Mesut Tığlıoğlu

Background and Aim: Similar to the uncertainties in the treatment criteria for indolent non-Hodgkin lymphoma (iNHL), the prognostic criteria have not been fully clarified. The Controlled Nutritional Status (CONUT) score is not only used as a predictor of malnutrition but also indicates prognosis in many chronic or malignant diseases. The aim of this study is to investigate the predictive and prognostic significance of the CONUT score in patients with iNHL. Patients and Methods: A retrospective evaluation was made of 109 patients with iNHL. The CONUT scores of the patients were compared between those with an indication for treatment and those followed without treatment. The same analysis was performed between patients who developed relapse after treatment. Survival analysis was performed on all patients, and associations between survival and the CONUT score were examined. Results: The median CONUT score was found to be higher in those who had treatment indications compared to those who did not (2 vs 1; P = 0.014). In the regression model, a CONUT absolute value above 5 was found as an independent risk factor predicting relapse. In the whole study population, a CONUT absolute value >2 predicted the risk of mortality with 53.9% sensitivity and 68.7% specificity (AUC ± SE = 0.639 ± 0.07; +PV = 35%; -PV = 82.6%; P = 0.034). Conclusion: CONUT score is a predictive and prognostic factor for patients with iNHL. The development of simple, low-budget prognostic and predictive biomarkers is critical not only for determining the course of the disease but also for follow-up and treatment management.

Introduction Predictive parameters that can affect the course of this infection have been the main topic of research since the beginning of the COVID-19 (Coronavirus disease 2019) pandemic. Since the discovery of blood groups, the effect of these on infectious diseases has always been of interest. Objectives To analyze the effect of ABO blood group on mortality, hospitalization duration and hematological and cytokine storm parameters in patients with COVID-19. Patients and methods: This retrospective study was conducted on 140 patients diagnosed with COVID-19. Demographic characteristics, laboratory parameters including ABO blood group, complete blood count (CBC) parameters, biochemical tests, cytokine storm parameters, duration of hospitalization, and final status (discharge or death) were recorded. Results: The 140 patients included in the analysis comprised 72 (51.4%) males and 68 (48.6%) females with a mean age of 66.3±14.0 years. . Age and gender, hospitalization duration and mortality rates were similar in all blood group types. Only D-dimer levels were found to be higher in blood group A compared with other blood groups. Conclusion: Although no difference in mortality was determined between groups, the D-dimer level was statistically significantly higher in COVID-19 patients with A blood group. Larger studies are needed to reflect D-dimer levels on the clinical course of infection, and thus on daily practice.

Introduction Coronavirus disease 2019 (COVID-19) were declared as pandemic by World Health Organization. With this study, we aimed to define our patients who were followed up with malign or benign hematological diagnoses and diagnosed with COVID-19; determine the distribution of this infection in patient groups and contribute to the literature by creating descriptive statistics with its clinical and demographic features. Patients and methods: It is planned to retrospectively examine patients with a history of COVID-19 who were followed up in Hematology Department of Dışkapı Yıldırım Beyazıt Training and Research Hospital with benign and malignant diagnoses. Results: 88 patients who had COVID-19 infection while being followed in our clinic due to hematological diseases were included in the study. 77 patients had been followed by hematologic malignancies and 11 patients had been followed by benign hematological disease.In the group with malignancy, COVID was found most frequently in patients diagnosed with Philadelphia chromosome negative myeloproliferative neoplasms (22%), nonhodgkin lymphoma (19%) and multiple myeloma (16%). ITP (64%) was the most common disease in patients with benign hematological disorder who had COVID history. 52 (67%) of the malignant cases and 8 (73%) of the bening cases were found to be followed up with the disease in remission. The all patient's most common symptoms at COVID-19 diagnosis were fever (77%), cough (70%) and weakness (65%). 45% of the patients were isolated at home, 48% were required hospitalization. 49% of patients had mild; 27% had moderate and 24% had severe COVID-19 infection. Almost all of the patients in the moderate and severe disease group were followed up in patients diagnosed with malignant hematological disease. 16 (18%) patients received mechanical ventilation and 16 (18%) patients was transferred intensive care unit. All of the patients who were intubated and needed intensive care were diagnosed with malignant hematological disease. 17 patients died due to COVID-19 infection. The mortality rate was 22% in patients with diagnosis of malignant hematological diseases, and 19% when all patients (malignant and bening) were included. Conclusion: In conclusion, the COVID-19 pandemic is a problem all over the world. Determining the course of the disease in certain diagnostic groups is important in the management of both the main disease and the COVID-19 infection. Therefore, the contribution of such recording studies to the literature is important and valuable.

