original molecules during all cohorts, switched to second generation TKI. On the other hand, only one patient, who was using generic molecules, switched to second generation TKI. Our paper may help to clarify the doubts about the efficacy of generic IM compared to original molecule. In our study we did not find any significant difference in HR, CR, and MR for original and generic drugs in each visit. Herein, we find low rates of need to switch to second generation TKIs with generic IM and no difference in treatment responses between generic and original molecules that confirms the non-inferiority of generic TKIs over original molecules.
12 citations
TL;DR: It was determined in this study that individuals with gynecological cancer face multidimensional problems regarding sexual life and adoption of holistic approach by health professionals in the evaluation of sexual problems of women and attempting to solve the problem are of significance.
Abstract: This study was conducted to examine problematic areas related to sexual life of individuals with gynecological cancer. Qualitative phenomenological research design was used in the study. The data were collected through “Semistructured In-depth Interview Form” and “Individual Information Form” with 30 women diagnosed with gynecological cancer. In-depth interview technique was used for obtaining data related to sexual problem areas of women. The data obtained were evaluated by content analysis. Average age of women who participated in the study was 46.70±10.66 (min=30, max=67), and women who were followed for the diagnosis of endometrium cancer (53.3%), ovarian cancer (36.7%), cervical cancer (10%). It was determined that there were significant changes in sexual lives of the individuals following the illness, and that body image, role of sexuality, sexual functions and reproduction ability, which are the four important components of sexual health, were affected unfavorably to a great extent. It was determined in this study that individuals with gynecological cancer face multidimensional problems regarding sexual life. Adoption of holistic approach by health professionals in the evaluation of sexual problems of women and attempting to solve the problem are of significance.
8 citations
TL;DR: It was found that as women’s breast cancer risk level went up so did their mean HBMS scores for susceptibility and health motivation (p<0.05), and those who were susceptible to breast cancer and whose health motivation was high showed higher risk for breast cancer.
Abstract: This study was conducted in order to determine risk level of breast cancer and breast cancer awareness among the women aged ≥ 65 years. The sample of the study was composed of 445 women aged over ≥ 65 years. The data were gathered with Breast Cancer Risk Assessment Tool and Champion’s Health Belief Model Scale for breast cancer (HBMS) and were evaluated with percentages and Kruskal Wallis test. It was found out that 1.6% of the women were under high risk while 2.7% of them were under very high risk for breast cancer. Breast cancer risk for those with personal breast cancer history was very high (mean risk score (MRS): 549.58 ± 48.26) and breast cancer risk level of the women whose mothers and sisters had breast cancer history was high (MRS: 328.46 ± 107.02). It was noted in the study that as women’s breast cancer risk level went up so did their mean HBMS scores for susceptibility and health motivation (p<0.05). Women who had personal breast cancer history, whose family members had breast cancer history, whose menarche ages were ≤ 11 years, who gave the first birth after the age of 30 had higher MRS as compared with the other women. Those who were susceptible to breast cancer and whose health motivation was high showed higher risk for breast cancer.
5 citations
TL;DR: HE4 and CYFRA 21.1 might be used as potential diagnostic markers for lung cancer patients because of its high sensitivity, positive predictive value and diagnostic accuracy.
Abstract: Lung cancer is the leading cause of cancer related deaths. Despite the modern diagnostic and therapeutic advances, 5-year survival rate of all cases of lung cancer does not exceed 15%. Therefore, sensitive tumor biomarkers are needed for the early detection and differential diagnosis of lung cancer. The aim of the study was to evaluate the diagnostic efficiency of HE4 (Human epididymis protein 4) and CYFRA 21-1 in patients with lung cancer. Serum samples were collected from 80 patients; Group 1 consisted of 53 patients with lung cancer and Group 2 consisted of 27 patients as control. HE4 and CYFRA 21.1 levels were measured by chemiluminescent microparticle immunoassay (CMIA). The cut-off limits for HE4 was 70 pmol/L and 2 ng/mL for CYFRA 21-1. Serum mean HE4 levels in Group 1 (94.79±50.56 pmol/L) were significantly higher than that of Group 2 (52.00±21.06 pmol/L), (p< 0.001). CYFRA 21-1 levels in Group 1 and Group 2 were 5.15±7.89 ng/mL and 1.75±2.11 ng/mL, respectively (p= 0.004). The sensitivity rates were 73.5% for HE4 and 50.9% for CYFRA 21-1. Both tumor markers were clearly related to stage with significantly higher ratio of increase in advanced stages (III-IV) than in early stages (I-II), (p= 0.021 for HE4, p=0.003 for CYFRA 21-1). HE4 and CYFRA 21.1 might be used as potential diagnostic markers for lung cancer patients. Especially HE4 may be candidate as a “leading-marker” for the discrimination of lung cancer because of its high sensitivity, positive predictive value and diagnostic accuracy.
