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Öğe A complete response with daratumumab, venetoclax, azacitidine and dexamethasone in a heavily pre-treated, chemo-refractory early t-precursor acute lymphoblastic leukemia/lymphoma patient(2025) Yiğit Kaya, Süreyya; Vatani, Mehrad; Akil, Rima; Çakır, Tansel; Maral, Senem; Kaynar, Leylagül; Sevindik, Ömür GökmenEarly T-precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL) is a rare and aggressive subtype of T-cell leukemia with poor prognosis and resistance to standard treatments. We report a 21-year-old male with ETP-ALL/LBL who, after an initial complete remission with the HOELZER protocol, experienced early relapse and was refractory to subsequent FLEND and BFM protocols. Following disease progression and complications, he was treated with a combination of daratumumab, venetoclax, azacitidine, and dexamethasone. This regimen achieved complete remission after one cycle. This case highlights the potential of this combination therapy as an effective treatment for refractory ETP-ALL/LBL, suggesting further research is warranted to validate its efficacy and safety.Öğe A real-life Turkish experience of venetoclax treatment in high-risk myelodysplastic syndrome and acute myeloid leukemia(CIG Media Group, 2021) Gemici, Aliihsan; Özkalemkaş, Fahir; Doğu, Mehmet Hilmi; Tekinalp, Atakan; Alacacıoğlu, İnci; Güney, Tekin; İnce, İdris; Gedük, Ayfer; Akgün Çağlıyan, Gülsüm; Maral, Senem; Serin, İstemi; Gündüz, Eren; Karakuş, Volkan; Beköz, Hüseyin Saffet; Eren, Rafet; Pınar, İbrahim Ethem; Güneş, Ahmet Kürşad; Sargın, Fatma Deniz; Sevindik, Ömür GökmenVenetoclax is a selective B-cell lymphoma 2 (BCL2) inhibitor, which is approved to treat elderly patients with newly diagnosed acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS). A total of 60 patients with a median age of 67 years from different centers were included in the final analysis. Our real-life data support the use of venetoclax in patients with both newly diagnosed and relapsed high-risk MDS and AML. Introduction: Venetoclax is a selective B-cell lymphoma 2 (BCL2) inhibitor, which is approved to treat elderly patients with newly diagnosed acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) in combination with either low-dose cytarabine (ARA-C) or hypomethylating agents. We aimed to collect and share data among the efficacy and safety of venetoclax both as a monotherapy or in combination with other drugs used to treat high-risk MDS or AML. Materials and Methods: A total of 60 patients with a median age of 67 (30-83) years from 14 different centers were included in the final analysis. Thirty (50%) of the patients were women; 6 (10%) of the 60 patients were diagnosed with high-risk MDS and the remaining were diagnosed with AML. Results: The best objective response rate (complete remission [CR], complete remission with incomplete hematological recovery (CRi), morphological leukemia-free state [MLFS], partial response [PR]) was 35% in the entire cohort. Best responses achieved during venetoclax per patient number were as follows: 7 CR, 1 CRi, 8 MLFS, 5 PR, and stable disease. Median overall survival achieved with venetoclax was 5 months in patients who relapsed and not achieved in patients who were initially treated with venetoclax. Nearly all patients (86.7%) had experienced a grade 2 or more hematologic toxicity. Some 36.7% of these patients had received granulocyte colony stimulating factor (GCSF) support. Infection, mainly pneumonia (26.7%), was the leading nonhematologic toxicity, and fatigue, diarrhea, and skin reactions were the others reported. Conclusion: Our real-life data support the use of venetoclax in patients with both newly diagnosed and relapsed high-risk MDS and AML.Öğe An interim analysis of the Turkish Myeloma Registry among patients who have received up to two lines of therapy(CIG Media Group, 2021) Sevindik, Ömür Gökmen; Özkurt, Zübeyde Nur; Boğa, Can; Kalayoğlu Beşışık, Sevgi; İpek, Yıldız; Gedük, Ayfer; Harmandalı, Aybüke; Salihoğlu, Ayşe; Haydaroğlu Şahin, Handan; Sönmez, Mehmet; Vural, Filiz; Akay, Olga Meltem; Kurt Yüksel, Meltem; Maral, Senem; Ekinci, Ömer; Kırkızlar, Hakkı Onur; Tekinalp, Atakan; Demir, Nazlı; Merter, Mustafa; Saydam, Güray; Alacacıoğlu, İnci; Yeğin, Zeynep Arzu; Kasar, Mutlu; Mastanzade, Metban; Özsan, Güner HayriBackground To investigate the demographics and treatment details of the myeloma patients who were diagnosed and followed up in Turkey and received up to two lines of therapy. Methods Patients who were recorded on the database of Turkish Myeloma Registry project were included in this study if they had only received one or two lines of therapy. Demographics, patient, and disease related parameters both at the time of diagnosis and at the follow up and treatment outcomes were presented.