GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, yeni taný konmuþ lenfoma hastalarýnda ilk evreleme sýrasýnda kemik iliði (BM) tutulumunun deðerlendirilmesinde PET-BT'nin rolünü belirlemektir.
YÖNTEM ve GEREÇLER: Ocak 2010-Eylül 2016 tarihleri arasýnda Hematoloji Bölümümüze baþvuran ve lenfoma tanýsý alan 104 hastanýn retrospektif analizi yapýldý. Hastalar Hodgkin (HL) ve Hodgkin Dýþý Lenfoma (HDL) olarak sýnýflandýrýldý. HDL hastalarý da agresif ve yavaþ seyirli olmak üzere iki alt grupta deðerlendirildi.
BULGULAR: Hastalarýn 54’ü (% 51.9) erkek ve 50’si (% 48.1) kadýndý ve 24 HL'li ve 80 HDL olarak sýnýflandýrýldý. Kemik iliði (KÝ) biyopsisi 40 hastada (% 38,5) KÝ tutulumu gösterdi ve 64 (% 61,5) hastada patolojik bulgu görülmedi. PET-BT ile tüm hasta grubunun 41'inde (% 39,4) KÝ tutulumu saptandý, bunlarýn 26'sýnda (% 63,4) yaygýn infiltrasyon, kalan 15'inde (% 36,6) yamalý infiltrasyon vardý. Tüm lenfoma hastalarý için PET-BT'nin duyarlýlýðý% 80 ve özgüllüðü% 85.9'du. PET-BT'nin duyarlýlýðý ve özgüllüðü HL hastalarý için sýrasýyla %92,3 ve %81,8 ve NHL hastalarý için %74,1 ve %86,8 idi. Sadece agresif HDL hastalarý için PET-BT duyarlýlýðý% 81.8 ve özgüllük% 87.75 idi.
TARTIÞMA ve SONUÇ: PET-BT, yamalý tutulumun saptanmasýnda özellikle HL ve agresþf HDL hastalarýnda KÝ tutulumunu daha yüksek bir duyarlýlýkla deðerlendirmek için etkili bir yöntemdir. Non-invaziv ve uygulanmasýnýn kolay olmasý BM biyopsisi yerine kullanýlabileceðini destekleyebilir.

INTRODUCTION: The aim of the current study was to determine the role of PET-CT in the evaluation of bone marrow (BM) involvement during initial staging in patients with newly diagnosed lymphoma.
METHODS: A retrospective analysis was made of 104 patients who were admitted to our Hematology Department between January 2010 and September 2016 and were diagnosed with lymphoma. Patients were classified as Hodgkin (HL) and Non-Hodgkin Lyphoma (NHL). NHL patients were evaluated in two subgroups as aggressive and indolent.
RESULTS: The patients comprised 54 (51.9%) males and 50 (48.1%) females and were classified as 24 patients with HL and 80 with NHL. BM biopsy showed BM involvement in 40 patients (38.5%) and there was no pathological finding in 64 (61.5%) patients. BM involvement was detected on PET-CT in 41 (39.4%) of the whole patient group, of which 26 (63.4%) cases had diffuse infiltration and the remaining 15 (36.6%) cases had patchy infiltration. For all lymphoma patients, sensitivity of PET-CT was 80% and specificity was 85.9%. Sensitivity and specificity of PET-CT was 92.3% and 81.8% for HL patients and 74.1% and 86.8% for NHL patients, respectively. For only aggressive NHL patients, PET-CT sensitivity was 81.8% and specificity was 87.75%.
DISCUSSION AND CONCLUSION: PET-CT is an effective method for assessing BM involvement with a higher sensitivity especially for HL and aggressive NHL patients in detecting patchy involvement. The fact that it is non-invasive and easy to apply may support that it can be used instead of BM biopsy.

GÝRÝÞ ve AMAÇ: Prostat kanseri tanýsýnda prostat biyopsisi halen altýn standart tetkik olmakla birlikte 1,5 Tesla (T) ya da 3 T cihazlarla uygulanan multi-parametrik MRG (MpMRG), tanýda vazgeçilmez bir tetkik haline gelmiþtir. Bu çalýþmada; prostat kanseri þüphesiyle 1,5 T cihaz ile MpMRG yapýlan hastalarýn, Prostat Görüntüleme Raporlama ve Bilgi Sistemi versiyon2 (PI-RADSv2) skorlarýný, prostat biyopsisi patoloji sonuçlarýyla karþýlaþtýrmayý amaçladýk.

