ALBERT

Description: Background: CLL is the most common leukemia in Western World. Hypogammaglobulinemia is the most common immune deficiency detected in CLL. Patients with CLL have increased risk of recurrent infections. Despite hypogammaglobulinemia reported as a cause of both infections and morbidity, controversy exists in its role. Aim: In the present study, we have evaluated the impact of hypogammaglobulinemia at diagnosis on survival and infection risk in CLL. Patients and Mathods: We have included 75 CLL patients diagnosed between 2000 and 2014 with B lymphocyte count 〉5000mm3, CD5, CD19, CD30, CD 23, CD79b positivity and surface Ig light chain restriction in flow cytometry at Ankara University School of Medicine Department of Hematology. The diagnosis and treatment criterias were depended on IWCLL 2008. The patient's performance status was evaluated by physician. If levels were considered decreased when values were below the normal ranges, defined as IgG 6.1-14.9 g/L, IgA 0.8-4.9 g/L and IgM 0.41-2.2 g/L. Overall survival (OS) was calculated by Kaplan-Meier method. Results: The median age at diagnosis was 59 (range, 32-85). 47 patients (63%) were male. The frequencies of RAI staging from 0 to 4 were as follows; 17%, 13%, 25%, 13%, 32%. The ECOG performance status at diagnosis were stage 1 in 81%, stage 2 in %16, stage 3 in %3 of patients. FISH abnormality was detected in 19 patients (25%), del 13q was the most common. 39 patients (52%) (25 fit, 12 unfit, 2 unknown) received treatment. Fit patients got Rituximab-Fludarabine-Cyclophosphomide (R-FC) in first line whereas RFClite was preferred in unfit patients. 37 patients (49%) had any hypogammaglobulinemia at diagnosis; low IgG in 7 (9%), low IgM in 28 (37%), low IgA in 18 (24%) patients. During first year after diagnosis 26 patients (35%) had moderate to severe infections. Twenty five patients (68%) received intravenous immunoglobulin (IVIG) after diagnosis of hypogamaglobulinemia. No significant associations were found with Ig levels and infections. Six patients died during follow-up. 5-year OS in patients with normal and decreased gammaglobulin were 90% vs 86% (P=0.72). There were no survival advantage detected in low IgG, IgM, IgA subgroup analysis. Conclusion: Hypogammaglobulinemia is considered predictive risk of infections. However we have not detected any significant increase of infections or decrease of survival in our cohort. Most of patients with hypogammaglobulinemia received IVIG after diagnosis which would effect our results. Disclosures No relevant conflicts of interest to declare.

Description: INTRODUCTION: Though widely used and accepted as a first line regimen, published data regarding R-CODOX-M/IVAC is very limited. Up to date only three prospective studies and one case series have been reported. Herein, we present our institution’s experience with the management of Burkitt’s lymphoma with a special emphasis on the R-CODOX-M/IVAC regimen. METHODS: The files and electronic records of 35 patients diagnosed with Burkitt’s lymphoma between January 2005 and June 2014 were retrospectively revised. RESULTS: The median age at diagnosis was 40 (21-86 years). Male patients constituted 71.4 (n=25). Stage IV disease was present in 60.6% (n=20), and stage I disease in 27.3% (n=9) of the patients. ECOG performance scoring was 〈 3 in 70.6% (n=24) and Burkitt’s lymphoma risk scoring (availability of complete surgical resection, stage, serum LDH and CNS involvement) 〉 2 in 58.6% (n=17). The distribution of patients to administered regimens were as follows: R-CODOX-M/IVAC 10 patients (28.6%), HyperCVAD 5 patients (14.3%), R-CHOP 9 patients (25.7%), R-CVP 2 patients (5.7%), CALGB 10002 1 patient (2.9%) and other regimens (high dose methotrexate, high dose cytarabine, vincristine-prednisolone, etc.) 8 patients (23.0%). Median overall survival (OS) was 23.5 (1-114) months and median progression free survival was 17.0 (0-114) months. Relapses occurred in 7 patients (20.0%), mortality in 12 patients (34.3). R-CODOX-M/IVAC group (n=10) was compared to other rituximab containing regimens (R-CHOP, R-CVP) (n=11) and HyperCVAD (n=5) and other rituximab-free regimens (n=9) with respect to patient and disease characteristics, DFS and OS. The disease stage, ECOG performance score and Burkitt’s lymphoma risk score were similar between the four groups (p=0.6, p=0.2 and p=0.2, respectively). However, median OS was 13 (1-42) months in R-CODOX-M/IVAC group and it was significantly lower than other regimens (p=0.04 log rank test). Median PFS was 13 (0-42) months and also lower compared to other regimens, however, the difference was not statistically significant (p=0,1 log rank test). CONCLUSIONS: Burkitt’s lymphoma is currently one of the most aggressive mature B- cell origin lymphomas and there is no consensus on the standard of care. CODOX-M/ IVAC is one of the most frequently used regimen. Adding rituximab is also known to prolong overall survival in this patient population. Though the sample sizes are too small and the drawbacks of the retrospective study design exist, the inferior OS and PFS observed in this study with R-CODOX-M within patients having similar disease characteristics should be taken into account. Further studies comparing the efficiency of currently used regimens are needed to reach a clear conclusion. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.

