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Öğe A single center experience with allogeneic hematopoietic stem cell transplantation for acquired severe aplastic anaemia in childhood(Nature Publishing Group, 2014) Eker, Nurşah; Tayfun, Funda; Yaşar, Ansar-Ul-Haque; Hoş, P.; Doğru, Ömer; Hazar, Volkan; Güler, Elif; Yeşilipek, Mehmet Akif; Küpesiz, Osman Alphan[Abstract Not Available]Öğe COVID-19 disease in children and adolescents following allogeneic hematopoietic stem cell transplantation: A report from the Turkish pediatric bone marrow transplantation study group(2024) Bozkurt, Ceyhun; Hazar, Volkan; Malbora, Barış; Küpesiz, Alphan; Aygüneş, Utku; Fışgın, Tunç; Karakükçü, Musa; Kuşkonmaz, Barış; Çakı Kılıç, Suar; Bayırlı, Derya; Arman Bilir, Özlem; Yalçın, Koray; Gözmen, Salih; Uygun, Vedat; Elli, Murat; Sarbay, Hakan; Küpesiz, Funda Tayfun; Şaşmaz, Hatice İlgen; Adaklı Aksoy, Başak; Yılmaz, Ebru; Okur, Fatma Visal; Tekkeşin, Funda; Demir Yenigürbüz, Fatma; Özek, Gülcihan; Atay, Abdullah Avni; Ok Bozkaya, İkbal; Çelen, Suna; Öztürkmen, Seda; Güneş, Adalet Meral; Gürsel, Orhan; Güler, Elif; Özcan, Alper; Uçkan Çetinkaya, Duygu; Aydoğdu, Selime; Özbek, Namık Yaşar; Karasu, Gülsün; Sezgin, Gülay; Doğru, Ömer; Albayrak, Davut; Öztürk, Gülyüz; Aksoylar, Serap; Daloğlu, Hayriye; Odaman Al, Işık; Sezgin Evim, Melike; Akbayram, Sinan; Öncül, Yurday; Zengin, Emine; Albayrak, Canan; Timur, Çetin; Düzenli Kar, Yeter; Çakmaklı, Hasan Fatih; Tüfekçi, Özlem; Töret, Ersin; Antmen, BülentBackground: Data on the risk factors and outcomes for pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited. Objectives: The study aimed to analyze the clinical signs, risk factors, and outcomes for ICU admission and mortality in a large pediatric cohort who underwent allogeneic HSCT prior to COVID-19 infection. Method: In this nationwide study, we retrospectively reviewed the data of 184 pediatric HSCT recipients who had COVID-19 between March 2020 and August 2022. Results: The median time from HSCT to COVID-19 infection was 209.0 days (IQR, 111.7–340.8; range, 0–3845 days). The most common clinical manifestation was fever (58.7%). While most patients (78.8%) had asymptomatic/mild disease, the disease severity was moderate in 9.2% and severe and critical in 4.4% and 7.6%, respectively. The overall mortality was 10.9% (n: 20). Deaths were attributable to COVID-19 in nine (4.9%) patients. Multivariate analysis revealed that lower respiratory tract disease (LRTD) (OR, 23.20, p:.001) and lymphopenia at diagnosis (OR, 5.21, p:.006) were risk factors for ICU admission and that HSCT from a mismatched donor (OR, 54.04, p:.028), multisystem inflammatory syndrome in children (MIS-C) (OR, 31.07, p:.003), and LRTD (OR, 10.11, p:.035) were associated with a higher risk for COVID-19-related mortality. Conclusion: While COVID-19 is mostly asymptomatic or mild in pediatric transplant recipients, it can cause ICU admission in those with LRTD or lymphopenia at diagnosis and may be more fatal in those who are transplanted from a mismatched donor and those who develop MIS-C or LRTD.