4 citations
TL;DR: Serum cystatin C concentration had better sensitivity, specificity, PPV, and NPV compared to creatinine in detection of early stages of renal dysfunction in cancer patients under treatment with cisplatin.
Abstract: Renal function can be impaired in cancer patients treated with cisplatin. Currently, serum creatinine is used to diagnose renal dysfunction. This study aims to determine the efficacy of serum cyatatin C and ceratinine in contrast to the 24-hour urine creatinine clearance [CrCl] as the gold standard method in diagnosis of renal dysfunction in cancer patients under treatment with cisplatin. Seventy patients under treatment with cisplatin included. Serum cystatin C and creatinine were measured. CrCl in 24-hour urine was calculated. Measurements were done two times; before initiation of chemotherapy and before the fourth cycle of the chemotherapy. Then, using Receive Operating Curve [ROC] curve and at different cut-off points, sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV] of both cystatin C and creatinine to detect renal dysfunction were calculated. 24-hour urine CrCl was the gold standard method to define renal dysfunction. Sensitivity and specificity values of cystatin C of > 1.28 mg/L to predict CrCl< 78 mL/min were 77% and 95%, respectively. PPV and NPV of cystatin C were 95% and 79%, respectively with a diagnostic accuracy of 86%. On the other hand, sensitivity and specificity of creatinine were 64% and 47%, respectively. Serum cystatin C concentration had better sensitivity, specificity, PPV, and NPV compared to creatinine in detection of early stages of renal dysfunction in cancer patients under treatment with cisplatin. This marker can be used as an effective screening method in such patients to find renal dysfunction at its early stages.
3 citations
TL;DR: It is shown that women with SEOC was often young and mostly have an excellent prognosis, among the variables only omental involvement independently affected OS.
Abstract: Synchronous primary cancers of the endometrium and ovary (SEOC) occur in approximately 10% of all women with ovarian cancer and 5% of all women with endometrial cancer. Diagnosis of these tumors as independent primaries or metastases is necessary for appropriate staging and treatment. We aimed to demonstrate the clinic-pathological characteristics and prognosis of patients diagnosed as SEOC. Clinico-pathological data of cases with SEOC were retrieved from the computerized database of Etlik Zubeyde Hanim Women’s Health and Research Hospital. Twenty-six patients with SEOC who underwent comprehensive surgical staging between 1998 and 2014 were included in study. Mean age at diagnosis of women with primary SEOC in our study was 50.9. Median follow up was 86.5 months and the 10 year overall survival (OS) rates were 86.0% for patients with SEOC. Among the variables only omental involvement independently affected OS (p= 0.008). Most of the tumors were well-differentiated, early stage and of endometrioid cell type. In this study we showed that women with SEOC was often young and mostly have an excellent prognosis.
2 citations
TL;DR: The overall survival of the patients did not increase in any treatment group, though the severity of GvHD and the disease status before HSCT were shown to negatively impact OS, and responses could be achieved in steroid-refractory acute Gv HD using rabbit or horse ATG, survival rates did not increased because of high mortality rates due to infection during treatment.
