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Öğe Adult Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in Daily Practice: A Multicenter Experience(CIG MEDIA GROUP, LP, 2016) Tekgunduz, Emre; Goker, Hakan; Kaynar, Leylagul; Sari, Ismail; Pala, Cigdem; Dogu, Mehmet Hilmi; Ozturk, Erman; Turgut, Burhan; Korkmaz, Serdal; Tetik, Aysegul; Buyukasik, Yahya; Hacioglu, Sibel Kabukcu; Bozdag, Sinem Civriz; Ozdemir, Evren; Altuntas, FevziIn this retrospective, multicenter study, we evaluated the real-life outcomes of adult Philadelphia-positive acute lymphoblastic leukemia patients. The best results in terms of survival are achieved in patients who were treated with tyrosine kinase inhibitors during induction and received allogeneic hematopoietic cell transplantation as part of consolidation. Background: The prognosis of Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) is generally poor. Currently, allogeneic hematopoietic cell transplantation (allo-HCT) is the only accepted therapy with curative potential. Patients and Methods: Herein, we report our multicenter, retrospective experience with 46 (23 female; 23 male) Ph+ ALL patients, who were treated off-study between 2005 and 2012. Results: The median age of the patients was 46 years (range, 19-73 years). During induction, 30 (65%), 13 (28%), and 3 (7%) patients received tyrosine kinase inhibitors (TKIs) concurrent with chemotherapy (TKIs/chemotherapy), chemotherapy only, and TKIs only, respectively. Following induction, rates of complete remission (CR) of the study population were 85% (n = 39). CR rate in patients receiving TKIs during induction (n = 33) was significantly higher compared with patients who received chemotherapy only (n = 13; P = .011). Taking TKIs during induction significantly reduced induction mortality (3.3% vs. 38%; P = .01). Allo-HCT was performed subsequently in 21 (46%) patients. More patients who received TKIs with or without chemotherapy (19/33; 58%) during induction were able to undergo to allo-HCT compared with patients who received chemotherapy only (2/13; 15%; P = .005). Median overall survival of patients who were treated with TKIs during induction and received allo-HCT (not reached; NR) was significantly prolonged compared with patients who received allo-HCT but without TKIs during induction (23.2 months) and to the rest of the cohort (21.2 months; P = .019). Conclusions: Current state-of-the art management of Ph+ ALL in real-life seems to be incorporation of TKIs to chemotherapy regimens and proceeding to allo-HCT, whenever possible. (C) 2016 Elsevier Inc. All rights reserved.Öğe The Clinical Characteristics and Therapeutic Outcomes of Elderly Patients with Chronic Lymphocytic Leukemia: A Retrospective Multicenter Study(AMER SOC HEMATOLOGY, 2014) Tombak, Anil; Tiftik, Naci; Dogu, Mehmet Hilmi; Sari, Ismail; Akay, Meltem Olga; Karagulle, Mustafa; Kaya, Emin; Korkmaz, Serdal; Sencan, Mehmet; Akyol, Gulsah; Kaynar, Leylagul; Comert, Melda; Saydam, Guray; Dal, Sinan Mehmet; Ayyildiz, Orhan M.; Yildirim, Rahsan; Kiki, Ilhami; Kara, Erdal; Esen, Ramazan; Sungur, Mehmet Ali; Erkurt, Mehmet Ali; Altuntas, Fevzi; Unal, Ali; Ilhan, Osman…Öğe Clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study(WILEY-BLACKWELL, 2015) Korkmaz, Serdal; Dal, Mehmet Sinan; Berber, Ilhami; Sahin, Deniz Goren; Dogu, Mehmet Hilmi; Ayyildiz, Orhan; Nizam, Ilknur; Albayrak, Murat; Esen, Ramazan; Namdaroglu, Sinem; Sencan, Mehmet; Akay, Olga Meltem; Hacioglu, Sibel; Yildirim, Rahsan; Eser, Ali; Tombak, Anil; Pala, Cigdem; Ilhan, OsmanAimsWe aimed to investigate whether older age leads to limitations in the starting dose of imatinib in daily treatment of chronic myeloid leukemia, and to determine the compliance of elderly patients with tyrosine kinase inhibitors (TKI) therapy. MethodsData including the clinical characteristics, therapeutic outcomes and compliance