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    Coronavirus Anxiety Level and COVID-19 Vaccine Attitude Among Patients With Hematological Malignancies
    (Springernature, 2023) Guven, Zeynep Tugba; Celik, Serhat; Keklik, Muzaffer; Unal, Ali
    Introduction: The COVID-19 vaccine is the most essential tool for altering the pandemic's trajectory. The pandemic's control is complicated by society's unwillingness to vaccinate. The aim of this cross-sectional study was to assess patients with hematological malignancies and their attitudes regarding COVID-19 immunization and to investigate COVID-19 anxiety in this susceptible population. yMethods: In this cross-sectional study, 165 patients with hematological malignancies were included. COVID-19 anxiety was evaluated with the coronavirus anxiety scale (CAS), and COVID-19 vaccine attitude was evaluated with the Vaccine Attitudes Review (VAX) scale. Results: The mean CAS score was 2.42 ( 0-17). There were 22 (13%) participants with a mean CAS score of >= 9. Half of the participants had a CAS score of 0. The CAS score was higher in females ( p = 0.023). Similarly, it was significantly higher in patients who were not in remission for hematological malignancy and who received active chemotherapy (p = 0.010). The mean VAX score was 49.07 +/- 8.76 (27-72). Most of the participants (64%) had a neutral attitude toward the COVID-19 vaccination. In a survey of 165 patients, 55% said that they were skeptical about vaccination safety, and 58% said that they were concerned about unintended side effects. In addition, 90% expressed moderate concerns about commercial profiteering. Natural immunity was preferred by 30% of the participants. There was no statistically significant correlation between CAS scores and the Vaccine Attitudes Review (VAX) scale. Conclusion: This study draws attention to the level of anxiety in patients with hematological malignancies during the COVID-19 pandemic. Negative attitudes toward the COVID-19 vaccine are worrisome for at-risk patient groups. We think that patients with hematological malignancies should be informed to eliminate their hesitations about COVID-19 vaccines.
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    Dendritic Cell Production from Allogeneic Donor Cd34+Stem Cells and Mononuclear Cells; Cancer Vaccine
    (Amer Soc Hematology, 2016) Unal, Ali; Birekul, Ayse; Unal, Mehmet Cagri; Karakus, Esen; Koker, Yavuz; Ozkul, Yusuf; Comu, Faruk Metin
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    Fludarabine-induced bradycardia in allogeneic hematopoietic stem cell transplantation: A retrospective study
    (Sage Publications Ltd, 2024) Celik, Serhat; Guven, Zeynep Tugba; Altinsoy, Abdullah; Tubay, Saziye Esra; Keklik, Muzaffer; Unal, Ali
    Introduction Fludarabine, a purine analog, is getting more attention with the increasing use of reduced intensive conditioning regimens in allogeneic hematopoietic stem cell transplantation (allo-HSCT). The side effect of bradycardia was observed in only a few cases reported in the literature. In clinical practice, bradycardia can be asymptomatic or cause syncope and cardiac arrest. This study aimed to evaluate the bradycardia side effect of fludarabine used in the conditioning regimen in allo-HSCT recipients and to increase awareness of this issue. Methods This retrospective study included 73 patients who received fludarabine in the allo-HSCT conditioning regimen between January 2015 and January 2021. Patients with and without bradycardia were compared regarding demographic data, allo-HSCT characteristics, electrolyte values, fludarabine administration dose and duration, and survival. Univariate and multivariate analyzes were performed to evaluate independent predictors for fludarabine-induced bradycardia. Results Fludarabine administration doses and days were higher in the bradycardia group, but no statistically significant difference was observed. In the multivariate analysis, age was the only independent predictor of fludarabine-induced bradycardia (odds ratio (OR) 0.93, 95% confidence interval (CI): 0.89-0.98, p = 0.007). The median age in the group with bradycardia was 19 years younger than those without bradycardia (34 (19-49) vs 53 (19-69), p = 0.005). In 11 (84.6%) of the patients who had bradycardia, bradycardia improved with the discontinuation of fludarabine alone, but atropine was administered in 2 (15.4%) patients. Conclusion Age was the only independent predictor of fludarabine-induced bradycardia; therefore, close heart rate monitoring is recommended during fludarabine administration, especially in younger patients.