Abstract: Although there is currently no consensus regarding the treatment of steroid-refractory acute graft-versus-host disease (GvHD) after hematopoietic stem cell transplantation (HSCT), antithymocyte globulin (ATG) is one of the most widely used immunosuppressive drugs in this setting. We retrospectively summarized our transplant center’s experience with 35 steroid-resistant acute GvHD patients who were treated with three different ATG preparations. Severe (grade III-IV) acute GvHD was observed either during the posttransplantation period (n= 32) or after donor lymphocyte infusion (n= 3). For secondary treatment of acute GvHD, rabbit Jurkat cell linereactive ATG (ATG Fresenius®) (n= 22), rabbit thymus cell-reactive ATG (Thymoglobulin®) (n= 9) or equine antilymphocyte globulin (ALG) (Lymphoglobulin®) (n= 4) was administered at a dose of 2-10 mg/kg/day for five consecutive days. The median time from the diagnosis of acute GvHD to the first day of infusion of ATG or ALG was 15 days (3-70 days). An overall response was observed in 15 patients (42%), with similar response rates among patients treated with any of the three ATG preparations. The overall survival (OS) of the patients did not increase in any treatment group, though the severity of GvHD and the disease status before HSCT were shown to negatively impact OS. Although responses could be achieved in steroid-refractory acute GvHD using rabbit or horse ATG, survival rates did not increase because of high mortality rates due to infection during treatment.
2 citations
TL;DR: The results demonstrated that ADAMTS10,17 and -20 might have a role in cancer progression, and further studies are needed to characterize chondrosarcoma cells because of the possible association between cancer progression and ADAMts proteins.
Abstract: Some of A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) enzymes have been suggested to facilitate invasion and metastasis in cancer. ADAMTS20 is called gon-ADAMTS and ADAMTS10 and -17 are called orphan ADAMTSs. ADAMTS20 degrades versican and aggrecan in extracellular matrix. We aimed to investigate the effects of insulin on ADAMTS10,-17 and -20 in OUMS-27 chondrosarcoma cells. OUMS-27 cells were cultured in Dulbecco’s modified Eagle’ medium (DMEM) containing 10 μg/mL insulin. The medium was changed every other day up to 11th day. Cells were harvested at 1, 3, 7, and 11th days and RNA isolation was performed at appropriate times according to study setup. The levels of RNA expression of ADAMTS10,-17 and -20 were estimated by qRT-PCR using appropriate primers. ADAMTS10 mRNA expression gradually decreased within 7 days after insulin induction compared to control group. There was a significant difference between control and Day 7 groups (p=0.021) as well as Day 1 and Day 7 groups (p=0.028). ADAMTS17 mRNA expression increased right after insulin induction at day 1 compared to control group and protected its high levels throughout insulin application. The most evident and statistically significant increase in mRNA concentration was observed at day 7 after insulin induction (p= 0.014). Our results demonstrated that ADAMTS10,-17 and -20 might have a role in cancer progression. Although functions of ADAMTS10 and -17 are not known, their expression levels have changed in chondrosarcoma cell line. Further studies are needed to characterize chondrosarcoma cells because of the possible association between cancer progression and ADAMTS proteins.
2 citations
TL;DR: The absence of lymph node metastasis and adjuvant treatment had positive effects on survival in patients with large cell lung carcinoma who underwent resection, and although not statistically significant, neuroendocrine differentiation led to a lower survival rates.
Abstract: The aim of this study was to evaluate of the results of the treatment of patients who underwent surgery due to large cell lung carcinoma and to analyze the variables affecting the survival outcomes. Pulmonary resections were performed on 1221 patients with pathological stages I, II, III non-small cell lung cancer between January 2003 and January 2013. A total of 85 patients (7%) who were histologically diagnosed with large cell lung carcinoma and 10 patients were excluded from the study because of operative mortality, incomplete resection, and follow-up. The records of 75 patients undergoing complete resection were evaluated in terms of demographics, survival rates, and variables affecting the survival. Seventy-one (94.7%) male and four (5.3%) female patients with a mean age of 58.1±9.8 years (range: 38 to 76 years) were included in the study. Neoadjuvant treatment was administered to four (5.3%) patients. Lobectomy was performed on 53 (70.7%) patients and 28 (37.3%) had neuroendocrine differentiation (NED) in their tumors. Median and five-year survival rates were 80.8 months and 51.1%, respectively in a mean follow-up period of 34.9±27.7 months (range: 2.4 to 91.6 months). Five-year survival rates in the groups with and without neuroendocrine differentiation were 37.8% and 57.9%, respectively, with no statistically significant difference between the groups (p=0.53). The absence of lymph node metastasis and adjuvant treatment had positive effects on survival in patients with large cell lung carcinoma who underwent resection. Although not statistically significant, neuroendocrine differentiation led to a lower survival rates.
