Browsing by Author "ALİ, RIDVAN"
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Publication A case of an antithrombin deficiency with mesenteric thromboses and cerebral infarct(Elsevier, 2016-05-01) Alp, Kırkızlar, Tuğcan; Özkocaman, Vildan; Özkalemkaş, Fahir; Şanlı, Cihat; Gözden, Hilmi Erdem; Yeğen, Zafer Serenli; Ali, Ridvan; Alp, Kırkızlar, Tuğcan; ÖZKOCAMAN, VİLDAN; ÖZKALEMKAŞ, FAHİR; Şanlı, Cihat; Gözden, Hilmi Erdem; Yeğen, Zafer Serenli; ALİ, RIDVAN; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Bölümü; 0000-0002-1361-6213; AAI-5246-2020; AAG-8495-2021; HMD-4249-2023; AAH-1854-2021; DQF-8966-2022; JMQ-2372-2023; EFO-5712-2022; GXD-8209-2022Publication Association of the ACE I/D Gene Polymorphisms with JAK2V617F-Positive Polycythemia Vera and Essential Thrombocythemia(Mary Ann Liebert, 2015-06-01) Görükmez, Orhan; Sağ, Şebnem Özemri; Görükmez, Özlem; Türe, Mehmet; Topak, Ali; Şahintürk, Serdar; Özkaya, Güven; Gülten, Tuna; Ali, Rıdvan; Yakut, Tahsin; ÖZEMRİ SAĞ, ŞEBNEM; Görükmez, Özlem; Türe, Mehmet; Topak, Ali; ŞAHİNTÜRK, SERDAR; ÖZKAYA, GÜVEN; Gülten, Tuna; ALİ, RIDVAN; Yakut, Tahsin; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Bilim Dalı.; 0000-0002-9241-0896; 0000-0003-0297-846X; IUN-6616-2023; ACQ-9887-2022; AAH-8355-2021; A-4421-2016; HNQ-2791-2023; ECY-8582-2022; EYU-9227-2022; GXD-8209-2022; GIS-1493-2022The renin-angiotensin system contributes to cell growth, proliferation, and differentiation in the bone marrow. We investigated the role of the ACE I/D gene polymorphism in 108 polycythemia vera (PV) and essential thrombocytosis (ET) patients who were positive for the JAK2V617F mutation, with a thrombosis group (TG) of 95 patients who had a history of vascular events, but did not have a history of myeloproliferative neoplasms and compared these to a healthy control group (CG) of 72 subjects. In the patients, II genotype and I allele frequency (p=0.009, odds ratio [OR]=9.716, 95% confidence interval [CI]=1.242-76.00, p=0.004, OR=2.019, 95% CI=1.243-3.280, respectively) were found to be higher than those in the controls. The DD genotype (p=0.021, OR=0.491, 95% CI=0.268-0.899) and D allele (p=0.004, OR=0.495, 95% CI=0.305-0.805) were found to be correlated with a decreased risk of a myeloproliferative neoplasm. These findings support the hypothesis that the ACE II genotype and I allele may be related to increased risk of ET and PV. Conversely, the DD genotype and D allele may be related to decreased risk of ET and PV. The results also indicated that the ACE I/D gene polymorphism was independent of thrombosis formation.Publication Conventional amphotericin b associated nephrotoxicity in patients with hematologic malignancies(Cureus, 2021-07-17) Gürsoy, Vildan; Özkalemkaş, Fahir; Özkocaman, Vildan; Yeğen, Zafer Serenli; Pınar, İbrahim Ethem; Ener, Beyza; Akalın, Halis; Kazak, Esra; Ali, Rıdvan; Ersoy, Alparslan; ÖZKALEMKAŞ, FAHİR; ÖZKOCAMAN, VİLDAN; PINAR, İBRAHİM ETHEM; ENER, BEYZA; AKALIN, EMİN HALİS; ALİ, RIDVAN; ERSOY, ALPARSLAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.; 0000-0001-9907-1498 ; 0000-0002-4803-8206; DLR-8474-2022 ; JIR-6730-2023 ; JGM-6601-2023 ; AAG-8523-2021 ; AAU-8952-2020; AAG-8459-2021; GXD-8209-2022; CPX-5894-2022Introduction: Amphotericin B (AmB-d) is one of the most effective therapeutic options against frequently life-threatening systemic fungal infections in patients with hematologic malignancies. However, significant adverse effects including nephrotoxicity associated with its use limit its more widespread use. The objectives of our study were to determine the incidence of AmB-d associated nephrotoxicity, to evaluate clinical and epidemiological characteristics of patients, and to support the notion that conventional amphotericin B remains a valid therapeutic option among hematologic patients with proper patient selection.Materials and methods: A total of 110 patients with hematologic malignancies were admitted to our Hematology Unit between January 2014 and November 2017 who required anti-fungal therapy during intensive systemic chemotherapy. The incidence of AmB-d associated nephrotoxicity, side effect profile, time to nephrotoxicity, and clinical and epidemiological characteristics associated with treatment success were assessed retrospectively.Results: Of the 110 patients receiving AmB-d, 70 (63.6%) were male and 40 (36.4%) were female. The mean age of participants was 44 years. The most common diagnosis was acute myeloid