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Saðlýk hizmetine yönelik kanýta dayalý literatür günümüzde katlanarak artmaktadýr. Makine öðrenimi gibi yapay zeka (YZ) araçlarýndaki ilerlemenin saðladýðý fýrsatlar ile mevcut saðlýk hizmetindeki zorluklarýn pek çoðunun üstesinden gelinecek gibi görünmektedir. Bu yüzden, YZ entegrasyonu saðlýk hizmetinin hematoloji alaný dahil çoðu alanýnda artmaktadýr. Bu çalýþmada hematopoietik hücre transplantasyonunda (HHT) mevcut YZ uygulamalarýnýn gözden geçirilmesi hedeflenmektedir. Ýzleyen veri tabanlarýný içeren bir literatür taramasý yapýlmýþtýr: Ovid MEDLINE, Google Akademik, iþlemde olan ve dizine eklenmemiþ diðer alýntýlar dahil. Aþaðýdaki profesyonel derneklerin özetleri de taranmýþtýr: Amerikan Hematoloji Derneði, Amerikan Kan ve Kemik Ýliði Transplantasyon Derneði ve Avrupa Kan ve Kemik Ýliði Transplantasyon Derneði. Bu literatürlerin taranmasý ile HHT alanýna YZ’nin entegrasyonunun son on yýlda anlamlý ölçüde arttýðý ve transplant öncesi ve sonrasý zorluklarýn hedeflendiði HHT popülasyonun teþhis ve prognozunda umut vaat eden yollar sunduðu görülmüþtür. HHT’ye YZ’nin entegrasyonu ile ilgili çalýþmalar, yetersiz test edilmiþ algoritmalar, genelleþtirilebilme eksikliði ve farklý YZ araçlarýnýn sýnýrlý kullanýmý gibi pek çok sýnýrlamalara sahiptir. Geleceðin uygulama paradigmasý olacaðýna inandýðýmýz HHT’de makine öðrenim teknikleri, daha fazla geliþmeye ve hematolojiden, HHT derneklerinden ve organizasyonlarýndan yoðun desteðe ihtiyaç duyan araþtýrmanýn yoðun olduðu bir alandýr.

The evidence-based literature on healthcare is currently expanding exponentially. The opportunities provided by the advancement in artificial intelligence (AI) tools such as machine learning are appealing in tackling many of the current healthcare challenges. Thus, AI integration is expanding in most fields of healthcare, including the field of hematology. This study aims to review the current applications of AI in the field of hematopoietic cell transplantation (HCT). A literature search was done involving the following databases: Ovid MEDLINE, including In-Process and other non-indexed citations, and Google Scholar. The abstracts of the following professional societies were also screened: American Society of Hematology, American Society for Blood and Marrow Transplantation, and European Society for Blood and Marrow Transplantation. The literature review showed that the integration of AI in the field of HCT has grown remarkably in the last decade and offers promising avenues in diagnosis and prognosis in HCT populations targeting both pre- and post-transplant challenges. Studies of AI integration in HCT have many limitations that include poorly tested algorithms, lack of generalizability, and limited use of different AI tools. Machine learning techniques in HCT are an intense area of research that needs much development and extensive support from hematology and HCT societies and organizations globally as we believe that this will be the future practice paradigm.

