Do DPP-4 enzyme inhibitors affect hemoglobin, leucocyte and thrombocyte levels in patients with type 2 diabetes mellitus?

OBJECTIVE: Dipeptidyl peptidase-4 (DPP-4) enzyme inhibitors are used to increase the effect of incretins in the treatment of type 2 diabetes mellitus (DM). This study aimed to explore possible effects of DPP-4 enzyme inhibitors, which are widely used for blood sugar regulation in patients with type 2 DM, on hemoglobin, leukocyte (leucocyte), mean corpuscular volume (MCV) and thrombocyte levels. PATIENTS AND METHODS: The study included 110 patients aged over 18 and diagnosed with type 2 diabetes mellitus, who applied to the Internal Medicine Polyclinic of Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital between 01.01.2019 and 31.08.2019 for routine control. Patients using metformin for DM and patients using metformin combined with DPP-4 enzyme inhibitors were divided into 2 groups. The data on patient hemogram (complete blood count) parameters were recorded retrospectively from the electronic patient file system. Patients with nutritional anemia were not included in the study. Besides, patients with known additional diseases (such as liver disease, kidney failure and malignancy) that may affect hemogram parameters, and patients with known infectious or inflammatory diseases were not included. Pregnant women were also excluded from the study. In addition, patients using angiotensin-converting enzyme (ACE) inhibitor class drugs were not included in the study. RESULTS: There were no statistically significant differences between the two groups in terms of hemoglobin levels, MCV levels, leukocyte counts and thrombocyte counts (p>0.05). CONCLUSIONS: Abnormalities in hemogram parameters in type 2 DM patients using DPP-4 enzyme inhibitors should not be immediately related to DPP-4 enzyme inhibitors, and non-drug etiologies that may cause abnormal levels in hemogram parameters should be carefully investigated.

Nivolumab as a bridge to allogeneic hematopoietic stem cell transplantation is associated with improved survival.

OBJECTIVE: The aim of the present study was to compare the effects of nivolumab bridge to allogeneic hematopoietic stem cell transplantation (allo-SCT) on progression-free survival (PFS) and overall survival (OS) and toxicity profile. PATIENTS AND METHODS: The study population consisted of relapsed/refractory cases of HL, who were treated with nivolumab for disease control and subsequently underwent allo-SCT at our institution. The control group consisted of HL patients who relapsed or refractory after multiple lines of therapy and underwent allo-SCT without nivolumab before transplantation as bridging therapy. RESULTS: The incidence of acute and chronic graft vs. host disease (GVHD) was similar in both groups. The 100-day mortality occurred in 1 patient (10%) in the nivolumab group and 4 patients (16.7%) in the control group (p = 0.54). During 30-month follow-up, PFS was achieved in 60% of patients in the nivolumab group and 45.8% in the control group (p = 0.69). OS during 30-month follow-up was 80% in the nivolumab group and 41.7% in the control group, OS was superior in patients in the nivolumab group than in the control group (p = 0.04). CONCLUSIONS: Allo-SCT after bridging therapy with nivolumab provides a survival advantage over patients who underwent allo-SCT without the bridging. Therapy with nivolumab in combination with post-transplant cyclophosphamide does not appear to increase GVHD.

Is classical Hodgkin lymphoma a different disease in the elderly? A single-center retrospective cohort study.

OBJECTIVE: Although the clinical features and treatment results of Hodgkin lymphoma (HL) in young adults are well known, it is thought that the disease may have different characteristics in elderly patients with HL, which constitutes almost 25% of the group. In this study, our aim is to evaluate the clinicopathological features, treatment outcomes, and survival of elderly classical Hodgkin lymphoma (CHL) patients. PATIENTS AND METHODS: Patients aged 60 and over who were treated with a diagnosis of CHL were included in our retrospective cohort study. Patients under the age of 60, those with a diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) were excluded from the study. RESULTS: The median age of 51 patients in the study was 66 (60-76). Forty (78.4%) patients had at least one comorbid disease. The most common histological subtype was mixed cellular HL (n = 23, 45%) and 23 (45%) patients had B-symptoms. Thirty-two (62.8%) patients were in the advanced stage. The most preferred regimen in first-line treatment was doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) combination chemotherapy (n: 45; 88.2%). Forty-three (84.3%) patients were able to complete the initially planned treatment. Complete response was achieved in 34 (66.7%) patients. During the median follow-up period of 45.2 months, 23 (42.6%) patients had died. The 5-year OS was 57.4%. CONCLUSIONS: In conclusion, it was observed that the distribution of histological subtypes was different in elderly patients with CHL, B-symptoms were more common in elderly patients, and OS decreased with increasing age.

Large pedunculated angiomyofibroblastoma of the vulva with concomitant anemia: a case report and mini review of the literature.

Angiomyofibroblastoma is a rare myxoid tumor and is often seen in vulvar and vaginal area. Patients usually present with a mass on the vulva or labium majus at the premenopausal ages. The lesions are usually between 0.5 cm and ten cm. Lesions have quite cellularity with regular borders under the microscope. Lesions contain numerous veins and bulging stromal cells. Treatment of angiomyofibroblastoma is simple surgical resection. Angiomyofibroblastoma should be differentiated from the other vulvar neoplasms, which need radical surgical treatment, especially from the aggressive angiomyxoma. Hereby, the authors aimed to report a premenopausal women presented with vulvar mass and accompanying anemia. She was diagnosed with angiomyofibroblastoma.