Asu Fergun Yilmaz

The effect of the additional cytogenetic abnormalities on major molecular response and BCR-ABL kinase domain mutations in long-term follow-up chronic myeloid leukemia patients, a cross sectional study.

Abstract The aim of the study was to examine the relation between additional chromosomal aberrations (ACAs) with major molecular response (MMR) and BCR-ABL kinase domain (KD) mutations in the long-term follow-up of the chronic myeloid leukemia (CML) disease. The study design was cross-sectional observational and used the CML patients’ data of Izmir Ataturk Education and Research Hospital from 2011 to 2015. Conventional cytogenetic, fluorescence in situ hybridization (FISH), quantitative real-time polymerase chain reaction (RQ-PCR) test results from 89 CML patients’ and pyrosequencing analysis results from 17 patients’ were set up for comparison analysis. The chi-square test was used in statistical analysis of the experimental data. There were no statistically significant correlations between ACAs and MMR (p = .361, p > .05) groups or BCR-ABL KD mutations (p = .576, p > .05) groups observed in the study. This study has revealed that MMR and BCR-ABL KD mutations did not correlate with ACAs.

Extramedullary Relapse in a CML Patient after Allogeneic Stem Cell Transplantation

Myeloid or granulocytic sarcoma (GS) is a tumoral lesion consisting of immature granulocytic cells. It is a rare entity during the course of CML patients especially after allogeneic stem cell transplantation (SCT). Relapse without bone marrow involvement is much rarer. We report a case of CML patient who relapsed with isolated granulocytic sarcoma after allogeneic SCT during cytogenetic and molecular remission. 28-year-old male was diagnosed as CML and allogeneic SCT was performed because of refractory disease to tyrosine kinase inhibitors. Complete cytogenetic and molecular response was achieved after allogeneic SCT followed by dasatinib treatment. Approximately 5 years after the transplantation, very rapidly progressive lesion was documented and diagnosed as GS although he was at molecular and cytogenetic remission. The patient died during chemotherapy due to sepsis. GS relapse after allogeneic SCT is a very rare type of relapse in CML patients with molecular and cytogenetic remission. Since it is a very aggressive disease with a poor prognosis, combined chemoradiotherapies with other possible options like DLI or second allogeneic SCT should be considered as soon as the diagnosis is confirmed.

Retrospective analysis of primary gastric diffuse largeB-cell lymphoma: a single center study from Turkey

BACKGROUND/AIM Diffuse large B-cell primary gastric lymphomas (DLBC-PGLs) are treated with different therapies. Their optimal treatment is not well documented. MATERIALS AND METHODS We retrospectively analyzed the data of 51 patients diagnosed with DLBC-PGL in the previous 10 years. All patients were treated with R-CHOP as first line. Radiotherapy was added to chemotherapy in 8 patients. Surgery was performed in 5 patients. RESULTS The median follow-up time of the 51 patients was 45.5 (range 5-144) months and the complete response (CR) rate was 90.2%. CR was achieved in 34 (89.4%) of 38 patients treated with single chemotherapy, in all (100%) 5 patients treated with chemotherapy plus surgery, and in 7 (87.5%) of 8 patients treated with chemotherapy plus radiotherapy. The 5-year overall survival (OS) and event-free survival (EFS) rates were 85.8% and 89.6%, respectively. The 5-year OS and EFS rates were not significantly different between patients treated with single chemotherapy or chemotherapy plus radiotherapy/surgery (P > 0.05). CONCLUSION R-CHOP chemotherapy is as effective as R-CHOP plus radiotherapy/surgery in the treatment of DLBC-PGL patients. Prospective randomized large cohort studies are needed to generate guidelines for the treatment of DLBC-PGL.

Determining expression of miRNAs that potentially regulateSTAT5A and 5B in dasatinib-sensitive K562 cells

In the era of tyrosine kinase inhibitors, resistance still constitutes a problem in chronic myeloid leukemia (CML) patients; thus, new pathway-specific inhibitors like miRNAs have become important in the treatment of refractory patients. There are no satisfying data regarding the miRNAs and anti-miRNA treatment targeting STAT5A and 5B. In this study, we first researched the effect of dasatinib on apoptosis in the CML cell line K562. The expressions of miRNAs possibly targeting both STAT5A and 5B were then determined. The down- and upregulation of the miRNAs were compared using the ΔΔCT method. At the last stage of the study, we used a new primer probe in order to validate the results. The level of hsa-miR-940 was decreased 4.4 times and the levels of hsa-miR-527 and hsa-miR-518a-5p were increased 12.1 and 8 times, respectively, in the dasatinib-treated group when compared to the control group. We detected similar results in the validation step. As a conclusion, we determined the expression profiles of miRNAs targeting STAT5A and 5B that had an important role in the pathogenesis of CML. The data obtained could lead to determining new therapeutic targets for CML patients.

Perforation of Ileum Due to Thrombosis in the Course of Paroxysmal Nocturnal Hemoglobinuria: A Case Report

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disease which is characterized by hemolysis, thromboses in unexpected sites and multi-organ involvement. Arterial thromboses could result in necrosis and dysfunction of involved organs. In some cases, organ dysfunctions could be fatal as in involvement of heart, small intestine and lung. Eculizumab is a monoclonal antibody which decreases risk of thrombosis and hemolysis in patients with PNH by inhibiting complement system. Hereby, we present a case with acute abdomen which was operated and small intestinal necrosis was detected due to thromboses which was resulted in PNH undiagnosed until the time of operation. Unexpected thromboses should be carefully investigated in terms of potential coexistence of PNH associated with multi-organ involvement and treated appropriately.