Description: Introduction: Respiratory viruses are known to be the major causes of morbidity and mortality in recipients of Allo-HSCT. In this study, we evaluated the results of respiratory viral panel in the patients after Allo-HSCT, having the symptoms and/or findings of upper or lower respiratory infections. Patients&Methods: In our center, the examination of the respiratory viral panel has been routinely performing in the patients having the symptoms and/or findings of upper or lowers respiratory infection since January 2013. We retrospectively evaluated the results of respiratory viral panel in 39 patients (24 M/ 15F) who underwent allo-HSCT for benign (n=4) or malign (n=35) hematological disease. Median age was 39 years (range, 20-67). Nasopharyngeal aspirates were used for obtaining upper respiratory specimens for respiratory viral panel. Viral panel was studied with PCR method, Seeplex RV 15 ACE Detectionkit (Seegene, Korea). Adenovirus A/B/C/D/E, Coronavirus 229E/NL63, Coronavirus OC43/HKU1, Parainfluenza virus 1,2,3,4, Rhinovirus A/B/C, Influenza A ve B virus, Respiratory Syncytial virus (RSV) A ve B, Boca virus 1/2/3/4, Metapneumovirus and Enterovirus can be detected with this technique. The sensitivity of the method is 5500 copies per ml. Results: We detected the viral panel positivity in 25 patients with median 140 days (range: 3-617 days) after the transplantation. The most frequent viral agent disclosed was RSV and parainfluenza (32 %; n=7) followed by Coronavirus (n=6), Rhinovirus (n=5), Influenza (n=3),H1N1 (n=1), Metapneumovirus (n=1) and Adenovirus (n=1). In five patients two viruses were detected concurrently (1 Rhinovirus plus influenza; 2 RSV plus Coronovirus; 1 Rhino plus RSV; 1 Parainfluenza plus Rhino; and 1 Parainfluenza plus Coronovirus). Although CMV reactivation was occurred in 4 patients at the time of viral panel positivity, there was no statistical correlation between CMV reactivation and respiratory viral panel positivity (p=0.11). Most of the patients (n=20) with viral panel positivity were under immunosuppressive therapy for graft versus host disease prophylaxis or treatment. In 7 of 25 viral panel positive patients, bacterial infections were accompanied. 15 viral panel positive patients were diagnosed as pneumonia by radiological imaging. In addition, viral panel positive patients have significantly lower lymphocyte counts (p=0.013)(Table 1). Conclusion: Parainfluenza and RSV are the most common viral agent detected similar to prior studies. Although viral panel positive patients have lower neutrophil count accompanied by higher CRP, the difference was not found to be statistically significant. CMV reactivation is not related with viral panel positivity. But the lymphocyte count was lower in the patients having positive results. In viral panel negative patients, high CRP levels might show infections rather than virus in etiology. The limitations of our study were that few patients were able to be evaluated in, and also the evaluations had both early and late time-period of the transplantation. Nevertheless, we thought that the results should give an opinion about the development of respiratory viral infections to the clinicians. Table 1. The comparisons of the other laboratory parameters in the patients with viral panel positive with the negative ones. Patients Lymphocyte count (10e6/L), (range) Neutrophil count (10e6/L), (range) CRP mg/dl, range Viral panel positive 1056(0-6500) 1656 (0-8100) 124 (1-506) Viral panel negative 3092 (0-6034) 2621 (0-15700) 67 (21-174) P 0.013 0.063 0.250 Disclosures No relevant conflicts of interest to declare.

