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    Can Serum Albumin Level At Diagnosis Be A Guide for Clinical Features, Time to Treatment, and Response in Patients with Follicular Lymphoma?
    (2024) Karışmaz Abdülkadir; Gülbağcı, Burcu; Eren, Rafet; Aslan, Ceyda; Suyanı, Elif
    Aim: The aim of the present study was to determine the association between serum albumin level and treatment demand, time to treatment and treatment response in patients with follicular lymphoma (FL). Materials and Methods: We retrospectively evaluated the data of 25 FL patients. The data comprised gender, age, lactate dehydrogenase (LDH) level, number of nodal sites, presence of extranodal involvement, B symptoms and bulky mass, presence of bone marrow, liver and spleen involvement, Follicular Lymphoma International Prognostic Index score, Eastern Cooperative Oncology Group (ECOG) performance score, tumor grade, albumin level, globulin level, white blood cell count, platelet count and hemoglobin level at diagnosis; treatment demand, time to treatment, and response to treatment. Results: The median age of the patients was 53 years. The patients were divided into 2 groups according to the median albumin level as >4.4 gr/dL and <4.4 gr/dL. While 13 (52%) patients had an albumin level of <= 4.4 gr/dL, 12 (48%) patients had an albumin level of >4.4 gr/dL. Two groups were comparable in terms of treatment demand, time to treatment and treatment response in patients who were applied treatment (p>0.05). No correlation was found between the level of serum albumin and the need for treatment in patients with FL. Conclusion: FL, constituting approximately 20% of all non-hodgkin lymphomas, is the second most common lymphoma in adults. The age, LDH and hemoglobin levels, ECOG performance score, stage, extranodal, involvement, number of nodal sites involved, beta 2 microglobulin level, bone marrow involvement, presence of B symptoms and bulky mass are the conventional risk factors used to determine prognosis in FL. Although we found that treatment requirement was higher and time to treatment was shorter in patients with low serum albumin levels, they did not reach a statistical significance.
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    Charlson comorbidity index (CCI) in diffuse large B-cell lymphoma: a new pproach in a multicenter study
    (Springer, 2022) Eren, Rafet; Serin, İstemi; Atak, Süheyla; Pirdal, Betül Zehra; Nizam, Nihan; Gemici, Aliihsan; Aydın, Demet; Demirel, Naciye; Doğan, Esma Evrim; Yokuş, Osman
    Purpose: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of adult lymphomas. The incidence of DLBCL increases with age and has a fairly rapid fatal course without treatment. Patients often have difficulty tolerating standard chemotherapy regimens due to their comorbidities. Charlson Comorbidity Index (CCI), which is calculated by considering 19 different comorbidities, was developed in 1987 and is widely used for mortality prediction in cancer patients. Literature data on CCI and hematological malignancies are limited. Main aim in this study is to evaluate the effectiveness of CCI and compare to the International Prognostic Index (IPI) scoring system in the DLBCL patient group. Methods: A total of 170 patients diagnosed with DLBCL between 1.1.2002- 1.12.2020 were included in the study. Statistical analyzes were performed among patients whose IPI and CCI scores were recorded by considering baseline data. Results: The median age of patients was 58 (range: 17–84). Thirty-five (20.6%) patients had stage III and 76 (44.7%) had stage IV disease. When the CCI, IPI and ECOG scores were compared with the mortality status of the patients as a reference, AUCs were resulted as 0.628 (95% CI: 0.506–0.749), 0.563 (95% CI: 0.484–0.639) and 0.672 (95% CI: 0.596–0.743), respectively. There was no significant difference between the ROC curves of CCI, IPI and ECOG scores. Patients with a CCI score of ? 4 had shorter OS comperad to those with a score of < 4. Conclusion: Rather than claiming that CCI is superior to IPI, ECOG or another scoring system in a single-center patient population, it should be stated that CCI is also an effective scoring system in patients diagnosed with DLBCL.