with TKI therapy of elderly patients with chronic myeloid leukemia aged >65years were collected from 13 institutions in Turkey, retrospectively. ResultsA total of 69 patients (27 [39%] men, 42 [61%] women) were evaluated retrospectively. The median age of the patients was 71years (range 66-85years). Of the patients, 66 (96%) were in the chronic phase and three (4.3%) were in the accelerated phase when diagnosed. A total of 63 (91.3%) patients were receiving imatinib as the first-line therapy. The initial dose of imatinib was 400mg/day in 59 patients (93.6%). Imatinib treatment induced 57 (90.5%) complete hematological responses at 3months, 29 (46%) complete cytogenetic responses at 6months and 49 (77.7%) major molecular responses at 12months. As a result, nilotinib and dasatinib were used in 14 patients as second-line therapy. Second-line TKI induced nine complete hematological responses (64.3%) at 3months, four complete cytogenetic responses (28.6%) at 12months and seven major molecular responses (50%) at 18months. A total of 56 of the patients (81.2%) are still alive. The median overall survival and progression-free survival rates were 35months (range 1-95months) and 17months (range 0.8-95months), respectively. ConclusionElderly patients should receive TKI according to the same guidelines that apply to younger patients. Geriatr Gerontol Int 2015; 15: 729-735.Öğe The clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study.(AMER SOC CLINICAL ONCOLOGY, 2014) Korkmaz, Serdal; Dal, Mehmet Sinan; Berber, Ilhami; Sahin, Deniz Goren; Dogu, Mehmet Hilmi; Ayyildiz, Orhan; Nizam, Ilknur; Albayrak, Murat; Esen, Ramazan; Namdaroglu, Sinem; Sencan, Mehmet; Akay, Olga Meltem; Hacioglu, Sibel Kabukcu; Yildirim, Rahsan; Eser, Ali; Tombak, Anil; Pala, Cigdem; Ilhan, Osman…Öğe Clinical characteristics, post-treatment assessment and prognostic factors affecting patient survival of patients at 65 years of age or older with hodgkin lymphoma: A retrospective multicenter study from Turkey(A. CARBONE Editore, 2015) Berber, Ilhami; Erkurt, Mehmet Ali; Keklik, Muzaffer; Dogu, Mehmet Hilmi; Terzi, Hatice; Pala, Cigdem; Sari, Hakan IsmailIntroduction: During the last three decades, major advances have been made in the therapy of Hodgkin's lymphoma. However, despite these advances, Hodgkin's lymphoma has a poor prognosis in the elderly. The proportion of Hodgkin's lymphoma patients aged > 60 ranges in the different reports between 15% and 35%. This study aimed to examine clinical characteristics, treatment outcomes and prognostic factors affecting patient survival in Hodgkin's lymphoma patients aged 65 years or older. Material methods: Hodgkin's lymphoma patients at 65 years of age and older managed within last 5 years in a total of 5 centers in Turkey were retrospectively assessed. Results: The median age of a total of 32 patients was 71 (65-83) years. Elderly patients presented more frequently with B symptoms, elevated sedimentation rate, mixed cellularity histologic subtype and comorbid disease. Less frequent were bulky disease, bone marrow involvement, and the application of autologous stem cell transplantation. The nodular lymphocyte predominant subtype and lymphocyte rich subtype were not observed at all. Eastern Cooperative Oncology Group, ferritin, total protein, and histological type were significant predictors affecting survival (p<0.05). Conclusions: Hodgkin's lymphoma is a more fatal disease in 65 years of age or older, when compared to the young population. Tumor biology, older age itself, and other factors related to comorbidity probably contribute to the worse outcome of elderly patients. Further large-scale studies are needed to better investigate the factors that were significant predictors of patient survival.