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ALİ, RIDVAN

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    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; Tıp Fakültesi; Hematoloji Ana Bilim Dalı; 0000-0001-8616-4935; 0000-0003-4241-5231; AAI-7132-2021; AAK-5246-2021; GQR-0671-2022; ESW-7456-2022; GXD-8209-2022
    Objective: 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.
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    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; Tıp Fakültesi; Dahiliye Bölümü; GXD-8209-2022; JGT-3036-2023
    Invasive 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.
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    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; 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-8182-2021
    Paroxysmal 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.
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    Systemic inflammatory indices for predicting prognosis of myelofibrosis
    (Nature Portfolio, 2023-08-02) Ersal, Tuba; Özkocaman, Vildan; Pınar, İbrahim Ethem; Yalçın, Cumali; Orhan, Bedrettin; Candar, Ömer; Çubukcu, Sinem; Koca, Tuba Güllü; Hunutlu, Fazıl Çağrı; Yavuz, Şeyma; Ali, Ridvan; Özkalemkaş, Fahir; ERSAL, TUBA; ÖZKOCAMAN, VİLDAN; PINAR, İBRAHİM ETHEM; YALÇIN, CUMALİ; ORHAN, BEDRETTİN; CANDAR, ÖMER; ÇUBUKÇU, SİNEM; GÜLLÜ KOCA, TÛBA; HUNUTLU, FAZIL ÇAĞRI; YAVUZ, ŞEYMA; ALİ, RIDVAN; ÖZKALEMKAŞ, FAHİR; Tıp Fakültesi; İç Hastalıkları Ana Bilim Dalı; Hematoloji Bilim Dalı; 0000-0001-9907-1498; 0000-0003-4168-2821; 0000-0003-3970-2344; 0000-0002-4991-9830; AAJ-4354-2021; FQG-8981-2022; JGM-6601-2023; KIE-5102-2024; ACW-2157-2022; EOZ-1609-2022; JJB-0254-2023; GWQ-5007-2022; KCK-7512-2024; GXS-5860-2022; GXD-8209-2022; JIW-1248-2023
    The impact of inflammatory markers such as systemic immune-inflammation (SII) index and systemic inflammation response index (SIRI) on myelofibrosis (MF) prognosis was evaluated for the first time in this study. Data from 60 patients diagnosed with MF between March 2011 and September 2022 were retrospectively analyzed. In addition to disease-related markers, the impact of SII and SIRI on prognosis was evaluated. In our study, the overall median survival (OS) was 64 months. OS was significantly shorter in patients older than 65 years, with high ferritin and lymphocyte levels, transfusion dependence at diagnosis, platelet count below 100 x 10(9)/L, Hb level below 8 g/dl, and high risk according to the dynamic international prognostic scoring system (DIPSS)-Plus score. When these variables were included in the multivariate Cox regression model, it was found that being older than 65 years, having a high ferritin value, being at high risk according to the DIPSS-plus score and Hb values below 8 increased the risk of death. Platelet-to-lymphocyte ratio (PLR) and SII index were lower in patients with a fatal outcome. No statistically significant relationship was found between SIRI and mortality. The findings of this study showed that low PLR and high ferritin were associated with poor prognosis in MF. Elevated SII and SIRI, evaluated for the first time in patients with myelofibrosis, did not predict prognosis. Since non-inflammatory variables play a role in the pathogenesis of MF, bone marrow indicators and systemic inflammation indicators derived from hematologic parameters may not be accurate.
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    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; Tıp Fakültesi; Hematoloji Ana Bilim Dalı; GXD-8209-2022
    Objective: 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.
