Person: ÖZKALEMKAŞ, FAHİR
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ÖZKALEMKAŞ
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FAHİR
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Publication Outcome is worse in male compared to female de novo aml patients and can be improved with the use of granulocyte colony stimulating factor(g-csf) during induction.: Results of a randomized multicentric trial(Turkish leukemia study group (tlg95-002).(Amer Soc Hematology, 2002-11-16) Beksaç, M; Özcan, M; Dündar, S; Bayık, M; Paydaş, S. A; Büyükaşık, Y; İlhan, O; Gürman, G; Uysal, A; Akan, H; Akcağlayan, E; Özdemir, O; Tunalı, Ahmet; Ali Rıza, Yıldız; Özkalemkaş, Fahir; ÖZKALEMKAŞ, FAHİR; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; AAG-8495-2021Publication The role of white blood cell count in perianal pathologies: A retrospective analysis of hematologic malignancies(Mattioli 1885, 2022-07-01) Orhan, Bedrettin; Özkalemkaş, Fahir; Özkocaman, Vildan; Gürbüz, Büsra; Ersal, Tuba; Pınar, İbrahim Ethem; Yalçın, Cumali; Candar, Ömer; Çubukcu, Sinem; Koca, Tuba Güllü; Ali, Rıdvan; ORHAN, BEDRETTİN; ÖZKALEMKAŞ, FAHİR; ÖZKOCAMAN, VİLDAN; GÜRBÜZ, BÜŞRA; ERSAL, TUBA; PINAR, İBRAHİM ETHEM; YALÇIN, CUMALİ; CANDAR, ÖMER; ÇUBUKÇU, SİNEM; GÜLLÜ KOCA, TÛBA; ALİ, RIDVAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0001-9907-1498; 0000-0003-4168-2821; 0000-0002-5129-2977; 0000-0002-5564-8862; 0000-0001-7602-6926; JWP-2738-2024; ACW-2157-2022; GWQ-5007-2022; KIE-5102-2024; JGM-6601-2023; GMY-8535-2022; FQG-8981-2022; JJB-0254-2023; GWQ-5007-2022; GXD-8209-2022; AAJ-4354-2021Background and Objective: Infections are the most common cause of anal and perianal pathologies in patients with hematological malignancies. Perianal infection diagnosis in this group of patients is difficult; thus, a careful anorectal examination is necessary with imaging modalities. In addition, the literature reveals a knowledge gap in the approach to anal pathologies in patients with neutropenia during diagnosis or chemotherapy. This study aimed to examine our institutional data on perianal complications and investigate the relationship between the white blood cell-neutrophil count, perianal lesion, and the type of treatment in patients with hematologic malignancies during the neutropenic period.Methods: Patients with a hematologic malignancy, hospitalized for cytotoxic chemotherapy, complicated by perianal pathology, documented by at least one imaging method, were included in the study.Results: A total of 42 patients were included in the study. Most of them had acute leukemia, 31 were affected by acute myeloid leukemia (AML), and 7 by Acute lymphoid leukemia (ALL). There was no statistically significant relationship between the anal abscess formation, the neutrophil count, and a previous perianal pathology. Anal abscess development was significantly more frequent in acute myeloid leukemia. An inverse relationship was found between the total white blood cell number at onset and having a surgical intervention for anal pathology.In conclusion, this article has shown that white blood cell count at the time of hospitalization can affect the surgical intervention in patients with hematological malignancy (in the majority with acute leukemia) affected by anal pathologies occurring in the neutropenic period.Publication Primary pulmonary amyloidosis associated with multiple myeloma(Turkish Assoc Tuberculosis & Thorax, 2006-01-01) Ege, Ercüment; URSAVAŞ, AHMET; Uzaslan, Esra; UZASLAN, AYŞE ESRA; Ursavaş, Ahmet; Güçlü, Metin; Özkalemkaş, Fahir; ÖZKALEMKAŞ, FAHİR; Tolunay, Şahsine; TOLUNAY, ŞAHSİNE; 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/Patoloji Anabilim Dalı.; 0000-0001-5082-9894; ABI-4847-2020; AAI-1612-2021; AAG-8495-2021; AAI-3169-2021; AAI-1004-2021Amyloidosis is a syndrome characterized by the deposition of an insoluble proteinaceous material in the extracellular matrix of one or several organs. Respiratory tract involvement with amyloid is rare and deposition of lower respiratory tract has been recognized in a variety of situations with different presentations. Primary idiopathic amyloidosis may be a diagnostic problem because of its low incidence and its variable manifestations. We report herein a case with multiple myeloma presenting diffuse interstitial infiltration, in which pulmonary AL type amyloidosis was diagnosed through