Öğe Cross-sectional analysis of health-related quality of life in survivors of childhood cancer: A study from Turkey(Wiley-Blackwell, 2014) Hazar, Volkan; Erol, Alkım; Velipaşaoğlu Güney, Sevtap[Abstract Not Available]Öğe Different kinetics and risk factors for isolated extramedullary relapse after allogeneic hematopoietic stem cell transplantation in children with acute leukemia(Elsevier Science Inc., 2021) Hazar, Volkan; Öztürk, Gülyüz; Yalçın, Koray; Uygun, Vedat; Aksoylar, Serap; Küpesiz, Alphan; Ok Bozkaya, İkbal; Karagün, Barbaros Şahin; Bozkurt, Ceyhun; İleri, Talia; Atay, Didem; Koçak, Ülker; Tezcan Karasu, Gülsün; Yeşilipek, Akif; Gökçe, Müge; Kansoy, Savaş; Tüysüz Kintrup, Gülen; Karakükcü, Musa; Okur, Fatma Visal; Ertem, Mehmet; Kaya, Zühre; Gürsel, Orhan; Yaman, Yöntem; Özbek, Namık; Antmen, Bülent; Tüfekçi, Özlem; Albayrak, Canan; Adaklı Aksoy, Başak; Sezgin, Gülay; Albayrak, Davut; Sezgin Evim, Melike; Zengin, Emine; Pekpak, EsraRelapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the most frequent cause of post-transplantation mortality. Isolated extramedullary (EM) relapse (iEMR) after HSCT is relatively rare and not well characterized, particularly in pediatric patients. We retrospectively analyzed 1527 consecutive pediatric patients with acute leukemia after allo-HSCT to study the incidence, risk factors, and outcome of iEMR compared with systemic relapse. The 5 -year cumulative incidence of systemic relapse (either bone marrow [BM] only or BM combined with EMR) was 24.8%, and that of iEMR was 5.5%. The onset of relapse after allo-HSCT was significantly longer in EM sites than in BM sites (7.19 and 5.58 months, respectively; P =.013). Complete response (CR) 2 +/active disease at transplantation (hazard ratio [HR], 3.1; P <.001) and prior EM disease (HR, 2.3; P =.007) were independent risk factors for iEMR. Chronic graft-versus-host disease reduced the risk of systemic relapse (HR, 0.5; P=.043) but did not protect against iEMR. The prognosis of patients who developed iEMR remained poor but was slightly better than that of patients who developed systemic relapse (3 -year overall survival, 16.5% versus 15.3%; P =.089). Patients experiencing their first systemic relapse continued to have further systemic relapse, but only a minority progressed to iEMR, whereas those experiencing their iEMR at first relapse developed further systemic relapse and iEMR at approximately similar frequencies. A second iEMR was more common after a first iEMR than after a first systemic relapse (58.8% versus 13.0%; P =.001) and was associated with poor outcome. iEMR has a poor prognosis, particularly after a second relapse, and effective strategies are needed to improve outcomes.Öğe Durable remissions in TCF3-HLF positive acute lymphoblastic leukemia with blinatumomab and stem cell transplantation(Ferrata Storti Foundaition, 2019) Mouttet, Brice; Vinti, Luciana; Ancliff, Philip; Bodmer, Nicole; Brethon, Benoit; Cario, Gunnar; Chen-Santel, Christiane; Elitzur, Sarah; Hazar, Volkan; Kunz, Joachim; Moericke, Anja; Stein, Jerry; Vora, Ajay; Yaman, Yöntem; Schrappe, Martin; Anak, Sema; Baruchel, Andre; Locatelli, Franco; von Stackelberg, Arend; Stanulla, Martin; Bourquin, Jean-PierreTCF3-HLF-positive leukemia represents a rare subtypeof childhood acute lymphoblastic leukemia (ALL), characterized by a high rate of treatment failure despite treatment intensification and allogeneic stem cell transplantation (SCT). Given the high and homogeneous expressionof CD19 on blast cells of this leukemia subtype, thesepatients may benefit from CD19-directed immunotherapy. Here, we report the experience on nineTCF3-HLF-positive ALL patients, most of whom weretreated early in first consolidation with blinatumomab asa bridge to SCT between 2015 and 2018. Treatment withblinatumomab was generally well tolerated; reversibleneurotoxicity was observed in two patients. All ninepatients achieved molecular remission after blinatumomab treatment; seven underwent SCT and for onepatient SCT is planned. Median follow up after start ofblinatumomab treatment was 342 days, and four patientsremain in molecular remission after a follow up of 1317,1292, 1245, and 342 days, respectively. Three patientsdied because of infectious complications not directlyrelated to blinatumomab, because they occurred eitherafter SCT or after emergence of a CD19-negativeleukemia clone. In the light of these encouraging observations, CD19-directed immunotherapy should be considered early after induction chemotherapy inTCF3-HLF-positive ALL children and patients’ outcomemonitored systematically by study groups.