Person: HUNUTLU, FAZIL ÇAĞRI
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HUNUTLU
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FAZIL ÇAĞRI
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Publication The clinical impacts of the controlling nutritional status score on patients with hodgkin lymphoma(Verduci Publisher, 2023-10-01) Gürsoy, V.; Pinar, I. -E.; Ali, R.; Hunutlu, Fazıl Çağrı; GÖKTUĞ, MEHMET REFİK; HUNUTLU, FAZIL ÇAĞRI; Özkocaman, Vildan; ÖZKOCAMAN, VİLDAN; Özkalemkaş, Fahir; ÖZKALEMKAŞ, FAHİR; Tıp Fakültesi; Hematoloji Ana Bilim DalıOBJECTIVE: The aim of the study was to evaluate the clinical importance and potential mechanisms of controlling nutritional status (CONUT) score as a prognostic tool for Hodgkin lymphoma (HL). PATIENTS AND METHODS: Diagnosed with HL, 307 patients were included in the study. Patients' demographic data, stages, B symptoms, extranodal involvement, presence of bulky disease, laboratory findings, treatments, treatment responses, nutritional status, and overall survival (OS) rates were evaluated from the hospital records. The pri-mary endpoint of our study was to evaluate and classify newly diagnosed HL patients under the CONUT score. The secondary endpoint was to indicate any relationship between nutritional status, CONUT score, and other prognostic factors and OS.RESULTS: Of 307 patients (173 males, 134 females), the mean age was 41.58 +/- 16.26 (ranging between 18-82 years). The most common type of malignancy was nodular sclerosis (72.53%). To the receiver operating characteristic (ROC) curve analysis, the best cut-off point was 2.5 to predict mortality. Eigthy-five (27.7%) and 222 (72.3%) patients had >= 3 and <= 2 CONUT scores, respectively. Twenty-four (10.80%) and 23 (27.10%) cases were also mortal in the patients with <= 2 and >= 3 CONUT scores, respectively (p<0.001). Survival times were significantly lower in those with higher (>= 3) CONUT scores (p<0.001) than among the other patients.CONCLUSIONS: Evaluation of nutritional status plays an important role in the response and survival of those with hematological malignancies. Malnutrition can reduce patients' tolerance to chemotherapy and increase the risk of secondary infections. In this study, undernutrition evaluated with the CONUT score was demonstrated to be a potential independent prognostic factor for OS in patients with HL.Publication Systemic inflammatory indices for predicting prognosis of myelofibrosis(Nature Portfolio, 2023-08-02) Ersal, Tuba; Özkocaman, Vildan; Pınar, İbrahim Ethem; Yalçın, Cumali; Orhan, Bedrettin; Candar, Ömer; Çubukcu, Sinem; Koca, Tuba Güllü; Hunutlu, Fazıl Çağrı; Yavuz, Şeyma; Ali, Ridvan; Özkalemkaş, Fahir; ERSAL, TUBA; ÖZKOCAMAN, VİLDAN; PINAR, İBRAHİM ETHEM; YALÇIN, CUMALİ; ORHAN, BEDRETTİN; CANDAR, ÖMER; ÇUBUKÇU, SİNEM; GÜLLÜ KOCA, TÛBA; HUNUTLU, FAZIL ÇAĞRI; YAVUZ, ŞEYMA; ALİ, RIDVAN; ÖZKALEMKAŞ, FAHİR; Tıp Fakültesi; İç Hastalıkları Ana Bilim Dalı; Hematoloji Bilim Dalı; 0000-0001-9907-1498; 0000-0003-4168-2821; 0000-0003-3970-2344; 0000-0002-4991-9830; AAJ-4354-2021; FQG-8981-2022; JGM-6601-2023; KIE-5102-2024; ACW-2157-2022; EOZ-1609-2022; JJB-0254-2023; GWQ-5007-2022; KCK-7512-2024; GXS-5860-2022; GXD-8209-2022; JIW-1248-2023The impact of inflammatory markers such as systemic immune-inflammation (SII) index and systemic inflammation response index (SIRI) on myelofibrosis (MF) prognosis was evaluated for the first time in this study. Data from 60 patients diagnosed with MF between March 2011 and September 2022 were retrospectively analyzed. In addition to disease-related markers, the impact of SII and SIRI on prognosis was evaluated. In our study, the overall median survival (OS) was 64 months. OS was significantly shorter in patients older than 65 years, with high ferritin and lymphocyte levels, transfusion dependence at diagnosis, platelet count below 100 x 10(9)/L, Hb level below 8 g/dl, and high risk according to the dynamic international prognostic scoring system (DIPSS)-Plus score. When these variables were included in the multivariate Cox regression model, it was found that being older than 65 years, having a high ferritin value, being at high risk according to the DIPSS-plus score and Hb values below 8 increased the risk of death. Platelet-to-lymphocyte ratio (PLR) and SII index were lower in patients with a fatal outcome. No statistically significant relationship was found between SIRI and mortality. The findings of this study showed that low PLR and high ferritin were associated with poor prognosis in MF. Elevated SII and SIRI, evaluated for the first time in patients with myelofibrosis, did not predict prognosis. Since non-inflammatory variables play a role in the pathogenesis of MF, bone marrow indicators and systemic inflammation indicators derived from hematologic parameters may not be accurate.Publication The evaluation of risk factors leading to early deaths in patients with acute promyelocytic leukemia: A retrospective study(Springer, 2022-02-21) Baysal, Mehmet; Gürsoy, Vildan; Hunutlu, Fazıl Çağrı; Erkan, Buket; Demirci, Ufuk; Baş, Volkan; Gülsaran, Sedanur