leukemia (n=53, 48.2%), and the most common chemotherapy protocol was 7 + 3 remission-induction (cytarabine 100 mg/m(2) days 1-7, Idarubicin 12 mg/m(2) days 1-3; n=24, 21.8%). In 56.4% of the patients, antifungal therapy was given empirically. In 40 patients (36.4%), nephrotoxicity was observed following antifungal treatment, and only four patients had stage 3 renal failure. The mean duration of time to nephrotoxicity from initiation of amphotericin B was four days (min: 2, max: 31). All patients were found to receive at least one additional potential nephrotoxic treatment during the antifungal treatment process.Conclusion: AmB-d is associated with a significant risk of nephrotoxicity. In most hematological patients, antifungal treatment is initiated empirically, and patients received prolonged courses of treatment. Therefore, it is plausible to initiate such treatment with AmB-d, when one considers the already high treatment costs in this patient group as well as the fact that AmB-d offers similar efficacy to antifungal agents at a lower cost. AmB-d may be recommended as a first-line agent in this patient group with the introduction of newer and more costly antifungal agents when needed, on the basis of the fact that these patients can be closely monitored in a hospital setting, reversible nature of nephrotoxicity upon discontinuation, and rare occurrence of severe renal failure requiring dialysis.Publication Evaluation of sexual dysfunction in patients with hematological malignancies(Elsevier Science, 2021-12-02) Karacan, Yasemin; Yıldız, Hicran; Demircioğlu, Burçin; Ali, Rıdvan; Karacan, Yasemin; YILDIZ, HİCRAN; Demircioğlu, Burçin; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Fakültesi/Hemşirelik Bölümü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; 0000-0001-8616-4935; 0000-0003-4241-5231; AAI-7132-2021; AAK-5246-2021; GQR-0671-2022; ESW-7456-2022; GXD-8209-2022Objective: Physiological and/or psychological problems that affect the quality of life of the patients occur depending on the diagnosis and treatment of hematological malignancies. Cancer treatment causes sexual problems such as infertility, vaginal dryness, and erectile dysfunction in the patients. Erectile dysfunction and loss of sexual desire are the most common sexual problems of men, while dyspareunia and loss of sexual desire are the most common sexual problems of women. This descriptive study was carried out to evaluate sexual problems and affecting factors in the patients with hematological cancer. Methods: Between July 1, 2011, and July 31, 2011, 45 sexually active patients who volunteered to participate in the study and whose written consents were obtained were included in the study. The data of the study were collected using the descriptive characteristics form prepared by the researchers based on the relevant literature and the Arizona Sexual Experiences Scale (ASEX). The scale scores range from 5 to 30 and a score of >11 above indicates sexual dysfunction. Results: Sexual dysfunction was observed in 62.2% of the patients. About 80.0% of women and 57.1% of men had sexual dysfunction. Sexual dysfunction was observed to be highest between the ages of 52-71 (81.2%) years. The mean total ASEX score was 15.90 +/- 4.25 in women and 13.34 +/- 5.37 in men. The ability to reach orgasm subscale score was found to differ by gender in the ASEX scale (P < 0.05). Conclusions: The prevalence of sexual dysfunction is high in the patients with hematological malignancies. It is recommended to evaluate these patients in terms of the presence of sexual dysfunction, as in the patients with other chronic diseases.Publication Evolution of clinical characteristics of patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab in Turkey: A multicenter retrospective analysis.