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Amaç: Bu çalýþmada, allogeneik hematopoetik kök hücre nakli (HKHN) geçiren akut myeloid lösemi (AML) hastalarýnda NPM1 ve FLT3 mutasyonlarýnýn varlýðýnda, DNMT3A ekzon 23 mutasyonlarýnýn prognostik etkilerinin deðerlendirmesi amaçlanmaktadýr.
Gereç ve Yöntem: Bu çalýþma Shariati Hastanesi Hematoloji- Onkoloji ve Kök Hücre Araþtýrma Merkezi’ne baþvuran 128 eriþkin AML hastasýný kapsamaktadýr. NPM1 ve FLT3-ITD mutasyonlarý, fragman analizi ile tespit edilmiþtir. DNMT3A ekzon 23 mutasyon analizi için Sanger dizi analizi kullanýlmýþtýr. Genel saðkalým (OS) ve relapsýz saðkalým (RFS) eðrileri için Kaplan-Meier yöntemi ve gruplar arasý farklýlýklarý hesaplamak için log-rank testi kullanýlmýþtýr.
Bulgular: DNMT3A ekzon 23 mutasyonlarýnýn prevalansý %15,6 olarak bulunmuþtur ve bunlarýn içinde sýcak bölge R882 mutasyonlarý öne çýkmaktadýr. Tek deðiþkenli analiz kullanýlarak DNMT3A ekzon 23 mutasyonlarý olan ve olmayan hastalarda RFS ve OS karþýlaþtýrýlmýþ ve bu hasta gruplarý arasýnda anlamlý fark bulunmamýþtýr. Aksine, FLT3- ITD mutasyonu taþýyan ve allogeneik HKHN geçiren AML hastalarýnda OS (p=0,009) ve RFS (p=0,006) deðerleri anlamlý derecede düþmüþ olarak gözlenmiþtir. Bir sonraki adýmda, AML hastalarý FLT3-ITD ve DNMT3A mutasyonlarý açýsýndan dört gruba ayrýlmýþtýr ve DNMT3A R882mut/FLT3-ITD mutasyonu taþýyan hastalar en kötü OS ve RFS’ye sahip olarak bulunmuþtur. Bu sonuçlar, DNMT3A mutasyonlarýnýn tek baþýna allogenik HKHN yapýlan AML hastalarýnýn klinik sonuçlarýný etkilemediðini iþaret etmektedir, ancak FLT3-ITD mutasyonlarý eþlik ettiði zaman, OS’nin önemli ölçüde azaldýðý (DNMT3A R882mut/FLT3-ITD pozitif hastalarda 5 yýllýk OS %0 ve DNMT3A R882wt/FLT3-ITD negatif hastalarda %62 oranýnda, p=0,025) ve nüksetme oranýnýn arttýðý görülmüþtür.
Sonuç: AML hastalarýnda allogeneik HKHN’den sonra bile, DNMT3A R882mut/FLT3-ITD pozitifliðinin kötü prognostik faktör olduðu sonucuna varýlabilir.

Objective: This study aimed to evaluate DNMT3A exon 23 mutations and their prognostic impacts in the presence of NPM1 and FLT3 mutations in acute myeloid leukemia (AML) patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT).
Materials and Methods: This study comprised 128 adult AML patients referred to the Hematology-Oncology and Stem Cell Research Center of Shariati Hospital. NPM1 and FLT3-ITD mutations were detected by fragment analysis. For DNMT3A exon 23 mutation analysis, we used Sanger sequencing. Overall survival (OS) and relapse-free survival (RFS) curves were estimated by the Kaplan-Meier method and the logrank test was used to calculate differences between groups.
Results: The prevalence of DNMT3A exon 23 mutations was 15.6% and hotspot region R882 mutations were prominent. RFS and OS were compared in patients with and without DNMT3A exon 23 mutations using univariate analysis and there was no significant difference between these groups of patients. On the contrary, the FLT3-ITD mutation significantly reduced the OS (p=0.009) and RFS (p=0.006) in AML patients after allogeneic HSCT. In the next step, patients with AML were divided into four groups regarding FLT3-ITD and DNMT3A mutations. Patients with DNMT3A R882mut/FLT3-ITDpos had the worst OS and RFS. These results indicate that DNMT3A mutations alone do not affect the clinical outcomes of AML patients undergoing allogeneic HSCT, but when accompanied by FLT3-ITD mutations, the OS was significantly reduced (5-year OS 0% for DNMT3A R882mut/FLT3-ITDpos patients vs. 62% DNMT3A R882wt/FLT3-ITDneg, p=0.025) and the relapse rate increased.
Conclusion: It can be deduced that DNMT3A R882mut/FLT3-ITDpos is an unfavorable prognostic factor in AML patients even after allogeneic HSCT.