YÖNTEM ve GEREÇLER: Çalýþmamýza kliniðimizde Ocak 2017-Ocak 2020 tarihleri arasýnda prostat kanser þüphesi nedeniyle MpMRG ve ardýndan prostat biyopsisi yapýlmýþ 52 hasta (26 benign, 26 malign) dahil edildi. Bu olgularýn yaþý, prostat hacmi, kan PSA (prostat spesifik antijen) deðeri, yoðunluðu ve patoloji sonuçlarý analiz edildi. Deneyimli bir radyolog tarafýndan her bir hasta için PI-RADSv2 skorlama sistemine göre kategorizasyon yapýldý. Ýstatistiksel analizde “Ki kare” testi ile “Student-t” test kullanýldý.

BULGULAR: Benign hasta grubunun (96,4±77,7) ortalama prostat hacmi malign gruptan (47,4±17.3) anlamlý olarak daha yüksektir (p=0,003). Ortalama PSA deðeri ve yoðunluðu malign hastalarda (PSA deðeri, 13,7±16,5 ng/ml; PSA yoðunluðu, 0,33±0,46 ng/ml/cc) benign hasta grubundan (PSA deðeri, 6,8±3,3 ng/ml; PSA yoðunluðu, 0,09±0,05 ng/ml/cc; p<0,05) daha yüksektir. 1,5T cihaz ile uygulanan MpMRG’nin anlamlý prostat kanseri saptamadaki sensitivitesi %73,08, spesifitesi %84,62 pozitif prediktif deðeri %82,61 iken negatif prediktif deðeri ise %75,86 olarak hesaplandý.

TARTIÞMA ve SONUÇ: PI-RADSv2’ye göre negatif MpMRG’nin yüksek negatif prediktif deðeri göz önüne alýndýðýnda MRG gereksiz biyopsi oranýný azaltabilir.

INTRODUCTION: Although prostate biopsy is still the gold standard in diagnosis of prostate cancer (PC), multi-parametric MRI (MpMRI) applied with 1.5 Tesla (T) or 3T systems has become an indispensable method in diagnosis. We aimed to compare “Prostate Imaging-Reporting and Data System version2” (PI-RADSv2) scores with pathology of patients who underwent MpMRG (1.5T) for the suspicion of PC.

METHODS: Between January 2017 and January 2020, 52 patients (26 benign, 26 malignant patients) who underwent MpMRI followed by biopsy in our center due to suspicion of PC were included in our study. Age, prostate volume, blood PSA (prostate specific antigen) value, density and pathology of these cases were analyzed. The PI-RADSv2 assessment category was assigned for each patient by an experienced radiologist. The "Chi-square" test and "Student-t" test were used for statistical analysis.
RESULTS: The mean prostate volume of benign group (96.4±77.7) was significantly higher than patients with cancer (47.4±17.3) (p=0.003). Mean PSA value and PSA density in patients with malignancy (PSA value, 13.7±16.5 ng/ml; PSA density, 0.33±0.46 ng/ml/cc) were significantly higher than benign group (PSA value, 6.8±3.3 ng/ml; PSA density, 0.09±0.05 ng/ml/cc, p<0,05). The sensitivity, specificity, negative predictive value and positive predictive value of MpMRI applied with 1.5 T system in detection of significant PC was 73.08% 84.62%, 82.61% and 75.86%, respectively.

DISCUSSION AND CONCLUSION: Considering the high negative predictive value of negative MpMRI findings for significant PC due to PI-RADSv2, MRI can reduce unnecessary biopsy.

