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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.

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.

Purpose: Vitamin B12 (cobalamin) has the most complex chemical structure of all vitamins and itis obtained naturally only from products of animal origin in developing countries. Vitamin B12deficiency is prevalent in countries of origin of refugees. The aim of this study was to determinethe prevalence of vitamin B12 deficiency among newly-arrived Syrian refugees in CentralAnatolia of Turkey.Journal of Anatolian Medical Research 2017; 2(1): 22-30OrjinalAraştırma23Methods: Newly arrived 256 refugees aged ≥ 16 years were tested for vitamin B12 level andother hematological parameters.Results: We found that 50 participants (19.5%) had vitamin B12 deficiency (≤ 150 pmol/L). Lowlevels of vitamin B12 were prevalent among males those over the age of 50 (44.4%) (p=0.01) andfemales those under the age of 50 (75%) (p

Amaç: Mutipl Myeloma, tüm kanser tiplerinin %1' ini, hematolojik malignitelerin ise %10' unu oluşturan tamamen kürün sağlanamadığı fatal bir hastalıktır. Genellikle yaşlı populasyonda izlenir. Bu çalışmanın amacı, son 5 yılda farklı rejimlerle tedavi edilen 65 yaş ve üzerindeki 105 Mutipl Myeloma' lı hastadaki klinik deneyimimizi sunmaktır. Yöntem: 65 yaş üzerindeki Mutipl Myeloma'lı hastaların klinik karakterleri ve terapötik sonuçlarını analize etmek için, Türkiye'deki 5 farklı merkezden retrospektif olarak veriler toplandı.Bulgular: 51 erkek ve 54 kadından oluşan toplam 105 yaşlı Multipl Myeloma hastası (65 yaş ve üzeri) retrospektif olarak değerlendirildi. Hastalara ilk basamak olarak, VAD( vinkrsitin, adriamisin, deksametazon), VCD ( Bortezomib, siklofosfamid, deksametazon), MP( melphalan, prednizolon), MPT (Melphalan, prednizolon, thalidomid) rejimleri verildi. 29 hastada tam yanıt elde edildi ve bu hastaların 18 'ine otolog kök hücre nakli yapıldı. Tam yanıt elde edilemeyen 46 hastaya, ikinci basamak tedavi olarak bortezomib, lenalidomid ve talidomid bazlı rejimler verildi. İkinci basamak tedavi ile tedavi edilenlerin 29'unda tam yanıt elde edildi ve bu hastalardan 20'sine otolog kök hücre nakli yapıldı. 16 hastaya ise birinci ve ikinci basamak rejimlere yanıt vermediğinden lenalidomid bazlı rejimler (n:10), talidomid bazlı rejimler (n:6) verildi. Bu tedavilerle remisyona giren 5 hastaya Otolog kök hücre nakli yapıldı. Sonuç: Optimal tedavi yaklaşımı, verimli, güvenli, kaliteli yaşam sağlamalı ve amaç tam yanıtın yanı sıra hastalıksız sağ kalımı ve genel sağ kalımı uzatmak olmalıdır