Öğe Effect of central nervous system complications and radiologic findings on patients' survival after hematopoietic stem cell transplantation(Nature Publishing Group, 2015) Eker, Nurşah; Karaali, Kamil; Tayfun, Funda; Küpesiz, Alphan; Tezcan, Gülsün; Uygun, Vedat; Akcan, Mediha; Güler, Elif; Hazar, Volkan; Yeşilipek, Akif[Abstract Not Available]Öğe Evaluation of risk factors and outcomes of invasive fungal infections in the first six months after allogeneic hematopoietic stem cell transplantation in pediatric acute leukemia: A Turkish multicenter study(Nature Publishing Group, 2015) Hazar, Volkan; Karasu, Gülsün; Öztürk, Gülyüz; Çakı Kılıç, Suar; Uygun, Vedat; Karakükçü, Musa; Özbek, Namık Yaşar; Gürsel, Orhan; Atay, Didem; Küpesiz, Alphan; Aksoylar, Serap; Özyürek, Emel; Koçak, Ülker; Daloğlu, Hayriye; Ünal, Emel; Yılmaz, S.; Ünal, Ekrem; Eker, İbrahim; Tunç, B.; Erbey, Fatih; Eker, Nurşah; Kansoy, Savaş; Fışgın, Tunç; Kaya, Zühre; Ören, Hale; Sezgin, Gülay; Ertem, Mehmet; Kürekçi, Emin; Tanyeli, Atila; Ünal, Emine İlknur; Yeşilipek, Akif[Abstract Not Available]Öğe Extracorporeal photopheresis did not prevent the development of an autoimmune disease: myasthenia gravis(Wiley-Blackwell, 2016) Uygun, Vedat; Daloğlu, Hayriye; Irmak Öztürkmen, Seda; Döşemeci, Levent; Karasu, Gülsün; Hazar, Volkan; Yeşilipek, AkifBACKGROUNDMyasthenia gravis (MG) is a neuromuscular disorder characterized by an autoimmune defect in the neuromuscular junction. In most patients, the autoimmune attack is mediated by antibodies against the acetylcholine receptor (AChR) on the postsynaptic membrane. Deficient immunoregulation, including regulatory T cells, is consistently observed. Extracorporeal photopheresis (ECP) leads to the induction of regulatory T cells that mediate immunologic tolerance in autoimmune diseases; however, the data regarding MG are very limited. CASE REPORTHere, we report a patient who, during ongoing ECP therapy for his severe, refractory, chronic graft-versus-host disease (cGVHD), developed MG, although he responded very well to ECP, as indicated by the lowering of his chronic cGVHD severity grade to moderate. RESULTSDespite receiving ECP, our patient developed MG, which was resistant to treatment and required intensive care unit support. CONCLUSIONSClose surveillance is required when ECP is planned as one of the treatment alternatives in myasthenia gravis that develop in cGVHD.Öğe Extracorporeal photopheresis in steroid refractory pediatric gvhd patients: A single center experience(Nature Publishing Group, 2015) Uygun, Vedat; Karasu, Gülsün; Daloğlu, Hayriye; Dinçer Toker, Zeynep; Bozkurt, Kerem; Hazar, Volkan; Yeşilipek, Akif[Abstract Not Available]Öğe Hematopoietic stem cell transplantation for hemophagocytic lymphohistiocytosis: A single center experience(Nature Publishing Group, 2015) Yalçın, Koray; Küpesiz, A.; Tayfun, Funda; Eker, N.; Uygun, Vedat; Akcan, Mediha; Karasu, Gülsun; Hazar, Volkan; Yeşilipek, Mehmet Akif[Abstract Not Available]Öğe Hematopoietic stem cell transplantation in refractory or recurrent lymphomas of children and adolescents: a multicenter survey of Turkish pediatric BTM