Mahmut Bayik

Chemotherapy-induced acral erythema in leukemic patients: a report of 15 cases.

Background Chemotherapy‐induced acral erythema is a distinct localized cutaneous response to certain systemic chemotherapeutic agents.

Behçet's disease in patients with chronic myelogenous leukemia: possible role of interferon-alpha treatment in the occurrence of Behçet's symptoms.

Abstract Two patients with chronic myelogenous leukemia (CML) who developed characteristic features of Behçets disease (BD) during alpha-interferon (IFN-α) treatment and another patient who had a diagnosis of BD preceding CML are presented. In the first two patients, features of BD appeared 6 months after the initiation of IFN-α treatment; they included recurrent oral aphthae, genital ulceration, arthritis, folliculitis, and a positive skin pathergy test. The third patient, however, had a diagnosis of Behçets disease 4 years before diagnosis of Philadelphia-positive CML. We prospectively examined the skin pathergy reaction in a group of patients with CML, multiple myeloma, and hairy cell leukemia both before and after IFN-α treatment and found two additional patients with CML who developed a positive skin pathergy test following IFN-α treatment.

Bortezomib: a new therapeutic option for POEMS syndrome

Objective: POEMS syndrome with its classical five findings (Polyneuropathy, Organomegaly, Endocrinopathy, M protein, and Skin changes) is a rare multisystem disease. Proinflammatory and proangiogenic cytokines play important roles in its pathogenesis. Treatment options are still debated. Methods: We present a 65‐year‐old man with POEMS syndrome who was successfully treated with bortezomib. Results: After seven cycles of this protocol, serum M protein level declined to normal range, and near‐to‐complete remission was achieved. His symptoms of polyneuropathy improved dramatically. Conclusion: Bortezomib may be an effective and safe therapeutic option for patients with POEMS syndrome.

Efficacy of high‐dose methylprednisolone as a first‐line therapy in adult patients with idiopathic thrombocytopenic purpura

Fifty‐seven adult patients with idiopathic thrombocytopenic purpura (ITP) were treated with either conventional‐dose prednisolone (CDP) (1 mg/kg/d, 36 patients) or high‐dose methylprednisolone (HDP) (30 mg/kg/d, 21 patients), as first‐line treatment. Patients in the HDP arm responded more rapidly (4.7 v 8.4 d), with a higher response rate (80% v 52.7%), and without severe side‐effects. One quarter of the patients (3/12) who were non‐responsive to CDP achieved complete remission when they were treated with HDP. The findings suggest that HDP may be a more effective first‐line treatment than CDP for adult ITP, and it may also be preferred for life‐threatening cases of ITP. However, these results must be confirmed by a randomized study prior to any change in the current practice of employing CDP as first‐line treatment for adult ITP.

Human herpes virus 8‐unrelated primary effusion lymphoma‐like lymphoma: report of a rare case and review of the literature

Primary effusion lymphoma (PEL) is a very rare type of lymphoma usually confined to the body cavities predominantly in immunosupressed patients infected with human herpes virus 8 (HHV‐8). The new term for HHV‐8 independent PEL is HHV8‐unrelated PEL‐like lymphoma. We describe an 89‐year‐old human immunodeficiency virus (HIV)‐negative male patient with HHV8‐unrelated PEL‐like lymphoma in the pleura. No hepatosplenomegaly or lymphadenopathy was detected. Chest radiography and computed tomography revealed right pleural effusion, but no evidence of tumor mass or lymph node enlargement. Cytological analysis of the pleural effusion revealed a high‐grade lymphoma with round nuclei, prominent nucleoli and abundant cytoplasm with immunophenotypes positive for CD45, CD30, CD38, CD7 and CD71. Because of the advanced age, no chemotherapy was given. Effusion resolved spontaneously. One year after the diagnosis, a new pleural effusion developed at the left side. Following thoracentesis and pleurodesis, the patient remained in complete remission for 40 months. To date, 30 cases of HHV8‐unrelated PEL‐like lymphoma/HIV negative have been reported in the literature. The outcome of the HHV8‐unrelated PEL‐like lymphoma patients who were HIV negative seems to be better than HIV‐ and HHV‐8‐positive PEL.

