AbstractBackground and aimIn the past, acute promyelocytic leukemia (APL) was considered as one of the most rapidly lethal form of acute myeloid leukemia (AML). The objective of this study was to assess clinical parameters affecting early death (ED) in patients with APL.Materials and methodsForty-three patients with APL who were diagnosed at Hacettepe University Hospital between the years of 2005 and 2018 were evaluated.ResultsIn univariate analyses, presentation with hemorrhage, DIC or infection at diagnosis, ECOG performance score, blast percentage on bone marrow, Sanz score, leukocyte, thrombocyte, fibrinogen and LDH levels were found to be statistically significantly different between patients with ER and patients without ED. In multivariate analysis, presentation with hemorrhage, DIC or infection at diagnosis, ECOG performance score, blast percentage on bone marrow, Sanz score, leukocyte, thrombocyte, fibrinogen, and LDH levels were found to be independent factors that are related with higher rate of ED in 30 days after treatment.ConclusionInduction chemotherapy should be started as soon as possible after diagnosis of APL. Improving ED rates may become the greatest challenge for the future treatment of the diseases.

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Objective: Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for a variety of malignant and non-malignant hematologic disorders. Myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens could have different clinical outcomes. This purpose of this study was to assess the long-term outcome of MAC versus RIC regimens in patients with acute myeloid leukemia (AML) undergoing allogeneic HSCT. Materials and Methods: We retrospectively compared long-term outcomes with MAC and RIC regimens in patients with AML who underwent allo-HSCT at our tertiary transplantation center. Results: We analyzed survival outcomes after MAC-HSCT versus RICHSCT among 107 adult patients with AML diagnosed from 2001 through 2017. Of those, 44 patients underwent a MAC regimen, whereas 63 patients received a RIC regimen. The median follow-up time was 37 months (range: 6-210) for the entire group. The 3-year overall survival (OS) for RIC and MAC patients was 67% and 60%, respectively (p>0.05). The 3-year progression-free survival (PFS) for RIC and MAC patients was 88% and 77%. In multivariate analysis, the type of conditioning regimen (RIC vs. MAC) did not influence PFS (p=0.24). Acute graft-versus-host disease (GVHD) was seen in five of the RIC patients and 9 of the MAC patients. Chronic GVHD was seen in 16 of the RIC patients and 6 of the MAC patients. There was no significant difference between the two groups in terms of acute GVHD (p=0.089), but there was a significant difference between the two groups in terms of chronic GVHD (p=0.03). Conclusion: This retrospective analysis confirmed that MAC and RIC regimens had a consistently equivalent rate of OS and PFS in AML patients who underwent allo-HSCT. The choice of MAC versus RIC conditioning regimen might be decided on the basis of patient and disease characteristics.

Serum biglycan might be used as a non-invasive marker of liver fibrosis. Further studies are needed to evaluate the usefulness of this marker.

