Berna Bozkurt Duman

Adana Numune Training and Research Hospital, Adhanah, Adana, Turkey

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Publications (35)43.41 Total impact

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    Acta Medica Mediterranea 07/2015; 31:883-888. · 1.05 Impact Factor
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    ABSTRACT: Although Hodgkin's lymphoma (HL) is one of the most curable cancers in adult patients, new targets have to be defined in cases resistant to traditional chemotherapy. The preferentially expressed antigen of melanoma (PRAME) is a cancer testis antigen and its expression is very scarce or absent in normal tissues. For this reason PRAME is a promising candidate for tumor immunotherapy. The aim of this study is to understand the correlation of PRAME expression with prognostic factors in HL, to determine the utility of PRAME as a targeted molecule for immunotherapy and to compare real-time polymerase chain reaction (real-time PCR) and immunohistochemistry (IHC) for the detection of PRAME. In 82 patients, PRAME was studied using real-time PCR and IHC. Data analyses were performed using statistical methods such as t test, Mann-Whitney U test, χ(2) test, Kaplan-Meier method, log-rank test and Cox regression analysis. PRAME was detected in 15 (18.3%) patients using IHC and in 8 (9.8%) patients using real-time PCR. A correlation was found between PRAME positivity and higher International Prognostic Score (p = 0.039). PRAME positivity detected using real-time PCR was found to be correlated with shorter disease-free survival (DFS) and overall survival (OS, p = 0.0005). The demonstration of PRAME especially in histiocytes and Reed-Sternberg cells may provide guidance for immunotherapy. Although PRAME positivity increases the risk for death (3.56), independent risk factors that affected DFS and OS occurred in advanced age and high-risk groups. Although real-time PCR is sensitive in the detection of PRAME, IHC can be another useful method. Despite the need for studies conducted on larger patient samples, PRAME expression is considered as a poor prognostic parameter in HL. © 2015 S. Karger AG, Basel.
    Acta Haematologica 06/2015; 134(4):199-207. DOI:10.1159/000381533 · 0.99 Impact Factor
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    ABSTRACT: Trastuzumab is a recombinant humanized monoclonal antibody used to treat human epidermal growth factor receptor 2 positive breast cancer, with recognized associated cardiotoxicity. In this retrospective observational study, we investigated associated cardiotoxicity on clinical outcomes using trastuzumab in women referred to our clinic. The study was made up of 111 women with human epidermal growth factor receptor 2-overexpressing breast cancer who received trastuzumab in the Medical Oncology Department, between 2010 and 2013. A > 10% reduction of the baseline fraction of the left ventricular ejection fraction was observed in 18 (16.21%) women. Two individuals (1.8%) suffered from symptomatic heart failure, seven women showed cardiac symptoms and nine women showed asymptomatic decline of left ventricular ejection fraction. Risk factors for cardiotoxicity in the group included: postmenopausal status (p = 0.01), hypertension (p = 0.002), obesity (p = 0.0001), previously diagnosed coronary artery disease (p = 0.0001) and smoking (p = 0.03). The aforementioned factors pose a risk for cardiotoxicity. We found postmenopausal status, hypertension, obesity, previous coronary artery disease and smoking to be associated with an increased risk of cardiac dysfunction in women using trastuzumab. While administering trastuzumab to women who have these conditions, one must be aware of the risk of cardiotoxicity of trastuzumab. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
    Journal of Oncology Pharmacy Practice 01/2015; DOI:10.1177/1078155214567162
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    V Ercolak · B Sahin · M Günaldi · B B Duman · Ç U Afşar
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    ABSTRACT: OBJECTIVE: Kaposi sarcoma is an angioproliferative disease. Kaposi sarcoma is clinicopathologically classified into four subgroups based on epidemiological data. For its systemic treatment, in addition to some chemotherapeutics, taxanes have also been used during the recent years for their anti-angio-genic properties. In this study, we aimed to compare paclitaxel and non-paclitaxel chemothera-peutic regimens in terms of efficacy and side effects. PATIENTS AND METHODS: In our center, de-mographical, clinical and histopathological characteristics of a total of 13 patients diagnosed with Kaposi sarcoma who received therapy were retrospectively recorded based on their medical files. RESULTS: Among these subjects, 7 have been treated with paclitaxel and 6 with non-paclitaxel therapies. Eleven patients were male. Twelve patients were found to have classical type of Ka-posi Sarcoma. The recurrence was observed in 2 patients treated with paclitaxel and in 1 patient treated with non-paclitaxel therapy. No statistically significant difference was found between the therapeutic modality, the stage of the disease and the percentage of the recurrence. Neu-ropathy developed in 3 patients treated with pa-clitaxel, whereas there was no neuropathy in the other group. Although the recurrence-free survival was worse in the patients treated with pa-clitaxel, there was no statistically significant difference. DISCUSSION: Cytotoxic chemotherapy is effective in treating patients with Kaposi Sarcoma, although it is palliative. Taxanes have demonstrated effectiveness against AIDS-associated Kaposi Sarcoma. The experience suggests that paclitaxel is an effective alternative in the treatment of classical form Kaposi's sarcoma. CONCLUSIONS: There was no difference in efficacy between paclitaxel and non-paclitaxel therapies whereas difference in occurrence of neuropathy which is one of the side effects, showed borderline statistical significance.