Description: Introduction: Patients after relapsing allogeneic hematopoietic stem cell transplantation (AHSCT) have a treatment option of donor lymphocyte infusion (DLI). DLI is a form of adoptive immunotherapy which induces graft versus leukemia effect. Severe forms of graft versus host disease (GVHD) and marrow aplasia are known complications. In this study, we aimed to detect the effect of the infused CD3+ T cell dose on response, GVHD and overall survival (OS) of hematological malignancies after AHSCT. Methods: We retrospectively evaluated 78 DLI procedures in 57 patients with different hematological malignancies for relapse after AHSCT from June 2000 through June 2015. Initial DLI CD3+ cell dose/kg recipient body weight was ≤ 1x10^7 (n=20; Group 1), 〉1.0 to ≤ 5 x10^7 (n=29; Group 2), 5-10 x10^7 (n=29; Group 3). Chi-square test was used in comparison between groups. P

Description: Introduction Antithymocyte globulin (ATG) is commonly used for graft-versus-host disease prophylaxis in allogeneic hematopoietic stem cell transplantation. However side effects of ATG is frequent and is caused by the cross reaction with lymphocytes and macrophages. Despite premedication with corticosteroids, acetaminophen and antihistamine drugs; complications like fever, chills, skin rashes, anaphylactic shock, nephritis and serum sickness occur frequently during or after ATG infusion. Hence, we have recently decided to use higher doses of methylprednisolone as premedication, with the aim of reducing frequency and severity of acute -and late- complications related to ATG administration. In this retrospective study we compared two different premedication protocols in terms of adverse reactions, clinical and laboratory changes that was observed during/after ATG infusion. Patients and methods 28 patients were included in this study. Patients were divided into two groups according to premedication protocol (Table 1). All patients received ATG-Fresenius (ATG-F; Fresenius Biotech GmbH, Munich, Germany) over 10 hours for 3 days. As clinical parameters fever, heart rate, blood pressure, weight gain, existence of skin rashes, chills, dyspnea, thrombocyte transfusion requirement and diuretic use were recorded from the first day to fourth day of ATG-F infusion. As laboratory parameters leucocyte and thrombocyte counts, glucose, blood urea nitrogen, creatinine, alanine aminotransferase, aspartate aminotransferase, total bilirubin, lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin, fibrinogen, D-dimer, prothrombin time and activated partial thromboplastin time values were evaluated from the first day to fourth day of ATG-F infusion. Day 1 values were obtained before ATG infusion and day 4 values were obtained after the day that ATG infusion finished. Lymphocyte counts at the beginning of conditioning regimen and before first ATG-F infusion day were also recorded. Mann-Whitney U and chi-square test were used for comparisons between two groups. Table 1. Premedication protocols Protocol A 1 mg/kg methylprednisolone, 45 mg pheniramine and 1000 mg acetaminophen one hour before ATG-F. 45 mg pheniramine and 1000 mg acetaminophen were repeated at middle of ATG-F infusion Protocol B 1 mg/kg methylprednisolone, 45 mg pheniramine 12 hours before ATG-F infusion 3 mg/kg methylprednisolone, 45 mg pheniramine 12 hours before ATG-F infusion 1 mg/kg methylprednisolone, 45 mg pheniramine at middle of ATG-F infusion Results Patients' characteristics of two groups are shown in table 2. Median age, patient number, gender and underlying disease distribution was similar for both groups. There was no significant difference between two groups according to laboratory parameters. For the clinical parameters, only day 2 "weight gain" was significantly higher in protocol B group and remaining parameters were insignificant. Frequency of hyperglycemia was similar. Regardless of the premedication protocol, D-dimer and CRP values increased to very high levels toward day 3 and then started to decrease (Figure 1). D-dimer and LDH levels at day 2 (p