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    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; 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-8209-2022
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    Outcomes with frontline nilotinib treatment in Turkish patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase (Retraction of vol 17, pg 1851, 2016)
    (Taylor, 2018-10-21) Saydam, Güray; Haznedaroğlu, İbrahim C.; Kaynar, Leylagül; Yavuz, Akif S.; Ali, Rıdvan; Güvenç, Birol; Akay, Olga M.; Başlar, Zafer; Özbek, Uğur; Sönmez, Mehmet; Aydın, Demet; Pehlivan, Mustafa; Undar, Bülent; Dağdaş, Simten; Ayyıldız, Orhan; Akkaynak, Diyar Z.; Akın, Gülnur; İlhan, Osman; ALİ, RIDVAN; Tıp Fakültesi; Dahiliye Kliniği; GXD-8209-2022
    Objectives: Nilotinib is a BCR-ABL1 tyrosine kinase inhibitor approved for the treatment of patients with chronic myeloid leukemia in chronic phase (CML-CP). This study was the first prospective evaluation of the efficacy and safety of nilotinib in Turkish patients with newly diagnosed CML-CP. The primary endpoint of the study was the rate of major molecular response (MMR; BCR-ABL1 <= 0.1% on the International Scale [BCR-ABL1(IS)]) by 12 months.Methods: Patients with newly diagnosed CML-CP were treated with nilotinib 300 mg twice daily. This analysis was based on the first 12 months of follow-up in a 24-month study. This study is registered with ClinicalTrials.gov (NCT01274351).Results: Of 112 patients enrolled, 66.1% (80% CI, 59.7-72.0%) achieved MMR and 22.3% achieved a deep molecular response of MR4.5 (BCR-ABL1(IS) <= 0.0032%) by 12 months. During the first year of treatment, one patient progressed to blast crisis and two patients died. Safety results were consistent with previous studies. Most adverse events (AEs) were grade 1/2. Most frequently reported nonhematologic AEs of any grade were elevations in bilirubin, alanine aminotransferase, and triglycerides.Conclusion: These results support the use of nilotinib 300 mg twice daily as a standard-of-care treatment option for patients with newly diagnosed CML-CP with low and intermediate risk.
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    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; Tıp Fakültesi; Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim 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-5894-2022
    Introduction: 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.
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    The evaluation of risk factors leading to early deaths in patients with acute promyelocytic leukemia: A retrospective study
    (Springer, 2022-02-21) Baysal, Mehmet; Gürsoy, Vildan; Hunutlu, Fazıl Çağrı; Erkan, Buket; Demirci, Ufuk; Baş, Volkan; Gülsaran, Sedanur Karaman; Pınar, İbrahim Ethem; Ersal, Tuba; Kırkızlar, Tuğcan Alp; Atlı, Emine Ikbal; Kırkızlar, Hakkı Onur; Ümit, Elif G.; Gürkan, Hakan; Özkocaman, Vildan; Özkalemkaş, Fahir; Demir, Ahmet Muzaffer; Ali, Rıdvan; GÜRSOY, VİLDAN; HUNUTLU, FAZIL ÇAĞRI; ERKAN ÖZMARASALI, BUKET; PINAR, İBRAHİM ETHEM; ERSAL, TUBA; ÖZKOCAMAN, VİLDAN; ÖZKALEMKAŞ, FAHİR; ALİ, RIDVAN; Tıp Fakültesi; İç Hastalıkları Ana Bilim Dalı; Hematoloji Bilim Dalı; 0000-0001-9907-1498 ; 0000-0002-4991-9830 ; CTT-7336-2022; KCK-7512-2024; CPN-8681-2022; JGM-6601-2023; AAJ-4354-2021; JIR-6730-2023; DLR-8474-2022; GXD-8209-2022
    Acute promyelocytic leukemia (APL) differs from other forms of acute myeloid leukemia (AML), including coagulopathy, hemorrhage, disseminated intravascular coagulation (DIC), and treatment success with all-trans retinoic acid (ATRA). Despite ATRA, early deaths (ED) are still common in APL. Here, we evaluated factors associated with ED and applicability of scoring systems used to diagnose DIC. Ninety-one APL patients (55 females, 36 males, and median age 40 years) were included. ED was defined as deaths attributable to any cause between day of diagnosis and following 30th day. DIC was assessed based on DIC scoring system released by the International Society of Thrombosis and Hemostasis (ISTH) and Chinese Diagnostic Scoring System (CDSS). Patients' median follow-up time was 49.2 months, and ED developed in 14 (15.4% of) cases. Patients succumbing to ED had higher levels of the Eastern Cooperative Oncology Group Performance Status (ECOG PS), lactate dehydrogenase (LDH), and ISTH DIC, and lower fibrinogen levels (p <0.05). In multivariate Cox regression analysis, age >55 and ECOG PS >= 2 rates were revealed to be associated with ED. Based on ISTH and CDSS scores, DIC was reported in 47.3 and 58.2% of the patients, respectively. Despite advances in APL, ED is still a major obstacle. Besides the prompt recognition and correction of coagulopathy, those at high ED risk are recommended to be detected rapidly. Implementation of local treatment plans and creating awareness should be achieved in hematological centers. Common utilization of ATRA and arsenic trioxide (ATO) may be beneficial to overcome ED and coagulopathy in APL patients.
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    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; Tıp Fakültesi; Hematoloji Ana Bilim Dalı; GXD-8209-2022
    Background: 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.