Person: ÖZKOCAMAN, VİLDAN
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ÖZKOCAMAN
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VİLDAN
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Publication Monitoring and management of cytomegalovirus reactivation in autologous stem cell transplant recipients: Results of more than a decade of experience(Springernature, 2022-11-18) Özkocaman, V.; Özkalemkaş, F.; Erdoğan, Z. H.; Ersal, T.; Pınar, I. E.; ÖZKOCAMAN, VİLDAN; ÖZKALEMKAŞ, FAHİR; ERDOĞAN, Zeynep Hilal; ERSAL, TUBA; PINAR, İBRAHİM ETHEM; Tıp Fakültesi; 0000-0001-9907-1498; AAJ-4354-2021; JGM-6601-2023; FQG-8981-2022; JIW-1248-2023; HFX-4624-2022Publication 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-8182-2021Paroxysmal 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 Phenotypes and functions of low(er)-density neutrophils (LDNs) in early childhood and children(Wiley, 2021-08-01) Dombaz, Fatma; Karaçay, Mehmet; Etgü, Onur; Kızmaz, Muhammed Ali; Şimşek, Abdurrahman; Çağan, Eren; Pınar, İbrahim Ethem; Bal, Salih Haldun; Özkocaman, Vildan; Özkalemkaş, Fahir; Budak, Ferah; Oral, Halük Barbaros; Ermiş, Diğdem Yöyen; Dombaz, Fatma; Karaçay, Mehmet; Etgü, Onur; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; PINAR, İBRAHİM ETHEM; BAL, SALİH HALDUN; ÖZKOCAMAN, VİLDAN; ÖZKALEMKAŞ, FAHİR; BUDAK, FERAH; ORAL, HALUK BARBAROS; YÖYEN ERMİŞ, DİĞDEM; Sağlık Bilimleri Yüksekokulu; İmmünoloji Ana Bilim Dalı; Hematoloji Bilim Dalı; 0000-0001-7625-9148 ; 0000-0001-9907-1498 ; 0000-0001-8850-0269 ; 0000-0001-5334-7911 ; DWR-5356-2022; JHB-7829-2023; JIJ-1849-2023; HKN-2347-2023; AAG-7381-2021; KBR-5535-2024; FQG-8981-2022; JIW-1248-2023; IZP-9398-2023; K-7285-2012; GYL-2038-2022Publication The clinical impacts of the controlling nutritional status score on patients with hodgkin lymphoma(Verduci Publisher, 2023-10-01) Gürsoy, V.; Pinar, I. -E.; Ali, R.; Hunutlu, Fazıl Çağrı; GÖKTUĞ, MEHMET REFİK; HUNUTLU, FAZIL ÇAĞRI; Özkocaman, Vildan; ÖZKOCAMAN, VİLDAN; Özkalemkaş, Fahir; ÖZKALEMKAŞ, FAHİR; Tıp Fakültesi; Hematoloji Ana Bilim DalıOBJECTIVE: The aim of the study was to evaluate the clinical importance and potential mechanisms of controlling nutritional status (CONUT) score as a prognostic tool for Hodgkin lymphoma (HL). PATIENTS AND METHODS: Diagnosed with HL, 307 patients were included in the study. Patients' demographic data, stages, B symptoms, extranodal involvement, presence of bulky disease, laboratory findings, treatments, treatment responses, nutritional status, and overall survival (OS) rates were evaluated from the hospital records. The pri-mary endpoint of our study was to evaluate and classify newly diagnosed HL patients under the CONUT score. The secondary endpoint was to indicate any relationship between nutritional status, CONUT score, and other prognostic factors and OS.RESULTS: Of 307 patients (173 males, 134 females), the mean age was 41.58 +/- 16.26 (ranging between 18-82 years). The most common type of malignancy was nodular sclerosis (72.53%). To the receiver operating characteristic (ROC) curve analysis, the best cut-off point was 2.5 to predict mortality. Eigthy-five (27.7%) and 222 (72.3%) patients had >= 3 and <= 2 CONUT scores, respectively. Twenty-four (10.80%) and 23 (27.10%) cases were also mortal in the patients with <= 2 and >= 3 CONUT scores, respectively (p<0.001). Survival times were significantly lower in those with higher (>= 3) CONUT scores (p<0.001) than among the other patients.CONCLUSIONS: Evaluation of nutritional status plays an important role in the response and survival of those with hematological malignancies. Malnutrition can reduce patients' tolerance to chemotherapy and increase the risk of secondary infections. In this study, undernutrition evaluated with the CONUT score was demonstrated to be a potential independent prognostic factor for OS in patients with HL.Publication 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-1248-2023The 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.