    European review for medical and pharmacological sciences 01/2015; · 0.99 Impact Factor
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    ABSTRACT: BACKGROUND: The aim of this study was to investigate the general characteristics of patients with deep vein thrombosis (DVT) and pancreatic cancer as well as evaluate the relationship between mean platelet volume (MPV), DVT and survival. MATERIALS AND METHODS: Seventy-seven patients with pancreatic cancer, who were admitted to Cukurova University Medical Faculty, Department of Medical Oncology, were enrolled in the study. Results: The mean age was 59±20. Forty-nine (63.6%) were men and 28 women (36.4%) . Sixty-eight (88.3%) patients had adenocarcinoma and 9 (11.7%) had a malignant epithelial tumor. Thirty-six (46.7%) had liver metastasis at diagnosis. Twenty-six (33.8%) patients were alive, 20 (26%) were dead and in 31 (40.2%) the status was unknown. Only 14 (18.1%) patients had DVT. In 42 (54.5%) patients MPV values were normal, in 28 (36.4%) patients they were above normal, and in 7 (9.1%) patients they were below normal. There was no statistically significant difference between gender, tumour localization, chemotherapy and survival rates (p:0.56, p:0.11, p:0.21). There was no significant difference between DVT, gender, localisation, histological subtype, the presence of metastasis, stage and if the patient had been treated with chemotherapy (p:0.5, p:0.6, p:0.2, p:0.32, p:0.1, p:0.84). There was also no significant difference between MPV and DVT (p:0.57) but there was a significant difference between liver metastasis and DVT (p:0.02). Age, stage, the presence of metastasis and DVT were prognostic in pancreatic cancer patients. CONCLUSIONS: Cases of pancreatic cancer with liver metastasis should be studied more carefully as thrombosis is more common in these patients.
    Asian Pacific journal of cancer prevention: APJCP 11/2014; 15(21):9143-6. DOI:10.7314/APJCP.2014.15.21.9143 · 2.51 Impact Factor
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    ABSTRACT: Actinomycosis is a chronic suppurative infection, for which immune suppression is a predisposing factor. In unusual cases, this disease may present as an abdominal wall involvement simulating a soft tissue tumor as seen in the present case. The presented patient had no signs of trauma or surgical approach and the pathology was considered to be a primary abdominal wall actinomycosis. Preoperative diagnosis is difficult due to the nonspecific nature of clinical presentation, radiographic and laboratory findings. Surgery combined with antibiotic treatment is a curative approach for this relatively rare infection. Surgeons must be aware of this disease in order to ensure correct diagnosis and to prevent performing any unnecessary procedures. The present study describes a case of abdominal actinomycosis with multiple myeloma, together with a review of important points related to this disease.