2 citations
TL;DR: It was observed that quality of life impaired in advanced arthropathy patients whose physical examination and radiological assessment scores were high among those who had more frequent bleedings, and with increased frequency of bleeding, factor consumption and treatment costs are also increasing.
Abstract: Hemophilic arthropathy is the most common complication of hemophilia, and the most important element for follow-up and treatment of hemophilia. In this study, hemophilic arthropathy was evaluated for bleeding, radiological assessment, and physical examination. Besides, socio-economic outcomes of hemophilic arthropathy and its impacts on quality of life were also investigated. Forty male patients diagnosed with hemophilia in the Hematology Unit of Gaziantep University Medical Faculty were included in the study. Of the 40 patients, 34 had hemophilia A and 6 had hemophilia B; 20 (50%) had severe, 8 (20%) had moderate and 12(30%) had mild hemophilia. According to our data collected in this study, there was a close relationship between hemophilic arthropathy and factor level. It was detected that the factor level and frequency of bleeding (p< 0.05), functional assessment of joints (p< 0.05) and scores of radiological assessment (p< 0.05) was negatively correlated. Frequency of joint bleeding during one-year period had a significantly positive correlation with functional assessment of joints (p< 0.01) and scores of radiological assessment (p< 0.01). It was observed that quality of life impaired in advanced arthropathy patients whose physical examination and radiological assessment scores were high among those who had more frequent bleedings. In addition, with increased frequency of bleeding, factor consumption and treatment costs are also increasing. Hemophilic arthropathy is a serious disease that imposes a large economic burden on patients and society. The full treatment of the disease may only be possible if the treatment is started at an early age and during this period it is crucially important to prevent joint bleedings, rehabilitate disabilities, and to introduce patients into society.
Journal Article•
TL;DR: 3DCRT and ADT combination is an effective treatment modality with acceptable toxicities in patients with clinically localized prostate cancer.
Abstract: The aim of this study is to evaluate the treatment results of three dimensional conformal radiotherapy (3DCRT) and androgen deprivation therapy (ADT) in patients with clinically localized prostate cancer (CLPC). Between June 1998 and December 2011, 577 patients with the diagnosis of CLPC were treated. ADT was started 3 months prior to radiotherapy (RT). 3DCRT was delivered to prostate and the seminal vesicles (SV) to a total dose of 70Gy. Additionally, patients with lymph node (LN) positivity received 50.4Gy RT to pelvic LN’s. Median follow up time was 65 months. Five-ten years overall survival (OS), cause specific survival (CSS), PSA relapse-free survival (PSA-RFS) and distant metastasis-free survival (DMFS) rates were 92-74%, 97-91%, 77-55% and 94-88%, respectively. OS was negatively affected from LN positivity (p< 0.001). In the subgroup of patients with GS≥ 8, there was no significant difference between < 1 years and ≥ 1 years of ADT in terms of CSS, PSA-RFS and DMFS. OS was better in patients with < 1 years of ADT (p= 0.01). Five year OS (p= 0.02), CSS (p= 0.05), PSA-RFS (p= 0.01) and DMFS (p= 0.07) rates were inferior in the high risk group patients that used ADT ≥ 1 year. Acute and late RTOG grade III/IV gastrointestinal system toxicity rates were 1.7% and 5% and acute and chronic RTOG grade III/IV genitourinary system toxicity rates were 1.4% and 5%, respectively. 3DCRT and ADT combination is an effective treatment modality with acceptable toxicities in patients with clinically localized prostate cancer.
TL;DR: There was no significant association between WT1expression, at diagnosis, and either of gender, organomegally, total leucocytic count (TLC), French-AmericanBritish system (FAB) subtypes, CD34 expression, cytogenetic studies, percentage of blast infiltration or response to induction therapy.