Description: Introduction Chronic myeloproliferative neoplasms (MPN) are clonal diseases of multipotent hematopoietic progenitor cells. Since the discovery of the JAK2V617F mutation in the pathogenesis of MPN in 2005, many studies have been conducted to evaluate the clinico-hematological importance of this mutation. High-risk patients are defined as those who are older age and have had a thrombotic attack. In this study, our aim was to identify the clinico-hematological and prognostic factors of MPN in geriatric patients compared with a young adult group based on JAK2V617F status. Method We retrospectively evaluated 140 patients total who had been diagnosed based on the WHO MPN diagnosis criteria, between 2007 and 2014 in the Department of Hematology at Ankara University. The frequencies of the JAK2V617F mutation, thrombosis, hemorrhage, treatment side effects, fibrosis and leukemic transformation between the groups were evaluated by the Pearson chi-square test, while the thrombosis risk due to hematologic parameters in the geriatric group was evaluated by the Mann-Whitney Test and T-test. Results Of the 140 MPN patients, 57 (41%) were diagnosed with polycythemia vera (PV), 66 (47%) with essential thrombocythemia (ET), and 17 (12%) with primary myelofibrosis (PMF). Fifty-two patients (37%) were in the geriatric age group, while 88 patients (62%) were defined as young adults. Twenty-two (42%) of the patients in the geriatric group were diagnosed with PV, 26 (50%) with ET, and 4 (%8) with PMF; similar numbers were observed in the young adult group (P 〉.05). In the young adult group, 31 patients (35%) were female, while in the geriatric group, 33 patients (64%) were female; this difference is statistically significant (P =.001). JAK2V617F mutation positivity was significantly higher in the geriatric group (35/52 (67%) vs 37/88 (42%) in the young adult group; (P =.004). In the geriatric group, the patients with PV were most frequently treated with hydroxyurea (HU) and acetylsalicylic acid (ASA), while in the young adult group, phlebotomy and ASA were the most common treatments (60% vs 57%, respectively). The preferred treatments for patients with ET were HU and ASA in both groups (54% vs 48%). Patients with PMF in the young adult group were most commonly treated with thalidomide and steroids (50%), while most of the geriatric patients received no treatment (38%). No significant difference was detected between the groups due to treatment side effects (P 〉.05). In both groups, the most frequent second line treatments used in both PV and ET were thromboreductin and ASA, while the PMF patients in the young adult group also underwent allogeneic stem cell transplantation. The thrombosis frequency during follow-up was similar between groups (25% vs 13%, P=.067), even in JAK2V617F mutation-positive patients (26% vs 19%, P 〉.05). Thrombosis in the central nervous system was most commonly detected in the geriatric group (34%), while coronary artery thrombosis was most common in young adults (44%). There was no significant relationship between leukocyte, hemoglobin and platelet counts and the frequency of thrombosis in the geriatric group (P 〉.05). Ten geriatric patients (19%) and 9 young adult patients (11%) had severe hemorrhage, and this difference was not statistically significant between the groups (P 〉.05). One patient in each group had leukemic transformation. The increased fibrosis frequency in bone marrow morphology was similar between the groups (P 〉.05). Two of the 9 patients with increased fibrosis in the young adult group and 1 patient with leukemic transformation in the geriatric group died during follow-up. Conclusion In this study, no significant differences were detected in treatment side effects, thrombosis risk, severe hemorrhage, leukemic transformation or increased bone marrow fibrosis between the geriatric and young adult groups, even though the JAK2V617F mutation frequency was significantly higher in the geriatric group. Early and effective treatment modalities used in geriatric patients will improve survival and prevent complications. Disclosures No relevant conflicts of interest to declare.