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Amaç: Geleneksel prognostik faktörler, kronik lenfositik löseminin (KLL) klinik davranýþýndaki heterojenitenin nedenini açýklamak için yetersiz bulunmaktadýr. Kriptokrom-1 ( CRY-1) sirkadiyen ritmin saðlanmasý ve hücre proliferasyonu regülasyonunda gerekli olan bir sirkadiyen saat genidir. Biz, KLL’de CRY-1 gen ekspresyonunu deðerlendirdik ve KLL’nin klinik seyri için prognostik gösterge olarak varsayýlan rolünü irdeledik.
Gereç ve Yöntem: Toplam 100 KLL hastasý taný sýrasýnda kantitatif gerçek zamanlý ters transkripsiyon polimeraz zincir reaksiyonu ile CRY-1 gen ekspresyonu için incelendi ve ilk tedaviye kadar geçen zamanýn (TFT) deðerlendirilmesi için takip edildi.
Bulgular: KLL hastalarýnýn %94’ünde taný anýnda CRY-1 ekspresyonu mevcuttu. Medyan CRF-1 rölatif gen ekspresyon düzeyi (0,006) hastalarý yüksek ve düþük ekspresyon gruplarýna ayýrmaktadýr. Yüz hastanýn 40’ý (%40) yüksek CRY-1, 54/100’ü (%54) düþük CRY-1, ve 6/100’ü (%6) tespit edilemez CRY-1 gen ekspresyonu gösterdi. Yüksek CRY- 1 gen ekspresyonu CD38+, Zap-70+ ve çift CD38+Zap-70+ ekspresyonu; olumsuz/orta sitogenetik; mutasyona uðramamýþ immünoglobulin aðýr zincir deðiþken bölge geni ve diffüz kemik iliði infiltrasyonu ile uyumlu idi. Yüksek CRY-1 gen ekspresyonu olan hasta grubu, düþük CRY-1 gen ekspresyonu olan hastalardan daha kýsa TFT gösterdi. Cox oransal hazard regresyon modeli CRY-1 gen ekspresyonunu TFT için baðýmsýz prediktif olarak tanýmlamýþtýr.
Sonuç: CRY-1, KLL hastalarýnda farklý olarak eksprese edilerek onlarý düþük-risk ve yüksek-risk gruplarýna ayýrmaktadýr. CRY-1 gen ekspresyonu, KLL progresyonu için iyi-belirlenmiþ standart prognostik planlamada ve KLL hastalarýnýn takibinde hastalýk progresyonu için prognostik bir gösterge olarak kullanýlabilir.

Objective: Traditional prognostic factors have proved insufficient to account for heterogeneity in the clinical behavior of chronic lymphocytic leukemia (CLL). Cryptochrome-1 (CRY-1) is a circadian clock gene essential in maintaining the circadian rhythm and regulating cell proliferation. We evaluated CRY-1 gene expression in CLL and addressed its putative role as a prognostic indicator for the clinical course of CLL.
Materials and Methods: A total of 100 CLL patients at diagnosis were studied for CRY-1 gene expression by real-time reverse-transcription polymerase chain reaction and were followed for assessment of time to first treatment (TFT).
Results: CRY-1 was expressed in 94% of the CLL patients at diagnosis. The median CRY-1 relative gene expression level (0.006) stratified patients into high and low expression groups. Forty of 100 (40%) CLL patients showed high CRY-1, 54/100 (54%) showed low CRY- 1, and 6/100 (6%) had undetectable CRY-1 gene expression. High CRY- 1 gene expression was concordant with CD38+, Zap-70+, and double CD38+Zap-70+ expression; unfavorable/intermediate cytogenetics; unmutated immunoglobulin heavy-chain variable-region gene; and diffuse marrow infiltration. The high CRY-1 gene expression patient group exhibited shorter TFT than the patients with low CRY-1 gene expression. A Cox proportional hazard regression model identified CRY- 1 gene expression to be independently predictive for TFT.
Conclusion: CRY-1 is differentially expressed among CLL patients, stratifying them into low-risk and high-risk groups. CRY-1 gene expression could constitute a reliable prognostic indicator for CLL progression, complementing the role of standard well-established prognostic factors. CRY-1 gene expression could be employed as a prognostic indicator for disease progression during the initial prognostic work-up and follow-up for CLL patients.