Öğe CLINICAL CHARACTERISTICS, POST-TREATMENT ASSESSMENT AND PROGNOSTIC FACTORS AFFECTING PATIENT SURVIVAL OF PATIENTS AT 65 YEARS OF AGE OR OLDER WITH HODGKIN LYMPHOMA: A RETROSPECTIVE MULTICENTER STUDY FROM TURKEY(CARBONE EDITORE, 2015) Berber, Ilhami; Erkurt, Mehmet Ali; Keklik, Muzaffer; Dogu, Mehmet Hilmi; Terzi, Hatice; Pala, Cigdem; Sari, Hakan Ismail; Sencan, Mehmet; Sivgin, Serdar; Hacioglu, Sibel; Altuntas, Fevzi; Aydogdu, Ismet; Ilhan, OsmanIntroduction: During the last three decades, major advances have been made in the therapy of Hodgkin's lymphoma. However, despite these advances, Hodgkin's lymphoma has a poor prognosis in the elderly. The proportion of Hodgkin's lymphoma patients aged > 60 ranges in the different reports between 15% and 35%. This study aimed to examine clinical characteristics, treatment outcomes and prognostic factors affecting patient survival in Hodgkin's lymphoma patients aged 65 years or older. Material methods: Hodgkin's lymphoma patients at 65 years of age and older managed within last 5 years in a total of 5 centers in Turkey were retrospectively assessed. Results: The median age of a total of 32 patients was 71 (65-83) years. Elderly patients presented more frequently with B symptoms, elevated sedimentation rate, mixed cellularity histologic subtype and comorbid disease. Less frequent were bulky disease, bone marrow involvement, and the application of autologous stem cell transplantation. The nodular lymphocyte predominant subtype and lymphocyte rich subtype were not observed at all. Eastern Cooperative Oncology Group, ferritin, total protein, and histological type were significant predictors affecting survival (p<0.05). Conclusions: Hodgkin's lymphoma is a more fatal disease in 65 years of age or older, when compared to the young population. Tumor biology, older age itself, and other factors related to comorbidity probably contribute to the worse outcome of elderly patients. Further large-scale studies are needed to better investigate the factors that were significant predictors of patient survival.Öğe Diffuse Large B-Cell Lymphoma in adults aged 65 years and older: A retrospective multicenter analysis of clinical characteristics and therapeutic outcomes(CIG MEDIA GROUP, LP, 2015) Dogu, Mehmet Hilmi; Keklik, Muzaffer; Terzi, Hatice; Korkmaz, Serdal; Erkurt, Mehmet Ali; Cagliyan, Gulsum Akgun; Kaynar, Leylagul; Sivgin, Serdar; Sari, Ismail; Keskin, Ali; Sencan, Mehmet; Altuntas, Fevzi; Ilhan, Osman…Öğe Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: twenty-four year Turkish experience in cladribine therapy(WILEY, 2015) Hacioglu, Sibel; Bilen, Yusuf; Eser, Ali; Sivgin, Serdar; Gurkan, Emel; Yildirim, Rahsan; Aydogdu, Ismet; Dogu, Mehmet Hilmi; Yilmaz, Mehmet; Kayikci, Omur; Tombak, Anil; Kuku, Irfan; Celebi, Harika; Akay, Meltem Olga; Esen, Ramazan; Korkmaz, Serdal; Keskin, AliIn this multicenter retrospective analysis, we aimed to present clinical, laboratory and treatment results of 94 patients with Hairy cell leukemia diagnosed in 13 centers between 1990 and 2014. Sixty-six of the patients were males and 28 were females, with a median age of 55. Splenomegaly was present in 93.5% of cases at diagnosis. The laboratory findings that came into prominence were pancytopenia with grade 3 bone marrow fibrosis. Most of the patients with an indication for treatment were treated with cladribine as first-line treatment. Total and complete response of cladribine was 97.3% and 80.7%. The relapse rate after cladribine was 16.6%, and treatment related mortality was 2.5%. Most preferred therapy ( 95%) was again cladribine at second-line, and third line with CR rate of 68.4% and 66.6%, respectively. The 28-month median OS was 91.7% in all patients and 25-month median OS 96% for patients who were given cladribine as first-line therapy. In conclusion, the first multicenter retrospective Turkish study where patients with HCL were followed up for a long period has revealed demographic characteristics of patients with HCL, and confirmed that cladribine treatment might be safe and effective in a relatively large series of the Turkish study population. Copyright (C) 2014 John Wiley & Sons, Ltd.