Background/aim: Carfilzomib (CFZ) is a new-generation proteasome inhibitor with significant activity in relapsed or refractory multiple myeloma (R/R-MM). We have retrospectively evaluated R/R-MM patients who were treated with CFZ plus dexamethasone. Materials and methods: Twenty-one R/R-MM patients who were treated with CFZ plus dexamethasone between October 2013 and January 2016 were screened. The patients were followed until March 2016 after CFZ treatment. Results: Ten (47.6%) of the patients were female and 11 (52.4%) of them were male. The median age was 62 (47-76) years. The median number of prior treatment lines was 3 (2-7). The median number of administered cycles of treatment for CFZ was 4 (1-10). The median overall response rate was 26.3%. The most common hematological adverse events were anemia and thrombocytopenia (38%). The most common nonhematological adverse event was fatigue (71.4%). One patient died because of a cerebrovascular event and 1 patient died because of pneumonia during the treatment period. The median duration of response rate and time to next therapy were 8 (7-9) and 3 (2-16) months, respectively. The median overall survival was 8 (0.5-33) months. Conclusion: Despite the small number of patients, our results suggest that CFZ provides acceptable responses in heavily pretreated R/R-MM patients.

AMAÇ: Tüm dünyada ve ülkemizde insanların tamamlayıcı ve alternatif tıp yöntemlerine ilgileri gün geçtikçe artmaktadır. Genellikle bitkisel ürünler ve gıda takviyeleri hastalar tarafından en çok kullanılan yöntemlerdir. Bu ürünlerin kullanımı diyabet hastalarında da çok sık tercih edilmektedir. Bu hastalarda bitkisel ürünler veya diğer yöntemlerin kullanımı morbidite ve mortalite açısından risk oluşturabilmektedir. Bu çalışma diyabetik hastalarda kullanılan bitkisel ürün, gıda takviyesi veya diğer yöntemleri, hangi sıklıkla kullandıkları ve yan etkilerini incelemek amacıyla planlanmıştır.GEREÇ VE YÖNTEM: Tanımlayıcı ve kesitsel tipte olan bu çalışma, Şubat 2020 - Mart 2020 tarihleri arasında Balıkesir Üniversitesi Hastanesi İç Hastalıkları Polikliniği ile Endokrinoloji ve Metabolizma Hastalıkları Polikliniğine başvuran, 18 ile 90 yaş arasında görüşmeyi kabul eden diyabetes mellitus tanılı ve takipli 569 hastada yüz yüze görüşme yöntemi ile yapılmıştır.BULGULAR: Çalışmamıza katılan diyabet hastaların 233 (%40,9)’ü erkek; 336 (%59,1)’i kadındı. Çalışmamıza katılan Diabetes Mellitus (DM) hastalarının hastalıklarına yönelik herhangi bir ilaç dışı bitkisel ürün veya diğer yöntem kullanıp kullanmadığı sorgulandığında 366 (%64,3)‘sı bitkisel ürün veya diğer yöntemleri kullanmadığını belirtirken, 203 (%35,7)‘ü kullandıklarını belirtmişlerdir. Bitkisel ürün veya diğer yöntemleri kullanan hastaların çoğunluğu 174 (%85,7)’ü gıda takviyelerini kullandıklarını belirtmişlerdir. Gıda takviyesi kullananlar ise en sık tarçın (%60,2) ve limon (%11,4) gibi gıdaları kullanmışlardır. Hastaların 156 (%76,8)’sı kullandığı bitkisel ürün veya diğer yöntemler hakkında doktoruna bilgi vermediğini söylemişlerdir. Kullananların sadece %3’ünde yan etki görülmüştür.SONUÇ: Diyabet tanılı hastaların önemli bir kısmı ilaç dışı bitkisel ürün, gıda takviyesi veya diğer yöntemleri kullanmaktadır. Katılımcıların çoğu kullanmış oldukları yöntemler hakkında hekimine bilgi vermediği görülmüştür. Bu durum istenmeyen sonuçlara neden olabilir. Bu yüzden hekimlerin anamnez kısmında ilaç sorgulama açısından dikkatli olmalıdır.