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Amaç: Bu çalýþmanýn amacý multipl myelom (MM) hastalarýnda kemik iliði florin-18 (18F) fluorodeoxyglucose (FDG) tutulumu ile plazma hücrelerinde CD38, CD138 ekspresyonu oraný ve diðer klinik parametreler arasýndaki iliþkiyi deðerlendirmektir.
Gereç ve Yöntem: MM tanýsý almýþ, ilk evreleme amacýyla 18F-FDG positron emisyon tomografi/bilgisayarlý tomografi (PT/BT) yapýlan hastalar geriye dönük olarak deðerlendirildi. Toplam 42 hasta analiz edildi (43-83 yaþ, ortalamasý: 64,4±9,9). Hematolojik ve biyokimyasal testlerden hemoglobin, hematokrit, C reaktif protein, beta 2-mikroglobulin, kreatinin, albumin, kalsiyum, laktat dehidrogenaz, sedimentasyon düzeyleri kayýt altýna alýndý. Kemik iliðinde plazma hücre düzeyi ve immünhistokimya ile CD38 ve CD138 boyanma oranýna bakýldý. 18F-FDG PET/BT görüntülerinde sað proksimal femur, sað ön ve arka ilyak krest ortalama standart tutulum oraný (SUVort.) kaydedildi. Kemik iliði SUVort. ve myelom hücrelerinde CD38, CD138 ekspresyonu ve diðer klinik parametreler arasýndaki korelasyon Spearman korelasyon testi ile analiz edildi. P deðerleri <0,05 olduðunda anlamlý kabul edildi.
Bulgular: Hastalarýn %45’ini IgGK, %21’ini IgGL, %7’sini IgAK, %10’unu IgAL ve %17’sini diðer myeloma tipleri oluþturuyordu. Otuz iki hasta (%76) Salmon-Durie sýnýflamasýna göre evre 3 idi. Kemik iliði FDG tutulumu ile plazma hücre oraný ve CD38, CD138 ekspresyonu arasýnda (r=0,403, r=0,339 ve r=0,409) ve beta 2-mikroglobulin ve C reaktif protein düzeyi arasýnda (r=0,676, r=0,541) istatistiksel anlamlý pozitif korelasyon vardý. Kemik iliði FDG uptake ile hemoglobin ve hematokrit deðerleri arasýnda negatif korelasyon bulundu (r=-0,377 ve r=-0,368). Diðer hematolojik paremetreler kemik iliði FDG tutulumu arasýnda bir korelasyon saptanmadý.
Sonuç: Kemik iliðinde artmýþ FDG tutulumu, plazma hücre oraný ve CD38, CD38 ekspresyonu ile iliþkilidir. MM hastalarýnda 18F-FDG PET/BT, ilk evreleme yanýnda tedavi planlamasý ve prognostik deðerlendirmede de yararlýdýr.