GÝRÝÞ ve AMAÇ: Onkoplastik meme cerrahisi, büyük tümörlerde bile iyi estetik sonuçlarla meme koruyucu cerrahi imkaný saðlayan bir tekniktir. Bu çalýþma, onkoplastik meme cerrahisi ile tedavi edilmiþ hastalarda uzun dönem onkolojik sonuçlarýn deðerlendirilmesini amaçlamaktadýr.
YÖNTEM ve GEREÇLER: Bu çalýþmada, 2007-2014 yýllarý arasýnda hastanemizde onkoplastik meme cerrahisi teknikleri kullanýlarak opere edilmiþ 230 meme kanseri hastasýna ait veriler retrospektif olarak deðerlendirilmiþtir. Bu alanda yapýlmýþ benzer çalýþmalarýn çoðunda erken evre meme kanseri hastalarýna ait veriler bulunmaktadýr. Biz böyle bir kýsýtlama yapmadan tüm hastalarýmýza ait verileri deðerlendirerek, tümör boyutunun bu tekniðin güvenilirliðini etkileyip etkilemediðini araþtýrdýk.
Ayrýca, hasta ve tumor özellikleri, uygulanan cerrahi yöntem, cerrahi komplikasyonlar, patolojik sonuçlar ile lokal nüks ve saðkalým özellikleri incelendi.

BULGULAR: Median takip süresi 73 ay (aralýk 7–149 ay) idi. 10 yýllýk hastalýksýz saðkalým oraný %74.4 ve 10 yýllýk toplam saðkalým oraný %80.0 olarak bulundu. 10 yýllýk lokal nüks oraný %1.7 idi. Erken komplikasyon oraný %22.6% olarak tespit edildi.
TARTIÞMA ve SONUÇ: Onkoplastik meme cerrahisi, büyük tümörü olan hastalarda bile komplikasyon, lokal nüks ve saðkalým oranlarýnda olumsuzluða neden olmadan güvenle uygulanabilir bir yöntemdir.

INTRODUCTION: Oncoplastic breast surgery is a safe and effective surgical technique that improves aesthetic outcomes and broadens the indication for breast-conserving surgery for larger tumors. The purpose of this study was to assess the long-term oncological results of oncoplastic breast-conserving surgery in breast cancer patients.
METHODS: This is a retrospective study of 230 breast cancer patients who underwent volume displacement oncoplastic breast surgery techniques between 2007 and 2014. Most of the similar studies had evaluated only patients with early-stage breast tumors. We did not limit our data due to the tumor stage to analyze all and see if tumor size affects the safety of this technique.
We explored patient and tumor characteristics, surgical treatments, surgery-related complications, and pathological outcomes. Moreover, disease-free survival, overall survival, and local recurrence rates of 10 years follow-up were also estimated.

RESULTS: The median follow-up time was 73 months (range 7–149 months). The 10-year disease free survival (DFS) rate was 74.4%, and 10-year overall survival (OS) was 80.0%. The 10-year local recurrence rate was 1.7%. The early complication rate was 22.6%.
DISCUSSION AND CONCLUSION: The oncoplastic breast-conserving surgery is a method that can be applied safely without unfavorable effects on local relapse and survival rates, even for large tumors.

GÝRÝÞ ve AMAÇ: Bu çalýþmada ileri evre küçük hücreli dýþý akciðer adenokarsinomu hastalarýnda pemetrexed kullanýmýnýn etkinliðini ve doz kýsýtlayýcý yan etkilerini deðerlendirmek amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Bu çalýþma 2017 – 2019 yýllarý arasýnda tedavi almýþ hastalarýn dosyalarý retrospektif olarak incelenerek yapýlmýþtýr. Hastalarýn geliþmiþ olan doz kýsýtlayýcý yan etkileri, her kür öncesi alýnan kan tetkikleri ve dosyalarýndaki notlara bakýlarak deðerlendi. Tüm toksisiteler Common Terminology Criteria for Adverse Events kullanýlarak sýnýflandýrýldý.
BULGULAR: Hastalarda en sýk doz kýsýtlayýcý yan etki 50% hastada geliþen nötropeni oldu. Hastalarýn 28,1%’inde tüm kan serilerini etkileyen yan etki görülmüþtür. Pemetrexedle birlikte verilen platinlerin yan etki insidanslarý benzerdi. Pemetrexed platin kombinasyon kemoterapisini ikinci ve sonraki basamaklarda alan hastalarda daha uzun median ortalama saðkalýmla iliþkiliydi (p < 0,05).
TARTIÞMA ve SONUÇ: Pemetrexed ileri evre akciðer küçük hücreli dýþý karsinomlarýnda kolay tolere edilebilen, etkili bir kemoterapi ajanýdýr.