study group(Nature Publishing Group, 2014) Hazar, Volkan; Kesik, Vural; Aksoylar, Serap; Küpesiz, Osman Alphan; Kartal Öztürk, Gökçen; Ataş, Erman; Karakükçü, Musa; Karasu, Gülsün; Kansoy, Savaş; Yeşilipek, Akif; Erbey, Fatih; Anak, Sema; Uygun, Vedat; Ünal, Ekrem; Yılmaz, S.; Tanyeli, Atila; Elli, Mauro; Atay, Didem; Taçyıldız, Nurdan; Kaya, Zühre; Kurucu, Nilgün; Ünal, Emel; Koçak, Ülker[Abstract Not Available]Öğe Hematopoietic stem cell transplantation in relapsed or refractory extracranial primitive neuroectodermal tumor of children and adolescents: A multicenter survey study(Wiley-Blackwell, 2015) Hazar, Volkan; Karakükçü, Musa; Küpesiz, Alphan; Kesik, Vural; Ünal, Ekrem; Koçak, Ülker; Eker, Nurşah; Ataş, Erman; Aksoylar, Serap; Taçyıldız, Nurdan; Elli, M.; Bengoa, Şebnem; Kaya, Zühre; Kansoy, Savaş; Ünal, Emel; Erbey, Fatih; Emir, Suna; Öniz, Haldun; Yeşilipek, Akif[Abstract Not Available]Öğe High ferritin levels in fever of unknown origin: Possible first sign of hemophagocytosis in bmt patients?(Ferrata Storti Foundation, 2016) Yaman, Yeşim; Hazar, Volkan; Sarıbeyoğlu, Ebru; Özdilli, Kürşat; Anak, Sema[Abstract Not Available]Öğe HLA-A allele mismatch (7/8 or 9/10) is the second best option after 8/8 or 10/10 matched unrelated donors: An analysis on results from Turkish centers(Nature Publishing Group, 2015) Beksaç, Meral; Savran Oğuz, Fatma; Topçuoğlu, Pervin; Karasu, Gülsun; Arat, Mutlu; Aksoylar, Serap; Kansoy, Savaş; Kalayoğlu Beşışık, Sevgi; Küpesiz, Alphan; Hazar, Volkan; Altuntaş, Fevzi; Ünal, Ali; Gülbaş, Zafer; Sargın, Fatma Deniz; İlhan, Osman; Gürman, Günhan; Yeşilipek, AkifIntroduction: Hematopoietic stem cell transplantation (HSCT) from an unrelated donor has been established as an effective treatment option for patients with hematological diseases who lack a human leukocyte antigen (HLA)-matched related donor. However, HLA mismatch at the genetic level (allele mismatch) may be observed among serologically HLAmatched (antigen match) donor-recipient pairs, which adversely affects the incidence of severe graft-versus-host disease (GVHD) and survival. The aim of this retrospective multicenter study was to evaluate the impact of HLA mismatch on unrelated transplantation outcomes in Turkey. Materials (or patients) and methods: The data set consisted of follow-up records of 444 (of which 436 with HLA matching data available) unrelated-donor stem cell transplantations performed at 14 centers between July 2002- September 2014 and facilitated by TRAN orTRIS .215 patients underwent single antigen and/or allele-mismatched (mm) HSCT. The distribution of the mismatches according to the HLA-A, HLA-B, HLA-C, and HLA-DR and HLA-DQ loci are:82, 58, 32, 35 and 9 patients, respectively.Twelve patients were transplanted with 8/10 HLA matching. The patients’ characteristics are summarized in Table 1. Results: The neutrophil engraftment was achieved in 82.2% of the patients. HLA mm has a negative impact on engraftment (HLA mm: median 17days vs HLA-matched: median 16 days, p=0.03). Acute GVHD wasobserved at a rate of 42.1%. HLA matching did not have an impact on the incidence of acute GvHD (p=0.35) but chronic GvHD was more frequent among HLA allele /antigen mismatched patients than HLA-matched (p=0.008). The possibility of 5-year overall survival (OS) was 50.2%±2.5%. The presence of HLA mismatch significantly shortened the OS (58.9±3.4% vs Allele mm: 49.8±5.7% vs Antigen mm 36.0±4.9%, p<0.0001).Among the allele level mm HLA-A mm was associated with better OS compared to other loci (55.9±11.7%vs. 17.2±8.2%). When analysis was performed regardless of HLA match or only among HLA matched donor-recipient-pairsgender and stem cell source (PB vs BM) did not have an impact on OS. The OS of patients transplanted between 2002-2007 were shorter than those transplanted later (2008-2014)(37.9±6.4% vs. 52.9±2.7; p= 0.02).