This study aimed to evaluate patients with RRMM who underwent daratumumab (DARA) therapy. This multicenter and retrospective study included 134 patients who underwent at least two courses of DARA from February 01, 2018 to April 15, 2022. Epidemiologic, disease and treatment characteristics of patients and, treatment related side effects were evaluated. Survival analysis were performed. The median age at initiation of DARA therapy was 60 (35-88) years. The median time to initiation of DARA and the median follow-up time were 41.2 (5.1-223) and 5.7 (2.1-24.1) months, respectively. The ORR after DARA therapy was 75 (55.9%), and ≥VGPR was observed in 48 (35.8%) patients. Overall survival (OS) and progression-free survival (PFS) for all patients were 11.6 (7.8-15.5) and 8.0 (5.1-10.9) months, respectively. OS was higher for patients undergoing DARA-Vd than for those undergoing DARA-Rd (16.9 vs. 8.3 months; p=0.014). Among patients undergoing Dara-Rd, PFS was higher in those without EMD (EMD-) than those with EMD (EMD+)(NA vs. 3.7 months; OR, 3.4; p < 0.001). The median number of prior therapies was 3 (1-8). Initiation of DARA therapy in the early period provides OS and PFS advantage, although statistically insignificant. Infusion-related reactions were observed in 18 (13.4%) patients. All reactions occurred during the first infusion and most reactions were grade 1-2 (94.5%). The frequency of neutropenia and thrombocytopenia was higher in the DARA-Rd group (61.9% vs. 24.7%; p < 0.001 and 42.9% vs. 15.7%; p < 0.001). Our study reflects real-life data in terms of DARA therapy for patients with RRMM and supports the early initiation of DARA therapy.

Objective: Chronic graft versus host disease (cGVHD) develops after allogeneic hematopoietic cell transplantation, when immune cells from a non-identical donor initiate an immune reaction against the transplant recipient. Extracorporeal photopheresis (ECP) can be used in combination with prednisone in steroid-resistant cGVHD. In this study, the effect of ECP use on survival in cGVHD was examined. Patients and Methods: Twenty-six patients who were followed up in the adult Hematology Clinic of Inonu University Turgut Ozal Medical Center for cGVHD were included in the study. Stem cell transplantation and ECP application parameters that may affect the survival of the patients were examined. Results: The degree of involvement in cGVHD affects survival. Involvements with clinical and laboratory scores of 2 and above according to the National Institutes of Health consensus criteria, significantly reduced survival. The development time of cGVHD was found to be associated with survival, and that it had a positive impact on survival, especially when the disease developed after 220 days after the transplantation. It was observed that steroid dose taken during ECP, patient age and cGVHD prophylaxis used affected survival. Conclusion: The use of ECP may be effective in survival, especially, in patients who develop cGVHD, 220 days after allogeneic transplantation. Concurrent use of steroids with ECP affects survival.

Background/Objectives: Real-world data on the therapeutic use of FLT3 inhibitors in Turkey remain limited. Therefore, we retrospectively evaluated outcomes from 13 academic centers nationwide, focusing on the multikinase inhibitor midostaurin in patients with newly diagnosed FLT3-mutated acute myeloid leukemia (AML). Methods: We collected comprehensive information regarding treatment efficacy, safety, and tolerability. Results: The overall response rate to intensive chemotherapy (3 + 7) plus midostaurin was 87.7%, with a complete remission rate of 84.2%, consistent with previously reported clinical trial results. Treatment discontinuation due to intolerance or toxicity was low (3.5%). One patient discontinued therapy because of septic shock during induction, and another due to a drug–drug interaction during consolidation. Median overall survival was 21.4 months. Allogeneic stem cell transplantation was performed in first remission in 52.6% of patients. Five patients (8.8%) were refractory to induction therapy, and relapse occurred in 21.1% (12 patients). Conclusions: These findings support the effectiveness and acceptable tolerability of midostaurin in routine clinical practice for FLT3-mutated AML.