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Biomedical subjects

Semra Paydas

Publications and source records attributed to Semra Paydas.

At least 19 recordsLinked to original sources

PRAME mRNA levels in cases with chronic leukemia: Clinical importance and review of the literature.

Preferentially expressed antigen of melanoma (PRAME) is a tumor antigen expressed in various malignant tumors including solid tumors and hemopoietic neoplasias but no or weak expression in normal tissues. The aim of this study is to determine the frequency and the clinical importance of PRAME expression in chronic myeloid leukemia (CML)/chronic myeloproliferative disorders (CMPD) and chronic lymphocytic leukemia (CLL). PRAME mRNA was measured by real time RT-PCR in 88 cases with chronic leukemia (CL) and 42 controls. Seventy cases had CML/CMPD (56 had chronic phase (CP)-14 had accelerated/blastic phase disease (AP/BP) and 18 cases had CLL (11 had early stage (Rai 0-I-II) and 7 had late stage (Rai III-IV). Mann Whitney U, Wilcoxon and Kruskal Wallis tests were used for statistical analyses. Twenty-four of 70 (34%) cases with CML/CMPD and 5 of 18 (28%) cases with CLL showed PRAME expression. Totally 29 of 88 cases showed PRAME expression (33%). However, only two controls showed weak PRAME expression. The difference for PRAME mRNA between the CLs and controls was significant (p = 0.000). PRAME (+) and PRAME (-) cases were not different for age, Hb, Hct, WBC count, platelet count, stage of the disease and response to therapy. PRAME was monitorised in eight cases during follow-up: in three cases PRAME was negative at CP and expression developed at the AP/BP disease. PRAME was positive at the beginning in five cases (4 CML-1CLL) and expression disappeared after chemotherapy. In conclusion, PRAME is detected in one third of the cases with CLs. PRAME mRNA changes may be detected during the progression of these disorders and/or after therapy. PRAME mRNA may be a useful marker to detect the minimal residual disease (MRD) and to determine the response to therapy in CLs.

Adolescent↗

Transfusion-associated graft-versus-host disease.

Transfusion-associated graft-versus-host disease (TA-GVHD) is a relatively rare and interesting entity. Despite a range of pathophysiological and therapeutic approaches, it has a high mortality. It is possible to prevent the disease by prophylaxis only. It is possible to miss the entity in routine clinical practice and reach a different diagnosis due to its non-specific signs and symptoms. Four patients with signs and symptoms suggestive of TA-GVHD were evaluated and the literature reviewed. The transfusion history was of great importance, as was the exclusion of other conditions that may present with similar signs and symptoms (fever, skin rash, diarrhea, pancytopenia, icterus and renal failure). Confirmation of TA-GVHD was by skin biopsy. TA-GVHD must be considered as a differential diagnosis in patients who present with fever, pancytopenia, diarrhea, skin rash and icterus, and the transfusion history must be questioned. Mortality is very high despite various therapeutic approaches. This makes prophylaxis essential. TA-GVHD can be prevented by irradiation of blood products and by avoiding the use of blood transfusions from family donors.

Journal Article↗

Granulocytic sarcoma: 32 cases and review of the literature.

Thirty-two cases of granulocytic sarcoma (GS) are reported in this paper. Age range was from 16 - 70 years. GS was accompanied by AML in 13 cases, ALL (My+) in one case, CML in 11 cases and MDS in two cases. GS was diagnosed simultaneously with leukemia in five cases and preceded the leukemia in eight. Lymph node and soft tissue were the most commonly detected localizations. Seven cases had first been diagnosed as NHL. Histopathologically blastic, immature and mature variants were found in 11, nine and 11 cases respectively and overall survival was shortest in the blastic type. Myeloperoxidase and lysozyme were found to be positive in 30 and 24 cases respectively. Therapy was radiation in five cases and surgery in three. Systemic chemotherapy was given to the cases. The clinical outcome of the patients after the diagnosis of GS was poor. GS is a unique entity; prognosis is poor but it is important to detect the signaling pathways associated with migration of myeloid cells to the extra-medullary tissues. The critical factors for detecting this interesting tumor are to be aware of this disease, cooperation between clinician and pathologist and the application of special stains to detect the myeloid origin.

Adolescent↗

PRAME mRNA levels in cases with acute leukemia: clinical importance and future prospects.

The PRAME (preferentially expressed antigen of melanoma) gene has been shown to be expressed in high levels in some solid tumors and hemopoietic neoplasias but not or only weakly expressed in normal tissues. It encodes an antigen recognized by autologous cytolytic T lymphocytes. PRAME is a good candidate for tumor immunotherapy and is a useful marker gene for detection of minimal residual disease (MRD). In this study, PRAME mRNA using real-time RT-PCR was studied in 74 adult cases with acute leukemia-68 had de-novo acute leukemia, 3 had chronic myeloid leukemia-blastic crisis (CML-BC), and 3 had myelodysplastic/myeloproliferative syndrome-blastic transformation (MDS/MPD-BT)-and the results were compared with 30 age-matched healthy volunteers. Nineteen of 74 cases with leukemia expressed PRAME, while only 2 controls showed weak expression. The prevalence of PRAME expression in AML and ALL cases was 30% and 17%, respectively. We did not find any important correlation between PRAME expression and clinical characteristics, such as age, sex, organomegaly/lymphadenopathy, Hb, WBC count, platelet count, LDH level, alkaline phosphatase, albumin, cell-surface antigens, response to therapy, or progression-free and overall survival. PRAME was monitored in 15 cases during remission and/or relapse. There was a good correlation between PRAME mRNA and hematological remission and/or relapse. Interestingly, PRAME was very high in one case with AML but was not found 3 months after allogeneic transplantation. PRAME mRNA is observed in about one-third of AML cases; it may be a useful marker to detect MRD, and it may also be a good predictor for the timing of donor lymphocyte infusions (DLI) in the post-transplant period in cases of molecular relapse.