Abstract: Wilms tumor gene (WT1) is a reliable marker for minimal residual disease assessment in acute leukemia children. This study was designed to demonstrate the potential use of WT1 to establish quality of remission in acute leukemia children for early identification of children at high risk of relapse. This study based on a quantitative Real–Time polymerase chain reaction (PCR) (TaqMan) assay in bone marrow samples collected from 45 acute myeloid leukemia children at diagnosis and during follow-up was established. Our results revealed, there was no significant association between WT1expression,at diagnosis, and either of gender, organomegally, total leucocytic count (TLC), French-AmericanBritish system (FAB) subtypes, CD34 expression, cytogenetic studies, percentage of blast infiltration or response to induction therapy. By comparing the results obtained at day 14 and those obtained at day 28, we cannot depend on WT1gene expression or MRD detection at day14 in predicting resistance to treatment or predicting mortality (p= 0.12). In contrast WT1 gene expression or MRD detection values after induction therapy (at day28) is an independent prognostic risk factor of relapse (p= 0.001) and death (p= 0.001). The blast percentage was significantly correlated to the WT1expression levels at day 28.The presence of MRD or WT1gene expression at the end of induction therapy is an extremely powerful adverse prognostic factor.WT1 at presentation has no prognostic significance whereas a high WT1 expression after induction therapy is a predictor for poor outcome. A rise inWT1expression during treatment is a predictor for relapse. WT1 expression is a valuable and important tool for MRD study in AML and the presence of MRD value at the end of induction therapy is an extremely powerful adverse prognostic factor despite of achievement of morphological remission.
TL;DR: Although some combination regimens showed significant OS benefit compared to single-agent gemcitabine, the median OS was less than 1 year, and future directions are needed to integrate new targeted agents and combination protocols for metastatic pancreatic cancer.
Abstract: Pancreatic adenocarcinoma is the fourth leading cause of cancer-related death and have extremely poor prognosis. Although, declining trends for some major cancers, death rates are rising in both sexes for pancreatic cancer. Surgical resection is the only curative treatment of pancreatic cancer, but only 10 to 20 percent of patients are candidates for curative surgery. Fifty to sixty percent of patients with pancreatic cancer diagnosed in metastatic stage and 5-year overall survival (OS) rate is less than 5% for metastatic pancreatic cancer. Gemcitabine was the first chemotherapeutic agent that superior to 5-Fluorouracil. In most of the phase II trials combination gemcitabine with cytotoxic chemotherapy or targeted therapy showed promising results, but phase III trials with gemcitabine in combination with cisplatin, oxaliplatin, capacitabine, pemetrexed, irinotecan, bevacizumab, aflibercept, axitinib and cetuximab failed to improve primary endpoint OS. Monotherapy with S-1 demonstrated noninferiority to gemcitabine in OS and S-1 approved for pancreatic cancer in Japan. In a randomized phase II/III ACCORD trial median progression free survival (PFS), response rate (RR), median OS and quality of life were significantly prolonged in FOLFIRINOX arm compared to gemcitabine alone arm. In phase III (MPACT) trial, like FOLFIRINOX regimen, median PFS, RR and OS significantly prolonged with the combination nab-paclitaxel and gemcitabine compared to gemcitabine arm alone. As a targeted agent erlotinib is the first and only agent that demostrate signifiacnt activity with gemcitabine combination in patients with metastatic pancreatic cancer. Gemcitabine plus erlotinib combination significantly prolonged PFS and OS compared to gemcitabine alone arm. Although some combination regimens showed significant OS benefit compared to single-agent gemcitabine, the median OS was less than 1 year. On these grounds, future directions are needed to integrate new targeted agents and combination protocols for metastatic pancreatic cancer.
TL;DR: The associations between TLR4 (Asp299Gly and Thr399Ile), NOD2 (Arg702Trp and Gly908Arg) mutations and the risk of febrile neutropenia (FN) is investigated in children with Burkitt lymphoma.