Amaç: Vitamin B12 tüm vitaminleriçindeki en karmaşık kimyasal yapıya sahip olanı olup, hematolojik ve sinirselsistemin normal fonksiyon görebilmesi için gereklidir. Dolayısıyla, vitamin B12 eksikliği tedaviedilmediğinde depresyon gibi psikiyatrik belirtilere yol açabilir. Bu çalışmadaamacımız, majör depresyon tanılı hastalarda vitamin B12 eksikliği sıklığınıtespit etmekti.Metod: Çalışmada Kayseri Eğitim ve Araştırma Hastanesi’nde DSM-5 kriterleri bazalınarak majör depresyon tanısı konan 425 erişkin hastaya ait verilerdeğerlendirildi. Tüm hastaların CBC, serum vitamin B12 ve folat düzeyleri ilerutin biyokimyasal tetkikleri incelendi. Bulgular: Toplam 425 depresif hastanınverileri incelendi. Hastaların%74.6’sı kadındı. Vitamin B12 eksikliği 93 hastada tespit edildi (% 21.9).Kadınlarda vitamin B12 eksikliği % 22.7 iken, erkeklerde bu oran % 19.4 olaraksaptandı. Her iki cinsiyet grubunda da folik asit, Hb, PLT ve WBC sayılarındaanlamlı farklılık yoktu.Sonuç: : Bu çalışmanın sonuçları, majördepresyon hastalarında vitamin B12 eksikliğinin nadir olmadığını göstermiştir.Depresif semptomları olan hastalarda fizikbulgularıdeğerlendirmek ve vitamin B12 eksikliğini saptamaya yönelik gerekli testleriyapmak faydalı olabilir. Aim: Vitamin B12 has the most complex chemical structure of all vitamins and it is necessary for normal functioning of hematological and nervoussystem. Thus, vitamin B12 deficiency could cause psychiatric symptoms such asdepression when it is untreated. Our aim was to determine vitamin B12deficiency frequency of patients diagnosed with major depression.Method: The present study included 425adult patients with major depression based on Diagnostic and Statistical Manualof Mental Disorders, fifth edition (DSM-5) criteria at Kayseri Education and Research Hospital.In all patients, laboratory evaluations were performed: complete blood count(CBC), serum vitamin B12 andfolate levels, and routine biochemical tests.Results: Theresults of 425 depressive patients were analyzed. Depression was prevelant among females (74.6%). Also, total 93patients (21.9%) were vitamin B12 deficient. While in female patients vitaminB12 deficiency was 22.7%, in male patients, the rate was 19.4%. There wereno significant differences between folate and hemoglobin(Hb) levels, platelet (PLT) and white blood cell (WBC) counts.Conclusion: The results of this study shownthat, the frequency of vitamin B12 deficiency among people is major depressionnot uncommon. It would be beneficial to consider the physical symptoms and toconduct the required examinations to determine vitamin B12 deficiency among this patients.

Aim: Polycythemia is a disease state in which the proportion of blood volumethat is occupied by red blood cells increases. Flow-mediatedvasodilation (FMD) is a non-invasive ultrasound method of evaluatingendothelial function. Theaim of this prospective study was to compare the systemic endothelial functionsby FMD method in patients with polycythemia withcontrol group.Method: Thepresent study included 50 patients with polycytemia (hemoglobin (Hb) ≥16.5 g/dl) and 61 healthy control group aged ≥ 18 years at KayseriEducation and Research Hospital were included. In allindividuals, the following laboratory evaluations were performed: completeblood count (CBC), serum iron indices, and routine biochemical tests. Also, all participants underwent the FMDstudy at Cardiology department with Doppler ultrasound. Results: The results of 111 participantswere analyzed. On the other hand, the rate ofsmoking was 76% in the polycythemia group, while it was 36.1% in the controlgroup (p< 0.005). Likewise, Hb, hematocrit andserum lipid parameters were significantly increased in polycythemia groupexcept high density lipoprotein (HDL) cholesterol (p < 0.001). Also, FMD was significantlyreduced in polycythemiagroup compared with control group (7.78 ± 4.83% vs. 10.98 ± 7.86%,respectively) (p= 0.010).Conclusion: Theresults of the study indicate that polycythemia is associated with endothelialdysfunction and hyperlipidemia. As the noninvasive ultrasound method forperipheral endothelial testing is generally accurate and reproducible, and canbe performed serially, FMD can be used safely in patients with polycythemia toevaluation of endothelial functions.Amaç: Polisitemi, kan volümünün bir parçasını teşkil eden eritrositmiktarındaki artışla karakaterize bir patolojik durumdur. Akış aracılı genişletme (FMD) yöntemi, sistemikvasküler fonksiyonların değerlendirilmesinde giderek önemi artan birnon-invaziv tetkik olup, çeşitli hastalıklarda bu yöntem ile vasküler endotelhakkında önemli bilgiler edinilmiştir. Bu prospektif çalışmada amacımız,polisitemik bireylerde FMD yöntemi ile vasküler fonksiyonları değerlendirmek vesağlıklı kontrol grubu ile karşılaştırmaktı. Metod: Bu çalışmaya; Kayseri Eğitim veAraştırma Hastanesi’ne başvuran 18 yaş ve üzeri, 61 sağlıklı ve Hb değerinormal sınırlarda olan gönüllü ile, 50 polisitemi olgusu alındı. Polisitemitanısı için Hb > 16.5 g/dL baz alındı. Bireylerin tam kan sayımları, demir parametreleri ve rutin biyokimyasaltetkikleri istendi. Katılımcılara Kardiyoloji kliniğinde Doppler ultrasonografieşliğinde FMD işlemi uygulandı.Bulgular: Toplam 111 olgunundeğerlendirildiği çalışmada, gruplar arasında yaş, cinsiyet, vücut kitleindeksi, hipertansiyon ve diabet oranları bakımından fark yoktu. Buna karşın,sigara içim oranı polisitemi grubunda kontrol grubuna göre anlamlı şekildeyüksekti (%76 ve %36.1, sırasıyla) (p< 0.005). Hb, hematokrit ve serum lipidparametreleri de yüksek densiteli lipoprotein (HDL) kolesterol dışındapolisitemi grubunda anlamlı şekilde yüksekti (p < 0.001). Ayrıca, FMD oranıpolisitemik grupta kontrol grubuna göre anlamlı şekilde düşük bulundu (% 7.78 ±4.83 ve %10.98 ± 7.86, sırasıyla)(p= 0.010). Sonuçlar: Bulgularımızla, polisitemik bireylerde vaskülerendotelyal fonksiyonların olumsuz etkilendiği ve hiperlipidemi birlikteliğiortaya konmuştur. Non invaziv ve kolay uygulanabilen FMD yöntemi ile,polisiteminin muhtemel endotelyal disfonksiyon gelişimindeki rolüöngörülebilir.