INTRODUCTION: The purpose of this study was to evaluate the efficacy and dose-limiting side effects of pemetrexed use in patients with advanced-stage non-small-cell lung adenocarcinoma.
METHODS: This study was conducted retrospectively by examining the files of patients who received treatment between 2017 and 2019. The dose-limiting side effects of the patients were evaluated by looking at the blood tests taken before each cycle and the notes in their files. All toxicities were classified by using the Common Terminology Criteria for Adverse Events.
RESULTS: The most common dose-limiting side effect was neutropenia, which developed in 50% of the patients. Side effects that affecting all blood series were observed in 28,1% of patients. The incidence of side effects of platinum given with pemetrexed was similar. Longer median survival was statistically correlated within patients receiving pemetrexed + platinum combination chemotherapy in the second and subsequent lines (p < 0.05).
DISCUSSION AND CONCLUSION: Pemetrexed is an easily tolerated and effective chemotherapy agent in advanced-stage non-small-cell lung carcinomas.

GÝRÝÞ ve AMAÇ: Meme lezyonlarýnýn sertliði, malign kitleleri benign kitlelerden ayýrmaya yardýmcý olur. Doku sertliði, sýrasýyla görünür difüzyon katsayýsý (ADC) ve ultrason elastografi teknikleri kullanýlarak manyetik rezonans görüntüleme (MRG) ve ultrasongrafi (US) ile kantitatif ve objektif olarak deðerlendirilebilir. Bu çalýþmada US elastografi ve difüzyon MR sekanslarýný kullanarak malign meme kitlelerinde strain ratio (SR) ve görünür difüzyon katsayýsý deðerlerinin (ADC) ve tanýya katkýlarýný belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmamýza XXX Hastanesi Radyoloji Kliniði’nde Kasým 2013-Nisan 2014 tarihleri arasýnda, tru-cut biyopsi ile histopatolojik olarak kanýtlanmýþ invaziv meme kanseri olan ve Radyoloji kliniði arþivinde, biyopsi ve tedavi öncesi meme US elastografi ve meme MRG incelemeleri bulunan 18 yaþ üzeri 50 kadýn olguda 50 lezyon dahil edildi. Sonoelastografik incelemeler 13-18 Mhz lineer yüksek rezolüsyonlu volümetrik prob ile gerçekleþtirildi (Toshiba Aplio 400, Japan, 2014). Görüntüleme ve ölçümler 10 yýl meme radyoloji tecrübesi olan tek uygulayýcý tarafýndan yapýlmýþtýr. MR görüntüleri pron pozisyonda, bilateral 16 kanallý phased-array meme koili kullanýlarak 1.5-Tesla MR cihazý (Signa HDi; GE Healthcare, Milwaukee, WI) ile gerçekleþtirilmiþtir. ADC haritalarýnda 10-40 mm2 ROI kullanýlarak lezyonun farklý bölgelerinden, kistik, nekrotik ve hemorajik alanlarý içermeyecek þekilde ADC deðerleri ölçüldü. Bu deðerler arasýndan en düþük ADC deðeri seçildi.
BULGULAR: Kitlelerin SR deðerleri ile boyutlarý arasýnda birbiriyle doðru orantýlý ve istatistiksel olarak orta derecede anlamlý iliþki izlenmektedir (p<0.001). Kitle ADC deðeri ile boyut arasýnda ise birbiriyle ters orantýlý ancak istatistiksel olarak düþük anlamlýlýk düþündüren korelasyon bulundu (p<0.031). Kitle ADC ve SR deðerleri arasýnda anlamlý korelasyon izlenmedi (p>0.05). En yüksek SR deðeri, mikst intrakistik müsinöz ve invazif duktal karsinom tanýlý tek olguda 92.79 ve en yüksek ADC deðeri ise müsinöz karsinom tanýlý tek olguda 1.49 x10-3 mm2/s olarak elde edilmiþtir.
TARTIÞMA ve SONUÇ: Ultrason Elastografi ve difüzyon aðýrlýklý görüntüleme yüksek duyarlýlýk ve özgüllüðü olan invazif olmayan nisbeten yeni yöntemlerdir. Bu yöntemlerin meme hastalýklarýnda temel yöntemler ile birlikte kullanýlmasý benign ve malign meme lezyonun ayrýmýnda diagnostik performansý artýrmaktadýr.