Öğe Nodular lymphocyte predominant Hodgkin's lymphoma in daily practice: A multicenter experience(WILEY, 2018) Gemici, Aliihsan; Aydogdu, Ismet; Terzi, Hatice; Sencan, Mehmet; Aslan, Alma; Kaya, Ali Hakan; Dal, Mehmet Sinan; Akay, Meltem Olga; Dogu, Mehmet Hilmi; Ayyildiz, Orhan; Sahin, Fahri; Cagliyan, Gulsum Akgun; Yilmaz, Mehmet; Gokgoz, Zafer; Bilen, Yusuf; Demir, Cengiz; Sevindik, Omur Gokmen; Korkmaz, Serdal; Eser, Bulent; Altuntas, FevziNodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is a rare subtype of Hodgkin's lymphoma. In this study, we aimed to investigate the clinical features and therapeutic outcomes of patients with NLPHL who were diagnosed at different institutes in Turkey. We retrospectively reviewed the records of the patients diagnosed with NLPHL. Adult patients who were diagnosed after 2005 with histological confirmation were selected for the study. Forty-three patients were included in the study. Median age of patients was 37.5years (18-70) at the time of diagnosis. About 60.5% patients were diagnosed as stage I and II NLPHL, and remaining 39.5% had stage III and IV disease. Median follow-up was 46months. During follow-up, none of the patients died. Seven patients relapsed or progressed after initial therapy at a median of 12months. Five of 7 relapsed/refractory patients (71.4%) were salvaged with chemotherapy only (DHAP, ICE), and the remaining 2 (28.6%) were salvaged with chemoimmunotherapy. All of relapsed/refractory patients were able to achieve complete remission after salvage therapy. Lactate dehydrogenase levels were significantly higher in patients with progressive disease compared with nonprogressive disease. Our study showed an excellent outcome with all patients alive at last contact with a median follow up of 46months despite a wide range of different therapeutic approaches. All relapsed and refractory patients were successfully salvaged despite a low frequency of patients received immunotherapy in conjunction with chemotherapy. Our results suggest that immunotherapy may be reserved for further relapses.Öğe Philadelphia-positive acute lymphoblastic leukemia in daily practice: A multicenter experience.(AMER SOC CLINICAL ONCOLOGY, 2013) Goker, Hakan; Tekgunduz, Emre; Sari, Ismail; Pala, Cigdem; Dogu, Mehmet Hilmi; Ozturk, Erman; Turgut, Burhan; Korkmaz, Serdal; Demiriz, Itir Sirinoglu; Buyukasik, Yahya; Hacioglu, Sibel Kabukcu; Kaynar, Leylagul; Bozdag, Sinem Civriz; Altuntas, Fevzi…Öğe Primary central nervous system lymphoma in daily practice and the role of autologous stem cell transplantation in relapsed disease: A retrospective multicenter study(PERGAMON-ELSEVIER SCIENCE LTD, 2016) Erkurt, Mehmet Ali; Berber, Ilhami; Tekgunduz, Emre; Dogu, Mehmet Hilmi; Korkmaz, Serdal; Demir, Cengiz; Yilmaz, Mehmet; Akay, Olga Meltem; Pala, Cigdem; Bilen, Yusuf; Kaya, Emin; Sari, Ismail; Sencan, Mehmet; Kuku, Irfan; Altuntas, Fevzi; Dal, Mehmet Sinan; Aydogdu, IsmetWe investigated the course of 54 patients presenting with primary central nervous system lymphoma, who were treated in daily practice. The patients were treated with chemotherapy and/or radiotherapy and/or intrathecal chemotherapy. At a median follow-up period of 23 months (range 1-71), median relapse-free survival (RFS) and overall survival (OS) were not reached. Estimated 2-year RFS and OS rates were 42% and 48%, respectively. Ten relapsed PCNSL patients underwent ASCT. Complete remission rate of these patients was 40%, with 20% treatment-related mortality. Estimated 2-year RFS and OS rates were 37% and 40%, respectively. The prognosis of patients with PCNSL, who received off-study treatment, is still dismal. (c) 2016 Elsevier Ltd. All rights reserved.
