Ebru Koca

Background/Aims: Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a chronic inflammatory disorder commonly associated with iron deficiency anemia and anemia of chronic disease. Hepcidin is a key regulator of iron homeostasis, increasing in response to inflammation and decreasing in iron deficiency. This study evaluated the relationship between serum hepcidin and fecal calprotectin levels and examined the potential role of hepcidin in assessing disease activity and differentiating anemia subtypes. Materials and Methods: The study included 29 patients with IBD with active disease, 45 in remission, and 34 controls; all participants were evaluated at Başkent University Ankara Hospital in 2014. Complete blood count, serum hepcidin, ferritin, serum iron, total ironbinding capacity (TIBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were analyzed in all participants. Fecal calprotectin was additionally measured in patients. Results: Hepcidin levels were significantly higher in patients with both active disease and in remission compared with controls (P < .05). Hepcidin levels were negatively correlated with hemoglobin, hematocrit, and ferritin and positive correlated with TIBC and ESR (P < .05). Fecal calprotectin levels were significantly higher in patients with active disease and were positively correlated with CRP and clinical activity scores (P < .01). However, no significant correlation was found between hepcidin and fecal calprotectin (P > .025). Conclusion: Fecal calprotectin was strongly associated with disease activity, whereas hepcidin was not, suggesting that hepcidin may have limited utility for disease activity assessment. Hepcidin may primarily reflect systemic iron metabolism and anemia of inflammation. Further studies are needed to clarify its clinical role. Cite this article as: Akıncıoğlu P, Dağlı ., Koca E. Comparative evaluation of serum hepcidin and fecal calprotectin for disease activity assessment in inflammatory bowel disease. Turk J Gastroenterol. Published online May 8, 2026. doi: 10.5152/tjg.2026.25774.

Although epidemiologic surveys indicate that the median age of acute myeloid leukemia (AML) patients is in the range of geriatric age groups, treatment of elderly AML patients still represents an unsolved clinical question mainly due to frailty of elder patients and the disease characteristics. Different prognostic models have been proposed to select suitable elderly AML patients for intensive chemotherapy including 3 recent models; French Cooperative group (ALFA), German Study Alliance Leukemia group and M. D. Anderson Cancer Center (MDACC) prognostic models. The French model suggested patients who had unfavorable karyotypes and at least 2 of the following features: ECOG performance status ≥2, WBC count ≥50x10⁹/L and age ≥75, should not be treated with intensive therapy. The MDACC group identified the following risk factors for adverse prognosis obviating intensive treatment: age ≥80, complex karyotype, ECOG performance status ≥2 and elevated creatinine > 1.3 mg/dl. The German group demonstrated karyotype, CD34 expression, WBC count, age, LDH and NPM1 status as independent prognostic risk factors and developed a scoring system. To the best of our knowledge, these models have not been externally validated. We retrospectively reviewed 114 non-acute promyelocytic leukemia AML patients older than 60 years treated in two University Hospital Hematology Departments between 1999 and 2014. Median age was 70 years. Eighteen (15.8%) patients received supportive care, 68 (59.6%) intensive and 28 (24.9%) non-intensive chemotherapy regimens. Primary end point of the study was overall survival (OS). OS was calculated from diagnosis to the date of mortality of any reason. The patients who did not die at last follow-up were censored at this time for OS computation. Survival analyses were computed by the Kaplan-Meier method. Comparisons of survival rates were done by the Log-rank test. Statistical Packages for the Social Sciences v17.0 (SPSS Inc., Chicago, IL) software was used for other statistical analyses. The median OS of all patients was 4.2 months. Median OS was better in patients who received intensive treatment compared to patients who did not receive: 5.3 months (0–11.58 95% CI) vs 2.4 months (0.8–3.9 95% CI), respectively (p= .012). We applied all three models to the patients who received intensive therapy. We could not use German model as NPM1 mutation status and CD34 were frequently missing. According to the French model, median OS was shorter in high risk group (n= 18); 1.5 months (0.1–2.84 95% CI) vs 28.7 months (10.3–47 95% CI) (p= .008). MDACC model also demonstrated inferior prognosis in patients with risk factor(s) against intensive treatment (i.e., high risk patients, n= 28) with a median OS 2.3 months (1.2–3.4 95% CI) vs 28.7 months (7.6–49.7 95% CI) (p= .013). There were 7 patients who did not receive intensive treatment although they were defined suitable for intensive treatment according to French and/or MDACC models. Median OS was significantly shorter in these cases compared to patients who received intensive treatment: 4.6 months (2.1-7 95% CI) vs 15.9 months (0.9-30.8 95% CI), respectively (p= .02). Intensive treatment did not change median OS in patients who were considered unsuitable for intensive treatment according to French and/or MDACC models (p> .05). In conclusion, we found that both French and MDACC models were predictive in our clinical practice to identify patients who could benefit from intensive treatment. The German model was difficult to use, as it consisted NPM1 status, which was not generally available.

