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Yayın The diagnosis of non Hodgkin lymphoma in an epidermodysplasia verruciformis patient(2009) Karagöz, Bülent; Erikçi, Alev Akyol; Karabudak, Özlem; Bilgi, Oğuz; Sayan, Özkan; Küçükkodaci, Zafer; Türken, Orhan; Kandemir, Emin Gökhan; Öztürk, Ahmet KutluEpidermodysplasia verruciformis is a rare, multifactorial disorder. The disease has genetic and immunologic components. Many patients have impaired cell-mediated immunity. Although squamous cell cancers may develop in EV patients, the association with other hematological or solid malignancies and EV is reported in a few studies. In this report, a case of EV with primary mediastinal large B-cell lymphoma is presented. A 20-year-old man with a five years history of red-brown macular lesions was admitted to our hospital. The skin biopsy revealed epidermodysplasia verruciformis. Persistent cough started during the hospitalization. On the chest X-ray, mediastinal enlargement was determined. Thoracic computed tomography demonstrated a mediastinal mass of 6 cm in diameter. Diffuse, large B-cell lymphoma was diagnosed. The chemotherapy (R-CHOP regiment) and involved field radiotherapy were administered. Complete response was achieved after the combined treatment modality. He is lymphoma-free for 18 months follow-up. Epidermodysplasia verruciformis is frequently seen in immunosuppressive patients and many accompany infections with type human papilloma virus subtypes such as 5 and 8. These human papilloma virus subtypes that have oncogenic properties may trigger lymphomagenesis. In addition, lymphomas are seen more frequently in immunosuppressive patients than healthy persons. We conclude that there may be a predisposition to lymphoma development in epidermodysplasia verruciformis patients.Yayın The diagnosis of non-hodgkin’s lymphoma in epidermodysplasia verruciformis patient(Turkish Society of Hematology, 2005) Karagöz, Bülent; Akyol Erikçi, Alev; Karabudak, Özlem; Bilgi, Oğuz; Sayan, Özkan; Kandemir, E. Gökhan; Öztürk, AhmetEpidermodysplasia verruciformis (EV) is a rare, multifactorial disorder. This disease contains genetic and immunologic components and accompanies infection with some specific Human Papilloma Virus (HPV) types. The patients may develop multiple in situ and/or invasive squamous cell carcinomas. The most of the patients have impaired cell-mediated immunity. Although EV accompanies frequently skin cancer and extracutanous squamous cell carcinoma, the association between EV and other cancers is not described. In this report, a case of EV with primary mediastinal large B cell lymphoma is presented. A 20-year-old man was seen in our outpatient clinic. He had red-brown macular lesions in sun exposed areas as face and neck for five years duration. EV was diagnosed by histopathologic examination of skin biopsy. One month later, he started to cough. The histological diagnosis of mediastinal mass measuring 6 cm in diameter was diffuse large Bcell lymphoma. B symptoms were absent. He was diagnosed to have stage IAX disease. R-CHOP chemotherapy (Rituximab plus CHOP) and involved field radiotherapy were administered. We have been following this case for 6 months and complete remission is achieved. EV accompanies infection with specific HPV types and is seen in immunosuppressive patients. Some of EV-specific HPVs, particularly HPV 5 and 8 have oncogenic properties. These may have also lymphogenic effect. Moreover the lymphomas are seen frequently in immunosuppressive patients. We conclude that EV may be a predisposition for lymphoma.Yayın İntraarteriyel kemoterapi ile tedavi edilen lakrimal gland adenoid kistik karsinomu olgusu(2009) Kandemir, Emin Gökhan; Başekim, Çınar; Bilgi, Oğuz; Özgün, Mehmet Alpaslan; Karagöz, Bülent; Türmen, Orhan; Haholu, AbdullahAdenoid kistik karsinom (AKK) lokal nüks ve uzak