transbronchial lung biopsy.Publication Extracorporeal photopheresis in the treatment of acute and chronic graft-versus-host disease: A position statement from the Turkish Society of Apheresis (TSA)(Elsevier, 2022-02-01) Kaynar, Leylagül; Tekgündüz, Emre; Kozanoğlu, İlknur; Özkan, Hasan Atilla; Aksu, Salih; Özkalemkaş, Fahir; Demirkan, Fatih; ÖZKALEMKAŞ, FAHİR; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Anabilim Dalı; DLR-8474-2022Graft versus host disease (GVHD) is still the most important cause of mortality and morbidity after allogeneic stem cell transplantation. Though perfect response rates are not achieved, steroids are still the first-line treat-ment. In the face of the presence of the drugs approved by FDA in recent years for acute and chronic GVHD as second-line therapy in the steroid-refractory group, there exists no standard approach. Extracorporeal photopheresis (ECP) with an immunomodulatory effect, is favored in the treatment of both acute and chronic steroid refractory GVHD as it does not increase the risk of relapses or infections. Having a low profile of side effects, ECP is also generally well-tolerated by patients. Being a time requiring procedure, the fact is that it is not able to be practiced in all health centers and requires central venous catheters in patients unfit for venous access may be enumerated among its shortcomings. No complete standard is available with respect to ECP application frequency-time; it varies from one center to another. The Turkish Society of Apheresis established the Turkish ECP (TECP) group and sought some answers to the questions regarding the use of ECP in the treatment of GVHD, and issued a position statement.Publication Macrophage polarization capacity of peripheral blood monocytes and monocytic cell line THP-1 in response to secreted factors from COVID-19 patients(Wiley, 2021-08-01) Etgü, Onur; Karaçay, Mehmet; Dombaz, Fatma; Kızmaz, Muhammed Ali; Şimsek, Abdurrahman; Asan, Ali; Yılmaz, Emel; Kazak, Esra; Pınar, İbrahim Ethem; Bal, Salih Haldün; Özkocaman, Vildan; Özkalemkaş, Fahir; Akalın, Emin Halis; Budak, Ferah; Oral, Haluk Barbaros; Ermiş, Diğdem Yöyen; Etgü, Onur; Karaçay, Mehmet; Dombaz, Fatma; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; YILMAZ, EMEL; KAZAK, ESRA; PINAR, İBRAHİM ETHEM; BAL, SALİH HALDUN; ÖZKOCAMAN, VİLDAN; ÖZKALEMKAŞ, FAHİR; AKALIN, EMİN HALİS; BUDAK, FERAH; ORAL, HALUK BARBAROS; YÖYEN ERMİŞ, DİĞDEM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Temel Tıp Bilimleri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dr Raşit Durusoy Kan Bankası.; 0000-0001-7288-3250; 0000-0001-5334-7911; 0000-0001-8850-0269; 0000-0002-8856-7356; 0000-0003-1785-3539; 0000-0001-9907-1498; 0000-0001-7530-1279; 0000-0001-7625-9148; 0000-0003-0463-6818; JIJ-1849-2023; JHB-7829-2023; DWR-5356-2022; HKN-2347-2023; AAG-7381-2021; GDP-0005-2022; AAG-8459-2021; JGM-6601-2023; KBR-5535-2024; FQG-8981-2022; JIW-1248-2023; AAU-8952-2020; 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; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim 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; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim 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 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; Bursa Uludağ Üniversitesi/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 Evaluation of indoleamine 2, 3 dioxygenase (IDO) gene polymorphisms in COVID-19(Wiley, 2021-08-01) Karaca, Mert; Arslan, Gözde; Ermiş, Diğdem Yöyen; Bal, Salih Haldun; Uzaslan, Esra Kunt; Özkalemkaş, Fahir; Macunluoğlu, Aslı Ceren; Budak, Ferah; Akalın, Halis; Oral, Haluk Barbaros; KARACA, MERT; Arslan, Gözde; YÖYEN ERMİŞ, DİĞDEM; BAL, SALİH HALDUN; Uzaslan, Esra Kunt; ÖZKALEMKAŞ, FAHİR; Macunluoğlu, Aslı Ceren; BUDAK, FERAH; AKALIN, EMİN HALİS; ORAL, HALUK BARBAROS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmunoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biostatik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0002-6802-5998; 0000-0001-7625-9148; 0000-0001-7530-1279; 0000-0003-0463-6818; 0000-0002-6802-5998; 0000-0001-6711-676X; IZP-9398-2023; AAU-8952-2020; K-7285-2012; F-4657-2014; JFS-2013-2023; AAG-7406-2021; GYL-2038-2022; KBR-5535-2024; AAI-1004-2021; JLE-5241-2023; GBP-6589-2022Publication 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.
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