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; 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 A case of an antithrombin deficiency with mesenteric thromboses and cerebral infarct(Pergamon-elsevier Science Ltd, 2016-05-01) Alp, Tuğcan; ÖZKALEMKAŞ, FAHİR; Özkocaman, Vildan; ÖZKOCAMAN, VİLDAN; Özkalemkaş, Fahir; Şanlı, C.; Gözden, H. E.; Yeğen, Z. S.; Ali, R.; Tıp Fakültesi; HematolojiAna Bilim Dalı; 0000-0002-1361-6213; HMD-4249-2023; AAG-8495-2021; AAI-5246-2020; AAH-1854-2021Publication The effect of cryopreservation on engraftment kinetics in fully matched allogeneic stem cell transplantation: Real-life data and literature review(Pergamon-Elsevier Science Ltd, 2023-12) Ersal, Tuba; Özkocaman, Vildan; Yalçın, Cumali; Orhan, Bedrettin; Candar, Ömer; Çubukçu, Sinem; Koca, Tuba Güllü; Hunutlu, Fazıl Cağrı; Özkalemkaş, Fahir; ERSAL, TUBA; ÖZKOCAMAN, VİLDAN; YALÇIN, CUMALİ; ORHAN, BEDRETTİN; CANDAR, ÖMER; ÇUBUKÇU, SİNEM; GÜLLÜ KOCA, TÛBA; HUNUTLU, FAZIL ÇAĞRI; ÖZKALEMKAŞ, FAHİR; Tıp Fakültesi; İç Hastalıkları; Hematoloji Bölümü; 0000-0003-3970-2344; 0000-0002-4991-9830; AAJ-4354-2021; JJP-2815-2023; KIE-5102-2024; ACW-2157-2022; JWF-3713-2024; JJB-0254-2023; GWQ-5007-2022; KCK-7512-2024; JJW-7463-2023Introduction: The standard approach for allogeneic stem cell transplantation (allo-SCT) is to administer donor cells on the same day as a fresh product to a patient who has been given a preparative regimen. The difficulty in collecting and transporting donor cells, especially during the COVID-19 pandemic, has made it essential to collect and cryopreserve the grafts before the recipient begins the transplant preparation regimen. However, the shortand long-term impacts of cryopreservation on transplant outcomes remain controversial. Materials and methods: This retrospective study included 93 patients who underwent allo-SCT between January 2012 and August 2022 at the Stem Cell Transplant Unit of Bursa Uludag University Faculty of Medicine using frozen and fresh products of peripheral blood stem cells from a fully matched sibling donor. The effect of cryopreservation of donor grafts on engraftment kinetics was investigated. Results: Frozen and fresh products were used in 37 and 56 patients, respectively. The majority of patients had acute myeloid leukemia and acute lymphoblastic leukemia. The median age at transplantation was 41 years. Neutrophil engraftment time was similar between the two groups (median: 14 vs. 16 days, p = 0.393). Platelet engraftment time was longer in the frozen product group (median: 12 vs. 15 days, p < 0.001). There was no statistically significant difference between freezing time and viability. The acute graft-versus-host disease (GVHD) rate was 37.8 % in the frozen product group and 28.6 % in the fresh product group (p = 0.349). There was no significant difference between the two groups in terms of primary and secondary graft failure, chronic GVHD, 30-day chimerism, relapse, overall survival, progression-free survival, and nonrelapse mortality. Conclusion: Having donor cells ready before transplantation significantly prevents donor-induced adverse events and provides confidence and practicality to both the clinician and the recipient. Allo-SCT with frozen products is a successful method that can be safely applied, especially when disruptions in donor-derived cell collection or transportation are foreseen.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; 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-5894-2022Introduction: 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 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-8209-2022Acute 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.