metastazlarla seyreden glanduler dokuların malign tümörüdür. Bu yazıda, intraarteriyel kemoterapi ile beraber multimodal yaklaşımla tedavi edilen bir lakrimal gland AKK olgusu sunuldu. Otuz iki yaşındaki kadın hastaya sol lakrimal gland AKK (solid varyant) tanısı konuldu. Neoadjuvan intraarteriyel sisplatin ve intravenöz doksorubisin tedavisinden sonra orbita eksanterasyonu uygulandı. Hasta 32 ay sonra halen hastalıksız izlemdedir. Söz konusu hastalık için iyi bir hastalıksız sağkalım süresi sağlanması, lakrimal gland AKK tedavisinde intraarteriyel kemoterapinin yararını gösteren yayınları destekler durumdadır.Yayın Küçük hücreli dışı akciğer kanserinde komorbiditenin prognostik önemi ve diğer prognostik faktörlerle ilişkisi(2009) Kandemir, Emin Gökhan; Türken, Orhan; Karagöz, Bülent; Bilgi, Oğuz; Özgün, M. AlpaslanAkciğer kanseri hastalarında komorbidite sık görülmektedir. Ancak, akciğer kanseri ve komorbidite arasındaki ilişki bugüne kadar yeterince araştırılmamıştır. Bu çalışmada, GATA Haydarpaşa Eğitim Hastanesinde küçük hücreli dışı akciğer kanseri tanısı konmuş 358 hastadaki komorbidite sıklığı incelenmiş, komorbiditenin diğer bilinen prognostik faktörlerle ilişkisi ve prognostik önemi araştırılmıştır. Komorbiditenin tanımlanmasında ve derecelendirilmesinde Charlson komorbidite indeksi kullanılmıştır. Komorbidite derecesi ile yaş, evre ve performans durumu arasında anlamlı bir korelasyon bulunmuştur (p= 0.0001). Komorbidite derecesi ile cinsiyet ve histopatolojik tip arasında ise anlamlı bir korelasyon bulunamamıştır (p= 0.9, p= 0.5). Tek değişkenli analizde komorbidite derecesi, yaş, evre, performans durumu ve histopatolojik tip ile genel sağkalım arasında anlamlı bir ilişki olduğu bulunmuştur (p= 0.00001). Çok değişkenli analizde ise, yüksek komorbidite derecesinin diğer faktörlerden bağımsız olarak genel sağkalımı olumsuz yönde etkilediği bulunmuştur (p= 0.0001). Sonuç olarak, küçük hücreli dışı akciğer kanseri hastalarında komorbiditenin diğer prognostik faktörlerden bağımsız olarak kötü prognostik bir faktör olduğu bulunmuştur.Yayın Lacrimal gland adenoid cystic carcinoma treated with intraarterial chemotherapy(Kare Publ, 2009) Karagöz, B.; Bilgi, Oğuz; Duman, Cengiz; Basekim, Çınar; Kandemir, Emin Gokhan; Haholu, Aptullah; Özgun, AlpaslanAdenoid cystic carcinoma is a malignant tumor of glandular tissue and progresses with local relapse and distant metastasis. In this report, we present a case of lacrimal gland adenoid cystic carcinoma who treated by multimodal approach with intraarterial chemotherapy. A 32-year-old woman was diagnosed with adenoid cystic carcinoma (solid variant) of the left lacrimal gland. Neoadjuvant intraarterial cisplatin, intravenous doxorubicin, and orbital exenteration were performed. The patient was followed for 32 months without relapse. Achievement of long-time survival for this disease supports studies that show benefit of intraarterial chemotherapy.Yayın Peripheral blood gamma-delta T cells in advanced-stage cancer patients(Springer Link, 2008) Bilgi, Oğuz; Karagöz, Bülent; Kandemir, E. Gökhan; Öztürk, Ahmet; Gümüş, Mahmut; Yaylacı, MustafaGamma-delta T (?? T) cells form a subgroup which has been reported to play a role in both natural and acquired immunity. Their levels have been found to increase in some tumour tissues. The aim of this study was to investigate the ratio of ?? T cells to all T cells in the peripheral blood of advanced-stage cancer patients; the level of ?? T cells expressing the V?2-T-cell receptor (TCR) chain; NKG2D receptor expression; and apoptotic (Annexin-V) ?? T-cell levels. Twenty patients with advanced-stage cancer and 13 healthy controls were included. No statistical differences were found between control and patient groups in terms of the ?? T/total T-cell ratio (P=0.53), the V?2-TCR expressing ?? T-cell ratio (P=0.19) or the Annexin-V ratio (P=0.48). However, NKG2D expression in ?? T cells was significantly different between the control and patient groups (P=0.014). In summary it was shown that the levels of NKG2D receptors, which are responsible for the cytolytic effect of ?? T cells, were lower in cancer patients than in healthy adults. However, no significant differences were observed in the other parameters studied between groups.Yayın The relapse of non-hodgkin’s lymphoma presented with large renal mass and pulmonary multiple nodules mimicking renal cell carcinoma.