Person: ATAGÜNDÜZ, IŞIK
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ATAGÜNDÜZ
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IŞIK
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Publication Metadata only Effects of Deeper Molecular Responses on Outcomes in Chronic Myeloid Leukemia Patients in Chronic Phase Treated With Imatinib Mesylate(CIG MEDIA GROUP, LP, 2017) ATAGÜNDÜZ, IŞIK; Atagunduz, Isik Kaygusuz; Toptas, Tayfur; Deniz, Rabia; Kara, Osman; Eser, All; Sezgin, Aslihan; Ozgumus, Toluy; Gecgel, Fatma; Tuglularl, Tulin FiratliThe significance of molecular response depth is not well defined in patients with chronic phase chronic myeloid leukemia (CP-CML) under imatinib treatment. We retrospectively evaluated clinical records of 178 patients with CP-CML. Eighty-eight patients achieved complete molecular response during long term follow-up. Our results implicate that deeper molecular response is associated with improvement in disease outcome and a slight prolongation in progression-free survival. Background: The prognostic significance of complete cytogenetic response (CCyR) is well defined in patients with chronic phase chronic myeloid leukemia treated with imatinib as first-line therapy. However, the effect on outcomes of obtaining molecular response itself and the depth of it is not clear. In this study we aimed to determine the frequency of complete molecular response (CMR) during long-term follow-up and the clinical significance of CMR on patient outcomes and survival. Patients and Methods: We retrospectively evaluated the files of 178 chronic phase chronic myeloid leukemia patients using imatinib therapy. Forty-seven patients with missing data were excluded from the study and the assessment was done in 131 patients. CiviR was defined as undetectable BCR-ABL transcripts using real-time quantitative polymerase chain reaction with a sensitivity level of >= 10(4) in 2 consecutive analyses at least 3 months apart. Cytogenetic and molecular monitoring during treatment was performed according to the European LeukemiaNet recommendations criteria. Our primary objective was to analyze the association of deeper molecular response with differences in progression-free survival (PFS). Results: Eighty-eight patients (67%) achieved CMR at any time in a median of 65 months of follow-up. The rate of CMR was higher in patients who achieved CCyR at 12 months and major molecular response (MMR) at 18 months. Fewer events occurred in the CMR group than the MMR group (26.1% vs. 50.0%). Overall survival was not different in both groups. CMR was associated with longer PFS with borderline significance. Conclusion: Prolonged imatinib therapy helps to achieve a deeper molecular response in the long-term. Achieving deeper molecular response at any time positively affects maintaining the cytogenetic and molecular responses, and decreases the transformation to accelerated and/or blastic phase. The slight prolongation in PFS did not reach statistical significance.Publication Metadata only Splenectomy in Immune Thrombocytopenia: A Retrospective Analysis of 25-Year Follow-up Data from a Tertiary Health Clinic(SPRINGER INDIA) ATAGÜNDÜZ, IŞIK; Ozkok, Serdar; Atagunduz, Isik Kaygusuz; Kara, Osman; Sezgin, Aslihan; Ozgumus, Toluy; Gecgel, Fatma; Tuglular, Tulin Firatli; Toptas, TayfurImmune thrombocytopenia (ITP) is a rare autoimmune disorder presenting with isolated thrombocytopenia. Splenectomy is still one of the treatment alternatives for these patients. Here we aim to analyze long term follow-up data of splenectomy in immune thrombocytopenia. This retrospectively designed study was conducted in a tertiary health clinic. Patients with ITP who were splenectomized between 1990 and 2015 were included. Response to treatment was interpreted as 'complete response', 'response' or 'no response'. The incidence of response loss was evaluated. Perioperative and long term complications and overall survival rates were determined. Out of 51 patients, who underwent splenectomy after 12 months of diagnosis, 47 achieved a response (92.2%). Of 47 patients who had a platelet count at least 30.000/mu L, 41 (87.2%) had CR. Incidence of loss of response was 10.5% (95% confidence interval (CI): 4%-26.1%) at 30 months. Two patients died, and overall survival rate was 97.4% (95% CI: 82.8%-99.6%) at 30 months of follow up. Considering the complications: two patients had venous thromboembolism, 11 had minor bleeding episodes and 15 suffered from perioperative infections. Our study suggests that splenectomy promises a high level of response with acceptable complication rates. Although less preferred recently, splenectomy should still be taken into consideration when remission is not achieved especially after 12 months of disease.Publication Metadata only Quality of Life and Symptom Burden With First- and Second-generation Tyrosine Kinase Inhibitors in Patients With Chronic-phase Chronic Myeloid Leukemia(CIG MEDIA GROUP, LP, 2020) BOSTAN, HAYRİ; Bostan, Hayri; Toptas, Tayfur; Tanrikulu, Funda Pepedil; Kut, Kevser; Arikan, Fatma; Yilmaz, Fergun; Atagunduz, Isik; Firatli-Tuglular, TulinWe assessed the quality of life and symptom burden in patients with chronic-phase chronic myeloid leukemia (CML) receiving first- or second-generation tyrosine kinase inhibitors, to demonstrate whether there are differences between tyrosine kinase inhibitor generations. A total of 121 patients with CML with good performance and low comorbidity scores were enrolled in the study. Similar results were observed between the groups in the quality of life and symptom burden scores, which were examined using CML-specific (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Chronic Myeloid Leukemia module, MD Anderson Symptom Inventory for Chronic Myeloid Leukemia) questionnaires. Background: With the advent of tyrosine kinase inhibitors (TKIs), patients with chronic myeloid leukemia (CML) have a life expectancy similar to those of age- and gender-matched healthy populations. Nevertheless, patients receiving TKIs report chronic adverse events such as fatigue, edema, and muscle cramps, which lead to a decrease in their quality of life (QoL). Therefore, the aim of this study was to assess the QoL and symptom burden in patients receiving original imatinib, generic imatinib, dasatinib, and nilotinib. Patients and Methods: A total of 121 patients with CML who received TKIs for at least 3 months were enrolled in the study. The QoL was assessed with the Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire-Chronic Myeloid Leukemia (QLQ-CML24) modules. The symptom burden was assessed with MD Anderson Symptom Inventory for Chronic Myeloid Leukemia (MDASI-CML) and EORTC QLQ-CML24. Results: The median age of the study population was 53 years (range, 28-90 years), and 83 (81.4%) patients had a low-to-medium Sokal risk score. The Eastern Cooperative Oncology Group performance status of most patients were good (< 2; 96%), and comorbidity scores were low (HCT-CI < 3; 90.8%). There was no significant difference between the general health status of patients in terms of EORTC QLQ-C30 and QLQ-CML24. According to the results of the MDASI-CML and QLQ-CML24 modules, the most common symptom was fatigue (58.7%) in all groups, and there were no significant differences between the groups in terms of the effects on the daily life activities of the patients. Conclusion: Patients with CML receiving first- and second-generation TKIs were seen to have a similar QoL and symptom burden. (C) 2020 Elsevier Inc. All rights reserved.