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Biomedical subjects

O Ilhan

Publications and source records attributed to O Ilhan.

At least 55 records · Page 3Linked to original sources
PubMed1997

Use of high-dose chemotherapy plus granulocyte colony-stimulating factor for the salvage of refractory or resistant-relapse lymphoma patients without stem cell support.

The combination of cyclophosphamide (CY) and etoposide is synergistic, spares bone marrow stem cells and can be given repeatedly in high doses without stem cell support. Thirteen patients with non-Hodgkin's lymphoma (n = 8) or Hodgkin's disease (n = 5), received high-dose chemotherapy (HDC). Median age was 32 years (24-52). Male to female ratio was 10:3. All the patients were in advanced-stage. Karnofsky score prior to HDC was 60% (range 40-90). Six patients showed primary refractoriness and 7 had resistant relapse. HDC consisted of CY 1,500 mg/m2/day and etoposide 300 mg/m2/day, both for 4 days. rhG-CSF was started 24 h after the last dose of chemotherapy as a continuous intravenous infusion at a dose of 0.01 mg/kg/day and stopped when the leukocyte count reached 1 x 10(9)/1 on 3 consecutive days. Overall, 69% (9/13) of patients responded to HDC. Four achieved CR and 5 achieved PR. Two of the patients showed disease progression. The other 2 died during the early period of HDC. Neutrophil and platelet recovery after HDC were 8 (6-16) and 10 (4-14) days, respectively. The major nonhematological toxicities were nausea-vomiting (100%) and diarrhea (61%). The median follow-up was 204 (7-600) days. Two patients relapsed 48 and 185 days after HDC. Eight patients are still alive, 7 progression free. The progression-free survival is 220 (40-285) days. In conclusion, HDC + granulocyte colony-stimulating factor (G-CSF), without stem cell support seems to be promising in refractory or resistant relapse lymphoma patients bringing the need for randomized studies to show the cost effectiveness of HDC + G-CSF compared to HDC + autologous stem cell support.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Hemorrhagic cystitis as a complication of bone marrow transplantation.

Hemorrhagic cystitis (HC) is one of the most troublesome complications of bone marrow transplantation (BMT) and sometimes may be life-threatening. The etiology and prevalence of HC depends on the type of the transplant and the period after BMT. Here we report about 134 patients transplanted in a single center (89 allogeneic and 45 autologous) between May 1988 and August 1995. Forty-six patients (34.3%) had HC after BMT. Thirty-four (38%) alloBMT patients and 12 (27%) autoBMT patients had HC (p = 0.18). The onset of HC was 7 to 125 days after transplantation. The degree of HC was mild to moderate in 25 (28%) and severe in 9 (10%) allogeneic transplants. In autologous transplants, all of the episodes of HC were mild to moderate. Age, sex, diagnosis and the dosage of mesna used for prophylaxis were not correlated with the incidence of HC. In 36 of 46 (78.2%) patients HC occurred early and as a transient form. Ten (21.7%) were late and long-lasting. In 2 patients who had late starting and long-lasting HC after allogeneic BMT, electron microscopic examinations revealed virus-like structures in bladder epithelial cells.

Adolescent↗
PubMed1997

Allogeneic peripheral blood stem cell transplantation: is there an increased risk of graft vs host disease in leukemia patients?

Fifteen patients with hematological malignancies [9 acute nonlymphoblastic leukemia (ANLL), four chronic myelogenous leukemia (CML), two acute lymphoblastic leukemia (ALL)] received allogeneic peripheral blood stem cell transplantation (alloPBSCT) from HLA-identical sibling donors. Donors received 2.5-15 micrograms/kg/day of recombinant human granulocyte colony stimulating factor (rhG-CSF) for 5-10 days. Administration of rhG-CSF was well tolerated except for mild to moderate bone pain occurring in all the donors which was relieved by oral paracetamol. A total of 40 leukaphereses were performed for the 15 donors using the bilateral antecubital veins. None of the donors needed central venous line insertion. The median number of apheresis procedures for each patient was 3 (2-3). A median of 7.7 (4-38.2) x 10(8)/kg mononuclear cells, 35 (2.4-90.0) x 10(6)/kg CD34+ cells, 1.85 (0.45-4.8) x 10(8)/kg CD3 and 0.3 (0.16-1.01) x 10(8)/kg natural killer cells were given without any manipulation. Cyclosporin A (CsA) plus short-course methotrexate (MTX) (12 patients) and CsA alone (3 patients) were used for graft versus host disease (GVHD) prophylaxis. Median granulocyte and platelet engraftments were done on days 11 (10-31) and 16 (11-54) respectively. Grades II-IV GVHD occurred in 62% of the patients and grades III-IV in 15%. Twelve patients are still alive with full engraftment and disease-free. In conclusion, alloPBSCT is an alternative to allogeneic bone marrow transplantation, because of the ease of collection and rapid hematological recovery. However, there is a trend for increased acute GVHD in our leukemia patients compared to allogeneic bone marrow.

Adult↗
PubMed1997

Administration of MINE protocol in untreated patients with intermediate and high grade non-Hodgkin's lymphoma.