(E-century Publishing Corp, 2021-01-01) Karadag, Fatma Keklik; Yenerel, Mustafa Nuri; Yilmaz, Mehmet; Uskudar, Hava; Tuglular, Tulin Firatli; Erdem, Fuat; Unal, Ali; Ayyildiz, Orhan; Ozet, Gulsum; Comert, Melda; Kaya, Emin; Ayer, Mesut; Salim, Ozan; Guvenc, Birol; Ozdogu, Hakan; Mehtap, Ozgur; Sonmez, Mehmet; Guler, Nil; Hacioglu, Sibel; Aydogdu, Ismet; Bektas, Ozlen; Toprak, Selami Kocak; Kaynar, Lale; Yagci, Munci; Aksu, Salih; Tombak, Anil; Karakus, Volkan; Yavasoglu, Irfan; Onec, Birgul; Ozcan, Mehmet Ali; Undar, Levent; Ilhan, Osman; Saydam, Guray; Sahin, Fahri; Ozkocaman, Vildan; ÖZKOCAMAN, VİLDAN; Ali, Ridvan; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0003-2687-9167; 0000-0002-7798-4349; 0000-0001-8605-8497; 0000-0003-1977-0104; 0000-0002-8902-1283; 0000-0002-2176-4371; 0000-0003-0604-6475; 0000-0003-0757-9206; 0000-0001-7717-5827; 0000-0002-7195-1845; 0000-0001-9178-2850; 0000-0003-2824-1044; 0000-0001-7842-9702; AAA-2012-2021; S-4300-2019; GLU-6163-2022; HRC-6282-2023; ABH-5764-2020; W-2951-2017; ABE-4485-2021; ITT-2117-2023; IZQ-0529-2023; W-3827-2017; GLQ-6094-2022; HKM-4739-2023; ABC-8182-2021Paroxysmal nocturnal hemoglobinuria (PNH) is a rare X-linked genetic disorder. On the contrary to its name, it is a multisystemic disease and various symptoms other than hemoglobinuria could be occurred. It could be life threatening especially because of thromboembolic events. In the last decade, a terminal complement inhibition with eculizumab approved with promising results for PNH patients. We conducted this study to evaluate the long term experience of eculizumab therapy from Turkey for the first time. Our cohort included 138 patients with PNH treated with eculizumab between January 2008 and December 2018 at 28 centers in Turkey. Laboratory and clinical findings at the time of diagnosis and after eculizumab therapy were recorded retrospectively. The median age was 39 (range 18-84) years and median granulocyte PNH clone size was 74% (range 3.06-99.84%) at the time of diagnosis. PNH with bone marrow failure syndrome was detected in 49 patients and the rest of 89 patients had classical PNH. Overall 45 patients (32.6%) had a history of any prior thrombotic event before eculizumab therapy and only 2 thrombotic events were reported during the study period. Most common symptoms are fatigue (75.3%), hemoglobinuria (18.1%), abdominal pain (15.2%) and dysphagia (7.9%). Although PNH is commonly related with coombs negativity, we detected coombs positivity in 2.17% of patients. Seven months after the therapy, increased hemoglobin level was seen and remarkably improvement of lactate dehydrogenase level during the treatment was occurred. In addition to previous studies, our real life data support that eculizumab is well tolerated with no serious adverse events and improves the PNH related findings.Publication Fatal cryptococcal meningitis in a patient with chronic lymphocytic leukemia(Pagepress Publ, 2012-01-01) Dizdar, Oğuzhan Sıtkı; Karakeçili, Faruk; Coşkun, Belkıs Nihan; COŞKUN, BELKIS NİHAN; Ener, Beyza; ENER, BEYZA; Ali, Rıdvan; ALİ, RIDVAN; Mistik, Reşit; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hemotoloji Anabilim Dalı.; D-6213-2013; AAG-8523-2021; AAG-7155-2021Patients with chronic lymphocytic leukemia (CLL) are susceptible to infections, especially opportunistic infections. We have described a patient with CLL who had cryptococcal meningitis. Despite lack of previous immunosuppressive treatment history, the patient experienced serious and fatal fungal infection. Physicians should be alert for a diagnosis of cryptococcal meningitis in patient with CLL who developed fever and headache.Publication Identification of psychological and social problems in caregivers of individuals diagnosed with hematologic malignancy(Elsevier Science, 2021-12-02) Karacan, Yasemin; Akkuş, Yeliz; Özçelik, Emine Tülay; Ali, Rıdvan; Karacan, Yasemin; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Fakültesi/Hemşirelik Bölümü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; 0000-0001-8616-4935; GQR-0671-2022; GXD-8209-2022Objective: Caring for patients with hematological malignancy could lead to many problems in different aspects regarding the lives of caregivers. However, there is limited data on the emotional and social problems of caregivers, who deal with patients of hematological malignancy. The aim of this study is to determine the emotional and social problems in caregivers of individuals diagnosed with hematological malignancy. Methods: The study was carried out descriptively to identify the emotional and social problems in the relatives of the patients diagnosed with hematological malignancy as their caregivers, as well as the factors affecting these problems. The data of the study were collected with the Introductory Information Form and Identification of Emotional and Social Problems Form that were administered to the relatives of the patients. The data were evaluated by using Spearman's Rho correlation analysis and the Logit analysis in Statistical Package for the Social Sciences software. Results: Among the caregivers, 59.8% were in the