INTRODUCTION: The firmness of breast lesions helps to differentiate malignant masses from benign masses. Tissue stiffness can be evaluated quantitatively and objectively by magnetic resonance imaging (MRI) and ultrasonography (USG) using the apparent diffusion coefficient (ADC) and ultrasound elastography techniques, respectively. We aimed to determine the strain ratio (SR) and ADC and their contribution to the diagnosis in malignant breast masses using US elastography and diffusion MR sequences.
METHODS: Our study included 50 lesions in 50 female patients over 18 years of age who had invasive breast cancer proven histopathologically by tru-cut biopsy and had breast US elastography and breast MRI examinations before biopsy in the Radiology clinic archive. Sonoelastographic studies were performed with a 13-18 Mhz linear high resolution volumetric probe (Toshiba Aplio 400, Japan, 2014). Imaging and measurements were made by a single practitioner with 10 years of experience in breast radiology. ADC values were measured from different parts of the lesion, not including cystic, necrotic and hemorrhagic areas, using 10-40 mm2 ROI on ADC maps and the lowest ADC value was selected.
RESULTS: A significant correlation between the SR and sizes of the masses (p<0.001). A correlation between the mass ADC and the size was found to be inversely proportional to each other, but suggesting statistically low significance (p<0.031). The highest SR and ADC were 92.79 in a single case with mixed intracystic mucinous and ductal carcinoma and 1.49 x10-3 mm2/s in a single case with mucinous carcinoma, respectively.
DISCUSSION AND CONCLUSION: Sonoelastography and DWI are relatively new non-invasive methods with high sensitivity and specificity. The use of these methods together with basic methods in breast diseases increases the diagnostic performance in the differentiation of benign and malignant breast lesions.

GÝRÝÞ ve AMAÇ: Kronik miyeloid lösemi (KML), Philadelphia kromozomunun (Ph) varlýðý ve miyeloid serideki hücrelerin aþýrý üretimi ile karakterize klonal miyeloproliferatif bir hastalýktýr. Tirozin kinaz inhibitörlerinin (TKÝ'ler) geliþmesiyle, KML için tedavi seçenekleri önemli ölçüde deðiþmiþtir. KML hastalarýnýn saðkalýmýný ve prognozunu deðerlendirmede anahtar rol, BCR-ABL yükünün, uygun tedavi ile tanýmlanan zaman ve deðerde azalmasýdýr. Bu çalýþmanýn amacý, KML hastalarýnýn klinik ve demografik özelliklerinin yaný sýra tedavi etkinliklerini, yan etki profillerini, tedavi dirençlerini ve saðkalýmlarýný analiz etmekti.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþma, 2010-2020 yýllarý arasýnda hastanemiz hematoloji bölümünde BCR-ABL pozitif KML tanýsý alan hastalar üzerinde gerçekleþtirilmiþtir. KML hastalarýnýn klinik ve demografik özellikleri, tedavi etkinliði, yan etkiler, tedaviye direnç, olasý komplikasyonlar ve saðkalým parametreleri ile birlikte analiz edildi.
BULGULAR: Bu çalýþmaya toplam 59 hasta dahil edildi. Ortalama yaþ 55.59 ± 14.48 (yýl) ve medyan toplam takip süresi 33.9 [0.2-172.0] aydý. Tüm hastalara ilk tedavi olarak imatinib verildiði görüldü. Baþka bir merkezdeki imatinib kesilme çalýþmasýna 2 hasta dahil edildi. Ýmatinib tedavisinden 12 ay sonra, hastalarýn %53.3'ünde majör moleküler yanýt elde edildi (BCR ABL <0.1). Ýkinci kuþak TKÝ olarak 14 (% 46,7) hastada dasatinib, 15 hastada (% 50) nilotinib tercih edildi. 2. basamak TKÝ tedavisinden 12 ay sonra, hastalarýn %77.8'i majör moleküler yanýt elde etti (BCR ABL <0.1). 3 hastada, takipte blastik transformasyon saptandý.
TARTIÞMA ve SONUÇ: Mevcut çalýþmanýn sonuçlarý, tedavi seçeneklerinin, yanýt oranlarýnýn ve yan etkilerin, mevcut literatür sonuçlarýyla karþýlaþtýrýlabilir olduðunu göstermiþtir. Hastalýklarýn seyrini daha iyi yönetmek ve tedavilerini düzenlemek için daha geniþ popülasyonlu çalýþmalara ihtiyaç vardýr.