Summary Objective The aim of this study was to examine the effect of coronavirus disease 2019 (COVID-19) on the malignancy-related clinical course and overall survival, and to determine the factors affecting mortality. Methods This retrospective study included 77 patients with hematological cancer and COVID-19. Patients were sub-grouped for analysis as survivors and non-survivors. Results COVID-19 was seen more frequently in myeloproliferative neoplasms (MPN), non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) patients. Mortality rate due to COVID-19 was 20.8%. No statistically significant difference was determined between the survivor and non-survivor groups with respect to age and gender, presence of any comorbidity, leukocyte, neutrophil, lymphocyte, and monocyte values. Platelet count and hemoglobin count were significantly lower in the group with mortality than in the group with recovery. Conclusion It should be kept in mind that low hemoglobin and platelet levels contribute to mortality. In addition, it is important to protect patients with hematological cancer from COVID-19 and undertake effective vaccination due to its mortal course.

Introduction: Imatinib is generally well tolerated by patients. The most common ophthalmic side effects are eyelid edema and periorbital edema. Other side effects which occur at rates of <1% include blepharitis, blurred vision, conjunctival hemorrhage, conjunctivitis, retinal hemorrhage, etc. An uncommon case is here reported of a 51-year-old male with chronic myeloid leukemia who developed vitreous hemorrhage due to imatinib after 9 months of treatment. Case report: A 51-year-old male with leukocytosis detected in the blood test examination was referred to the Hematology Department. The bone marrow biopsy result was compatible with chronic myeloid leukemia. Imatinib treatment (400 mg/day) was started. In the ninth month of imatinib treatment, the patient complained of a sudden decrease in vision. Vitreous hemorrhage was detected in the left eye and the patient underwent surgery. Vitreous hemorrhage recurred 1 month after the operation. On the fourth day after the discontinuation of imatinib treatment, the patient's ophthalmic complaints improved significantly. The Naranjo algorithm was applied and a score of 9 was detected. The vitreous hemorrhage of the patient was attributed to imatinib, and so the treatment of the patient was switched to bosutinib. Discussion: Imatinib is an oral signal inhibitor that targets tyrosine kinase for BCR/ABL, platelet-derived growth factor, stem cell factor, and c-kit (CD117). The conjunctiva and sclera have a large amount of c-kit positive mast cells which are inhibited by imatinib. The inhibition of c-kit positive mast cells by imatinib may be responsible for further exposure of the conjunctival mucosa to injuries.

What is known and objective Primary myelofibrosis (PMF) is characterized by myeloid cell proliferation and prominent bone marrow fibrosis. Ruxolitinib, a selective inhibitor of JAK 1 and 2, significantly reduces constitutional symptoms and spleen size compared with placebo, and has significant clinical benefits in patients with myelofibrosis. The most common haematological side effects are thrombocytopenia and anaemia, and the most common non-haematological side effects are grade 1–2 diarrhoea and pyrexia. Leukocytoclastic vasculitis is small vessel vasculitis, characterized histopathologically by immune complex-mediated vasculitis of the dermal capillaries and venules in the lower extremities, which can be seen as palpable purpura. Although the cause is 50% idiopathic, the aetiology of leukocytoclastic vasculitis can be collected under many headings. Case Summary The case is here presented of a patient with PMF who developed leukocytoclastic vasculitis after ruxolitinib treatment. Ruxolitinib was discontinued as the lesions were thought to be drug-related and all skin lesions disappeared approximately 2 months after termination of the drug. When the ruxolitinib treatment was restarted at the same dose (2 × 15 mg), the skin lesions recurred. The drug dose was reduced to 1 × 15 mg, and the rashes disappeared. Currently, the patient has no active complaints and is being followed up with ruxolitinib 1 × 15 mg without any complications. What is new and Conclusion To the best of our knowledge, leukocytoclastic vasculitis due to ruxolitinib is extremely uncommon. This case report can be considered to contribute to the literature of this rare event.