age group of 30-51 years, and 66.2% were female. Of the caregivers, 70.1% had difficulty in fulfilling their responsibilities. Spiritual distress had the highest score among the emotional problems, and experiencing caregiver strain had the highest score among the social problems. In the Logit model, the changes in the professional life was the variable that affects the emotional and social problems the most and significantly. In addition, emotional problems were affected by the financial problems at a statistically significant level. Conclusions: In this study, it is suggested that the caregivers should be provided with certain conveniences in their professional lives based on the fact that the problem, which affected emotional and social problems the most, is the change in the professional life; it is recommended that further studies should be carried out on the caregivers.Publication Impact of posaconazole prophylaxis and antifungal treatment on BAL GM performance in hematology malignancy patients with febrile neutropenia: A real life experience(Springer, 2023-10-16) Acet-Öztürk, Nilüfer Aylin; Ömer-Topcu, Dilara; Vurat Acar, Kübra; Aydın-Güçlü, Özge; Pınar, İbrahim Ethem; Demirdoğen, Ezgi; Görek-Dilektasli, Aslı; Kazak, Esra; Özkocaman, Vildan; Ursavaş, Ahmet; Özkalemkaş, Fahir; Ener, Beyza; Ali, Rıdvan; Akalın, Halis; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖMER TOPÇU, DİLARA; VURAT ACAR, KÜBRA; AYDIN GÜÇLÜ, ÖZGE; PINAR, İBRAHİM ETHEM; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; ÖZKOCAMAN, VİLDAN; URSAVAŞ, AHMET; ÖZKALEMKAŞ, FAHİR; ENER, BEYZA; ALİ, RIDVAN; AKALIN, EMİN HALİS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0001-7530-1279; AAI-3169-2021; JGM-6601-2023; Z-1424-2019; AAH-9812-2021; AAU-8952-2020; AAG-8459-2021; FRE-8778-2022; JQQ-5505-2023; GXD-8045-2022; JHW-9355-2023; FQG-8981-2022; JIW-1248-2023; CNK-0895-2022; GXD-8209-2022BackgroundDiagnostic accuracy of galactomannan measurements is highly variable depending on the study population, diagnostic procedures, and treatment procedures. We aimed to evaluate the effect of posaconazole prophylaxis and empiric antifungal treatment upon diagnostic accuracy of GM measurements in bronchoalveolar lavage (BAL), bronchial lavage (BL), and serum in hematological malignancy population.MethodsPatients hospitalized in a single tertiary care center with hematologic malignancies undergoing fiberoptic bronchoscopy (FOB) with a preliminary diagnosis of IPA were retrospectively included.ResultsIn all the study population (n = 327), AUC for BAL, BL, and serum GM were as follows: 0.731 [0.666-0.790], 0.869 [0.816-0.912], and 0.610 [0.540-0.676] with BL samples having the best diagnostic value. GM measurements in patients under posaconazole prophylaxis (n = 114) showed similar diagnostic performance. While specificity was similar between patients with and without posaconazole prophylaxis, sensitivity of GM measurements was lower in patients with prophylaxis. Analyses with patient classified according to antifungal treatment at the time of FOB procedure (n = 166) showed a decreased diagnostic accuracy in serum GM and BAL GM measurements related with the duration of treatment. However, BAL, BL, and serum GM measurements presented similar sensitivity and specificity in higher cut-off values in longer durations of antifungal treatment.ConclusionOur study shows that posaconazole prophylaxis and active short-term (3 days) antifungal treatment do not significantly affect overall diagnostic performance of GM measurements in bronchoalveolar lavage and bronchial lavage samples. However, using different cut-off values for patients receiving active treatment might be suggested to increase sensitivity.Publication Impact of revised EORTC/MSGERC 2020 criteria on diagnosis and prognosis of invasive pulmonary aspergillosis in patients with hematological malignancies undergoing bronchoscopy(Masson Editeur, 2022-06-14) Acet-Öztürk, N. A.; Ömer-Topcu, D.; Vurat-Acar, K.; Aydın-Güçlü, O.; Pınar, I. E.; Demirdoğen, E.; Görek-Dilektaşli, A.; Kazak, E.; Özkocaman, V; Ursavaş, A.; Akalın, H.; Özkalemkas, F.; Ener, B.; Ali, R.; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖMER TOPÇU, DİLARA; VURAT ACAR, KÜBRA; AYDIN GÜÇLÜ, ÖZGE; PINAR, İBRAHİM ETHEM; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; ÖZKOCAMAN, VİLDAN; URSAVAŞ, AHMET; AKALIN, EMİN HALİS; ÖZKALEMKAŞ, FAHİR; ENER, BEYZA; ALİ, RIDVAN; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0001-9907-1498; 