INTRODUCTION: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder, characterized by overproduction of cells of the myeloid series with the presence of the Philadelphia chromosome (Ph). With the development of tyrosine kinase inhibitors (TKIs), treatment options for CML have changed significantly. A key role in assessing the survival and prognosis of CML patients is the reduction of the BCR-ABL burden with appropriate treatment in defined time. The aim of this study was to analyze the clinical and demographic characteristics of CML patients, as well as their treatment efficacy, side-effect profiles, treatment resistance and survival.
METHODS: This retrospective study was conducted on patients diagnosed with BCR-ABL positive CML in the Hematology Department of our hospital between 2010 and 2020. The clinical and demographic characteristics of CML patients were analyzed together with treatment efficacy, side-effects, resistance to treatment, possible complications and survival.
RESULTS: Evaluation was made of a total of 59 patients, with the mean age of 55.59 ± 14.48 years, and median total follow-up period of 33.9 [0.2-172.0] months. All patients were given imatinib as the first-line treatment. 2 patients were included in a trial of imatinib cessation at another center. At 12 months after imatinib treatment, 53.3% patients achieved major molecular response (BCR ABL <0.1). As second generation TKIs, dasatinib was preferred in 14 (46.7%) patients and nilotinib was preferred in 15 patients (50%). At 12 months after 2nd line TKI treatment, 77.8% patients achieved major molecular response (BCR ABL <0.1). Blastic transformation was detected in 3 patients during follow-up.
DISCUSSION AND CONCLUSION: The results of the current study demonstrated that treatment options, response rates and side-effects were all comparable with the results of other real-world studies. Larger patient-based studies are needed to cover the course of the disease and to better manage these patients.

GÝRÝÞ ve AMAÇ: Otolog hematopoietik kök hücre transplantasyonunun (ASCT) morbidite ve mortalitesinin baþlýca nedenlerinden biri, uzun süreli nötropeni sýrasýndaki enfeksiyonlardýr. Bu çalýþmada ASCT hastalarýnda profilaktik G-CSF kullanýmýnýn enfeksiyon sýklýðý, nötrofil engraftmaný ve nötropeni süresi, hastanede kalýþ süresi ve nakille iliþkili morbidite ve mortalite üzerine etkisini araþtýrmayý amaçladýk.

Çalýþmaya toplam 226 hasta (129 erkek, 97 kadýn) dahil edildi. Profilaktik G-CSF alan hastalarda nötrofil engraftmaný daha erkendi [13 (9-23) ve 12 (10-22) gün] ve nötropeni süresi [11 (5-23) ve 8 (5-19) gün] daha kýsaydý (p <0.001). ASCT serisinde profilaktik olarak G-CSF kullanýmýnýn nötropeni süresini azalttýðýný ve nötropenik ateþ sýklýðýný azalttýðýný göstermiþtir. Organ nakline baðlý ölüm oraný (TÝM) ve enfeksiyona baðlý ölüm oraný analizleri, olay seviyesinin düþük olmasý nedeniyle çok anlamlý deðildi (p> 0.05).
YÖNTEM ve GEREÇLER: G-CSF, birimimizde Þubat 2014'ten itibaren 3 yýldýr otolog kök hücre nakli sonrasý rutin olarak kullanýlmaktadýr. Bu çalýþmada, uygulamadan üç yýl önce ve sonra ardýþýk oto-HSCT verileri geriye dönük olarak toplanmýþtýr. Rutin antimikrobiyal profilaksiye ek olarak, G-CSF alan grupta beþinci günden itibaren 5 mcg/kg/gün G-CSF sc baþlandý ve nötrofil engraftrasyonuna kadar uygulamaya devam edildi.
BULGULAR: Çalýþmaya toplam 226 hasta (129 erkek, 97 kadýn) dahil edildi. Profilaktik G-CSF alan hastalarda nötrofil engraftmaný daha erkendi [13 (9-23) ve 12 (10-22) gün] ve nötropeni süresi [11 (5-23) ve 8 (5-19) gün] daha kýsaydý (p <0.001). ASCT serisinde profilaktik olarak G-CSF kullanýmýnýn nötropeni süresini azalttýðýný ve nötropenik ateþ sýklýðýný azalttýðýný göstermiþtir.
TARTIÞMA ve SONUÇ: Organ nakline baðlý ölüm oraný (TÝM) ve enfeksiyona baðlý ölüm oraný analizleri, olay seviyesinin düþük olmasý nedeniyle çok anlamlý deðildi (p> 0.05).