    Oncology letters 10/2014; 8(4):1876-1878. DOI:10.3892/ol.2014.2375 · 0.99 Impact Factor
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    ABSTRACT: Özet Giriş: Osteosarkomlar patolog, radyolog, ortopedist, radyasyon onkoloğu ve medikal onkolog tarafından multidisipliner olarak yönetilmesi gereken bir hastalıktır. Biz bu çalışmada merkezimizdeki osteosarkom tanılı hastaların demografik özellikleri ve tedavi modalitelerini incelemeyi amaçladık. Gereç ve Yöntem: Cukurova Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı'nda 1999-2010 tarihlerinde osteosarkom tanısıyla tedavi almış ve takip edilmiş hastaların verileri retrospektif olarak araştırıldı. Bulgular: Osteosarkom ta-nılı 119 hastanın %74 ü erkek, %26 sı kadın hastadan oluşmaktaydı. Medi-an yaş 19, median takip süresi 37 ay dı. En sık görülen patolojik alt tip, % 82.4 osteoblastik osteosarkomdu. Hastalığın lokalizasyonu %55 alt extremi-te, %14.1 i üst extremite, %13 baş-boyun bölgesi, %6.6 torakal bölge, %4.1 pelvik bölge idi. Hastaların %6.41 lokal, %25.64 lokal-ileri, %15.8 metastatik evre ve %14.10 nüks hastalıktı. 119 hastanın 77 si kemoterapi aldı. Hastala-rın %23.1 i preoperatif, %16.67 si postoperatif, %9.52 si palyatif, %33.33 ü preoperatif+postoperatif, % 2.38 postoperatif+palliative, %9.52 si preopera tif+postoperatif+palliative kemoterapi ve %4.76 hast ise kemoterapi almadı. Cerrahi yaklaşımlar radikal ve konservatif olarak yapıldı. En sık metastaz yeri %18.1 oranla akciğerdi. Genel sağ kalım süresi 65 ay dı (95%CI 30-59). Pre-operatif, postoperatif, preoperatif+postoperatif kemoterapi alanlar ve diğer grup arasında sağ kalım süreleri açısından fark izlenmedi (sırasıyla 23ay, 36 ay, 28 ay 44 ay) (p=0.8). Radyoterapi uygulanan ve uygulanmayanlar arasında istatistiksel olarak anlamlı sağkalım farkı gözlenmedi (p=0.06). Tartışma: Os-teosarkom cerrahi, kemoterapi ve radyoterapi yöntemleriyle tedavi edilebi-len bir hastalıktır. Çalışmamızda hastalara uygulanan kemoterapi yöntemle-ri arasında sağ kalım farkı izlenmemiştir. Bu sonuçlar cerrahi, kemoterapi ve radyoterapiyide içeren multidisipliner tedavinin önemini ortaya koymaktadır.
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    ABSTRACT: Paragangliomas are relatively rare chromaffin cell tumors which may be cured through resection. Patients with paragangliomas may develop metastatic diseases. There is no consensus regarding refractory chemotherapy for treatment of metastatic disease. In this report, we presented a case of a 43-year-old woman who was admitted to the hospital with a history of episodic headaches, diaphoresis, and weakness. Elevated plasma catecholamine levels and a right paraaortic mass were observed on computed tomography. The mass was excised, and a diagnosis of paraganglioma was confirmed. After 20 months of follow up, local recurrence and metastases were detected in the thorax, abdomen, and skeletal system. Plasma and urinary catecholamine levels were high. Chemotherapy was administered, and no improvement was observed. Therefore, following this palliative conventional chemotherapy, Sorafenib was administered for three months, and, finally, Positron Emission Tomography showed that the patient's lesions had completely regressed.
    Cancer Research and Treatment 07/2014; 46(4). DOI:10.4143/crt.2013.093 · 2.98 Impact Factor
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    Berna B Duman · Oğuz I Kara · Aysum Uğuz · Berna T Ates
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    ABSTRACT: Aim of the study Important signalling pathways play fundamental roles in the pathogenesis of thyroid carcinoma (TC). PTEN, mTOR, PI3K-p85 and K-Ras are the principal factors involved in these signalling pathways. To immunohistochemically examine the expressions of PI3K, mTOR and PTEN in patients suffering from follicular TC, papillary TC or variants thereof, as well as to investigate KRAS mutations via PCR to determine their clinical and prognostic relevance to differentiated thyroid cancer. Material and methods The expression of PTEN, PI3K-p85 and mTOR was immunohistochemically examined, and the mutation of K-Ras was examined via PCR. The results obtained were compared to the clinico-pathologic characteristics of the patients. Results A significant correlation was found between p85 expression and lymphovascular invasions and between PTEN expression and multifocality (p = 0.048 and p = 0.04, respectively), and a correlation between p85 and capsular invasion was found, with a borderline statistical significance (p = 0.056). No expression of PTEN, p85 or Mtor was detected in normal tissue. K-Ras mutation was examined in 66 of the 101 patients (57.4%), and the percentage of patients exhibiting a K-Ras mutation was 17.4%. All of the patients exhibiting a K-Ras mutation were women (p = 0.047). The disease-free survival was 44.6 months (95% CI: 37.9–51.3) and was statistically significantly higher in the group that displayed level 1 or lower expression of p85 (p = 0.043). Conclusions The expression levels of the aforementioned markers were significantly higher in TC cells than in normal tissue. A significant correlation was detected between K-Ras mutation and gender. This study demonstrates that p85 and PTEN are markers that should be evaluated in further studies of TC.