0000-0002-7380-2501; JII-3270-2023; FRE-8778-2022; GXC-7806-2022; GXD-8045-2022; JGM-6601-2023; JIA-5197-2023; CRM-4095-2022; CZK-6380-2022; JIR-6730-2023; AAI-3169-2021; EJJ-6847-2022; JIW-1248-2023; CNK-0895-2022; GXD-8209-2022Introduction: The first consensus definitions for invasive fungal diseases (IFD) were published in 2002. Advan-ces in diagnostic tests and a clear need for improvement in certain areas led to a revision of these definitions in 2008. However, growing data on Aspergillus galactomannan (GM) thresholds and the introduction of new polymerase chain reaction-based diagnostic tests resulted in a further update by EORTC and Mycoses Study Group Education and Research Consortium (MSGERC) in 2020. Compared to the 2008 version, the 2020 EORTC/MSGERC criteria have stricter definitions, especially regarding GM levels, which should lead to improved specificity. Thus, our study aimed to evaluate diagnostic changes, based on GM levels, resulting from these new definitions and ascertain the impact of the new classification on mortality rates. Method: Patients hospitalized in a single tertiary care center with hematologic malignancies and undergoing bronchoscopy for suspected IPA between April 2004 and December 2019 were included in this retrospective study. Results: The study population consisted of 327 patients with 31 patients (nine patients with proven IPA and 22 patients with no IPA) excluded from the study. 194 patients were classified as probable IPA cases according to 2008 EORTC/MSG criteria. However, 53 (27.3%) of these patients were re-classified as possible IPA according to 2020 EORTC/MSGERC criteria, due to novel galactomannan cut-off levels. Compared to re-classified possible IPA patients, those remaining in the probable IPA category experienced a higher incidence of septic shock (34.0% vs 16.9%, p=0.02), and required more non-invasive (12.0% vs 0.0%, p=0.004) and invasive (44.6 vs 24.5%, p=0.01) mechanical ventilation. There was a higher in-hospital mortality rate in probable IPA patients than in the re-clas-sified possible IPA group (42.5% vs 22.6%, p=0.01). Patients reassigned to possible IPA had similar underlying dis-eases, radiological features and prognosis to patients already classified as possible IPA. Independent risk factors for mortality were classification as probable IPA according to 2020 EORTC/MSGERC criteria, lack of remission from hematologic malignancy, and number of nodules in Thorax CT. Conclusion: The use of 2020 EORTC/MSGERC criteria resulted in a 27.3% significant reduction in probable IPA diagnoses and created a more homogeneous category of patients with respect to treatment response, prog-nosis and mortality. Therefore, 2020 EORTC/MSGERC criteria afford more reliable mortality prediction than 2008 EORTC/MSG criteria.(c) 2022 SFMM. Published by Elsevier Masson SAS. All rights reserved.Publication Impact of the revised EORTC/MSGERC 2020 criteria upon prognosis in patients with hematologic malignancies undergoing bronchoscopy(European Respiratory Soc Journals, 2021-09-05) Topcu, Dilara Omer; Acer, Kubra Vurat; Guclu, Ozge Aydin; Pinar, Ibrahim Ethem; Demirdogen, Ezgi; Dilektasli, Asli Gorek; Kazak, Esra; Ozkocaman, Vildan; Ursavas, Ahmet; Akalin, Halis; Ozkalemtas, Fahir; Ener, Beyza; Ali, Ridvan; Ozturk, Nilufer Aylin Acet; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖMER TOPÇU, DİLARA; VURAT ACAR, KÜBRA; AYDIN GÜÇLÜ, ÖZGE; PINAR, İBRAHİM ETHEM; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; ÖZKOCAMAN, VİLDAN; URSAVAŞ, AHMET; AKALIN, EMİN HALİS; Ozkalemtas, Fahir; ENER, BEYZA; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0002-6375-1472; 0000-0003-1005-3205; 0000-0002-7400-9089; 0000-0001-7530-1279; 0000-0002-6375-1472; 0000-0003-1005-3205; 0000-0002-4803-8206; JGM-6601-2023; KHE-5423-2024; AAU-8952-2020; JPK-7012-2023; JWP-2738-2024; AAI-3169-2021; Z-1424-2019; JIF-7772-2023; CBS-8892-2022; AAG-9930-2019; CNP-1063-2022; AAG-8459-2021; FQG-8981-2022; FQJ-3657-2022; AAG-8523-2021; GXD-8209-2022Publication Invasive fusariosis in patients with hematologic malignancies at a university hospital(Amer Soc Hematology, 2015-12-03) Özkocaman, Vildan; Özkalemkaş, Fahir; Cilo, Burcu Dalyan; Alp, Tuğcan; Ersal, Tuba; Gözden, Erdem; Yeğen, Zafer Serenli; Rıdvan, Ali; Ener, Beyza; ÖZKOCAMAN, VİLDAN; ÖZKALEMKAŞ, FAHİR; Cilo, Burcu Dalyan; Alp, Tuğcan; ERSAL, TUBA; Gözden, Erdem; Yeğen, Zafer