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Öğe A MALT LYMPHOMA PRESENTING WITH PRIMARY DIFFUSE RENAL INVOLVEMENT(Eskişehir Şehir Hastanesi, 16 Ekim 2023) Doğu, Mehmet Hilmi; Karışmaz, Abdülkadir; Suyani, Elif; Huq, Erdem Gülben; Altındal, Sermin; Serin, İstemi; Yokuş, OsmanThe involvement of kidney in marginal zone lymphoma (MZL) is not a frequent condition. Seventy-seven year old female presented with renal failure. Renal biopsy revealed diffuse lymphoid infiltration replacing the normal renal tissue. Immunohistochemical staining was CD20, CD38, kappa, IgD positive and CD3, lamda, cyclin D1, CD5, CD23, CD43, lambda negative. Ki-67 was 10% positive. The patient was diagnosed as MALT type MZL. Body 18Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed for staging revealed diffuse FDG uptake in both kidneys and no lymphadenopathy was detected. Bone marrow aspiration and biopsy were normal. Rituximab-bendamustin chemotherpy regimen was started. In conclusion, this is the first case of MALT lymphoma involving kidney diffusely which requires rapid diagnosis and treatment to prevent irreversible loss of renal functions.Öğe 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, OsmanPurpose: 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.Öğe Efficacy of the lactate dehydrogenase (LDH)/lymphocyte ratio (LLR) to reduce the need for X-ray in pregnant patients with COVID-19(De Gruyter Open, 2022) Doğu, Sevilay Yavuz; Serin, İstemi; Doğu, Mehmet Hilmi; Güleroğlu, Filiz Yarşılıkal; Dane, CemPregnancy carries a significant risk for coronavirus disease-2019 (COVID-19) due to natural immunosuppression. A previous study from our center has shown that the lactate dehydrogenase (LDH)/lymphocyte ratio (LLR) can be used in the early diagnosis of COVID-19 and predicting mortality. Based on this, we aimed to determine the effect of LLR on early detection of critical pregnant women and mortality in COVID-19. The data of 145 patients who were admitted to our hospital between March and December 2020; diagnosed with COVID-19 and hospitalized, were retrospectively analyzed. The median gestation period was 31 weeks (range: 5-41), 30.3% (n: 44) gave birth and 68.3% (n: 99) were pregnant. Median LLR was 0.13 (range: 0.04-0.70). The rate of cough (47% vs. 22.8%; p=0.003) was found to be high in patients with LLR>0.13. The patients were divided into subgroups. The proportion of patients without active complaints was higher in the Q1, followed by the Q4. The proportion of patients with an initial complaint of cough increased as LLR from Q1 to Q4, the distribution of other complaints did not differ between the quartiles. The higher rate of cough in the group with high LLR indicates that it may be an important indicator of lung involvement during pregnancy. The highest rate of non-treatment follow-up in the lowest LLR group proved that the LLR value at the time of diagnosis can be used as an important clinical marker in pregnant women. © 2022 De Gruyter. All rights reserved.Öğe 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, RafetIntroduction: 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.Öğe Quality of Life assessment with EORTC QLQ in patients with hodgkin lymphoma: multicenter study(Tr dizin, 2022) Gemici, Ali Ihsan; Serin, İstemi; Erol, Vedat Buğra; Doğu, Mehmet Hilmi; Karakuş, VolkanAim: The aim of our study is to obtain data on the quality of life (QoL) in Hodgkin lymphoma (HL) patients in a representative sample of the general population of Turkey with the help of the EORTC QLQ-C30 and QLQ-HL27 questionnaires. Material and Methods: A total of 68 patients from seven different centers diagnosed with HL between 2018-2020 were included in the study. The questionnaires were answered cross-sectionally by the patient under the control of a physician in the centers participating in the study. Results: Out of 68 patients, 42.6% (n=29) were female and 57.4% (n=39) were male. The ages of the patients ranged from 18 to 74 years, with a mean of 42.10±16.62 and with a median value of 40 years. There was no significant difference between age subgroups in terms of QLQ-C30 global health status/ QoL, functional or symptom scales and HL27 SB, PC, EI and WF scores (p>0.05, for all). It was determined that the constipation scores of females were higher than the scores of males (p=0.041). No statistically significant difference was found in terms of HL27 SB, PC, EI and WF sub-dimension scores according to gender (p>0.05). Conclusions: There was only a statistically significant difference in terms of QLQ-C30 constipation sub-dimension scores according to gender. The constipation scores of females were higher than the scores of men. More detailed and large population studies are needed to reveal the effectiveness of QoL assessment in HL patients.Öğe Relaps/refrakter lenfoma (mantle hücreli lenfoma hariç) hastalarında lenalidomid bazlı tedavi sonuçları: Çok merkezli sonuçlar(TR- Dizin, 2021) Doğu, Mehmet Hilmi; Serin, İstemi; Gemici, Ali Ihsan; Karışmaz, Abdülkadir; Turgut, BurhanAmaç: Lenfomalar, çoğunlukla B hücre kökenli heterojen bir hastalık grubunu temsil eder. Lenalidomid, kemo-immünoterapötik ajanlara talidomidin yapısal bir analoğu olarak dahil edilmiştir. Bu çalışmada amaç, mantle hücreli lenfoma dışı lenfomalarda, lenalidomid ile ilgili gerçek yaşam verilerimizi ortaya çıkarmaktır. Hastalar ve Yöntem: Ocak 2018- Ocak 2020 tarihleri arasında lenfoma tanısı alan hastalar geriye dönük olarak incelendi. Lenalidomid kombine rejimleri şu şekilde gruplandırılmıştır: Lenalidomi -deksametazon (Len-D); lenalidomid-bendamustin (Len-B); lenalidomid-rituksimab (Len-R). Bulgular: On beş (%60.9) hasta Len-D, 6 (%30.4) hasta Len-B ve 2 (%8.7) hasta Len-R aldı. En yaygın yanıt 13 (%56.5) hasta ile progresif hastalık idi, sadece 2 (%8.7) hastada tam yanıt vardı. Sonuç: Lenalidomid, diffüz büyük B hücreli lenfomalar (DBBHL), folliküler lenfoma (FL) ve indolen relaps/refrakter lenfomalar ile relaps/refrakter Hodgkin lenfomada (HL) yeni tedavi seçenekleri arasında yer almaktadır.Öğe 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, LeeAim 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.Öğe The use of hypomethylating agents in hematologic malignancies: treatment peferences and result(International Journal of Hematologi Oncology, 2021) Doğu, Mehmet Hilmi; Serin, İstemiAim: The objective of this article was to compare the efficiency of azacitidine (AZA) and decitabine (DAC) in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) who are not suitable for high-dose chemotherapy. Materials and methods: MDS and AML patients who were treated with hypomethylating agents (HMAs) between January 2005 and 2020 were evaluated retrospectively. Results: No statistically significant difference was found between the patients who received AZA or DAC in AML patients. In MDS group, the rate of patients who achieved remission was statistically significantly higher in patients who received DAC (p = 0,032). Conclusion: The advantage in terms of response for MDS and no survival difference between AZA and DAC for AML and MDS patients will be an important contribution to the literature. First draft submitted: 24 August 2020; Accepted for publication: 6 September 2021; Published online: 12 November 2021