Öğe An interim analysis of the Turkish myeloma registry among the patients who have received up to two lines of therapy(American Society of Hematology, 2021) Sevindik, Ömür Gökmen; Özkurt, Zübeyde Nur; Boğa, Can; Kalayoğlu Beşışık, Sevgi; Yıldız, İpek; Gedük, Ayfer; Harmandali, Aybüke; Salihoğlu, Ayşe; Haydaroğlu Şahin, Handan; Sönmez, Mehmet; Vural, Filiz; Akay, Olga Meltem; Kurt Yüksel, Meltem; Maral, Senem; Ekinci, Ömer; Kırkızlar, Hakkı Onur; Tekinalp, Atakan; Demir, Nazlı; Merter, Mustafa; Saydam, Güray; Alacacıoğlu, İnci; Yeğin, Zeynep Arzu; Kaşar, Mutlu; Mastanzade, Metban; Özsan, Güner Hayri[Abstract Not Available]Öğe Atypical presentation of pjp: hypercalcemia and kidney injury in an allogeneic stem cell transplant recipient(2024) Özalp, Yunus Can; Shehabie, Hajrij; Tekin, Mehmet Günhan; Kaya, Süreyya Yiğit; Beköz, Hüseyin Saffet; Maral, Senem; Sevindik, Ömür Gökmen; Kaynar, LeylagülBackground: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection that primarily affects immunocompromised individuals. Typical symptoms of PJP include the subacute onset of dyspnea, nonproductive cough, and low-grade fever. In hematology patients, particularly those who are allogeneic stem cell transplant recipients, the disease often presents with a more aggressive clinical course. While hypercalcemia has been documented as a manifestation of PJP in some solid organ transplant recipients, it has not been reported in hematology or stem cell transplant patients. Case presentation: Here, we present a case of PJP in a 56-year-old male allogeneic stem cell transplant recipient, who developed hypercalcemia and renal failure during the late post-transplant period. The patient had a history of allogeneic stem cell transplantation due to acute myeloid leukemia. He presented with symptoms of fatigue and weakness. Laboratory tests revealed hypercalcemia (13.8 mg/dL) and elevated serum creatinine levels (2.3 mg/dL). The patient was hospitalized, and despite initial treatment with hydration and furosemide, the hypercalcemia persisted, leading to the administration of denosumab. During follow-up, hypoxia was detected, and a chest CT scan revealed mosaic attenuation and ground-glass opacities. Bronchoscopy was performed, and PCR testing confirmed the presence of Pneumocystis jirovecii. Other causes of hypercalcemia were ruled out, with PTH measured at 13.8 pg/mL (normal range 15–65 pg/mL), albumin at 3.71 g/dL, 1.25-dihydroxy vitamin D3 at 96 ng/dL (normal range 26–95 ng/dL), and 25-hydroxy vitamin D at 32.5 ng/mL (normal range 20–40 ng/mL). A PET-CT scan demonstrated no pathological FDG uptake, with the exception of findings suggestive of a pulmonary infection. Following treatment with trimethoprim-sulfamethoxazole and denosumab, the patient’s hypercalcemia and infection resolved. Conclusions: Although rare, PJP can present with hypercalcemia and kidney injury in allogeneic stem cell transplant recipients. Early diagnosis and treatment can improve both PJP and hypercalcemia.Öğe Azacitidine-related pyoderma gangrenosum(2025) Maral, Senem; Uzunabdullah, E.; Yamiş, Nur Zilan; Kuzucular, E.; Surul, Barış; Sevindik, Ömür Gökmen...Öğe Clinical characteristics and outcomes of COVID-19 in Turkish patients with hematological malignancies(NLM (Medline), 2022) Civriz Bozdağ, Sinem; Cengiz Seval, Güldane; Yönal Hindilerden, İpek; Hindilerden, Fehmi; Andıç, Neslihan; Baydar, Mustafa; Aydın Kanyar, Lale; Toprak, Selami Koçak; Göksoy, Hasan Sami; Balık Aydın, Berrin; Demirci, Ufuk; Can, Ferda; Özkocaman, Vildan; Gündüz, Eren; Güven, Zeynep Tuğba; Özkurt, Zübeyde Nur; Demircioğlu, Sinan; Beksaç, Meral; İnce, İdris; Yılmaz, Umut; Eroğlu Küçükdiler, Hilal; Abishov, Elgün; Yavuz, Boran; Ataş, Ünal; Mutlu, Yaşa Gül; Baş, Volkan; Özkalemkaş, Fahir; Üsküdar Teke, Hava; Gürsoy, Vildan; Çelik, Serhat; Çiftçiler, Rafiye; Yağcı, Münci; Topçuoğlu, Pervin; Çeneli, Özcan; Abbasov, Hamza; Selim, Cem; Ar, Muhlis Cem; Yücel, Orhan Kemal; Sadri, Sevil; Albayrak, Canan; Demir, Ahmet Muzaffer; Güler, Nil; Keklik, Muzaffer; Terzi, Hatice; Doğan, Ali; Yegin, Zeynep Arzu; Kurt Yüksel, Meltem; Sadri, Soğol; Yavaşoğlu, İrfan; Beköz, Hüseyin Saffet; Aksu, Tekin; Maral, Senem; Erol, Veysel; Kaynar, Leylagül; İlhan, Osman; Bolaman, Ali Zahit; Sevindik, Ömür Gökmen; Akyay, Arzu; Özcan, Muhit; Gürman, Günhan; Ünal, Şule; Yavuz, Yasemin; Diz Küçükkaya, Reyhan; Özsan, Güner HayriObjective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARS-CoV- 2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixty-nine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.