Aberrant expression of c‐met and HGF/c‐met pathway provides survival advantage in B‐chronic lymphocytic leukemia

B‐chronic lymphocytic leukemia (B‐CLL) is characterized by accumulation of CD5+ B lymphocytes. Decreased VLA‐4 (Cd49d/CD29) and CD11a expression and defective adhesion in B‐CLL have been previously shown, although there was no substantial data about its importance in immunobiology of B‐CLL. The hepatocyte growth factor (HGF) receptor, c‐met, plays a role in adhesion by acting on VLA‐4. c‐met and VLA‐4 share crucial signaling molecules in cell survival. In this study, relationship between expressions of c‐met and CD49d, CD11a, and additional common signaling molecules in B‐CLL was investigated.

Stage IV Hodgkin's Disease presenting with spinal epidural involvement and cauda equina compression as the initial manifestation: Case report

Hodgkins disease very rarely presents clinically, initially with a paraspinal mass, but this should be considered in the differential diagnosis. A patient presenting with back pain was diagnosed to have Stage IV Hodgkins disease. MRI revealed an extradural and intraspinal soft tissue mass with bone infiltration. The importance of MRI in the early evaluation of a paraspinal mass and in determining the extent of the disease is emphasized.

Expression and prognostic significance of cox-2 and p-53 in hodgkin lymphomas: a retrospective study

BackgroundCyclooxygenase (cox) is the rate-limiting enzyme, which catalyzes the conversion of arachidonic acid into prostaglandins and contributes to the inflammatory process. Cyclooxygenase-2 (cox-2), which is one of the two isoforms, plays a role in tumor progression and carcinogenesis. p53 contributes to apoptosis, DNA renewal and cell cycle. Studies concerning the relationship of cox-2 and p53 expressions and carcinogenesis are available, but the association between cox-2 and p53 in Hodgkin lymphoma (HL) is not exactly known.In our study, we examined the association of cox-2 and p53 expression, with age, stage, histopathological subtype, and survival in HL. We also examined correlation between cox-2 and p53 expression.MethodsCox-2 and p53 expressions in Hodgkin-Reed Sternberg cells (HRS) were examined in 54 patients with HL depending on cox-2 expression, stained cases were classified as positive, and unstained cases as negative. Nuclear staining of HRS cells with p53 was evaluated as positive. The classifications of positivity were as follows: negative if<10%; (1+) if 10-25%; (2+) if 25-50%; (3+) if 50-75%, (4+) if >75%.ResultsCox-2 and p53 expressions were found in 49 (80%) and 29 (46%) patients, respectively. There were differences between histological subtypes according to cox-2 expression (p = 0.012). Mixed cellular (MC) and nodular sclerosing (NS) subtypes were seen most of the patients and cox-2 expression was evaluated mostly in the mixed cellular subtype.There were no statistically significant relationships between p53 and the histopathological subtypes; or between p53, cox-2 and the factors including stage, age and survival; or between p53 and cox-2 expression (p > 0.05).ConclusionConsidering the significant relationship between the cox-2 expression and the subtypes of HL, cox-2 expression is higher in MC and NS subtypes. However the difference between these two subtypes was not significant. This submission must be advocated by studies with large series

Effect of Interferon-α2a on Neutrophil Adhesion and Phagocytosis in Chronic Myeloid Leukemia and Behçet’s Disease

Abstract: Alpha-interferon (α-IFN) is implicated in a Behçet’s disease (BD)-like syndrome observed in a small number of chronic myeloid leukemia (CML) patients. The effect of α-IFN on neutrophil adhesion and phagocytosis in CML patients, BD patients and healthy volunteers was investigated to clarify the reason for this observation. Ten subjects were studied for each group by incubating neutrophils with various doses of α-IFN. Basal neutrophil adhesions for CML patients, BD patients and healthy volunteers were similar. However, BD patients had greater basal phagocytosis than CML patients, and both groups had greater basal phagocytosis than healthy volunteers. Neutrophil adhesion and phagocytosis of CML patients increased following incubation with higher doses of α-IFN, and phagocytosis approached the high levels observed with BD neutrophils. This study provides evidence that α-IFN activates neutrophils in CML patients in a dose-dependent manner, and leads to a neutrophil function profile that resembles BD.

Subcutaneous Nodules Caused by Pseudomonas aeruginosa: Healing Without Incision and Drainage

In a patient with multiple myeloma, numerous indurated, subcutaneous nodules and pyomyositis due to Pseudomonas aeruginosa were noted. These lesions resolved with ciprofloxacin plus ceftazidime therapy without surgical incision and drainage. Despite another course of cancer chemotherapy after total disappearance, there were no recurrences at the end of 3 months. Quinolones initially combined with other antipseudomonal beta-lactam agents may be the drugs of choice in the management of patients with subcutaneous nodules caused by P. aeruginosa.