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Öğe Addition of Thalidomide (T) to Oral Melphalan/Prednisone (MP) in Patients with Multiple Myeloma: Initial Results of a Randomized Trial From the Turkish Myeloma Study Group.(AMER SOC HEMATOLOGY, 2009) Beksac, Meral; Haznedar, Rauf; Firatli-Tuglular, Tulin; Ozdogu, Hakan; Aydogdu, Ismet; Konuk, Nahide; Sucak, Gulsan[Abstract not Available]Öğe Addition of thalidomide to oral melphalan/prednisone in patients with multiple myeloma not eligible for transplantation: results of a randomized trial from the Turkish Myeloma Study Group(WILEY, 2011) Beksac, Meral; Haznedar, Rauf; Firatli-Tuglular, Tulin; Ozdogu, Hakan; Aydogdu, Ismet; Konuk, Nahide; Sucak, GulsanThe combination of melphalan-prednisone-thalidomide (MPT) has been investigated in several clinical studies that differed significantly with regard to patient characteristics and treatment schedules. This prospective trial differs from previous melphalan-prednisone (MP) vs. MPT trials by treatment dosing, duration, routine anticoagulation, and permission for a crossover. Newly diagnosed patients with multiple myeloma (MM) (n = 122) aged greater than 55 yr, not eligible for transplantation were randomized to receive 8 cycles of M (9 mg/m2/d) and P (60 mg/m2/d) for 4 d every 6 wk (n = 62) or MP and thalidomide (100 mg/d) continuously (n = 60). Primary endpoint was treatment response and toxicities following 4 and 8 cycles of therapy. Secondary endpoints were disease-free (DFS) and overall survival (OS). Overall, MPT-treated patients were younger (median 69 yr vs. 72 yr; P = 0.016) and had a higher incidence of renal impairment (RI, 19% vs. 7%, respectively; P = 0.057). After 4 cycles of treatment (n = 115), there were more partial responses or better in the MPT arm than in the MP arm (57.9% vs. 37.5%; P = 0.030). However, DFS and OS were not significantly different between the arms after a median of 23 months follow-up (median OS 26.0 vs. 28.0 months, P = 0.655; DFS 21.0 vs. 14.0 months, P = 0.342, respectively). Crossover to MPT was required in 11 patients, 57% of whom responded to treatment. A higher rate of grade 3-4 infections was observed in the MPT arm compared with the MP arm (22.4% vs. 7.0%; P = 0.033). However, none of these infections were associated with febrile neutropenia. Death within the first 3 months was observed more frequently in the MP arm (n = 8, 14.0%) than in the MPT arm (n = 2, 3.4%; P = 0.053). Long-term discontinuation and dose reduction rates were also analyzed (MPT: 15.5% vs. MP: 5.3%; P = 0.072). Although patients treated with MPT were relatively younger and had more frequent RI, better responses and less early mortality were observed in all age groups despite more frequent discontinuation. This study is registered at http://www.clinicaltrials.gov as #NCT00934154.Öğe Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera(WILEY-BLACKWELL, 2011) Kayrak, Mehmet; Acar, Kadir; Gul, Enes Elvin; Baglicaklioglu, Murat; Kaya, Zeynettin; Sonmez, Osman; Aydogdu, IsmetAims: The aim of this study was to evaluate myocardial performance index (MPI) which reflects the combined systolic and diastolic performance of the ventricles by tissue Doppler imaging (TDI) in patients with polycythemia vera (PV). Method and Materials: Twenty-eight patients with PV (17 men; mean age 60 +/- 9 years) and 30 age-matched healthy subjects were prospectively evaluated. The diagnosis of PV was performed according to the World Health Organization (WHO) criteria. Left ventricular (LV) systolic and diastolic functions were assessed by conventional echocardiography and TDI. MPI of both the LV and right ventricles (RV) were measured by TDI method. Results: The LV MPI was significantly higher in PV group than in the controls (0.61 +/- 0.16 vs. 0.49 +/- 0.05; P = 0.001). Also, the RV MPI was impaired in patients with PV compared to the control subjects (0.51 +/- 0.11 vs. 0.43 +/- 0.09; P = 0.005). RV late A filling velocity (Am) and RV isovolumetric relaxation time were significantly higher in the PV group compared to healthy subjects (P = 0.03 and 0.05, respectively). In logistic regression models, PV was determined as an independent predictor of impaired MPI (odds ratio: 3.7; CI 95%, 1.2-7.5). In addition, pulmonary arterial pressure was significantly elevated in patients with PV compared to the controls (P = 0.02). Conclusion: This study demonstrated that biventricular MPI is impaired in patients with PV. (Echocardiography 2011;28:948-954)Öğe Extramedullary myeloid leukemia mimicking lepromatous leprosy(NATL MED ASSOC, 2008) Sevinc, Alper; Aydogdu, IsmetGranulocytic sarcoma is an extramedullary localized tumoral lesion of myeloid precursors, It is composed of immature cells of the granulocytic series known to occur in patients with myelodysplastic syndrome, chronic myelogenous leukemia or acute myelogenous leukemia. We present a.29-year-old female who was admitted to hospital for lesions that appeared on the face, lips and nose, mimicking lepromatous leprosy. It should be kept in mind that granulocytic sarcoma may mimick lepromatous leprosy.Öğe Fulminant progression of peripheral T-cell lymphoma with skin involvement mimicking zona zoster: Letter to editor(2012) Demircioglu, Sinan; Aydogdu, Ismet; Erkurt, Mehmet Ali; Gurses, Iclal; Kuku, Irfan; Kaya, Emin; Ozhan, OnurBurada periferik T hücreli lenfomalı bir erkek hasta sunduk. Hasta remisyona girdikten iki ay sonra nüks etti. Kurtarma tedavisi sırasında vefat etti. Periferik T hücreli lenfomalar kötü prognoza sahiptir ve agresif seyir gösterirler. Hastalar hızlı değerlendirilmelidir. Çünkü kemoterapinin başarı şansı düşüktür. Tedavi için kemik iliği nakli akılda tutulmalıdır.Öğe The levels of nitric oxide in megaloblastic anemia(AVES YAYINCILIK, 2009) Erkurt, Mehmet Ali; Aydogdu, Ismet; Bayraktar, Nihayet; Kuku, Irfan; Kaya, EminObjective: The purpose of this study was to investigate the relationship between nitric oxide degradation products (nitrate and nitrite) levels and megaloblastic anemia which is treated with cyalocobalamin. Materials and Methods: A total of 30 patients with megaloblastic anemia (16 Male, 14 Female) were included in the study, Cyanocobalamin was administered (1.000 mu g/day intramuscularly) until the reticulocyte crisis occurred to the normal range. The control group consisted of 30 healthy subjects (15 Male, 15 Female). Nitric oxide levels were measured before treatment and compared with the values obtained during peak reticulocyte count. Results: Plasma direct nitrite, total nitrite and nitrate levels were 24,86 +/- 3,87, 60.56 +/- 7,01 and 36,02 +/- 5,24 in before treatment versus 15,48 +/- 3,05, 38,92 +/- 6,44 and 22,77 +/- 6,04 mu mol/dl in after treatment, respectively, Plasma direct nitrite, total nitrite and nitrate levels were significantly lower in after treatment compared with the before treatment (p<0.001). Conclusion: Nitric oxide levels are seen to increase in megaloblastic anemia. This study suggested that abnormalities in the nitric oxide levels in megaloblastic anemia are restored by vitamin B12 replacement therapy. (Turk J Hematol 2009; 26: 197-200)Öğe A Rare and Undesirable Complication of Heparin-Induced Thrombocytopenia: Acute Massive Pulmonary Embolism(SAGE PUBLICATIONS INC, 2011) Gul, Enes Elvin; Abdulhalikov, Turyan; Aslan, Ramazan; Aydogdu, IsmetA 69-year-old woman presented to the emergency department with sudden onset of dyspnea. She reported bilateral total knee surgery 12 days prior for gonarthrosis. The patient was recommended low-molecular-weight heparin (LMWH) 0.4 cc (4 milliliter) twice a day. On evaluation, severe thrombocytopenia was detected. An echocardiogram was performed because of her dyspnea, which revealed right ventricular dilatation and hypokinesis. Due to suspicion of a pulmonary embolism (PE), a pulmonary computed tomography (CT) was performed, which revealed bilateral massive PE. This event occurred while the patient was receiving LMWH for prophylaxis of PE. Due to the presence of severe thrombocytopenia, fondaparinux and immunoglobulin were initiated. Her platelet levels improved significantly and she was discharged on warfarin.
