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Öğe Assessment of patients with thrombotic thrombocytopenic purpura(2010) Demir C.; Altintaş A.; Paşa S.; Ali Kaplan M.; Küçükzeybek Y.; Ayyildiz O.Thrombotic thrombocytopenic purpura (TTP) is a severe microvascular occlusive thrombotic microangiopathy characterized by systemic platelet aggregation, organ ischemia, profound thrombocytopenia, and fragmentation of erythrocytes. Unexplained occurrence of thrombocytopenia and anemia should prompt immediate consideration of the diagnosis and evaluation of peripheral blood smear for evidence microangiopathic hemolytic anemia. Excellent remission and survival rates were achieved by therapeutic plasma exchange. We reviewed characteristics and response rates to plasmapheresis of our TTP patients. A total of 25 cases were diagnosed. The parameters of hemoglobin and platelet were analyzed at presentation, as well as the number of plasmapheresis sessions and adjunctive treatment given. We found a response rate of 80 percent to plasma exchange. Response was better in 23 patients who presented with idiopathic TTP. Response was poor in patients with TTP secondary to underlying metastatic carcinoma. Two patients relapsed and one of the relapsed patients died. Plasmapheresis is mandatory and effective for primary TTP. Plasmapheresis may not be effective in all instances, especially if TTP is secondary to underlying disseminated cancer.Öğe Cranial involvement in a follicular lymphoma patient with systemic complete remission after Yttrium-90-ibritumomab-tiuxetan treatment: Scientific letter(Turkiye Klinikleri, 2008) Çil T.; Altintaş A.; Paşa S.; Kilinç I.; Işikdoğan A.Non-Hodgkin's lymphoma is a heterogeneous group of lymphoproliferative disorders with varying patterns of behavior and treatment responses. Advances in understanding of tumor biology have made it possible to exploit novel treatment strategies such as monoclonal antibodies and their conjugation with radioimmunotherapy was recommended in patients with first relapse of low-grade lymphomas such as follicular lymphoma after rituximab containing chemotherapy. Treatment with radioimmunotherapy such as yttrium-90-ibritumomab-tiuxetan utilizes a monoclonal anti-CD20 antibody to deliver beta-emitting yttium-90 to the malignant B-cells. Clinical trials have demonstrated its efficacy, which is largely independent of the intrinsic activity of the anti-CD20 antibody. Relapses of nodal lymphomas usually occur in extra lymphoid areas. Central nervous system (CNS) involvement develops in less than 1% of patients with lymphomas. Herein, we are presenting a rare case of CNS involvement of follicular lymphoma in a patient who has achieved systemic complete remission after yttrium-90-ibritumomab treatment. Copyright © 2008 by Türkiye Klinikleri.Öğe Gastric ring cell carcinoma metastasis to the breast: Two case reports(2009) Çil T.; Altintaş A.; Paşa S.; Işikdoğan A.Metastatic tumors of breast are rare and account only for approximately 2% of all malignant breast cancers. Breast metastasis of stomach's signet ring cell carcinoma (SRCC) is also a very rare condition. Herein, we report two rare cases of gastric SRCC metastasis to the breast. First case is a 63-year-old female patient who was admitted to our clinic with swelling in the left breast and arm with enlarged left axillary lymphadenopathy. She was diagnosed with gastric SRCC a year ago. Second case is a 65-year-old woman diagnosed with gastric SRCC who had undergone total gastrectomy two years ago, and had one-year history of operation for kruckenberg's tumor. This patient was admitted to our clinic with two months history of pain and swelling in the left breast. She was also diagnosed as a gastric SRCC metastasis.Öğe Retinoic acid syndrome after the first dose of all-trans retinoic acid(2006) Altintaş A.; Paşa S.; Ağgil C.; Tural B.; Ayyildiz O.All-trans retinoic acid (ATRA) was firstly used as a differentiating agent in 1987 in Shanghai for the treatment of acute promyelocytic leukemia (APL). Retinoic Acid Syndrome (RAS) became an important complication of therapy after the administration of ATRA. The frequency of syndrome is 27% and the precise cause is not entirely known. The mortality rate of patients with APL due to this complication is 1%. Symptoms of RAS resembles to sepsis, pneumonia, iatrogenic volume overload and blood transfusion reactions frequently seen in the course of leukemia and may cause confusion in the diagnosis of RAS. Dexamethasone must be administered urgently in the suspicion of RAS since it has a fatal outcome. Herein, we reported an APL patient with white blood cell count of lower than 1000/ml at presentation and complicated with retinoic acid syndrome subsequent to the first dose of all-trans retinoic acid.
