aot2022v55i2

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Acta Oncologica Turcica 2022; 55: 109-115112Patients with Patients withoutcomplication(n=99) complication (n=44)P valueAge,median (range ) 41 (18-65) 38 (18-65) 0,4Gender (male:female) 58:41 25:19 0,8Gender Compatibility 0,5Present, n 52 (%52,5) 21(47,7%)Absent, n 47(%47,5) 23(52,2%)DiagnosisAcute myeloid leukemia, n 57 (57,5%) 26 (59,9%)Acute lymphoblastic leukemia, n 25 (25,2%) 7 (15,9%)Myelodisplastıc syndrome, n 5 (5,05%) 1 (2,27%)Non-hodgın lymphoma, n 4 (4,04%) 1 (2,27%)Others, n 8 (8,08%) 9 (20,4%)Blood Group Compatibility 0,6concordant, n 61 (61,6%) 22 (50%)major mismatch, n 16 (16,1%) 9 (20,4%)minor mismatch, n 11 (11,1%) 7 (15,9%)mix mixmatch, n 11(11,1%) 6 (13,6%)Donor age, median (range) 40 (12-65) 37 (15-67) 0,899Relationship 0,1Matched sibling donor, n 87 (87,8%) 42 (95,4%)Matched unrelated donor, n 12 (12,1%) 2 (4,5%)Cd34 (+) x 10 6 cell, median(range) 7 (4,7-15,7) 8 (5-13) 0,016Engraftment time, median (range) 20 (12-35) 18 (11-35) 0,970Table 2. Distribution of patients according to the preparation regimenConditioining chemotherapy regimen n %Busulfan-Cyclophosphamide (Bu-Cy) 89 62.3Busulfan-Fludarabin-Anti-thymocyte globulin (Bu-Flu-ATG) 26 18.2Fludarabine–Amsacrin–Cytarabine (Flu-Ams-Siter) 10 6.9Treosulfan-Flu-ATG 8 5.6Fludarabine, Anti-thymocyte globulin, Thiotepa (Flu-ATG-Tio) 4 2.8Busulfan, Cyclophosphamide, Etoposide (Bu-Cy-Eto) 4 2.8Fludarabine, Anti-thymocyte globulin, Cyclophosphamide (Flu-ATG-Cy) 2 1.4Table 3. Distribution of GVHD by site of involvementSite of involvement n %Skin 10 23Skin and liver 6 16Gastrointestinal system (GIS) 2 3GIS and skin 2 3Gıs and liver 1 2Kidney 1 2Lung 1 2unknown reasons in five patients, due to drugtoxicity in 12 patients, iron overload in sixpatients, associated with GVHD in 19patients, cholecystitis in one patient,cholestasis in three patients, viral hepatitis intwo patients, and pancreatitis in two patients.www.actaoncologicaturcica.comCopyright©Ankara Onkoloji Hastanesi
Acta Oncologica Turcica 2022; 55: 109-115113Type 2 diabetes mellitus in 11 patients,hypothyroidism in two patients, subclinicalhyperthyroidism in two patients, infertility intwo patients, early menopause in two patients,euthyroid sick syndrome in one patient, andinappropriate antidiuretic hormone syndromein one patient were detected.HSV infection in any region was seen in fiveof the patients, zona zoster in 16, xerosis inthree, paraneoplastic ichthyosis in one andseborrheic dermatitis in one of the patients.Ocular complications were seen in 18patients, including conjunctivitis in sixpatients, dry eye in five patients, blepharitis intwo patients, keratitis in one patient, uveitis inone patient, preseptal cellulitis in one patient,subretinal hemorrhage in one patient, andpapilledema in one patient.When the patients were grouped according tothe preparation regimens, statisticallysignificantly more complications wereobserved at the rate of 78.8% in the patients inthe myeloablative regimen group (p=0.005).It was observed that the rate of recurrence ofthe primary disease, renal complications andneurological complications was higher in the90-120th days after transplantation. Ocularand GVHD complications were more likely todevelop later. It was observed that endocrinecomplications were encountered equally inboth early and late periods.DiscussionBeing able to predict and managecomplications that may develop in the earlyand late period after transplantation hasbecome one of the most important factorsaffecting the success of transplantation.Similarly, the prevalence of AML and ALLdiagnoses in our study and other studiesreviewed confirms that transplantation ismostly performed with leukemia indicationsand that stem cell transplantation is anwww.actaoncologicaturcica.comeffective treatment option in acute leukemia[6,7].It was determined that the preparatory regimesapplied in each center differed, and it wasobserved that each center applied apreparatory regime in line with its ownexperience and possibilities [8,9].In a study involving 121 patients between2003 and 2009, the mean duration ofneutrophil engraftment was found to be 15 (8-41) and when analyzed according to bloodgroup compatibility, it was seen that bloodgroup compatibility had no effect onengraftment duration [10].In our study, the median value of the meanneutrophil engraftment time was determinedas 19 (11-35) days.In our study, it was observed that blood groupcompatibility had no effect on thedevelopment of any late complications, thedevelopment of chronic GVHD, and theengraftment times in line with the literature.In the study published by Nina Worel in 2015,Klump et al.'s study on 240 patients found thatABO mismatch had no effect on thedevelopment and severity of chronic GVHD[11,12].In the studies, it was found that the amount ofstem cells given was effective on the successof transplantation and the ideal CD34 (+)amount was determined as 4x10 6 /kg, and thelower limit value was determined as 2x10 6 /kg.In our study, a statistically significantrelationship was found between CD34 (+) cellcount and chronic GVHD. It was found thatchronic GVHD developed more in the groupwith low CD34 (+) number. In the study ofPrzepiorka et al. on 116 patients, CD34 (+)count was 8.3x 10 6 . There was no differencein terms of the development of chronic GVHDin patients with and above / kg [13]. In thestudy of Jose et al., it was observed that theincidence of grade 2-4 chronic GVHDCopyright©Ankara Onkoloji Hastanesi
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