Description: Introduction Survival after hematopoietic stem cell transplantation has increased due to effective supportive treatment. Infertility is a major late side effect after transplantation. Fertility preservation is an essential step in the young patient’s therapy. In this paper, we aim to present our experience with fertility after allogeneic stem cell transplantation. Method We retrospectively evaluated the fertility of 122 (14%) of 849 patients who had allogeneic stem cell transplantation (ASCT) between 1989-2012 at the Ankara University Hematology Department and survived 2 years or more after the procedure. We used Pearson chi-square test to compare groups. P〈 .05 was considered statistically significant. Results Of the 122 patients, 56 (46%) were female and 66 were male (54%). The mean age of ASCT in the female patients was 33.48 ± 8.41, whereas the mean age in the male patients was 32.85 ± 7.92. The mean follow-up period was 90.74 ± 53.51 months (range 18-237 months). Six of the female patients (11%) and 16 of the male patients (24%), a total of 22 patients (18%) had a child after ASCT. The female patients became pregnant naturally, whereas the partners of the 2 male patients became pregnant via in vitro fertilization (IVF). The mean time period from ASCT and pregnancy to fertility evaluation was 68.5 ± 27.5 months in male patients and 63.3 ± 35.5 months in female patients. In most patients who had a child after ASCT, the initial diagnosis was bone marrow failure and chronic myeloproliferative disease. As expected, chemotherapy was used less in these groups (P=.005). All patients who had given birth after ASCT had received transplants from full-match HLA sibling donors or relatives. We could not demonstrate a relationship between fertility and unrelated donor transplantation because the frequency of cases was low (Table 1). The conditioning regimen, total body irridation (TBI) and its frequency, and acute or chronic graft vs. host disease (GVHD) had no impact in fertility (P 〉.05). However, a relapse of the disease had an unfavorable effect on fertility (P=.04). Conclusions Treatments prior to ASCT have damaging effects on gonadal tissue and induce infertility. The nature of the initial diagnosis, a prior chemotherapy regimen before ASCT, and a relapse of the primary disease contribute to infertility. Unexpectedly, we found no relation between the myeloablative conditioning regimen, radiotherapy prior to ASCT, TBI usage and frequency, development of acute and chronic GVHD and infertility. Table 1: Distribution and comparison of fertile and unfertile patients Parameters Fertility Yes % (n=22) Fertility No (n=100) P Diagnosis Acute leukemia (AML, ALL, sec leukemia) Chronic MPD (CML, PMF) Bone marrow Failure (AAA, PNH, MDS) Others (Lymphoma, Myeloma) 10.8% (7/22) 45.5% (10/22) 22.7% (5/22) 0% (0/22) 58% (58/100) 28% (28/100) 5% (5/100) 9% (9/100) 0.005* Relative donors 100% (22/22) 96% (96/100) 1.0 Chemotherapy prior to ASCT 72.7% (16/22) 93% (93/100) 0.005* Radiotherapy prior to ASCT 0% (0/22) 3% (3/100) 0.55 Myeloablative conditioning regimen 95.5% (21/22) 90% (90/100) 0.69 TBI in conditioning regimen 0.5% (1/22) 12% (12/100) 0.46 Acute GVHD 36.4% (8/22) 38% (38/100) 0.89 Chronic GVHD 54.5% (12/22) 64% (64/100) 0.41 Disease relapse 0.09% (2/22) 31% (31/100) 0.04* Disclosures No relevant conflicts of interest to declare.

Description: Introduction: Flow cytometric assays (FCA), especially FLAER based methods, have become important recently in means of diagnosis of paroxysmal nocturnal hemoglobinuria (PNH). In this retrospective study, we aimed to describe diagnostic features of PNH patients along with disease characteristics. Methods: FCA results of patients ordered for PNH diagnosis between November 2007 and July 2014 were retrospectively evaluated. FCA results were expressed as percentage of granulocytes and monocytes negative for CD55/59. The FLAER/CD24-CD14 assay has been available in our center since December 2011 and used for confirmation of FCA results since then. The distribution of erythrocyte types according to CD59 expression (type 1, 2 and 3) were also given in percentages. Results: FCA for PNH diagnosis was performed for a total of 175 patients. FLAER method was available in 136 of these assays (77.7%). A PNH clone was not detected in 136 (77.7%) of the FCAs. PNH clone free patients were diagnosed with unclassified anemia (n=34, 19.4%), other unclassified cytopenias (n=30, 17.2%), non-PNH hemolytic anemias (n=7, 4.0%), myelodysplastic syndrome (n=23, 13.1%), aplastic anemia (n=9, 5.1%), primary myelofibrosis (n=1, 0.6%), leukemia (n=7, 4.0%), lymphoma (n=3, 1.7%), thrombotic incidents (n=14, 8.0%), rheumatological disorders (n=4, 2.3%) and unknown