Serenli; ALİ, RIDVAN; ENER, BEYZA; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0002-1361-6213; 0000-0002-4803-8206; AAJ-4354-2021; AAG-8523-2021; AAI-5246-2020; AAG-8495-2021; IVV-5845-2023; AAH-1854-2021; HMD-4249-2023; EWL-5375-2022; EFO-5712-2022; DMU-2091-2022Publication Invasive pulmonary aspergillosis in acute leukemia: Current issues for pathogenesis, diagnosis and treatment(Bentham Science, 2006-01-01) Ali, Rıdvan; Özçelik, Tülay; ALİ, RIDVAN; Özçelik, Tülay; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Bölümü; GXD-8209-2022; JGT-3036-2023Invasive pulmonary aspergillosis (IPA) is a frequently life-threatening fungal infection that complicates acute leukemia patients following conventional chemotherapy and bone marrow transplantation. The mortality rate reaches 50% in leukemic patients during chemotherapy-induced neutropenia and can exceed 90% in bone marrow transplantation patients. Despite advances in antimicrobial therapy and supportive care, IPA remains a major clinical problem in patients with acute leukemia. Current issues for IPA in adults are reviewed.Publication Nilotinib results in improved rates of molecular response in Turkish newly diagnosed CML-CP patients: A 24-month update(Ferrata Storti Foundation, 2015-06-01) Saydam, G.; Haznedaroğlu, I. C.; Kaynar, L.; Yavuz, A. S.; Ali, Rıdvan; Güvenç, B.; Akay, O. M.; Başlar, Z.; Özbek, U.; Sönmez, M.; Aydın, D.; Pehlivan, M.; Undar, B.; Dağdaş, S.; Ayyıldız, O. M.; Uar, B.; Dağ, I. M.; İlhan, O.; ALİ, RIDVAN; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı; GXD-8209-2022Publication Pain, anxiety, and depression during bone marrow aspiration and biopsy(Kare Publ, 2017-10-01) Yuvalı Karacan, Yasemin; Demircioğlu, Burçin; Ali, Rıdvan; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; 0000-0001-8616-4935; GQR-0671-2022Objectives: This study is performed with the aim of prospectively analyzing the factors that affect pain, anxiety, and depression in cases for whom bone marrow aspiration and biopsy are performed and the relationships among them.Methods: This study consisted of 90 patients who consulted to Department of Hematology, Faculty of Medicine, Uludag University, and followed-up for bone marrow aspiration and biopsy indication. The data was gathered using a personal information form, Hospital Anxiety Depression scale, and Wong-Baker face pain scale where generally face expressions exist.Results: The average age of the patients who participated in the study was 50.90 years (16.59), and the pain level after the application was 1.98 (1.33). After the application, a positive relationship is determined between the pain level and anxiety (r=-0.79; p=0.02), whereas this has a negative relationship with age (r=0.78; p=0.03).Conclusion: As a result, pain develops depending on bone marrow aspiration and biopsy; therefore, taking precautions aimed at alleviating pain and evaluation of pain before and after the application within the scope of total maintenance have been suggested.Publication Patterns of hydroxyurea prescription and use in routine clinical management of polycythemia vera: A multicenter chart review study(Galenos Yayincilik, 2020-01-01) Büyükaşık, Yahya; Turgut, Mehmet; Saydam, Güray; Yavuz, Selim; Ünal, Ali; Ar, Muhlis Cem; Ayyıldız, Orhan; Altuntaş, Fevzi; Okay, Mufide; Çiftçiler, Rafiye; Meletli, Özgür; Soyer, Nur; Mastanzade, Metban; Güven, Zeynep; Soysal, Teoman; Karakuş, Abdullah; Yiğenoğlu, Tuğce Nur; Uçar, Barış; Gökçen, Ece; Tuğlular, Tülin; Ali, Rıdvan; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; GXD-8209-2022Objective: This study aimed to evaluate real-life data on patterns of hydroxyurea prescription/use in polycythemia vera (PV).Materials and Methods: This retrospective chart review study included PV patients who had received hydroxyurea therapy for at least 2 months after PV diagnosis. Data were collected from 10 representative academic medical centers.Results: Of 657 patients, 50.9% were in the high-risk group (age 60 years and/or history of thromboembolic event). The median duration of hydroxyurea therapy was 43.40 months for all patients; 70.2% of the patients had ongoing hydroxyurea therapy at last followup. Hydroxyurea was discontinued in 22.4% of the patients; the most common reason was death (38.5%). The predicted time until hydroxyurea discontinuation was 187.8 months (standard error: +/- 21.7) for all patients. This duration was shorter in females (140.3 +/- 37.7 vs. 187.8 +/- 29.7) (p=0.08). This trend