Objective: The aim of this study was to evaluate the relation between the rate of fluorine-18 (18F) fludeoxyglucose (FDG) uptake and CD38 and CD138 expression in myeloma cells in bone marrow and other clinical parameters in patients with multiple myeloma (MM).
Materials and Methods: Patients with the diagnosis of MM who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) for initial staging were evaluated retrospectively. We analyzed a total of 42 patients (43-83 years old, mean: 64.4±9.9). Hematological and biochemical tests including hemoglobin, hematocrit, C-reactive protein, β2-microglobulin, creatinine, albumin, calcium, lactate dehydrogenase, and erythrocyte sedimentation rate were recorded. In bone marrow samples, plasma cell ratio and CD38 and CD138 immunohistochemical staining were evaluated. On PET/ CT images, mean standardized uptake values (SUVmean) of the right anterior and posterior iliac crest and right proximal femora were calculated. The correlations between the average SUVmean of bone marrow and CD38- and CD138-expressing myeloma cells and other parameters were analyzed by Spearman’s correlation test. Values of p<0.05 were considered statistically significant.
Results: Types of MM were IgGK (45%), IgGL (21%), IgAK (7%), IgAL (10%), and others (17%). Thirty-two (76%) patients were at stage III according to the Salmon-Durie staging system. There was a statistically significant positive correlation between bone marrow FDG uptake and percentage of plasma cells in bone marrow and CD38 and CD138 expression in plasma cells (r=0.403, r=0.339, and r=0.409) and β2-microglobulin and C-reactive protein levels (r=0.676, r=0.541). There was a negative correlation between bone marrow FDG uptake and hemoglobin and hematocrit values (r=-0.377 and r=-0.368). Other hematological parameters were not correlated with FDG uptake in bone marrow.
Conclusion: Increased FDG uptake is correlated with the percentage of CD38 and CD138 expression in plasma cells in bone marrow. In addition to initial staging, 18F-FDG PET/CT is useful in treatment planning and prognostic evaluation in MM patients.

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Amaç: Diffüz büyük B hücreli lenfoma (DBBHL) hastalarý için yararlý prognostik belirteçler bildirilmiþtir. DBBHL hastalarýnda hemoglobin (Hb) düzeyleri ile prognoz iliþkisini araþtýrmak amacýyla retrospektif bir çalýþma yaptýk.
Gereç ve Yöntem: 2004-2014 yýllarý arasýnda rituksimab, siklofosfamid, doksorubisin, vinkristin ve prednizolon tedavisi almýþ olan 185 DBBHL hastasýnýn klinik ve laboratuvar bulgularý deðerlendirildi ve bunlarýn hastalýk sonuçlarýna, ilerlemesiz saðkalým (PFS) ve toplam saðkalýma (TS) etkileri araþtýrýldý.
Bulgular: Araþtýrma grubunda 121 erkek ve 64 kadýn vardý, ortanca yaþ 66 yýldý (minimum-maksimum: 21-83 yýl). Tek deðiþkenli analizde Eastern Cooperative Oncology Group performans durumunun ≥2 olmasý, Ann Arbor evre III veya IV olmasý ve Hb deðerinin <10 g/dL ile anemi olmasý PFS ve TS’yi etkileyen baðýmsýz deðiþkenler olarak bulundu. Çok deðiþkenli analizde ise Hb deðerinin <10 g/dL ile anemi ve Ann Arbor evre III veya IV olmasý uluslararasý indeks-baðýmsýz prognostik faktörler olarak bulundu (Hazard ratio: 2,4; p=0,04).
Sonuç: Anemi, DLBCL hastalarýnda kötü sonuçlarýn baðýmsýz prognostik bir göstergesidir. Hb, bu hastalarda risk sýnýflandýrmasý için kolayca bulunabilen bir prognostik belirteç olabilir.

Objective: Useful prognostic biomarkers for diffuse large B-cell lymphoma (DLBCL) patients have been reported. To determine the prognostic value of hemoglobin (Hb) level in DLBCL patients, we performed a retrospective study.
Materials and Methods: We evaluated disease outcome, progressionfree survival (PFS), overall survival as the endpoint, and clinical and laboratory factors affecting the outcome of 185 DLBCL patients who had received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy during 2004-2014.
Results: The study group included 121 men and 64 women with a median age of 66 years minimum-maximum: 21-83 years. In univariate analysis, factors independently associated with worse PFS were Eastern Cooperative Oncology Group performance status ≥2, Ann Arbor stage III or IV, anemia with Hb levels of <10 g/dL, and serum albumin of <3.5 g/ dL. In multivariate analysis, anemia with Hb levels of <10 g/dL and Ann Arbor stage III or IV were found to be international index-independent prognostic factors (hazard ratio: 2.4; p=0.04).
Conclusion: Anemia is an independent prognostic marker of poor outcome in DLBCL patients. Hb can be an easily available prognostic marker for risk stratification in these patients.