INTRODUCTION: One of the major causes of morbidity and mortality of autologous hematopoietic stem cell transplantation (ASCT) is infections during prolonged neutropenia. In this study, we aimed to investigate the effect of prophylactic G-CSF use in ASCT patient on the frequency of infection, duration of neutrophil engraftment and neutropenia, length of hospital stay and transplant-related morbidity and mortality.

METHODS: G-CSF has been routinely used after autologous stem cell transplantation in our unit for 3 years since February 2014. In this study, three years before and after the application consecutive auto-HSCT data were collected retrospectively. In addition to routine antimicrobial prophylaxis, In the group receiving G-CSF, 5mcg / kg / day G-CSF sc was started from fifth day and application was continued until neutrophil engraftment.

RESULTS: A total of 226 patients (129 males, 97 females) were included in the study. In patients receiving prophylactic G-CSF, neutrophil engraftment was earlier [13 (9-23) and 12 (10-22) days], and the duration of neutropenia [11 (5-23) and 8 (5-19) days] was shorter (p <0.001). In the ASCT series prophylactic use of G-CSF showed that reduced the duration of neutropenia and decreased in neutropenic fever frequency.
DISCUSSION AND CONCLUSION: Transplant-related mortality (TÝM) and infection-related mortality analyzes were not very significant due to the low level of event (p> 0.05).

GÝRÝÞ ve AMAÇ: Bu çalýþmada, baþ boyun lezyonlarýnýn doku karakterizasyonunda difüzyon aðýrlýklý görüntülemenin kullanýmýný deðerlendirmek adýna, malign ve benign baþ boyun lezyonlarý (grup A), lenfoma ve karsinom (grup B), malign ve benign lenf nodlarý (grup C) ayrýmýný yapabilmek için ADC deðerleri arasýndaki farklýlýklarý araþtýrdýk ve bu ayrýmlar için eþik deðerler belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya 88 hastadaki 95 lezyonu dahil ettik. 84 lezyon histopatolojik olarak doðrulandý. 1.5T MR ünitesinde 0, 400 ve 800 sn/mm2 b deðerleri ile difüzyon aðýrlýklý görüntüleme yapýldý. Gruplar Kruskal-Wallis testi kullanýlarak karþýlaþtýrýldý.
BULGULAR: Grup A, grup B ve grup C'de istatistiksel olarak anlamlý fark bulundu. Grup A'da maligniteyi öngörmek için 1.13×10-3 mm2/s'lik bir ADC deðeri kullanýldýðýnda, duyarlýlýk, özgüllük ve doðruluk sýrasýyla %85.7, %71.7 ve %78.9 idi. Grup B'de ayrým yapmak için eþik deðer olarak 0.85×10-3 mm2/s kullanýldýðýnda en iyi sonuçlar %83,7 doðruluk, %92.9 duyarlýlýk ve %78,3 özgüllük ile elde edildi. Grup C'de ayrým yapmak için eþik deðer olarak 0.95×10-3 mm2/s kullanýldýðýnda en yüksek doðruluk %82.8, duyarlýlýk%90.5 ve özgüllük %71.4 ile elde edildi.
TARTIÞMA ve SONUÇ: Difüzyon aðýrlýklý görüntüleme ADC deðerleri kullanýlarak baþ ve boyun lezyonlarýný karakterize etmek için kullanýlabilir, ancak biyopsinin yerini alamaz.