was also observed in surviving patients aged >= 50 years at hydroxyurea initiation (122.2 +/- 12.4 vs. 187.8 +/- 30.7, p=0.03). Among the patients who were still on hydroxyurea therapy, 40.3% had a hematocrit concentration of >= 45% at their last followup visit, and the rate of patients with at least one elevated blood cell count was 67.8%.Conclusion: Hydroxyurea prescription patterns and treatment aims are frequently not in accordance with the guideline recommendations. Its discontinuation rate is higher in females.Publication Post-authorization safety of lenalidomide plus dexamethasone in patients with relapsed/refractory multiple myeloma: Early safety report of Turkish pass study(Ferrata Storti Foundation, 2015-06-01) Tuğlular, A. T. Fıratlı; Pehlivan, M.; Sarı, H. I.; Ayyıldız, M. O.; Saydam, G.; Sönmez, M.; Besisik, S. Kalayoğlu; Özgür, G.; Gürkan, E.; Kaynar, L.; Özet, G.; Demirkan, F.; Öngören, S.; Özdoğu, H.; Gündüz, E.; Tiftik, E. N.; Salim, O.; Turgut, M.; Hacıhanefioğlu, A.; Üre, U. B.; Özdemir, E.; Altuntas, F.; Şimsek, D.; Ulu, N.; Beksaç M.; Ali, R.; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp FakültesiPublication Potential modifications of the plasmic scoring system for predicting thrombotic thrombocytopenic purpura: Sometimes, less is more(Wiley, 2023-05-27) Orhan, Bedrettin; Özkocaman, Vildan; Akdemir, Çiğdem; Ersal, Tuba; Pınar, İbrahim Ethem; Yalçın, Cumali; Çandar, Ömer; Çubukcu, Sinem; Koca, Tuba Güllü; Ambarcıoğlu, Pınar; Ali, Rıdvan; Özkalemkaş, Fahir; ORHAN, BEDRETTİN; ÖZKOCAMAN, VİLDAN; AKDEMİR, ÇİĞDEM; PINAR, İBRAHİM ETHEM; YALÇIN, CUMALİ; CANDAR, ÖMER; ÇUBUKÇU, SİNEM; GÜLLÜ KOCA, TÛBA; ALİ, RIDVAN; ÖZKALEMKAŞ, FAHİR; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı/Dahiliye Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0003-4168-2821; 0000-0003-3970-2344; 0000-0001-9907-1498; 0000-0001-7602-6926; ACW-2157-2022; JWP-2738-2024; KHE-5423-2024; KIE-5102-2024; JGM-6601-2023; JJP-2815-2023; EJN-7496-2022; AAJ-4354-2021; EOZ-1609-2022; JJB-0254-2023; GWQ-5007-2022; GXD-8209-2022; JJW-7463-2023IntroductionThrombotic thrombocytopenic purpura (TTP) is a life-threatening occlusive disease of the microcirculation characterized by systemic platelet plugs, organ ischemia, deep thrombocytopenia, and fragmentation of erythrocytes. One of the widely used scoring system to determine the clinical probability of TTP is the PLASMIC scoring system. This study aimed to evaluate the contribution of PLASMIC score modifications to sensitivity and specificity in patients with microangiopathic hemolytic anemia (MAHA) undergoing plasma exchange with a prediagnosis of TTP at our center.Materials and MethodsThe data of patients who were hospitalized with a previous diagnosis of MAHA and TTP and underwent plasma exchange at Bursa Uludag University, Faculty of Medicine, Department of Hematology between January 2000 and January 2022 were retrospectively analyzed.ResultsOverall, 33 patients (including 15 and 18 with and without TTP, respectively) were included in this study. Receiver operating characteristic (ROC) analysis revealed that the area under the curve (AUC) for the original PLASMIC score was 0.985 (95% confidence interval [95% CI]: 0.955-1.000), and AUC for the PLASMIC score without mean corpuscular volume (MCV) was 0.967 (95% CI: 0.910-1.000), which is close to the original AUC. With the removal of MCV from the scoring system, the sensitivity decreased from 100% to 93%, whereas the specificity increased from 33% to 78%.ConclusionsBased on the results of this validation study, removing MCV from the PLASMIC score led to the categorization of eight non-TTP cases in the low-risk category, and this could avoid unnecessary plasma exchange. However, in our study increasing the specificity was at the expense of the sensitivity by missing one patient with this new scoring system without MCV. Further multicenter studies with large sample sizes are required owing to the fact that different parameters may be effective in TTP prediction among different populations.Publication Qualitative and quantitative evaluation of the BCR-ABL fusion gene in chronic Myelogenous Leukemia by flourescence in situ hybridization and molecular genetic methods(Mary Ann Liebert, 2015-10-01) Sağ, Şebnem Özemri; Yakut, Tahsin; Görükmez, Özlem; Görükmez, Orhan; Türe, Mehmet; Karkucak, Mutlu; Gülten, Tuna; Ali, Rıdvan; ÖZEMRİ SAĞ, ŞEBNEM; Yakut, Tahsin; Türe, Mehmet; Gülten, Tuna; ALİ, RIDVAN; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Bilim