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    Evaluation of the relationship between bone marrow changes and hemogram findings in HIV-positive patients
    (Galenos publ house, 2025) Karışmaz, Abdulkadir; Cavdar, Vahit Can; Doğu, Mehmet Hilmi; Aslan, Ceyda; Sarı, Nagehan Didem; Erdem Huq, Gülben; Eren, Rafet
    Aim: This study aimed to evaluate the relationship between bone marrow (BM) changes and initial laboratory findings in Human immunodeficiency virus (HIV)-positive patients, focusing on hematopoietic system alterations such as myeloid hyperplasia, erythroid hyperplasia, and megakaryocyte activity. Materials and Methods: A total of 57 HIV-positive patients were included in this retrospective study. BM findings, including cellularity, plasma cell ratio, reticulin fiber ratio, and specific features such as myeloid and erythroid hyperplasia, were analyzed. Initial laboratory parameters, including white blood cell (WBC), hemoglobin (HGB), hematocrit (HCT), platelet, and CD4 counts, were assessed. Results: Significant positive correlations were observed between cellularity and WBC (r=0.40, p=0.005), monocyte (r=0.40, p=0.005), and CD8 counts (r=0.32, p=0.02). Plasma cell ratio showed negative correlations with HGB (r=-0.35, p=0.01), HCT (r=-0.35, p=0.01), and albumin (ALB) (r=-0.50, p<0.001). Reticulin fiber ratio was negatively correlated with WBC (r=-0.30, p=0.03), HGB (r=-0.32, p=0.02), and ALB (r=-0.35, p=0.008). Conclusion: BM changes in HIV-positive patients, such as myeloid and erythroid hyperplasia, are associated with significant alterations in peripheral blood parameters, highlighting the importance of comprehensive hematological evaluations in this population. These findings contribute to a better understanding of HIV-related hematopoietic dysfunction and its clinical implications
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    Follicular lymphoma: frequency and timing of treatment: single center experience
    (Galenos publishing house, 2025) Karışmaz, Abdulkadir; Can Cavdar, Vahit; Serin, İstemi; Doğu, Mehmet Hilmi; Aslan, Ceyda; Eren, Rafet
    Introduction: This study aimed to investigate how often follicular lymphoma (FL) occurs in patients diagnosed with non-Hodgkin lymphoma (NHL). Additionally, we investigated whether patients with FL required treatment, and if so, whether the need for treatment arose at the initial diagnosis or during subsequent follow-up periods. Methods: Six thousand five hundred sixty patients diagnosed with NHL or chronic lymphocytic leukemia were reached, and healthy data were obtained from 1,719 of them. Data from 176 patients diagnosed with FL were evaluated. Demographic information (age, gender) of the patients was collected. The classifications were grouped by taking into account World Health Organization data, the histological subtype of the tumor, gender and need for treatment were evaluated. Results: Among the patients, 55.1% (n=97) were men and 44.9% (n=79) were women. The median age of those with FL was 50 years, with ages ranging from 18 to 87. When looking at histological subtypes, the FL accounts for 10.2% of cases (n=176). The proportion of patients requiring treatment was 70.9% (125), and the proportion of patients followed up without treatment was 27.8% (49). Of the patients who needed treatment, 57.1% (n=101) required it at the time of diagnosis and 13.6% (n=24) during follow-up. Conclusion: FL, making up around 20% of all NHL, is the second most prevalent type of lymphoma in adults. The incidence, as well as the gender and age distribution, of FL can differ across populations. This may be related to ethnicity, geographical conditions, and socioeconomic status. In addition, the proportion of patients requiring treatment may also vary. When all these are taken into account, social differences are some of the main determinants in the approach to FL.
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    The connection between anemia and limitations in daily activities among older males: the critical role of dynapenia
    (Springer science and business media deutschland GmbH, 2024) Karışmaz, Abdulkadir; Soysal, Pınar; Eren, Rafet; Serin, İstemi; Aslan, Ceyda; Rahmati, Masoud; Yon, Dong Keon; Smith, Lee
    Aim The aim of the present study was to examine the relationship between anemia and basic and instrumental activities of daily living in older male patients. Methods A total of 223 older males attending one geriatric outpatient clinic were included in this cross-sectional study. Anemia was defined as a hemoglobin level below 13 g/dL. Patients' demographic characteristics, comorbidities, and comprehensive geriatric assessment parameters were also recorded. Handgrip strength of < 27 kg for males was accepted as dynapenia. Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to evaluate functional capacity. Results The mean age (standard deviation) of the participants was 80.17 (7.69) years. The prevalence of patients with anemia was 43.9%. There was differences between anemic and non-anemic groups in terms of presence of diabetes mellitus (DM), congestive heart failure (CHF), chronic kidney disease (CKD), malnutrition, dynapenia, geriatric depression, BADL and IADL scores (all p < 0.05). In multivariate analysis, after adjusting for all confounding variables except for dynapenia, patients with anemia were associated with reduced BADL and IADL (all p < 0.05). After adjusting for all confounding variables including dynapenia, deterioration in total BADL and IADL scores did not remain significant in the anemic group compared to the non-anemic group (p > 0.05). Conclusion Close to one in two older outpatient men had anemia. Anemic men had a higher incidence of DM, CHF, CKD, malnutrition, geriatric depression and dynapenia. Anemia was associated with dependence in both BADL and IADL in older men. However, comorbidities, nutritional status, depressive mood and, specifically muscle strength, were important contributors to this association.