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    Acute Promyelocytic Leukemia Diagnosed at the End of First Trimester with a Successful Outcome
    (Kare Publ, 2018) Baysal, Mehmet; Umit, Elif G.; Ozdover, Ali Caner; Sutcu, Havva; Cilingir, Isil Uzun; Kirkizlar, Onur; Sayin, Cenk
    The treatment and management of patients with acute promyelocytic leukemia (APL) diagnosed in pregnancy can involve a wide range of difficulties and limitations. Thus, these cases are each unique and present challenges to physicians. The aim of this study was to present the case of a 24-year-old patient who was diagnosed with APL in the 14th week of pregnancy who was treated successfully with all-trans retinoic acid and chemotherapy.
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    A case of refractory chronic lymphocytic leukaemia with an unusual course
    (All India Inst Medical Sciences, 2019) Umit, Elif G.; Baysal, Mehmet; Ozdover, Ali Caner; Kirkizlar, Onur; Demir, Ahmet Muzaffer
    Chronic lymphocytic leukaemia (CLL) is a heterogeneous disease with uncertain course. Treatment should be tailored to the patient's disease as well as the prognostic subgroup. With the increased use of rituximab as well as other selective and non-selective immunomodulatory agents, the incidence of infectious complications and second malignancies has also increased. Progressive multifocal leucoencephalopathy (PML) is a complication of rituximab in HIV-negative patients. A 56-year-old male with CLL had been treated and relapsed four times in 6 years. Rituximab was added to the combination after the second relapse and repeated in the third relapse in combination with bendamustine. In the seventh year of diagnosis, relapse of CLL and an ulcerated tumorous lesion was observed in the left index finger, which progressed in 3 months and was later diagnosed as angiosarcoma. The cancer was treated with local radiotherapy and combination chemotherapy. One year after the last rituximab exposure, progressive muscle weakness developed and polyoma JC virus DNA was observed with increased titres in the cerebrospinal fluid, and the patient was diagnosed as having PML. The patient died 2 months later. Our patient had an unusual course of CLL over 8 years, with relapses, complicated with a secondary malignancy and an infectious complication.
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    Invasive fungal infection with a rare organism in a patient with acute myeloid leukaemia
    (Wolters Kluwer Medknow Publications, 2020) Baysal, Mehmet; Umit, Elif; Ozdover, Ali Caner; Kirkizlar, Onur; Demir, Ahmet Muzaffer
    Invasive fungal infections are a major cause for morbidity and mortality in patients with acute myeloid leukaemia (AML). Long duration of hospitalization and increased costs are secondary burdens for patients and caregivers. The clinical manifestations are variable with a spectrum of different organs or systems. Factors related with invasive fungal infections may be categorized as host-related including the underlying disease, treatment and colonization status and pathogen-related including the capacity of the microorganism for defence, growth, tolerance and tissue affinity. The diagnosis of invasive fungal infection is confirmed with histopathological or microbiological demonstration of the microorganism, and commonly treatments are based on probability rather than definitive diagnosis due to patients fragile conditions preventing interventions. We aimed to present the less frequent yet difficult-to-treat organism, Verticillium causing invasive fungal infection in a patient with AML undergoing remission induction therapy.
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    Thalidomide for the Management of Bleeding Episodes in Patients with Hereditary Hemorrhagic Telangiectasia: Effects on Epistaxis Severity Score and Quality of Life
    (Galenos Yayincilik, 2019) Baysal, Mehmet; Umit, Elif G.; Kirkizlar, Hakki Onur; Ozdover, Ali Caner; Demir, Ahmet Muzaffer
    Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominantly inherited disorder characterized by bleeding episodes. These episodes tend to happen spontaneously and reduce the quality of life. Patients are often unresponsive to local measures. With the pathophysiological role of angiogenesis in HHT, antiangiogenic drugs including thalidomide are used to control bleeding episodes. In our study, we evaluated 6 patients with HHT, calculating their Epistaxis Severity Score (ESS) and performing a quality of life assessment with the 36-Item Short Form Health Survey Questionnaire (SF-36), and we studied the alterations of these evaluations with thalidomide treatment. Three patients were male and three were female. Mean age was 60.50 years. No side effects were observed during the treatment period. Improvements of certain SF-36 dimensions including physical functioning, physical component summary, and mental component summary and of the ESS were observed after treatment. Thalidomide may be effective to control bleeding episodes with a reasonable tolerance profile in patients with HHT.