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Amaç: Kan kayýplarý, hastane öncesi dönemdeki yaralanmalara baðlý ölümlerin en sýk sebebidir. Türk ordusu için en kötü senaryolarý ve olasý ihtiyaçlarý araþtýrdýk. Çatýþma alanýndan nakil esnasýnda kan kaynaklarýný kullanmayý planladýðýmýz için nakil iþleminden kaynaklý mekanik stresin eritrosit konsantreleri üzerine etkisini analiz edilmiþtir.
Gereç ve Yöntem: Ýn vitro çalýþmalar ASELSAN®’ýn dýþ ortam test laboratuvarlarýnda gerçekleþtirildi. Çatýþma alanýnda kan taþýma iþleminde kullanýlmasý muhtemel olan Sikorsky helikopteri ve Kirpi® araçlarýnýn operasyonel vibrasyonlarý ve NATO MIL-STD-810G titreþim standart yazýlýmý kayýt altýna alýndý. NATO standardýnýn en güçlü titreþime neden olduðu hesaplandý. Kan saklama çantasý içindeki 15 ünite taze (≤7 gün) ve 10 ünite taze olmayan eritrosit konsantresi (>7 gün), NATO standardý olan mekanik strese maruz býrakýldý. Titreþim TDS v895 Medium-Force Shaker cihazý tarafýndan simüle edildi. Simülasyonun 0., 6. ve 24. saatinde biyokimyasal ve biyomekanik analiz için kan örnekleri alýndý.
Bulgular: Taze ve taze olmayan eritrosit konsantreleri sýrasýyla ortalama 4,9 [standart deviasyon (SD) ±2,2] ve 32,8 (SD ±11,8) günlüktü. Taze eritrosit konsantrelerinde 6. saatte geliþen mekanik hasar; artmýþ eritrosit fragmentasyonu (p=0,015), hemoliz oraný (p=0,003) ve supernatant potasyum (p=0,015) düzeyleri ile gösterildi. Taze olmayan eritrosit konsantrelerinin 6. saatte hemoliz oraný (p=0,015) ve supernatant potasyum düzeyi (p=0,015) yükselirken, hematokrit deðerleri (p=0,015) düþtü. Ýlk 6 saat içerisinde taze eritrosit konsantrelerinin 2’si (%13) transfüze edilebilir kalitede kalýrken, taze olmayanlarýn ise hiçbirisi uygun deðildi.
Sonuç: Taze ve taze olmayan eritrosit konsantrelerinin hemoliz oranlarý, bu ürünleri muharebe sahasýnda taþýdýðýmýzda, çoðunun kullanýlamaz hale geleceðini göstermektedir. Halihazýrda eritrositler üzerinde oluþan mekanik hasarlanmanýn önüne geçebilecek bir teknoloji bulunmamaktadýr. Yukarýdaki verilerin ýþýðý altýnda yeni bir ulusal proje gerçekleþtirilmektedir.