Total body irradiation (TBI) combined with chemotherapy is widely used as a pretreatment regimen of bone marrow transplantation (BMT) in hematologic disorders. Late complications related to TBI as part of the conditioning regimen for hematopoietic stem cell transplantation have been revealed. Acute transverse myelitis (ATM) is a neurological syndrome characterized by disorder of motor, sensorial, and autonomic nerves, and tracts at medulla spinalis, which is resulted from involvement of spinal cord. In this paper, we presented an ATM attack developed after TBI in a patient with acute lymphoblastic leukemia (ALL) as it is a rarely seen case.

A 59-year-old female patient was admitted to the emergency service with complaints of hematemesis and melena for the last few days. In laboratory tests, the platelet count was found to be 6×109/L. Intravenous or oral corticosteroid treatment was thought to be given for ITP but disclaimed due to upper GIS bleeding. On the 5th day of treatment, Brucella melitensis was isolated from blood culture before the results of Wright tube agglutination tests were reported positive as 1 : 80. On the second day of the anti-brucellosis treatment, the thrombocyte count was raised from 6000/mm3 to 110000/mm3, and on the 3rd day to 225000/mm3.

ÖZET Özefagus varis kanaması tüm üst gastrointestinal sistem kanamalarının % 10'unu oluşturmaktadır. Erken tanı ve tedaviye rağmen, mortalite halen % 30-50 gibi yüksek oranlardadır. Kanamanın kontrol altına alınmasında somatostatin, oktreotid ve diğer vazoaktif ilaçlar kullanılabilmektedir. Bu çalışmada oktreotid infüzyonu ve skleroterapi sonrasında deri altı yoldan uygulanan oktreotid idame tedavisinin kanama tekrarını önlemedeki etkinliği araştırılmıştır. 62Çalışmaya 61 aktif özefagus varis kanamalı olgu alınmış olup, randomize olarak seçilen 34'ü standart tedavi (ST) grubunu oluştururken, 27 olgu da idame tedavisi (İT) grubunu oluşturmuştur. Tüm hastalara 50 ug iv bolus olarak verilen oktreotidi takiben, kanamayı izleyen 12-36 saat boyunca (endoskopik skleroterapi yapılana kadar) 50 ug/saat hızında oktreotid infüzyonu yapıldı. İdame tedavisi grubuna skleroterapi sonrasında beş-yedi gün süreyle sekiz saatte bir 100 ug deri altı oktreotid verildi. Her iki gruba da ilk skleroterapiden sonraki beş-yedinci günlerde ikinci skleroterapi ler yapıldı. Gruplardaki kanama süresi (gün), transfüzyon sayısı (ünite), tekrar kanama süresi (gün), hastanede kalış süresi (gün) ve üç hafta içindeki mortalite durumu kaydedildi. Gruplar arasında yaş, cinsiyet, siroz etyolojisi, Child-Pugh derecesi, transfüzyon gereksinimi ve hastanede kalış sürese bakımından fark bulunmazken (p>0.05), üç haftalık mortalitenin ST grubunda İT grubuna göre anlamlı şekilde yüksek olduğu tespit edildi {9 (% 26.4)'a karşılık 1 (% 3.6) p0.05). Mortality within three weeks was significantly higher in ST group than MT group { 9 (26.4 %) vs. 1 ( 3.6 %), p