INTRODUCTION: We aimed in this study to evaluate the usefulness of DWI in tissue characterization of head and neck lesions, to investigate the difference in ADC values for distinguishing malignant and benign head and neck lesions (groupA), lymphoma and carcinoma (groupB), malignant and benign lymph nodes (groupC) and to determine threshold values for these distinctions.
METHODS: We included 95 lesions in 88 patients. 84 lesions were histopathologically confirmed. DWI using single-shot echo-planar imaging with b factors of 0, 400 and 800 sec/mm2 were performed on 1.5TMR unit. Groups were compared using Kruskal-Wallis test.
RESULTS: Statistically significant difference was found in groupA, groupB and groupC. When an ADC value of 1.13×10-3 mm2/s was used for predicting malignancy in groupA, the sensitivity, specificity and accuracy were 85.7%, 71.7%, 78.9%, respectively. If 0.85×10-3 mm2/s was used as a threshold value for differentiating in groupB the best results were obtained with an accuracy of 83.7%, sensitivity of 92.9% and specificity of 78.3%. When 0.95×10-3 mm2/s was used as a threshold value for differentiating in group C the highest accuracy of 82.8%, with 90.5% sensitivity and 71.4% specificity was obtained.
DISCUSSION AND CONCLUSION: DWI can be used to characterize head and neck lesions based on ADC values, but cannot replace biopsy.

Siklin-D-sikline baðýmlý kinaz 4/6 (CDK 4/6) inhibitörleri metastatik hormon reseptörü pozitif meme kanserinde yeni bir dönem baþlatmýþtýr. Ribociclib, palbociclib ve abemaciclib (CDK 4/6 inhibitörleri) endokrin tedavisi ile kombinasyon halinde kullanýlýr ve progresyonsuz ve genel saðkalýmda önemli bir fayda saðlamýþtýr. Yorgunluk, nötropeni, anemi ve diyare yaygýn görülen ve doz modifikasyonlarý ile kolaylýkla kontrol edilebilen yan etkilerdir. Burada, palbosiklib tedavisi altýnda geliþen, tekrarlayýcý ve tedavinin kesilmesi ile sonuçlanan nadir bir yan etki olan derin ven trombozu olgusunu sunduk.

Cyclin-D-cyclin dependent kinase 4/6 (CDK 4/6) inhibitors started a new era in metastatic hormone receptor positive breast cancer. Ribociclib, palbociclib and abemaciclib (CDK 4/6 inhibitors) are used in combination with endocrine therapy and they provided a significant benefit in progression free and overall survival. Fatigue, neutropenia, anemia, and diarrhea are commonly seen side effects which are easily manageable with dose modifications. Herein, we presented a case of deep vein thrombosis developed twice under palbociclib treatment which is a rarely reported side effect causing cessation of the treatment.

Ayný hastada farklý malign hastalýklarýn bir arada bulunmasý klinik olarak nadiren karþýlaþýlabilen bir durumdur. Bu, ayný hastada ayný anda veya farklý zamanlarda iki farklý kanser türünün ortaya çýkmasý olarak gözlemlenebilir. Bireyin genetik yapýsý, çevresel faktörler, kemoterapötik ajanlar ve birincil hastalýðýn tedavisinde kullanýlan radyoterapi bu süreçte rol oynayabilir. Hodgkin lenfoma, Hodgkin dýþý lenfoma tedavisinden sonra neredeyse çok nadir görülür. Bu yazýda, kliniðimizde Hodgkin dýþý lenfoma taný ve tedavisi sonrasý klasik Hodgkin lenfoma tanýsý alan iki olguyu paylaþmayý amaçladýk.

The coexistence of different malignant diseases in the same patient is an entity that can rarely be encountered clinically. This can be observed as the presentation of two distinct types of cancer in the same patient simultaneously or at different times. The genetic structure of the individual, environmental factors and chemotherapeutic agents and radiotherapy used in the treatment of primary disease may play a role in this process. Hodgkin lymphoma is hardly ever observed after non-Hodgkin lymphoma treatment. In this report, we aimed to share two cases that were diagnosed with classical Hodgkin lymphoma in their follow-up after non-Hodgkin lymphoma diagnosis and treatment in our clinic.