Karaman; Pınar, İbrahim Ethem; Ersal, Tuba; Kırkızlar, Tuğcan Alp; Atlı, Emine Ikbal; Kırkızlar, Hakkı Onur; Ümit, Elif G.; Gürkan, Hakan; Özkocaman, Vildan; Özkalemkaş, Fahir; Demir, Ahmet Muzaffer; Ali, Rıdvan; GÜRSOY, VİLDAN; HUNUTLU, FAZIL ÇAĞRI; ERKAN ÖZMARASALI, BUKET; PINAR, İBRAHİM ETHEM; ERSAL, TUBA; ÖZKOCAMAN, VİLDAN; ÖZKALEMKAŞ, FAHİR; ALİ, RIDVAN; Tıp Fakültesi; İç Hastalıkları Ana Bilim Dalı; Hematoloji Bilim Dalı; 0000-0001-9907-1498 ; 0000-0002-4991-9830 ; CTT-7336-2022; KCK-7512-2024; CPN-8681-2022; JGM-6601-2023; AAJ-4354-2021; JIR-6730-2023; DLR-8474-2022; GXD-8209-2022Acute promyelocytic leukemia (APL) differs from other forms of acute myeloid leukemia (AML), including coagulopathy, hemorrhage, disseminated intravascular coagulation (DIC), and treatment success with all-trans retinoic acid (ATRA). Despite ATRA, early deaths (ED) are still common in APL. Here, we evaluated factors associated with ED and applicability of scoring systems used to diagnose DIC. Ninety-one APL patients (55 females, 36 males, and median age 40 years) were included. ED was defined as deaths attributable to any cause between day of diagnosis and following 30th day. DIC was assessed based on DIC scoring system released by the International Society of Thrombosis and Hemostasis (ISTH) and Chinese Diagnostic Scoring System (CDSS). Patients' median follow-up time was 49.2 months, and ED developed in 14 (15.4% of) cases. Patients succumbing to ED had higher levels of the Eastern Cooperative Oncology Group Performance Status (ECOG PS), lactate dehydrogenase (LDH), and ISTH DIC, and lower fibrinogen levels (p <0.05). In multivariate Cox regression analysis, age >55 and ECOG PS >= 2 rates were revealed to be associated with ED. Based on ISTH and CDSS scores, DIC was reported in 47.3 and 58.2% of the patients, respectively. Despite advances in APL, ED is still a major obstacle. Besides the prompt recognition and correction of coagulopathy, those at high ED risk are recommended to be detected rapidly. Implementation of local treatment plans and creating awareness should be achieved in hematological centers. Common utilization of ATRA and arsenic trioxide (ATO) may be beneficial to overcome ED and coagulopathy in APL patients.Publication The effect of cryopreservation on engraftment kinetics in fully matched allogeneic stem cell transplantation: Real-life data and literature review(Pergamon-Elsevier Science Ltd, 2023-12) Ersal, Tuba; Özkocaman, Vildan; Yalçın, Cumali; Orhan, Bedrettin; Candar, Ömer; Çubukçu, Sinem; Koca, Tuba Güllü; Hunutlu, Fazıl Cağrı; Özkalemkaş, Fahir; ERSAL, TUBA; ÖZKOCAMAN, VİLDAN; YALÇIN, CUMALİ; ORHAN, BEDRETTİN; CANDAR, ÖMER; ÇUBUKÇU, SİNEM; GÜLLÜ KOCA, TÛBA; HUNUTLU, FAZIL ÇAĞRI; ÖZKALEMKAŞ, FAHİR; Tıp Fakültesi; İç Hastalıkları; Hematoloji Bölümü; 0000-0003-3970-2344; 0000-0002-4991-9830; AAJ-4354-2021; JJP-2815-2023; KIE-5102-2024; ACW-2157-2022; JWF-3713-2024; JJB-0254-2023; GWQ-5007-2022; KCK-7512-2024; JJW-7463-2023Introduction: The standard approach for allogeneic stem cell transplantation (allo-SCT) is to administer donor cells on the same day as a fresh product to a patient who has been given a preparative regimen. The difficulty in collecting and transporting donor cells, especially during the COVID-19 pandemic, has made it essential to collect and cryopreserve the grafts before the recipient begins the transplant preparation regimen. However, the shortand long-term impacts of cryopreservation on transplant outcomes remain controversial. Materials and methods: This retrospective study included 93 patients who underwent allo-SCT between January 2012 and August 2022 at the Stem Cell Transplant Unit of Bursa Uludag University Faculty of Medicine using frozen and fresh products of peripheral blood stem cells from a fully matched sibling donor. The effect of cryopreservation of donor grafts on engraftment kinetics was investigated. Results: Frozen and fresh products were used in 37 and 56 patients, respectively. The majority of patients had acute myeloid leukemia and acute lymphoblastic leukemia. The median age at transplantation was 41 years. Neutrophil engraftment time was similar between the two groups (median: 14 vs. 16 days, p = 0.393). Platelet engraftment time was longer in the frozen product group (median: 12 vs. 15 days, p < 0.001). There was no statistically significant difference between freezing time and viability. The acute graft-versus-host disease (GVHD) rate was 37.8 % in the frozen product group and 28.6 % in the fresh product group (p = 0.349). There was no significant difference between the two groups in terms of primary and secondary graft failure, chronic GVHD, 30-day chimerism, relapse, overall survival, progression-free survival, and nonrelapse mortality. Conclusion: Having donor cells ready before transplantation significantly prevents donor-induced adverse events and provides confidence and practicality to both the clinician and the recipient. Allo-SCT with frozen products is a successful method that can be safely applied, especially when disruptions in donor-derived cell collection or transportation are foreseen.