Abstract: Toll-like receptor (TLR) family regulates both innate and adaptive immune responses in humans.1 The first identified TLR polymorphism encodes an Asp299Gly amino acid substitution in TLR4. This polymorphism is associated with decreased signalling response to bacterial lipopolysaccharide. Previous studies have demonstrated that Asp299Gly and Thr399Ile polymorphisms cause an increased risk of gram-negative infections and systemic inflammatory response.1,2 TLR4 Asp299Gly and Thr399Ile were also shown to be associated with invasive aspergillosis.3-5 Nucleotide-binding oligomerization domain-containing protein 2 (NOD2) is a member of a superfamily of genes which are involved in intracellular recognition of pathogens and expressed in intestinal epithelium, macrophages and dendritic cells.6 It was shown that NOD2 has synergistic effects on TLR mediated cytokine production and may modulate pathogen recognition by interracting TLR2 and TLR4 signalling.7 The two most common NOD2 variants are Arg702Trp and Gly908Arg. In the present study, the associations between TLR4 (Asp299Gly and Thr399Ile), NOD2 (Arg702Trp and Gly908Arg) mutations and the risk of febrile neutropenia (FN) is investigated in children with Burkitt lymphoma (BL). Between September 1995 and December 2007; 27 children with BL were enrolled in the study. The stages of patients were as following: Stage 1, n:1 (4%), stage 2, n: 5 (19%), stage 3, n: 11 (40%) and stage 4, n: 10 (37%). In our unit, BFM-B cell NHL-95 protocol is used in treating patients with BL since 1995. Febrile neutropenia attacks (defined as fever >38.50C once, or 38°C > 1 h with an absolute neutrophil count below 0.5×109/l) and clinically documented severe mucositis during treatment periods were retrospectively analysed from patient files. Burkitt lymphoma cases and 110 age and sex matched healthy controls were investigated for TLR4 (Asp299Gly and Thr399Ile), NOD2 (Arg702Trp and Gly908Arg) genotypes using melting curve analysis on the LightCycler in blood specimens.
TL;DR: Autologous hematopoietic stem cell transplantation can be a salvage treatment for selected Hodgkin lymphoms patients who relapsed but it is important to evaluate prognostic factors and long term outcomes in terms of relapse and mortality after transplantation.
Abstract: In this study data of 45 patients with Hodgkin lymphoma who underwent autologous hematopoietic stem cell transplantation between July 2000 and January 2012 were evaluated retrospectively. Clinical, laboratory and demographic characteristics affecting disease free survival (DFS) and overall survival (OS) were evaluated. Relapse and mortality rates in second and fifth years were also calculated. According to our results, patients in remission status before transplantation had a longer OS (p= 0.031) and relapse after transplantation shortened OS (p= 0.016). High beta 2 microglobulin level was associated with a shorter disease free survival (p= 0.042). Four patients (8.8%) died and 14 patients (31.1%) relapsed in the second year; 7 patients (%15.5) died and 17 patients (37.7%) relapsed in the fifth year. Median survival was 39 (6-72) months. In conclusion, autologous hematopoietic stem cell transplantation can be a salvage treatment for selected Hodgkin lymphoms patients who relapsed but it is important to evaluate prognostic factors and long term outcomes in terms of relapse and mortality after transplantation. Sharing experience from different transplantation centers can help selecting the most suitable patient for autologous transplantation.
TL;DR: The study showed that a panel of differentially expressed protein profiles might serve as more objective biomarkers for accurate stratification of different risk categories of AML.
Abstract: Currently, there are no markers to predict response to acute myeloid leukemia (AML) therapy and patients have to wait for a period of 3-6 months to see treatment response. The study aimed to analyze changes in protein expression in AML cells between different categorization risk groups using proteomics techniques. Six peripheral blood (PB) and six bone marrow (BM) samples at diagnosis and remission times were collected from AML patients. Another Six PB samples were collected from different categories of AML. All samples were analyzed by liquid chromatography tandem mass spectrometry (LC-MS/MS). The levels of proteins in patients with AML were compared at different categorization risk, individual response to treatment and clinical characteristics. Twenty-one and 145 differentially expressed proteins were identified with disease progression and risk categories of AML, respectively. Three (3) proteins were noticeably highly expressed out of the range of others proteins by at least 3fold difference between diagnosis and remission. Two other of proteins were up regulated by more than 10 folds between risk categories of AML. Furthermore, 4 proteins were found to be expressed in one risk category, but were not detectable in other two risk categories. The study showed that a panel of differentially expressed protein profiles might serve as more objective biomarkers for accurate stratification of different risk categories of AML.
TL;DR: It is suggested that IVSI-I mutation always accompany homozygosity of Xmn-I polymorphism and the coinheritance of the two mutations will lead to a milder phenotype.