Adolescent↗

Bilateral choroidal infiltration from indolent non-Hodgkin's lymphoma: a rapid course with poor prognosis.

A 42-year-old-woman, with a 2 year history of non-Hodgkin's lymphoma suffered sudden bilateral visual loss. This unusual patient presented with an unifocal choroidal tumor in the superionasal quadrant in both eyes. Fluorescein angiography revealed early and late intense subretinal fluorescence. Cytological examination of the anterior chamber and vitreous tap material revealed abnormal lymphocytes compatible with NHL. Diffuse choroidal infiltration was diagnosed and treated with radiotherapy. Radiotherapy did not provide local control and preservation of the vision. Non-Hodgkin's lymphoma can infiltrate to the choroid and radiotherapy may not be efffective in every case.

Adult↗

Granulocytic sarcoma of the heart: extramedullary relapse of acute myeloblastic leukemia after allogeneic stem cell transplantation successfully treated by chemotherapy alone.

We present a case of granulocytic sarcoma (GS) of the heart. A 28-year-old man with relapsed acute myelogenous leukemia (AML-M2) had undergone a non-myeloablative allogeneic peripheral stem cell transplantation. Three years following transplantation, masses were evidenced in his heart by echocardiography but had completely disappeared following a common chemotherapy etoposide, mitoxantrone, ara-C (EMA) regimen for relapsed AML. The involvement of the heart with GS is very rare and this is the first case of extramedullary disease in the heart after allogeneic transplantation. Here we present the case history and related literature has been reviewed.

Adult↗

Different glomerulopathies accompanying non-small-cell lung cancer.

The coexistence of lung cancer and glomerular lesion is not commonly reported. Malignancy-related glomerulopathy is commonly membranous glomerulonephritis. Other glomerulopathies are seldom reported. We report two cases presenting with non-small-cell lung cancer, acute renal failure and nephrotic syndrome secondary to membranoproliferative glomerulonephritis and amyloidosis.

Acute Kidney Injury↗

Detection of hepatitis C virus RNA in paraffin-embedded tissues from patients with non-Hodgkin's lymphoma.

The aim of this study is to detect the possible role of hepatitis C Virus (HCV) in lymphomagenesis. HCV-RNA and anti-HCV antibodies were studied in tissue and serum samples taken from patients with non-Hodgkin's Lymphoma (NHL). The prevalence of HCV, the clinical presentation of these cases, and association with histologic subtypes were determined. RT-PCR was used to detect the HCV-RNA in serum and tissue samples. The anti-HCV antibodies were tested with microparticle enzyme immunoassay. Immunohistochemistry with the ABC method was used to detect the HCV core protein in HCV-RNA(+) cases. RNA could be detected in 30 of 35 cases, and other tests were performed in these 30 samples. HCV-RNA was detected in 11 tissue samples (11/30, 37%). HCV core protein was studied in 10 of 11 HCV-RNA(+) cases, and 1-3% nuclear staining was found in only 2 samples. Serologically, HCV-RNA was detected in 7 of 30 samples (23.3%) and anti-HCV antibody was detected in 3 of 30 samples (10%). Detection of HCV-RNA in 37% of the lymphoma tissue samples suggests that HCV may have a role or is a contributing factor in the pathogenesis of lymphoma. The very low HCV core protein in lymphoma tissues may be due to the low viral load in lymphoid tissues and/or higher sensitivity of the PCR method. Detection of anti-HCV antibody in only three cases may be associated with undetectable levels of antibodies due to the immune deficiency in cases with NHL.

Adolescent↗

Fludarabine-induced hemolytic anemia: successful treatment by rituximab.

Autoimmune disorders are frequent in chronic lymphocytic leukemia (CLL). Some drugs such as fludarabine may increase the risk of these phenomena and may even be fatal. The management of autoimmune disorders is not standard and corticosteroid is the most frequently used drug in these situations. Here, a case with CLL and severe autoimmune hemolytic anemia associated with fludarabine and successful treatment by rituximab has been reported.

Anemia, Hemolytic, Autoimmune↗

Ovarian granulocytic sarcoma.

Granulocytic sarcoma (GS) or chloroma is a neoplasia of immature myeloid cells. Bones, skins, soft tissues and lymph nodes are the most frequently involved organs with this entity and not infrequently it is diagnosed histopathologically as non-Hodgkin's lymphoma (NHL). Ovarian granulocytic sarcoma is a rare entity in daily practice. Here we report an ovarian granulocytic sarcoma, initially diagnosed as NHL, and review the literature.

Adult↗

Prostatic hypertrophy and prostatic infiltration in small lymphocytic lymphoma.

Extranodal involvement in non-Hodgkin's lymphoma (NHL) is not really that rare, but prostatic infiltration is uncommon and rarely detected clinically. Prostatic involvement by lymphoma can cause signs and symptoms of prostatic obstruction. Here we report a patient with prostatic infiltration due to NHL diagnosed 7 years earlier. The literature is also reviewed.

Fatal Outcome↗