Introduction Ankaferd hemostat (ABS; Ankaferd blood stopper, İstanbul, Turkey) is a folkloric medicinal plant extract. ABS has been conventionally used in Anatolia as a hemostatic agent for centuries (1). ABS contains a standardized combination of the plants Glycyrrhiza glabra, Thymus vulgaris, Alpinia officinarum, Vitis vinifera, and Urtica dioica. All of these plants have effects on the endothelium, the cellular components of blood, the development of new blood vessels, cell proliferation, and cell mediators (2,3). The hemostatic effect of ABS depends upon the quick promotion of a protein network, particularly fibrinogen gamma, in relation to the erythrocyte aggregation (1). In addition to hemostatic functions, antiinflammatory (4), antiinfective (5), antifungal (6), and antioxidative (4) effects have been demonstrated for ABS. Thymus vulgaris has bacteriostatic activity for gram-positive and gram-negative bacteria (7-10). Likewise, Glycyrrhiza glabra, Vitis vinifera, and Alpinia officinarum have been shown to be antibacterial agents (11,12). Urtica dioica also has significant antibacterial activity against Streptococcus pyogenes, Staphylococcus aureus, and Staphylococcus epidermidis (12). ABS is currently licensed for numerous bleeding lesions of GIS pathologies, such as peptic ulcers (13), fundal varices (14), dieulafoy lesions (15,16), radiation colitis (17), rectal ulcers (18) and nonvariceal upper gastrointestinal bleeding (19). Most of the bleeding lesions were controlled with ABS in all patient groups (20-23). Furthermore, ABS is a potent hemostatic drug for controlling malignant gastrointestinal (GI) tumors. It has successful antineoplastic effects on colon cancer (as represented by the in vitro effects on CaCo-2 cells) (24). It significantly decreases tumor microvessel density (25). Almost 70% of gastric ulcer and 85% to 95% of duodenal ulcer patients have coexisting H. pylori infections (26,27). It is well recognized that H. pylori eradication therapy can reduce the repetition of peptic ulcer. Several different studies support the important role played by H. pylori in mucosa-associated lymphoid tissue (MALT) lymphomagenesis. Chronic infection with H. pylori is significantly related with the induction of gastric lymphoid Background/aim: Ankaferd hemostat (ABS; Ankaferd blood stopper, İstanbul, Turkey) is a folkloric medicinal plant extract. The aim of this study was to determine the effect of Ankaferd hemostat (ABS) on the fate of Helicobacter pylori strains. The study also aims to determine alterations in the antimicrobial resistance of three different H. pylori strains in response to ABS exposure. Materials and methods: H. pylori Strain 1 was obtained from the culture collection ATCC 43504 and passaged three times for viability. Strain 2 was isolated from a gastric ulcer patient and Strain 3 was isolated from a gastritis patient. 1% of ABS was added to all of the strains and antimicrobial susceptibility was observed on 30 and 60 min after application. Results: The efficacy of ABS solutions in achievi...

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This is the first study to evaluate both the dynamic thiol-disulfide homeostasis and ischemia-modified albumin (IMA) levels in patients with chronic lymphocytic leukemia (CLL). Twenty-nine patients with CLL and 20 controls were included in the study. The dynamic thiol-disulfide balance was determined by the newly developed colorimetric method by Erel. IMA levels were determined by the cobalt binding test. We found that total antioxidant status levels were lower while total oxidant status (TOS) and oxidative stress index (OSI) levels were significantly higher in patients with CLL than controls. Moreover, native and total thiol levels were found to be statistically significant between the study and control groups (p<0.001), whereas no statistically significant difference was noted for IMA levels (p=0.365). A negative correlation was observed between native and total thiol levels, leukocyte, lymphocyte, and TOS. Total bilirubin showed positive correlation with direct bilirubin and alkaline phosphatase. In addition, IMA levels showed a positive correlation with OSI. This study highlights measurement of native and total thiol and IMA levels in patients with CLL for the first time. Dynamic thiol-disulfide homeostasis may contribute in the pathophysiological mechanism, and follow-up to disease in patients with CLL.

Background and aim: High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) has been considered the standard of treatment care for patients with multiple myeloma (MM). Insufficient mobilization and harvest of peripheral stem cells can be a major obstacle for performing ASCT. This is resulting in a lacking opportunity of cure in patients with MM. The aim of this study was to evaluate the factors which influence mobilization failure in patients with MM. Materials and methods: This study has been performed in a retrospective manner. Two hundred and thirty-four patients with diagnosed MM who underwent stem cell mobilization after induction chemotherapy at Hacettepe University Hospital between the years of 2003 and 2018 were evaluated. Results: A total of 234 patients were included in this study. The median age was 54 (32-76) years at the time of diagnosis. In 209 of 234 patients (89.3%) first mobilization trial was successful. At univariate analysis, among parameters identifiable before mobilization, male gender (p = 0.03), number of chemotherapy cycle before stem cell mobilization (p < 0.001), second ASCT (p < 0.001) and immunomodulatory treatment before stem cell mobilization (p < 0.001) predicted mobilization failure. At multivariate analysis, number of chemotherapy cycle before stem cell mobilization (p = 0.03), second ASCT (p < 0.001) and immunomodulatory treatment before stem cell mobilization (p = 0.02) retained independent predictive power. Conclusion: Detectable different clinical characteristics of MM patients before initiating mobilization may be predictors of poor mobilization. Therefore, the mobilization protocol should be evaluated on a patient basis. Minimization of exposure to chemotheraputic agents in MM patients, especially immunomodulatory agents, may increase CD34+ cell harvest yields.