(Turkish Society of Hematology, 2005) Karagöz, Bülent; Sayan, Özkan; Bilgi, Oğuz; Akyol Erikçi, Alev; Kandemir, E. Gökhan; Öztürk, AhmetPrimary renal involvement of non-Hodgkin lymphomas is rare, secondary involvement is not common. In case of renal mass, other causes should also be considered. There are some cases reporting an association of renal cell carcinoma with lymphoma in literature. We report a case of relapsed non Hodgkin lymphoma with pulmonary nodular involvement. A 32-year-old woman was admitted in oncology department anterior mediastinal mass and vena cava superior syndrome. Tru-cut biopsy revealed primary mediastinal diffuse large B cell lymphoma. She received six cycles of CHOP chemotherapy regimen followed by involved field radiotherapy. The complete response was achieved. After six months, she complained abdominal pain. The computed tomography demonstrated a mass with 8 cm in diameter and multiple nodules in lung parenchyma. This picture mimicked renal cell carcinoma with pulmonary metastasis. The association between renal cell carcinoma and lymphomas was reported. Although renal involvement of non Hodgkin lymphoma is seen as %50 in autopsy series, antemortem diagnosis is uncommon. Moreover after treatment of lymphoma, risk of renal cancer is elevated. However biopsy was applied from renal mass and established relapse of diffuse large B cell lymphoma. The probability of extranodal relapse of thymic lymphoma should be kept in mind.Yayın Results of combination therapy with amifostine, pentoxifylline, ciprofloxacin and dexamethasone in patients with myelodysplastic syndrome and acute myeloid leukemia(Taylor and Francis Online, 2008) Akyol Erikçi, Alev; Öztürk, Ahmet; Karagöz, Bülent; Bilgi, Oğuz; Top, Cihan; Kandemir, E. GökhanMyelodysplastic syndrome (MDS) is a clonal disease of the bone marrow characterized by abnormal hematopoiesis and cytopenias. It has been shown that abnormal cytokine production together with apoptosis are major contributors to the cytopenias associated with the disorder. As the interaction of cytokines plays a role in the pathogenesis, suppression of the cytokine production by the administration of the combination of pentoxyfilline, ciprofloxacin, and dexamethasone (PCD combination) has resulted in the correction of at least some aspects of the cytopenias in the majority of patients and in complete hematologic remission in a small percentage. The aminothiol prodrug amifostine, a compound to protect tissues from cytotoxic drugs and radiotherapy has been found to stimulate proliferation of normal hematopoesis and suppress apoptosis in patients with MDS. In this study we report the results of combination therapy of amifostine and PCD in 12 patients with MDS and acute myeloid leukemia (AML). Amifostine was given in a dose of 200 mg/m2, as an i.v. infusion administered in 10 min, three times a week; pentoxyfilline 2400 mg/day, (3 × 800 mg) p.o.; ciprofloxacine, 1 g/day p.o.; dexamethasone 4·5 mg/day p.o. We achieved 66% response rate in our patients. In some cases responses were achieved in only thrombocytopenia or anemia whereas in others responses were achieved in multiple series. As a result it was found that amifostine + PCD combination may be beneficial in reversing cytopenias in the treatment of MDS and AML and is worth further study.
