Person: ATAGÜNDÜZ, IŞIK
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ATAGÜNDÜZ
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IŞIK
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Publication Open Access Aplastic Anemia Associated with Oral Terbinafine: A Case Report and Review of the Literature(GALENOS YAYINCILIK, 2014-12-05) ATAGÜNDÜZ, IŞIK; Kantarcioglu, Bulent; Turkoz, Huseyin Kemal; Yilmaz, Guven; Tanrikulu, Funda Pepedil; Atagunduz, Isik Kaygusuz; Adiguzel, Cafer; Tuglular, Tulin FirathOnychomycosis (OM) is a common fungal infection of the toenails and/or fingernails that is highly prevalent in the general population and also responsible for significant morbidity. OM is caused by dermatophytes, nondermatophytic molds, or yeast. Today systemic antifungal agents are considered as the gold standard for all types of OM. Here we report a case of aplastic anemia associated with oral terbinafine use and a review of the literature on hematological toxicities associated with terbinafine.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 Open Access Pulmonary Endarterectomy in a Patient with Immune Thrombocytopenic Purpura(2015) YILDIZELİ, BEDRETTİN; Yıldızeli, Bedrettin; Yanartaş, Mehmed; Keskin, Sibel; Atagündüz, Işık; Altınay, EceImmune thrombocytopenic purpura (ITP) patients are at high risk for bleeding complications regarding surgeries involving cardiopulmonary bypass. We report an ITP patient with chronic thromboembolic pulmonary hypertension who underwent uncomplicated pulmonary endarterectomy with receiving postoperative intravenous immunoglobulin (IVIG) therapy. The positive outcome of this case may suggest that pulmonary endarterectomy surgery is performed safely for ITP patients.Publication Metadata only 18F-FDG PET/CT Findings and Baseline Clinical Parameters in Multiple Myeloma(CIG MEDIA GROUP, LP, 2017) ATAGÜNDÜZ, IŞIK; Tuglular, Tulin Firatli; Tanrikulu, Funda Pepedil; Toptas, Tayfur; Karadeniz, Asli; Atagunduz, IsikPublication Open Access Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment(SPRINGER LONDON LTD, 2020-07) ATAGÜNDÜZ, IŞIK; Soy, Mehmet; Keser, Gokhan; Atagunduz, Pamir; Tabak, Fehmi; Atagunduz, Isik; Kayhan, ServetCOVID-19 infection has a heterogenous disease coursePublication Metadata only Lenfoplazmosi̇ti̇k lenfomanin santral si̇ni̇r si̇stemi̇ tutulumu olgu sunumu(2012-04-19) ÖZGEN, ZERRİN; ATAGÜNDÜZ, IŞIK; BOZKURT, SÜHEYLA; ATASOY, BESTE MELEK; Özgen Z., Adıgüzel C., Karaüç G., Özden S., Atagündüz I., Gül D., Pepedil F., Bozkurt S., Atasoy B. M.Publication Open Access Molecular screening and the clinical impacts of BCR-ABL KD mutations in patients with imatinib-resistant chronic myeloid leukemia(SPANDIDOS PUBL LTD, 2017-12-13) TUĞLULAR, AYŞE TÜLİN; Kockan, Betul; Toptas, Tayfur; Atagunduz, Isik; Tuglular, Ayse Tulin; Ozer, Ayse; Akkiprik, MustafaThe present study aimed to detect the frequency of kinase domain (KD) mutations in order to evaluate their clinical significance and functional importance in 45 patients with chronic myeloid leukemia (CML) who were resistant to imatinib therapy. Sanger sequencing was used (45 patients), along with allele-specific oligonucleotide polymerase chain reaction (ASO-PCR; 3 patients), for the screening of mutations. BCR/ABL KD was amplified by nested PCR and sequencing was performed. Secondly, ASO-PCR was performed to confirm the results of the sequence analysis for E255K mutations. Mutations were detected in 11/45 patients (24.44%) via Sanger sequencing. D241G (4.4%), C369C (4.4%), K285N (2.2%), A380T (2.2%) and A366V (2.2%) mutations were detected. E255K (8.8%) was detected by ASO-PCR and Sanger sequencing. Mutations are a primary reason for suboptimal responses, loss of response and resistance to imatinib. In particular, the E255K mutation, which is characterized by resistance to imatinib and nilotinib, was detected in four patients. Analyzing the mutations and monitoring patients with CML may improve their prognosis and survival rate. ASO-PCR assays will be beneficial for the routine monitoring of mutations.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.Publication Open Access Hemophagocytic lymphohistiocytosis: a review inspired by the COVID-19 pandemic(SPRINGER HEIDELBERG, 2021-01) ATAGÜNDÜZ, IŞIK; Soy, Mehmet; Atagunduz, Pamir; Atagunduz, Isik; Sucak, Gulsan TurkozHemophagocytic syndrome (HPS) or hemophagocytic lymphohistiocytosis (HLH) is an acute and rapidly progressive systemic inflammatory disorder characterized by cytopenia, excessive cytokine production, and hyperferritinemia. Common clinical manifestations of HLH are acute unremitting fever, lymphadenopathy, hepatosplenomegaly, and multiorgan failure. Due to a massive cytokine release, this clinical condition is considered as a cytokine storm syndrome. HPS has primary and acquired (secondary, reactive) forms. Its primary form is mostly seen in childhood and caused by various mutations with genetic inheritance and, therefore, is called familial HLH. Secondary HLH may be caused in the presence of an underlying disorder, that is, secondary to a malignant, infectious, or autoimmune/autoinflammatory stimulus. This paper aims to review the pathogenesis and the clinical picture of HLH, and its severe complication, the cytokine storm, with a special emphasis on the developed classification criteria sets for rheumatologists, since COVID-19 infection has clinical symptoms resembling those of the common rheumatologic conditions and possibly triggers HLH. MED-LINE/Pubmed was searched from inception to April 2020, and the following terms were used for data searching: hemophagocytic syndrome OR macrophage activation syndrome OR hemophagocytic lymphohistiocytosis, OR cytokine storm. Finally, AND COVID-19 was included in this algorithm. The selection is restricted to the past 5 years and limited numbers of earlier key references were manually selected. Only full-text manuscripts, published in an English language peer-reviewed journal were included. Manuscript selection procedure and numbers are given in Fig. 2. Briefly, the database search with the following terms of Hemophagocytic syndrome OR Macrophage activation syndrome OR Hemophagocytic lymphohistiocytosis OR Cytokine storm yielded 6744 results from inception to April 2020. The selection is restricted to the past 5 years and only limited numbers of earlier key references were selected, and this algorithm resulted in 3080 manuscripts. The addition of (AND COVID-19) resulted in 115 publications of which 47 studies, together with four sections of an online book were used in the final review. No statistical method was used. HLH is triggered by genetic conditions, infections, malignancies, autoimmune-autoinflammatory diseases, and some drugs. In COVID-19 patients, secondary HLH and cytokine storm may be responsible for unexplained progressive fever, cytopenia, ARDS, neurological and renal impairment. Differentiation between the primary and secondary forms of HLH is utterly important, since primary form of HLH requires complicated treatments such as hematopoietic stem cell transplantation. Further studies addressing the performance of HScore and other recommendations in the classification of these patients is necessary.Publication Metadata only A case of conjunctival MALT lymphoma: successfully treated with solely extended rituximab therapy(SPRINGER, 2019) TOKER, AYŞE EBRU; Celiker, Hande; Toker, Ebru; Atagunduz, Isik KaygusuzPurposePrimary ocular adnexal lymphomas are cured by radiotherapy