Abstract: Thalassemia intermedia lies between asymptomatic β-thalassemia carrier state to severe thalassemia Major. XmnI polymorphism is one of the modifying factors of intermedia phenotype. This study intendeds to determine the frequency of Xmn-I polymorphism and its association with different beta chain mutations that would contribute towards the phenotype. 100 whole blood samples of thalassemia intermedia patients were tested for the common beta chain mutations found in Pakistan and then tested for Xmn-I polymorphism. The most common mutation identified in these patients was IVSI-5. Xmn-I polymorphism was found in 79% of the patients, 36% being homozygous and 43% being heterozygous. Xmn-I polymorphism was found in 84.7% of the samples with IVSI-5 mutation, 52.1% of Fr 8-9 , 45% of Cap+1, 85.7% of Cd30, 91.66% of HbE, and 33.3% of the samples with del619 mutation. Whereas δβ, HbS, IVSI-I showed 100% positivity for Xmn-I polymorphism. The age of start of transfusion was 3 -9 years and had high hemoglobin F levels. All the samples with IVSI-I mutation were homozygous (+/+) for Xmn-I polymorphism. Thus a firm linkage between the XmnI polymorphism and IVSI-I mutation is suggested and that IVSI-I mutation always accompany homozygosity of Xmn-I polymorphism and the coinheritance of the two mutations will lead to a milder phenotype.
TL;DR: The geometric changes in GTV and PTV positively influenced the DVH parameters, but were not statistically significant, and the clinical implications of this approach to CTS plan assessment should be examined using prospective studies with adequate number of patients.
Abstract: This study aimed to describe changes in gross tumour volume (GTV) that occurred during the course of radiotherapy (RT) in patients who underwent palliative thoracic radiotherapy (PTR), and to describe the role of adaptive treatment for protection of normal tissue. Twenty patients with non-small cell lung cancer (NSCLC) referred for PTR were treated using a total of 10 fractions and a dose of 300 cGy/day in accordance with the initial GTV, clinical target volume (CTV), and planning target volume (PTV). Computed tomography simulation (CTS) images were retaken for each patient at the end of the fifth fraction, and the second plan was created. The fractional volume reduction (FVR) of the GTV and the PTV were then calculated. The changes in normal tissue dose-volume histogram (DVH) parameters between the two plans were compared. Mean GTV and PTV values were 223.9 cc and 1113.3 cc for the first plan and 196.2 cc and 1029.7 cc for the second plan , respectively. After five fractionated treatments, the FVR was 15.9% of the GTV (p < 0.001) and 8% of the PTV (p< 0.001). The daily regression for GTV was 3.1 percent. A statistically non-significant decrease occurred for the normal tissue doses. The geometric changes in GTV and PTV positively influenced the DVH parameters, but were not statistically significant. The clinical implications of this approach to CTS plan assessment should be examined using prospective studies with adequate number of patients.
TL;DR: The present findings suggest that beside the antimicrobial activity of Antimicrobial Peptides (AMPs), hBD-3 and hCAP-18/LL-37 can also play a role in the pathogenesis of colon.
Abstract: This study investigated the immunohistochemical staining characteristics of human beta defensin-3 (hBD-3) and human cationic antimicrobial peptide-18/cathelicidin (hCAP-18/LL-37) in colon, stomach and lung adenocarcinomas and normal tissues (periphery to tumor tissues) from 22, 24 and 24 patients, respectively. Expressions of hBD-3 and hCAP-18/LL-37 were assessed by immunohistochemistry for colon, stomach and lung adenocarcinomas of 70 patients from Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital and Keçiören Training and Research Hospital. both located in Ankara, Turkey. The differences between the expressions of hBD-3 and hCAP-18/LL-37 in normal and carcinoma tissues were analyzed by Mann-Whitney U Test. When the normal and tumor tissues of these cases were compared according to their staining intensity of positive staining. the hBD-3 and hCAP-18/ LL-37 expressions in colon, stomach and lung adenocarcinomas cells were significantly higher than those in normal cells (p< 0.05). Immunostaining of HBD-3 and hCAP-18/LL-37 was found to be a marker of malignancy in colon. stomach and lung adenocarcinomas. The expressions of hBD-3 and hCAP-18/LL-37 were, for the first time, shown to be significantly altered in colon, stomach and lung adenocarcinomas as compared to controls. In conclusion, the present findings suggest that beside the antimicrobial activity of Antimicrobial Peptides (AMPs), hBD-3 and hCAP-18/LL-37 can also play a role in the pathogenesis of colon. stomach and lung adenocarcinomas.