    Contemporary Oncology / Wspólczesna Onkologia 07/2014; 18(4):234-40. DOI:10.5114/wo.2014.43803 · 0.22 Impact Factor
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    Turkish Journal of Haematology 06/2014; 31(2):205-6. DOI:10.4274/tjh.2013.0195 · 0.34 Impact Factor
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    01/2014; 2(6):299-310. DOI:10.9734/IBRR/2014/8832
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    ABSTRACT: Sweet syndrome, also referred to as acute febrile neutrophilic dermatosis, is characterized by tender, red inflammatory nodules or papules that occur in association with infection, malignancy, connective tissue disease, or following exposure to certain drugs. Here, we present Sweet syndrome in a case with small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) which is a relatively rare co-occurrence. Conflict of interest:None declared.
    Turkish Journal of Haematology 12/2013; 30(4):413-5. DOI:10.4274/Tjh.2012.0055 · 0.34 Impact Factor
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    Berna Bozkurt Duman · Semra Paydas · Umut Disel · Ayberk Besen · Emel Gurkan
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    Berna Bozkurt Duman · Semra Paydaş · Mehtap Evran
    Turkish Journal of Haematology 06/2013; 30(2):221-2. DOI:10.4274/Tjh.2012.0177 · 0.34 Impact Factor
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    Turkish Journal of Haematology 03/2013; 30(1):83-4. DOI:10.4274/tjh.2012.0153 · 0.34 Impact Factor
  • Oguz Kara · Berna Bozkurt Duman · Banu Kara · Seyda Erdogan · Cem Kaan Parsak · Gurhan Sakman
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    ABSTRACT: Background: No factor has thus far been identified to predict the efficacy of bevacizumab therapy for colorectal cancer. We here therefore studied PTEN, VEGF, HER2 and p53 by immunohistochemistry as possible prognostic and predictive factors. Materials and Methods: A total of 34 retrospectively collected tumor samples were evaluated, all from patients receiving bevacizumab-based regimens. VEGF-A, PTEN, HER2, p53 were assessed and data was compared with clinicopathologic characteristics of patients and the bevacizumab response rate. Results: In this study, the median age of the 34 metastatic colorectal cancer patients was 55.5 (24-75), twelve (35.3%) being women and 22 (64.7%) men. PTEN, VEGF, HER2, p53 expressions were compared with bevacizumab response and other chacteristics of disease. Statistical significant differences were not found between bevacizumab response rates and different expression levels of VEGF, PTEN, HER2 and p53 (respectively p=0.256, p=0.832, p=0.189, p=0.131). However, a survival difference was noted in the VEGF expression negative group (median OS:55 months; 95%CI, 22-88 months) (p=0.01). There was no statistically significant OS difference in other groups (PTEN p=0.6, HER2 p=0.189, p53 p=0.13). Conclusions: We did not find any predictive factor for BV therapy in our study. VEGF negative expression could be an important prognostic factor in metastatic colorectal carcinoma.
