International Forum: The Turkish perspective on apheresis activity: The Turkish apheresis registry report.

Therapeutic apheresis is an extracorporeal treatment that selectively removes abnormal cells or harmful substances in the blood that are associated with or cause certain diseases. During the last decades the application of therapeutic apheresis has expanded to a broad spectrum of hematological and non-hematological diseases due to various studies on the clinical efficacy of this procedure. In this context there are more than 30 centers performing therapeutic apheresis and registered in the apheresis database in Turkey. Herein, we, The Turkish Apheresis Registry, aimed to analyze some key articles published so far from Turkey regarding the use of apheresis for various indications.

Polatuzumab vedotin, rituximab, and bendamustine combination in relapsed or refractory diffuse large B-cell lymphoma: a real-world data from Turkey.

Polatuzumab vedotin (Pola) with bendamustine and rituximab (BR) is a promising option for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We analyzed the data of 71 R/R DLBCL patients who had been treated with Pola-BR in the named patient program from March 2018 to April 2021 from 32 centers in Turkey. All patients received up to six cycles of Pola 1.8 mg/kg, rituximab 375 mg/m2 on day 1, and bendamustine 90 mg/m2 on days 1-2 of each cycle. Median age at Pola-BR initiation was 55 (19-84). The overall response rate was 47.9%, including 32.4% CR rate when a median of 3 cycles was applied. With a median follow-up of 5 months, the median OS was 5 months. Grade 3-4 neutropenia and thrombocytopenia were the most common hematological toxicities. The real-world data from our cohort showed the Pola-BR is an effective option with a manageable toxicity profile.

Hodgkin's disease and autoimmune hemolytic anemia: a case report.

OBJECTIVE: To report a case of Hodgkin's disease presenting with immune hemolytic anemia. CLINICAL PRESENTATION AND INTERVENTION: A 47-year-old man was admitted to hospital because of weight loss, fever, and inguinal lymph node adenopathy. Biopsy of the inguinal lymph node revealed mixed-cellularity Hodgkin's disease. Three days after starting combined chemotherapy, the patient showed evidence of autoimmune hemolytic anemia, which responded well to prednisolone. CONCLUSION: This case shows that clinicians should be aware of the possibility of autoimmune hemolytic anemia in patients with Hodgkin's disease presenting with anemia, and distinguish it from the anemia of chronic disease.

The effects of Medroxyprogesterone acetate on apoptosis of CD34+ cells.

BACKGROUND: Medroxyprogesterone acetate (MPA) is widely used in oncology practice, especially in the treatment of gynecological malignancies and cachexia of cancer. Some studies have demonstrated that high-dose MPA might reduce hematological toxicity in patients receiving chemotherapy for solid tumors. The underlying mechanism of this action is still unknown. We aimed to investigate the in vitro effects of MPA on CD34+ cells. METHODS: We investigated the in vitro effects of two different doses of MPA (10 and 100 ng/ml) on acidic pH-induced apoptosis of CD34+ cells derived from 12 healthy volunteers. RESULTS: Compared with the control group, we found that MPA at the dose of 100 ng/ml has a negative effect on apoptosis (6.7 +/- 3.8 and 12.5 +/- 5.0% apoptosis, respectively; p = 0.038) and a positive effect on the number of CD34+ cells (680 +/- 294 and 350 +/- 131 x 10(3)/ml, respectively; p = 0.009). CONCLUSION: Our results indicate that further studies are needed on larger populations in order to assess the relationship between MPA and its myeloprotective effect.

Effect of interferon-alpha(2a) on neutrophil adhesion and phagocytosis in chronic myeloid leukemia and Behçet's disease.

Alpha-interferon (alpha-IFN) is implicated in a Behçet's disease (BD)-like syndrome observed in a small number of chronic myeloid leukemia (CML) patients. The effect of alpha-IFN on neutrophil adhesion and phagocytosis in CML patients, BD patients and healthy volunteers was investigated to clarify the reason for this observation. Ten subjects were studied for each group by incubating neutrophils with various doses of alpha-IFN. Basal neutrophil adhesions for CML patients, BD patients and healthy volunteers were similar. However, BD patients had greater basal phagocytosis than CML patients, and both groups had greater basal phagocytosis than healthy volunteers. Neutrophil adhesion and phagocytosis of CML patients increased following incubation with higher doses of alpha-IFN, and phagocytosis approached the high levels observed with BD neutrophils. This study provides evidence that alpha-IFN activates neutrophils in CML patients in a dose-dependent manner, and leads to a neutrophil function profile that resembles BD.