Öğe Hodgkin lenfoma nüks ve/veya kemoterapi dirençli olgularda hematopoetik kök hücre nakli ve yüksek doz kemoterapi: Tek merkez deneyimi(İstanbul Üniversitesi, 2021) Yaman, Yöntem; Elli, Murat; Özdilli, Kürşat; Telhan, Leyla; Bayram, Nihan; Hazar, Volkan; Tuprul Sarıbeyoğlu, Ebru; Şahin, Şifa; Anak, SemaGiriş: Standart tedavi alan Hodgkin Lymphoma (HL) hastalarının yaklaşık %20’sinde hastalık dirençli seyredebilir veya tekrar edebilir. Tekrar eden/ dirençli HL’da standart tedavi yüksek doz kemoterapi ve takip eden otolog kök hücre naklidir (OKHN). Otolog KHN sonrası tekrar eden hastalarda ise allojeneik kök hücre nakli (AKHN) önemli bir kurtarma tedavisi olarak görülmektedir. Amaç: Medipol Üniversitesi Tıp Fakültesi çocuk kemik iliği nakil ünitesinde OKHN ve AKHN yapılan hastalarda sonuçları değerlendirmek. Yöntem: Tekrar eden/dirençli HL nedeniyle 2014 Kasım ile Temmuz 2019 tarihleri arasında merkezimizde OKHN yapılan 18 olgu retrospektif olarak değerlendirilmiştir. Otolog KHN sonrası hastalığı tekrar eden ve AKHN yapılan hastalarda ayrıca değerlendirilmiştir. Bulgular: Onaltı hasta halen hayattadır. Onbir hastada OKHN sonrası has talık tekrar etmiştir. Relaps eden hastalardan 10’una AKHN yapılmıştır. Bu hastalardan üçünde tekrar görülmüş olup, sekizi nakil sonrası hayattadır lar.Öğe Hodgkin lymphoma single centre experience: Akdeniz University paediatric haematology oncology(Wiley-Blackwell, 2016) Güler, Elif; Yalçın, Koray; Akkaya, Bahar; Genç, Mine; Yavuz, Melek Nur; Küpesiz, Alphan; Hazar, Volkan[Abstract Not Available]Öğe Mesenchymal stem cell therapy for steroid refractory acute graft versus host disease(Nature Publishing Group, 2019) Anak, Sema; Yaman, Yöntem; Özdilli, Kürşat; Bilgen, Hülya; Sarıbeyoğlu, Ebru Tuğrul; Hazar, Volkan; Ayman, Fatma Nur; Elli, Murat[Abstract Not Available]Öğe National pediatric hematopoietic stem cell transplantation activity in Turkey(Nature Publishing Group, 2015) Kansoy, Savaş; Hazar, Volkan; Küpesiz, Alphan; Uçkan, Duygu; Kuşkonmaz, Barış; Tezcan, İlhan; Aksoylar, Serap; Tezcan, Gülsun; Çakı Kılıç, Suar; Ertem, Mehmet; Ünal, Emine İlknur; İkincioğulları, Aydan; Uygun, Vedat; Öztürk, Gülyüz; Erbey, Fatih; Gedikoğlu, Gökhan; Kürekçi, Emin; Kesik, Vural; Karakükçü, Musa; Albayrak, Davut; Öniz, Haldun; Azık, Fatih Mehmet; Tanyeli, Atila; Anak, Sema; Koçak, Ülker; Ören, Hale; Antmen, Bülent; Fışgın, Tunç; Özyürek, Emel; Atay, Didem; Gözmen, Salih; Yeşilipek, Akif[Abstract Not Available]Öğe Nephrotic syndrome after allogeneic hematopoietic stem cell transplantation as a late complication of chronic graft-versus-host disease in three children(Nature Publishing Group, 2014) Eker, Nebil; Doğru, Ömer; Tayfun, Funda; Uygun, Vedat; Hazar, Volkan; Yeşilipek, Mehmet Akif; Küpesiz, Osman Alphan[Abstract Not Available]Öğe Outcome of allogeneic hematopoietic stem cell transplantation in pediatric patients with acquired severe aplastic anemia: A Turkish multicenter study(Nature Publishing Group, 2015) Koçak, Ülker; Küpesiz, Alphan; Aksoylar, Serap; Hazar, Volkan; Karakükçü, Musa; Kansoy, Savaş; Karasu, Gülsün; Uygun, Vedat; Özbek, Namık Yaşar; İleri, Talya; Elli, M.; Öztürk, Gülyüz; Ünal, Ekrem; Kaya, Zühre; Gözmen, Salih; Ertem, Mehmet; Çakı Kılıç, Suar; Tunç, B.; Özyürek, Emel; Akçay, Arzu; Fışgın, Tunç; Ünal, Emel; Gürsel, Orhan; Atasoy, Deniz; Yeşilipek, Mehmet Akif[Abstract Not Available]