    Asian Pacific journal of cancer prevention: APJCP 12/2012; 13(12):6397-401. DOI:10.7314/APJCP.2012.13.12.6397 · 2.51 Impact Factor
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    ABSTRACT: BACKGROUND: Neurofibromatosis type 1 (NF1) is a genetic syndrome that predisposes patients to benign and malignant tumor development. Patients with NF1 develop multiple neurofibromas that can transform into aggressive sarcomas known as malignant peripheral nerve sheath tumors. In contrast, malignant tumors unrelated to the nervous system rarely coexist with neurofibromatosis. The aim of this article was to present four cases of adult NF1 patients with malignant tumors unrelated to the nervous system as well as a bibliographic search for papers describing these tumors in NF1, focusing on osteosarcomas, gastrointestinal stromal tumors (GISTs), leiomyosarcomas and somatostatinomas and their genetic alterations in NF1. METHODS: Search engines such as PubMed and MEDLINE were browsed for English-language articles since 1989 using a list of keywords, as well as references from review articles. Search terms were NF1, osteosarcoma, leiomyosarcoma, somatostatinoma and GIST. Data were summarized in a table at the end of the Results section. RESULTS: In our four NF1 cases, there were one osteosarcoma, one leiomyosarcoma, one somatostatinoma and GIST and one GIST. NF1 was diagnosed at an adult age when these patients were admitted to our oncology department. The results generated by the literature search yielded 75 articles about NF and GIST. We summarized the clinical characteristics of 43 patients with NF1 and somatostatinoma. Forty-five articles involving NF and osteosarcoma were found, and of these, 26 involved NF1; from these articles, we identified the clinical features of 8 patients. Twenty-five articles were found concerning NF1 and leiomyosarcoma, and of those, we summarized the clinical features of 15 patients. CONCLUSIONS: Here we reviewed somatostatinomas, GISTs, osteosarcomas and leiomyosarcomas occurring in NF1 patients. Patients with NF1 who present with gastrointestinal symptoms, should be carefully evaluated carefully with a high index of suspicion of potential GISTs, periampullary and duodenal tumors. Patients with pathological fractures or bone pain along with NF1 should be carefully screened for malignant bone tumors. Patients with NF1 can develop leiomyosarcoma less frequently than other malignancies, but the association of uterine leiomyoma and NF1 may not be fortuitous. Somatic mutations were defined for frequent tumors, including neurogenic tumors and GISTs but not for sarcomas due to the complexity of underlying mechanisms of the disease and tumorigenesis. Based on the findings; all NF patients can develop malignant tumors, including the less frequently observed ones. Therefore, we recommend that new genetic studies should be performed for rare malignancies in cases of NF1.
    Critical reviews in oncology/hematology 12/2012; 86(2). DOI:10.1016/j.critrevonc.2012.11.001 · 4.05 Impact Factor
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    ABSTRACT: Background and Objectives: This study aimed to present the clinicopathological characteristics and treatment of patients with bladder carcinoma with sarcomatoid differentiation at our institution. Methods: Between 1995- 2009, 950 patients were followed-up for bladder carcinoma. Among them, 14 patients with sarcomatoid carcinoma were retrospectively reviewed, and their clinical, pathological features and treatment were recorded. Results: Median age of the patients was 65 years (range: 41-86 years), 12 (86%) being male and 2 (14%) female. All the patients presented with hematuria and 11 (88%) had a history of smoking. The tumor growth pattern was solid in 10 patients, papillary in 2, and mixed in 2. In all, 5 of the patients had urothelial carcinoma with sarcomatoid differentiation and 9 were diagnosed with sarcomatoid carcinoma. Five patients underwent radical cystectomy with ileal conduit surgery, 2 patients refused cystectomy, and 8 patients underwent re-TUR. Following diagnosis ,12 of the patients died in mean 10.7 months (range: 1-48 months). Conclusion: Urothelial carcinomas with sarcomatoid features are aggressive and are usually at advanced stage at the time of diagnosis. The outcomes of multimodal treatment are not satisfactory. Significant findings of the present study are that early diagnosis positively affect survival and that gemcitabine and cisplatin in combination can positively affect survival.
    Asian Pacific journal of cancer prevention: APJCP 11/2012; 13(11):5729-33. DOI:10.7314/APJCP.2012.13.11.5729 · 2.51 Impact Factor
  • Meral Gunaldi · Ismail O Kara · Berna B Duman · Vehbi Ercolak
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    ABSTRACT: Background: Myeloid sarcoma rarely presents in the absence of systemic myeloid disease. Case Report: In this study, we present a case of intracerebral myeloid sarcoma with no diagnosis of any hematological disease in a 22-year-old male patient in whom brain magnetic resonance image revealed a meningioma. However, biopsy showed myeloid sarcoma. No myeloid disease was determined. The mass disappeared following 8 cycles of chemotherapy. In the literature, we determined only 8 similar cases cited between 1970 and 2011. Conclusion: Intracerebral myeloid sarcoma has currently no standard treatment and may be confused with a primary brain disease. Chemotherapy and/or radiotherapy are the most viable and widely used treatment modalities. Potential occurrence of hematological disease should also be closely followed due to conversion risks.
    Onkologie 11/2012; 35(11):694-7. DOI:10.1159/000343953 · 0.84 Impact Factor
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    Semra Paydas · Yusuf Sonay · Arbil Avci · Berna Bozkurt Duman · Evren Tümkaya
    European Journal of Internal Medicine 10/2012; 24(1). DOI:10.1016/j.ejim.2012.10.003 · 2.30 Impact Factor