Öğe Original vs. generic plerixafor for the mobilization of stem cells in multiple myeloma patients(2025) Yiğit Kaya, Süreyya; Mutlu, Yaşa Gül; Yücel, Orhan Kemal; Nizam Özen, İlknur; Ataş, Ünal; Melek, Elif; Maral, Senem; Karakuş, Volkan; Kaynar, Leylagül; Sevindik, Ömür GökmenThis study investigates the efficacy and safety of generic plerixafor (Pleksor – Gen Pharma) compared to the original plerixafor (Mozobil - Sanofi) in patients with multiple myeloma undergoing ASCT. A total of 59 patients from three centers, who underwent ASCT between 2018 and 2023, were included and divided into two groups: Mozobil (M) group (n = 32) and Pleksor (P) group (n = 27). Plerixafor was administered as a just-in-time approach with granulocyte-colony stimulating factor (G-CSF) alone or with cyclophosphamide (Cy) + G-CSF mobilization. The study aimed to assess mobilization success and engraftment kinetics. There was no statistically significant difference between the two groups in terms of age, gender, RT history, previous lines of treatment, pretransplant lenalidomide cycles (p = 0.778, 0.165, 0.520, 0.094, 0.530, respectively). However, lenalidomide exposure was significantly higher in P group (18,8% vs. 81,5%, p < 0.001). Both groups achieved a similar total yield of CD34 + cells, and no serious side effects related to plerixafor were noted. Median platelet engraftment time was longer in P group, while neutrophil engraftment time was similar in both groups. This study demonstrates the comparable efficacy of generic plerixafor in myeloma patients, suggesting that it can be a cost-effective alternative with a similar safety profile. These findings contribute to the body of evidence on the use of generic plerixafor in specific patient cohorts, emphasizing its efficacy and safety for ASCT in a sole multiple myeloma patient cohort.Öğe Relapsed refractory multiple myeloma with CNS involvement successfully treated with Elranatamab: First reported case(Frontiers Media SA, 2023) Mutlu, Yaşa Gül; Yiğit Kaya, Süreyya; Maral, Senem; Melek, Elif; Başlar, Zafer; Kaynar, Leylagül; Sevindik, Ömür GökmenCentral nervous system (CNS) involvement in multiple myeloma (MM) is a rare and challenging complication associated with poor prognosis and limited treatment options. Emerging T-cell directing therapies, such as bispecific antibodies (bsAbs) and chimeric antigen receptor T cells (CAR-T), have shown remarkable success in treating MM, but their efficacy in CNS involvement remains unclear. Elranatamab, a humanized bispecific antibody targeting B-cell maturation antigen (BCMA) and CD3-expressing T cells, has demonstrated promising results in relapsed refractory MM. However, its efficacy in treating CNS-MM has not been reported. We present a case of a 37-year-old male MM patient with CNS involvement who has been successfully treated with Elranatamab.Öğe Single agent vemurafenib or rituximab-vemurafenib combination for the treatment of relapsed/refractory hairy cell leukemia, a multicenter experience(2024) Yiğit Kaya, Süreyya; Mutlu, Yaşa Gül; Malkan, Ümit Yavuz; Mehtap, Özgür; Keklik Karadağ, Fatma; Korkmaz, Gülten; Elverdi, Tuğrul; Saydam, Güray; Özet, Gülsüm; Ar, Muhlis Cem; Melek, Elif; Maral, Senem; Kaynar, Leylagül; Sevindik, Ömür GökmenBackground: Hairy cell leukemia (HCL) is a rare mature B-cell malignancy that is primarily treated with purine analogues. However, relapse remains a significant challenge, prompting the search for alternative therapies. The BRAF V600E mutation prevalent in HCL patients provides a target for treatment with vemurafenib. Patients and methods: This multicenter retrospective study included nine patients with relapsed/refractory (R/R) HCL from six different centers. Patient data included demographics, prior treatments, clinical outcomes, and