Background: Rheumatoid arthritis (RA) is an autoimmune disease associated with systemic inflammation. Laboratory parameters such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and various disease evaluation indexes (such as DAS 28; HAQ score, SF-36) are used as indicators of the severity of inflammatory activity. Neutrophil-to-lymphocyte ratio (NLR); It has attracted attention in recent years as a non-specific inflammatory marker. In our study, it was aimed to investigate the possible role of peripheral blood NLR, which is easy and inexpensive to measure, in demonstrating disease activity and prognosis in patients with RA. Materials and Methods: Forty-three patients who were diagnosed with RA according to the criteria of the American Rheumatology Association and who had not received prior specific treatment for RA were included in the study. Laboratory parameters such as ESR, CRP, and disease assessment indices (DAS 28; HAQ score) were compared with the NLR at the time of diagnosis and at the time of enrollment after treatment. Results: There were no significant correlation found between the mean NLR and DAS 28, HAQ which provide information about the prognosis of the disease. When the relationship between NLR, ESR and CRP was examined in order to evaluate the relatonship between the disease activity and inflamation during the diagnosis instead of a composite index such as DAS 28, moderately weak relationship between NLR and CRP level was found (p=0.033, r=0,343) while the tendency between NLR and the average ESR was found to be also moderately weak (p=0.056, r=0.301). Conclusions: Moderate to weak correlation between mean NLR and mean CRP levels (p=0.033, r=0.343); between the mean ESR level, a moderate-weak correlation was found (p=0.056, r=0.301). The association with baseline CRP and the trend towards association with ESR suggest that NLR may be associated with inflammation. It was thought that the loss of this relationship during the study, that is, after the treatment, may be due to the fact that other factors such as medication affect this rate.

OBJECTIVE: The aim of this study was to compare the incidence of factors associated with an increased risk of thrombosis in patients with essential thrombocythemia. METHODS: A total of 200 patients followed-up in our unit with a diagnosis of essential thrombocythemia in 13 years were analyzed retrospectively. RESULTS: Of the study participants, 60.5% were females and 39.5% were males, with an overall mean (+/- SD) age of 54.93 (+/- 14.21) years. In 119 patients, Janus Kinase 2 was positive with 56.3% of cases. When two patient categories were defined as those with or without history of thrombosis, no significant differences were found in terms of Janus Kinase 2 positivity, mean age, as well as white blood cells and platelet counts (p>0.05). Also, no significant differences in thrombotic event incidence were found between patient categories defined on the basis of cut-off values for white blood cells (cut-off values of 15x10(3)/mm(3) and 8.7x10(3)/mm(3)) and platelets (cut-off values of 1500x10(3)/mm(3)) (p>0.05). CONCLUSION: Although our results are generally in line with the published data, some divergence from previous results has been observed with respect to risk factors for thrombotic events. Absence of a correlation between leukocytosis and thrombosis may be related with the significant decline in white blood cells after treatment. Also, a significant reduction in platelet counts occurring in association with treatment is linked with a lowered incidence of thrombosis. Janus Kinase 2-positive patients had a similar thrombosis frequency with that reported in the literature.

This study aimed to evaluate the prognostic significance and clinical impact of the revised 2022 European LeukemiaNet (ELN) classification for acute myeloid leukemia (AML), focusing particularly on patients harboring fms-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutations. A retrospective, multicenter observational study was conducted by the Turkish Society of Hematology-Acute Leukemias Working Group, analyzing 312 adult patients newly diagnosed with AML from January 2012 to December 2022. Patients with acute promyelocytic leukemia were excluded. FLT3-ITD mutations were detected using polymerase chain reaction and, when available, next-generation sequencing. Patients were classified according to the 2017 ELN risk stratification, and FLT3-ITD-positive cases were reclassified based on the updated 2022 ELN criteria. Endpoints were complete remission (CR), disease-free survival (DFS), and overall survival (OS). FLT3-ITD mutations were identified in 54 (17.3%) patients. According to the 2022 ELN classification, 29 patients previously categorized as the favorable (n = 6) or adverse-risk (n = 23) groups were reclassified into the intermediate-risk group, highlighting the substantial impact of removing the FLT3-ITD allelic ratio from risk stratification. With a median follow-up of 31.8 months, OS significantly differed among the 2017 ELN favorable-, intermediate-, and adverse-risk categories (not reached, 21.6 months, and 9.5 months, respectively, p < 0.001). FLT3-ITD-positive patients demonstrated significantly inferior DFS (p = 0.038) and OS (p = 0.009) compared to FLT3-ITD-negative patients. In patients achieving first CR, allogeneic hematopoietic stem cell transplantation (HSCT) improved OS in intermediate-risk (p = 0.003), showed a trend in adverse-risk (p = 0.098), and no benefit in favorable-risk (p = 0.351). Among reclassified FLT3-ITD-positive patients, survival outcomes aligned closely with the original intermediate-risk group defined by the 2017 ELN, supporting the rationale behind the ELN revision. Our findings validate the prognostic utility of the revised 2022 ELN guidelines, especially regarding FLT3-ITD-positive AML, emphasizing that the exclusion of the FLT3-ITD allelic ratio yields a more biologically consistent risk categorization. Furthermore, the data support tailored ELN-based risk stratification for older AML patients. Given the modest benefit of HSCT in adverse-risk patients, future refinements should further stratify this group to address their unmet therapeutic needs and enhance survival outcomes. The study was registered at ClinicalTrials.gov (NCT05979675).

Objective: Achieving an early molecular response (EMR) is crucial for improving the prognosis of patients with chronic myeloid leukemia (CML). The halving time (HT) and reduction ratio (RR) of BCR::ABL1 transcript levels have recently emerged as additional prognostic indexes besides the BCRABL1 International Scale (IS). We aimed to investigate the prognostic role of BeR:ABL1 transcript levels, HT, and RR on molecular response kinetics at 3 months in patients with newly diagnosed chronic-phase (CP)-CML. Materials and Methods: Forty patients with CP-CML who received first-line imatinib treatment were included in this study. BCR::ABL1 transcript levels and molecular responses at baseline and at 3, 6, 12, and 24 months of treatment were evaluated retrospectively. Major molecular response (MMR) at 12 months and event-free survival (EFS) were determined as primary endpoints and the effects of treatment kinetics on these parameters were examined. Results: Of the 40 patients, BCR:ABL1 IS was <= 10% at 3 months in 72.5%, representing EMR. The rate of event occurrence was 45.50/u in patients with BCR:ABL1 IS of >10%, whereas it was 6.9% in those with BCRABL1 IS of 10% (p=0.004). MMR was detected in 62.1% of the patients with EMR and in 9.1% of those without EMR (p=0.003). The cut-off value for achieving MMR was 24 days for HT and 0.04 for RR. Deep molecular response (DMR) at 24 months was associated with HT of 24 days and RR of 0.04. EFS was found to be significantly better in the group with BCRABL1 IS of 100/c) and HT of 24 days (p=0.001) and in the group with BCRABL1 IS of <= 10% and RR of < 0.04 (p=0.007) compared to others. Conclusion: Our findings revealed that MMR could be predicted via EMR as well as by HT and RR. Additionally, HT of 24 days and RR of <= 0.04 were more important than BCR::ABL1 IS of <= 10% in achieving DMR at 24 months, and the combination of BCRABL1 IS of <= 10% with both HI of <= 24 days and RR of <= 0.04 has the best predictive value for EFS.