Dalı.; AAH-8355-2021; GIS-1493-2022; ECY-8582-2022; EYU-9227-2022; GXD-8209-2022Aims: Fluorescence in situ hybridization (FISH) and quantitative real-time polymerase chain reaction (QRT-PCR) were used to diagnose or screen for minimal residual disease (MRD) in Philadelphia (Ph) chromosome-positive leukemia. We compared the diagnostic utility of FISH and QRT-PCR at various time points in the course of chronic myelogenous leukemia (CML) and to determine the mean initial values for patients whose QRT-PCR results were not known at the time of diagnosis. Results: We analyzed 135 results for 78 CML patients tested by FISH and QRT-PCR for the Ph chromosomal translocation. All newly diagnosed cases were positive by both methods. On follow-up following treatment, 1 case was FISH positive and QRT-PCR negative; 61 cases were FISH negative and QRT-PCR positive. Overall concordance was 54.1%. There was good concordance between QRT-PCR results and cytogenetic response categories. Conclusions: We confirmed that QRT-PCR allows precise measurement of low levels of BCR-ABL transcripts and can serve as a sensitive indicator of MRD. We also demonstrated 100% correlation between QRT-PCR and FISH in newly diagnosed CML.Publication Results of allogeneic stem cell transplantation in bone marrow failures: A single-center experience(Springernature, 2022-11-01) ERSAL, TUBA; ÖZKOCAMAN, VİLDAN; ÖZKALEMKAŞ, FAHİR; PINAR, İBRAHİM ETHEM; ORHAN, BEDRETTİN; CANDAR, ÖMER; ALİ, RIDVAN; Yalçın, Cihan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0001-9907-1498; 0000-0002-0510-2992; ACW-2157-2022; JGM-6601-2023; JWP-2738-2024Publication Study for the diagnostic screening of paroxysmal nocturnal hemoglobinuria in older patients with unexplained anemia and/or cytopenia(Clin Lab Publ, 2020-01-01) Ozdemir, Zehra N.; Ilhan, Osman; Özet, Gülsüm; Falay, Mesude; Yenerel, Mustafa; Tuğlular, Tulin; Turgut, Mehmet; Güvenç, Birol; Unal, Ali; Ayyıldız, Orhan; Andıç, Neslihan; Hacihanefioğlu, Abdullah; Şahin, Fahri; Şencan, Mehmet; Özsan, Güner H.; Yıldırım, Rahşan; Tiftik, Eyüp N.; Tombak, Anil; Salim, Ozan; Kaya, Emin; Akay, Olga M.; Okan, Vahap; Pehlivan, Mustafa; Saydam, Güray; Ali, Ridvan; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; GXD-8209-2022Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disease that may lead to weakness and death of patients, if unrecognized and untreated. Although consensus guidelines were reviewed recently for the diagnostic screening of PNH with multi-parameter flow cytometry (FCM), until now, no study has investigated the efficiency of such clinical indications in older patients.Methods: Overall, 20 centers participated in the study and a total of 1,689 patients were included, 313 of whom were at geriatric age and 1,376 were aged 18 - 64 years. We evaluated the efficiency of consensus clinical indications for PNH testing using FCM in peripheral blood samples and compared the results of older patients and patients aged 18 - 64 years.Results: PNH clones were detected positive in 7/313 (2.2%) of the older patients. Five (74.4%) of the patients with PNH clones had aplastic anemia, 1 had unexplained cytopenia, and 1 patient had myelodysplastic syndrome (MDS) with refractory anemia. PNH clones were not detected in any older patients who were screened for unexplained thrombosis, Coombs (-) hemolytic anemia, hemoglobinuria, and others (e.g., elevated lactate dehydrogenase (LDH), splenomegaly). We detected PNH clones in 55/1376 (4%) samples of the patients aged under 65 years. Forty-two (76.4%) patients with PNH clones had aplastic anemia, 2 patients had Coombs (-) hemolytic anemia, 3 patients had unexplained cytopenia, 1 patient had MDS with refractory anemia, 1 patient had hemoglobinuria, and 6 (10.9%) had others (e.g., elevated LDH, splenomegaly). PNH clones were not detected in any patients who were screened for unexplained thrombosis. There was no statistical difference between the geriatric population and patients aged 18 - 64 years in terms of clinical indications for PNH screening with FCM (p = 0.49).Conclusions: Our results showed that the current clinical indications for PNH screening with FCM were also efficient in older patients. We suggest that older patients with unexplained anemia, myelodysplastic syndrome with refractory anemia, and unexplained cytopenia should be screened for PNH with FCM to identify patients who would benefit from treatment.