adverse events. Results: Patients received different treatment regimens between centers, including vemurafenib alone or in combination with rituximab. Despite the differences in protocols, all patients achieved at least a partial response, with seven patients achieving a complete response. Adverse events were generally mild with manageable side effects. The absence of myelotoxic effects and manageable side effects make BRAF inhibitors attractive, especially for patients ineligible for purine analogues or those with severe neutropenia. Conclusion: Single agent vemurafenib or in combination with rituximab appears to be a promising therapeutic option for R/R HCL. Further research is needed to establish standardized treatment protocols and to investigate long-term outcomes.Öğe Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data(Kare Publishing, 2022) Karakuş, Volkan; Maral, Senem; Kaya, Egemen; Gemici, Aliihsan; Dere, Yelda; Sevindik, Ömür GökmenOBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that frequently affects elderly population. With introducing the hypomethylating agents (HMAs) in elderly AML treatment, survival rates and quality of life have improved. However, long-term management in elderly and frail patients is still a challenge. In the present study, we aimed to determine whether HMA maintenance therapy is required until disease progression in frail and elderly AML patients by examining with a real-life data.METHODS: In a multicenter study, we analyzed non-promyelocytic elderly AML patients who were treated with first-line azacitidine or decitabine monotherapy in two different groups, retrospectively. While patients were treated with HMA until progression in the maintenance group, 6+3 cycles of azacitidine or decitabine were administered as a standard care of elderly AML patients in the non-maintenance group. Survival outcomes were compared between the groups.RESULTS: HMA therapy was maintained until progression in 20 patients, and HMA therapy was terminated after 6+3 cycles in 21 patients. Patients received a median of 6 (1-14) HMA cycles during follow-up time. The median 7.5 months of overall survival were observed (2-17 months) in maintenance and 3 months (1-13 months) in non-maintenance groups (p=0.001).CONCLUSION: Despite long-term exposure to HMA may appear as a risk factor for complications and toxicities in elderly and frail AML patients, the maintenance of therapy until disease progression provides a significant survival advantage. Therefore, we suggest that HMA therapy should continue until disease progression regardless the sort of HMA.Öğe The prognostic impact of comorbidity, nutritional and performance status on patients with diffuse large B cell lymphoma(Wolters Kluwer Medknow Publications, 2023) Sağlam, Buğra; Albayrak, M.; Yıldız, Abdulkerim; Tı?lıo?lu, P.; Tı?lıo?lu, M.; Aras, M. R.; Yılmaz, F.; Maral, Senem; Öztürk, H. B. A.Background: The aim of the study was to investigate the impact of nutritional status, comorbidity, and performance status on patients with diffuse large B-cell lymphoma (DLBCL). Methods: A retrospective study was conducted on 112 DLBCL patients who were diagnosed at our center between 2009 and 2018. Demographic and disease characteristics and laboratory test results were recorded. Assessments were made using the age-adjusted Charlson comorbidity index (CCI-A) for comorbidity, albumin level for nutritional status, and Eastern Cooperative Oncology Group (ECOG) score for performance status. Results: The mean age of the patients was found to be 62.63 ± 15.16 years. The ECOG score of 65 patients (69.1%) was in the range of 0-1. The mean follow-up time of the patients was determined to be 25.24 ± 25.11 months, and at the end of the follow-up period, 64 patients (57.1%) were survivors. The progression-free survival (PFS), overall survival (OS), and 5-year OS rates of those with CCI-A > 4 were found to be significantly lower than those with CCI-A score ?4 (P < 0.05). As a result of the Cox-Regression (Backward: LR method) analysis, ECOG and albumin levels were found to be independent risk factors for both OS and PFS (P < 0.05). Conclusion: This study demonstrated that CCI-A, ECOG, and nutritional status are independent prognostic markers for DLBCL patients. Initial evaluation of these patients should include all these parameters, which are easily available at the time of diagnosis.