OBJECTIVE: Venous, arterial, and microcirculatory events are frequently encountered in the clinical course of essential thrombocytosis and polycythemia vera. We aimed to investigate the levels of soluble endothelial protein C receptor (sEPCR) in myeloproliferative diseases to see whether there was a difference between the patients with and without history of thromboembolism.\ud METHODS: The study included patients with polycythemia vera (n=12), patients with essential thrombocytosis (n=13), and controls (n=29). In all groups, we measured proteins C and S, antithrombin and sEPCR levels, and plasma concentrations of thrombin-antithrombin complex, prothrombin fragments 1+2, and D-dimer.\ud RESULTS: Comparing the patients with and without history of thromboembolic attack, statistically significant differences were not observed in terms of sEPCR, D-dimer, thrombin-antithrombin complex, prothrombin fragments 1+2, and hematocrit levels (p=0.318, 0.722, 0.743, 0.324, and 0.065, respectively). \ud CONCLUSION: Significant increase in the parameters that reflect activation of coagulation, such as sEPCR, thrombinantithrombin complex, prothrombin fragments 1+2, and D-dimer, reflects the presence of a basal condition that leads to a tendency toward thrombosis development in ET and PV when compared to healthy controls

Allogeneic stem cell transplantation (allo‐SCT) is the only potentially curative treatment for myelodysplastic syndrome (MDS). Recently, hypomethylating agents (HMAs) have been shown to improve survival in patients with high‐risk MDS. We conducted a retrospective case–control study to compare survival with these treatment modalities in patients with untreated MDS. Controls were identified using a departmental database and transplant patients were matched in at least three of the following five criteria: year of diagnosis, age, blast percentage, International Prognostic Scoring System cytogenetic risk, and time from diagnosis to treatment. Median overall survival (OS) was 26 and 25 months for, respectively, allo‐SCT [(n = 53); range, 2–210 months] and HMA [(n = 40); range, 2–98 months] (P = 0.89). Four‐year survival rates were 24 and 23% for allo‐SCT patients and the nontransplant cohort, respectively. Patients undergoing allo‐SCT after 2000 had longer median OS compared with those transplanted before 2000 (41 versus 7 months, P=0.001). These results would suggest that prospective studies are needed to delineate the timing and efficacy of allo‐SCT in the HMA era. Am. J. Hematol. 88:198–200, 2013.

Immediate hypersensitivity to low molecular weight heparin (LMWH) is rare, and we present here a case with an anaphylaxis-like symptoms to enoxaparin. The diagnosis of hypersensitivity to enoxaparin was confirmed by the clinical picture and positive skin tests. In this case, palmo-plantal itching after application of heparin was an early sign of immediate type hypersensitivity. His skin and provocation tests showed cross-reactivity with other types of LMWHs and un-fractionated heparin (UFH). Fondaparinux and desensitization with UFH were found to be safe alternative treatment options in this patient with heparin allergy.