In recent years, more effective and less toxic treatment protocols have been developed to increase the cure rates in intermediate and high grade non-Hodgkin's lymphoma (NHL). This study was undertaken to investigate the efficacy and toxicity of MINE (ifosfamide, mesna, mitoxantrone and etoposide) combination chemotherapy in patients with intermediate and high grade NHL. Twenty-one patients (16 male, 5 female; age between 26 and 70 years) with NHL were included in the study. An overall response rate of 73% and complete response rate of 56% were achieved and survival rate for responding patients was 80% at the 48th month. Side effects including mild myelosuppression, nausea/vomiting and alopecia were observed. MINE combination seems to be effective and well tolerated without significant toxicity as a first-line therapy in patients with intermediate or high grade NHL.

Adult↗
PubMed1997

A case report of a patient who has pure red cell aplasia and rheumatoid arthritis.

Pure red cell aplasia (PRCA) as an extra-articular manifestation of rheumatoid arthritis (RA) is rare. In the present report a 40-year-old female patient, with a 4-year-history of severe anemia and pain in the small joints of the hands, was diagnosed as having PRCA by bone marrow (BM) examination. Antithymocyte globulin (ATG), methylprednisolone and cyclosporin A (CSA) were used for the treatment of PRCA. The patient's hematological values responded within 6 months but pre-existing arthralgia continued, although with some relief. The patient subsequently fulfilled the criteria for diagnosis of RA at the 16th month. A review of nine published case reports on the coexistence of PRCA with RA revealed the initial diagnosis as RA. In our case, as the initial symptoms and findings were not sufficient for the diagnosis of RA, we therefore conclude that PRCA preceded RA. Although CSA was curative in the treatment of PRCA it could not prevent the full diagnostic features of RA.

Adult↗
PubMed1994

Peripheral T cell receptors alpha beta and gamma delta in patients with Hodgkin's lymphoma.

Antigen recognition by T cells is determined by an antigen specific T cell receptor (TCR). Two heterodimeric TCR structures associated with CD3 have been defined: TCR alpha beta and TCR gamma delta. TCR alpha beta and its function are well described but the role of TCR gamma delta in normal and lymphoproliferative disorders is not well established. In newly diagnosed or relapsed/refractory Hodgkin's disease (HD), a disease associated with defective T cell functions and increased sIL-2R, we determined levels of seven TCR alpha beta variable regions [beta V5(a), beta V5(b), beta V6(a), beta V12(a), alpha beta V(a), alpha V2(a)] and TCR gamma delta by using monoclonal antibodies (MCA). TCR gamma delta levels did not show any difference, but several variable regions of the TCR alpha beta differed when groups are compared with each other and the control group.

Adolescent↗
PubMed1993

The clinical correlations of serum tumor necrosis factor-alpha in acute leukemias: a predictor of response and relapse?

The clinical correlations of serum tumor necrosis factor alpha (TNF-alpha), a cytokine which can be released from leukemic blasts, has not been extensively studied. We have analyzed serum TNF-alpha in 20 ANLL, one CML-myeloblastic crisis, and 14 ALL adult patients by using a commercial ELISA kit. Sterile serum samples were taken on day 0, day 7, during remission and relapse with a mean follow-up period of 4.2 (1-19) months. After a median of 7 days following chemotherapy, serum TNF-alpha decreased both in responding ANLL (p = 0.004) and ALL (p > 0.05) but remained high in refractory leukemias. Values on day 7 were significantly different between responding and refractory patients in both ANLL (p = 0.0027) and ALL (p = 0.0099). At relapse, serum TNF-alpha increased starting at a median of 3 months preceding clinical symptoms in ANLL (p = 0.002). However, the relapse of ALL coincided with a slight increase which was not significant (p > 0.05). Together these findings indicate that serum TNF-alpha can be used as an early predictor of clinical response and relapse in ANLL.

Acute Disease↗
PubMed1992

P-glycoprotein expression in refractory hematological neoplasms and circumvention of resistance with verapamil or cyclosporine A containing protocols.

Either p-glycoprotein (pgp) or the encoding gene mdr1 expression has been reported to be correlated with multidrug resistance and poor treatment response. To investigate the incidence of pgp in refractory hematological neoplasms we analyzed malignant cells from 40 patients by an immunoperoxidase method using the monoclonal antibody C219. Pgp was positive in 75% of acute nonlymphoblastic leukemia (ANLL) and 50% of acute lymphoblastic leukemia (ALL). Pgp positivity was similarly distributed in both Tdt (-) and (+) ANLLs (64% versus 100%). Addition of Verapamil (VRP) (12 patients) or Cyclosporine A (CsA) (7 patients) to the previous chemotherapy protocol resulted in complete response in 7 (58%) and 3 (43%) of the patients respectively. Partial response was observed in one patient who received CsA. Both chemosensitizers were tolerated well with few reversible side effects. The preliminary results of this study have been presented in the 15th International Cancer Congress, August 1990 Hamburg, Germany.

ATP Binding Cassette Transporter, Subfamily B, Mem↗