Objective: Hemorrhage is the leading cause of injury-related prehospital mortality. We investigated worst-case scenarios and possible requirements of the Turkish military. As we plan to use blood resources during casualty transport, the impact of transport-related mechanical stress on packed red blood cells (PRBCs) was analyzed.
Materials and Methods: The in vitro experiment was performed in the environmental test laboratories of ASELSAN®. Operational vibrations of potential casualty transport mediums such as Sikorsky helicopters, Kirpi® armored vehicles, and the NATO vibration standard MIL-STD- 810G software program were recorded. The most powerful mechanical stress, which was created by the NATO standard, was applied to 15 units of fresh (≤7 days) and 10 units of old (>7 days) PRBCs in a blood cooler box. The vibrations were simulated with a TDS v895 Medium- Force Shaker Device. On-site blood samples were analyzed at 0, 6, and 24 h for biochemical and biomechanical analyses.
Results: The mean (±standard deviation) age of fresh and old PRBCs was 4.9±2.2 and 32.8±11.8 days, respectively. Six-hour mechanical damage of fresh PRBCs was demonstrated by increased erythrocyte fragmentation rates (p=0.015), hemolysis rates (p=0.003), and supernatant potassium levels (p=0.003) and decreased hematocrit levels (p=0.015). Old PRBC hemolysis rates (p=0.015), supernatant potassium levels (p=0.015), and supernatant hemoglobin (p=0.015) were increased and hematocrit levels were decreased (p=0.015) within 6 h. Two (13%) units of fresh PRBCs and none of the old PRBCs were eligible for transfusion after 6 h of mechanical stress.
Conclusion: When an austere combat environment was simulated for 24 h, fresh and old PRBC hemolysis rates were above the quality criteria. Currently, the technology to overcome this mechanical damage does not seem to exist. In light of the above data, a new national project is being performed.

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Amaç: Obez adölesanlarda aneminin kardiyovasküler bulgular üzerine etkisinin araþtýrýlmasý amaçlanmýþtýr.
Gereç ve Yöntemler: Çalýþmaya 29 anemik, 33 anemik olmayan obez adölesan ve 33 obez olmayan saðlýklý adölesan dahil edildi. Bu üç grup, anemi ve obesitenin klinik ve laboratuvar bulgularý açýsýndan deðerlendirildi. Kardiyak fonksiyonlarý deðerlendirmek için ekokardiyografi kullanýldý.
Bulgular: Anemik obez hastalarda anemi hafifti (ortalama hemoglobin 11,67±0,79 g/dL), ferritin seviyesi anlamlý olarak düþük, C-reaktif protein ve fibrinojen düzeyleri anlamlý olarak yüksek bulundu. Bu grupta kardiyak nabýz anemik olmayan obez adölesanlarýnkine göre anlamlý yüksekti ve ekokardiyografik incelemede anemik obez grupta erken ventriküler diyastolik disfonksiyon göstergesi olabilecek bulgular saptandý.
Sonuç: Obez adölesanlarda demir eksikliði ve kronik enflamasyona baðlý anemi geliþebilir. Hafif anemi varlýðý bile kardiyak nabýzda artýþa ve sol ventrikül diyastolik fonksiyonlarýnda etkilenmeye neden olabilir. Bu nedenle obez çocuklarda uzun dönemde kalp fonksiyonlarýnýn olumsuz yönde etkilenmemesi açýsýndan diyet programlarý demir eksikliði anemisini önleyecek þekilde dikkatlice planlanmalýdýr.

Objective: We assessed the effect of anemia on cardiovascular findings in obese adolescents.
Materials and Methods: We studied 29 anemic and 33 nonanemic obese adolescents, and 33 nonobese healthy adolescents. These three groups were investigated for clinical and laboratory features of anemia and obesity. Echocardiography was used to examine cardiac functions. Results: The anemia was mild (mean hemoglobin: 11.67±0.79 g/dL), ferritin level was significantly low, and C-reactive protein and fibrinogen levels were significantly high in anemic obese patients. Increased cardiac pulse and echocardiographic findings, which may be indicative of early left ventricular diastolic dysfunction, were present in these patients.
Conclusion: Anemia may develop due to iron deficiency and chronic inflammation in obese adolescents. Even mild anemia may cause increased heart rate and affect left ventricular diastolic functions. Diet programs for obese children should be carefully planned to avoid iron deficiency anemia, which may worsen the cardiac events in longterm follow-up.

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