diagnosis (n=4, 2.3%). A PNH clone was detected in 39 patients (22.3%). Of these, 27 (69.2%) constituted classical PNH and 12 (30.8%) PNH accompanying other bone marrow disorders. In the PNH clone positive group, the accompanying bone marrow disorders were aplastic anemia (n=9) and myelodysplastic syndrome (n=3). Median age at diagnosis was 31 (10-82) for classical PNH and 35 (18-77) for PNH accompanying other bone marrow disorders. Erythrocyte transfusion requirement was prominent in 48.7% (n=19) of the patients and thrombotic incidents occured in 20.5% (n=8). Leukemic transformation did not take place in any of the patients. In one patient with aplastic anemia, the FCA became positive for PNH clone within one year of follow-up. Among classical PNH patients, thrombosis was observed only among patients with a clone size of 〉 50%. Clone size (both for granulocyte and monocyte clones) correlated with corrected reticulocyte and serum lactate dehydrogenase levels (for granulocytes p=0.001 and p

Description: Introduction: Primary central nervous system lymphoma (PCNSL) is an aggressive non-Hodgkin lymphoma that is limited to the brain parenchyma, intraocular compartment, cranial nerves, leptomeninges and spinal cord. New treatment strategies have improved prognosis. Methods: We present 10 PCNSL patients diagnosed at Ankara University Department of Hematology between 2006 and 2014 and treated at both Ankara University Department of Hematology and Ankara Medicana Hospital. Survival data was analyzed using Kaplan Meier method and Log-Rank. Results: Five of the 10 patients were male. The average age of the group was 53.40 ± 14.45 years (range: 29-72 years); the average age was 60 ± 9.8 years (range: 48-72) for the female patients and 46.8 ± 16.2 years (range: 29-67) for the male patients. The patients’ performance statuses based on Eastern Cooperative Oncology Group (ECOG) scores were distributed as follows: score 0, 2 patients; score 1, 5 patients; score 2, 1 patient; and score 3, 2 patients. The most common symptoms at diagnosis was headache in 6 patients followed by dizziness in 2 patients, memory loss in 1 patient and lumbar pain in 1 patient. Diagnoses were established by craniotomy in 5 patients, stereotactic biopsy in 4 patients and cerebro-spinal fluid analysis in 1 patient. Four patients had total resection, and 1 patient had debulking surgery after diagnosis. The cerebral/spinal parenchyma was involved in 5 patients, whereas 5 patients exhibited deep brain involvement. Eight patients had brain edema, whereas 7 patients had mass effect. Multiple lesions were detected in 7 patients. The mean serum lactate dehydrogenase level was 354 U/L (range 102-555). All of our patients were HIV and EBV negative. Eight patients were treated every 28 days with rituximab (R; 375 mg/m2/day) on the first day, methotrexate (MTX; 3.5 gr/m2/day) and cytosine-arabinoside (ARA-C; 4.4 gr/m2/day) on the second day and ARA-C (4.4 gr/m2/day) on the third day. Of the 8 patients, 3 patients received 4 cycles. One patient received 3 cycles and displayed a complete remission response. This patient received autologous hematopoietic stem cell transplantation (AHSCT) with cyclophosphamide (4x1.5 g/m2), etoposide (4x250-400 mg/m2) and carmustine (4x150-200 mg/m2) conditioning regimen as consolidation treatment. One patient received 2 courses of R-MTX-ARA-C and exhibited progressive disease; AHSCT was applied. All 5 patients ultimately experienced complete remission. The remaining 3 patients are still in their first and second courses of R-MTX-ARA-C -with a successful outcome in interim analysis-. Two of the initial 10 patients had high ECOG performance scores, received 1 course of MTX and radiotherapy (RT; 36-45 Gy) and died. The median overall survival (OS) in the R-MTX-ARA-C group was 18.3 ± 8.5 months, whereas the OS was 4.5 ± 2.1 months in the MTX-RT group (p

Description: Introduction Diagnosis and classification of acute myeloid leukemia (AML) are based on morphology and genetics. FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD), FMS-like tyrosine kinase 3 tyrosine kinase domain (FLT3-TKD) and nucleophosmin1 gene (NPM1) are most frequent mutations found in patients with AML. In this study, we aimed to identify the prognostic value of FLT3 and NPM1 mutations in our AML patients. Method We retrospectively evaluated 121 patients who had been diagnosed based on the WHO AML diagnosis criteria, between 2007 and 2014 in the Department of Hematology at Ankara University. FLT3 and NMP 1 mutations were detected by Polymerase chain reaction (PCR) amplification method. The overall survival (OS) and relapse-free survival (RFS) due to FLT3 and NMP1 mutations were analyzed using Kaplan Meier method and Long-Rank. P