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Objective: The reactivation rate of dormant hepatitis B virus (HBV) in the liver is between 4.1% and 41.5% in immune-compromised patients. The disappearance of hepatitis B surface antibody (anti-HBs) can be an alarm for hepatitis B reactivation. In this study, the changes in serological status, reactivation rates, and antiviral prophylaxis rates were evaluated. Materials and Methods: A retrospective study was conducted involving patients who were followed up at Erciyes University HSCT Center between January 2018 and July 2019. The demographic data, type of hematological disease, pre- and post-transplant status of HBV, presence of antiviral prophylaxis, and frequency of hepatitis B flare were evaluated. Results: One hundred and seven patients were included in this study. The median follow-up duration was 18 months. New chemotherapy protocols were initiated in 36 patients due to progression and in 23 patients with a diagnosis of graft-versus-host disease. Anti-HBs levels decreased in 60% of the patients, and anti-HBs levels decreased to below the protective level in 13% of the patients. Among the 107 patients, 38 had resolved hepatitis B infection before transplantation, and 20 and four of 18 patients (22%) who did not receive antiviral prophylaxis developed HBV seroconversion and hepatitis B flare. The median levels of anti-HBs titers after transplantation were 167 IU/L and 15 IU/L in groups that received and did not receive antiviral prophylaxis, respectively (p=0.028). Conclusion: Antiviral prophylaxis should be administered in patients positive for hepatitis B core antibody before hematopoietic stem-cell transplantation. Measuring HBV serological parameters at regular intervals is essential in the high-risk group.

© 2022, UHOD - Uluslararasi Hematoloji Onkoloji Dergisi. All rights reserved.Inflammatory processes play an important role in the pathophysiology of cGVHD. Serum fibrinogen is a proinflammatory protein with a wide range of functions in inflammation. But its role in GVHD is unclear. The aim of this study was to evaluate the predictive impact of pre-transplantation fibrinogen levels on cGVHD in allo-HSCT recipients. We retrospectively analyzed 249 patients with hematologic diseases undergoing allo-HSCT from 10/10 HLA-matched donors. Serum high fibrinogen levels at the time of HSCT (day 0) were significantly associated with cGVHD development in univariate analyses (OR 2.01, p= 0.012) and multivariate analyses (OR 1.003, p= 0.037). There was no significant association between fibrinogen levels and overall survival, disease-free survival and, acute GVHD (p> 0.05). This is the first report demonstrating the association between high fibrinogen levels and increased cGVHD occurrence.Further studies are warranted and may identify the efficacy of fibrinogen as a predictive marker on cGVHD in allo-HSCT recipients.

© 2022 by Turkish Society of Hematology Turkish Journal of Hematology, Published by Galenos Publishing House.Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARS-CoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixty-nine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.

© 2022, UHOD - Uluslararasi Hematoloji Onkoloji Dergisi. All rights reserved.Diffuse large B-cell lymphoma(DLBCL) is the prototype of aggressive lymphomas. The abnormalities such as translocation, deletion, duplication are stated to affect the progress and the prognosis of the disease. This study investigates the presence and impact on the prognosis of K-ras mutation and C-myc overexpression in patients with DLBCL. Twenty eight patients diagnosed with DLBCL and 29 healthy controls, whose diagnostic lymph node biopsy was reactive, were enrolled in this study. Paraffin blocks were analyzed for K-ras mutations and C-myc expressions. The effects of C-myc and K-ras on overall and disease-free survival were evaluated. Of the 28 patients, three (10.7%) K-ras mutations were detected. K-ras mutation (+) cases have an average survival time of 28 months, while those without the mutation were 49 months. The average duration of disease-free survival was 17.6 months in patients with K-ras mutation, while it has been identified as 45 months in patients without mutations (p= 0.072). C-myc overexpression in 17 patients(61%) was detected. Median overall survival was 33 months in male patients, while it was 65 months in female patients (p= 0.006). The median disease-free survival time was 23 months in male patients, although 64 months in female patients (p= 0.003). Complete remission rate was 30% in C-myc overexpression group, while 69% in remaining group with the cut-off 2.48 (p= 0.02). The presence of K-ras and C-myc overexpression in patients with DLBCL does not affect overall and disease-free survival. C-myc overexpression harms complete remission. Gender was found to be influential on the overall and disease-free survival; meanwhile, the female gender was a better prognosis.

Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARS CoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixty nine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.