TL;DR: The results showed that none of patients in the study had JAK2V617F mutation, and it might not be practical to test de novo AML patients for it, and studies on JAK1V617f mutation should be carried out on larger number of patients.
Abstract: The JAK-STAT is the most important pathway that transmits signals in the cells of normal hematopoiesis and hematologic malignancies. JAK2V617F, which develops in the JH2 region of the JAK2 kinase, is a somatic point mutation. As a result of JAK2V617F mutation, growth of the cells independent of cytokine commences which, in return, produces an increased response to cytokine and causes antiapoptotic effects. Some recent studies have reported that JAK2V617F mutation is seen in 1-10% of AML patients. Compared to those with de novo AML, JAK2V617F mutation is even higher in patients with AML, which develops secondary to myeloproliferative disorders. In this study the incidence of JAK2V617F mutation in AML patients was examined. The study includes 51 patients with AML. Fourteen percent had secondary AML, 86% had de novo AML. Twenty-four of the 51 patients were newly diagnosed to have AML and the rest 27 were studied in remission. Genetic analysis of JAK2V617F mutation was performed by using PCR. The results showed that none of our patients had JAK2V617F mutation. This might be attributed to the small number of patients in the study, which develops secondary to myeloproliferative disorders. Another reason could be that JAK2V617F mutation might have disappeared in patients in remission. In conclusion, we thought that it might not be practical to test de novo AML patients for JAK2V617F mutation, and studies on JAK2V617F mutation should be carried out on larger number of patients.
TL;DR: It couldn’t find statistically significant differences between patient and control groups in terms of genotype distributions and allele frequencies, however, GC genotype frequency was slightly higher in CLL patients than healthy controls and TGFβ1 +915GC genotype was found associated with trisomy 12.
Abstract: TGFβ1 is an important cytokine acts as an antiinflammatory agent, and inhibits B cell proliferation. In patients with chronic lymphocytic leukemia (CLL), serum level of TGFβ1 are found elevated. Presence of G allele at position +915 in TGFβ1 gene results in arginine synthesis which is associated with higher expression of TGFβ1. We investigated the association of TGFβ1 +915G>C polymorphism with predisposition, clinical characteristics and laboratory findings of CLL. 50 CLL patients and 50 healthy controls were included in this study. Genotypes were determined by PCR-RFLP method. We couldn’t find statistically significant differences between patient and control groups in terms of genotype distributions and allele frequencies. However, GC genotype frequency was slightly higher in CLL patients than healthy controls. Furthermore, TGFβ1 +915GC genotype was found associated with trisomy 12 (p= 0.007). Further studies are needed to clarify exact role of TGFβ1 +915G>C polymorphism in patients with CLL.
TL;DR: APC and EC are effective, rapid and repeatable techniques for treating endoluminal airway lesions and can effectively decrease dyspnoea.
Abstract: Endobronchial treatments are widely used for treating airway obstruction with the goal of relieving large airway obstructions caused by malignant or benign lesions. However, they may be curative in patients with benign conditions. We aimed to evaluate the usefulness of endobronchial argon plasma coagulation (APC) and electrocautery (EC) for treating patients with airway obstruction. Methods: We conducted a retrospective study in the bronchoscopy unit of a training and research hospital. Endobronchial treatment was carried out in 56 evaluable patients between 2007 and 2012. We used a rigid bronchoscope in 18 patients and flexible bronchoscope in 38 patients. General anaesthesia was administered to 32% (18 patients) patients. Bronchogenic carcinoma was seen in 43 patients, metastatic bronchial tumours in 1, and benign airway disease in 12. Obstruction sites were the trachea in 15 patients, main stem bronchi in 28 and lobar bronchi in 5. Eight patients had obstruction at multiple sites. Mean degree of obstruction was 84%. Immediately after the treatment, the mean degree of obstruction was 44%. Mean overall decrease in degree of obstruction was 39%. Post-tretament improvement of dyspnoea was excellent in 31 cases (55%) and moderate in 23 cases (41%); dyspnoea improvement was absent in 2 cases. Three complications (2 cases of respiratory insufficiency, 1 of mediastinal emphysema) were directly related to the endobronchial treatment. Conclusion: APC and EC are effective, rapid and repeatable techniques for treating endoluminal airway lesions and can effectively decrease dyspnoea.