Faculty of Medicine
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Item type:Publication, Hematologic Autoimmune Manifestation Secondary to Coronavirus Disease 19 Infection – A Single-Center Experience(Scientific Foundation Spiroski (publications), 2021-09-11); ; BACKGROUND: Since December 2019, multiple human cases of novel coronavirus infection were reported, representing with upper respiratory symptoms (influenza-like presentation). The virus was named the severe acute respiratory system coronavirus 2 (SARS-COV-2). Studies have reported cases of patients with coronavirus disease 19 (COVID-19) infection, including development of several autoimmune events that suggest that infection with SARS-CoV-2 may be associated with initiation of autoimmune hematological autoimmune disorders.AIM: This study aims to review the hematological autoimmune phenomena after infection with SARS-CoV-2 to assist into the pathogenic mechanisms, clinical manifestations, and treatment of this group of patients.MATERIALS AND METHODS: This is a retrospective study that includes 21 patients with autoimmune diseases such as secondary immune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA), and thrombotic thrombocytopenic purpura (TTP) that have emerged after COVID-19 infection. The patients were diagnosed and treated at the University Clinic of Hematology-Skopje for a period of time from January 2020 to April 2021.RESULTS: The most common hematologic autoimmune disorder was ITP in 13 cases (62%) followed by AIHA in 5 cases (24%) and TTP in 3 individuals (14%). The mean time of onset of the hematologic autoimmune presentations was 18.4 ± 10.3 days. The therapy of this condition in patients with COVID-19 infection requires an individualized approach to achieve a precise balance between the risk of severe bleeding and of thromboembolic events.CONCLUSION: Causal relationship between COVID-19 infection and these autoimmune events still requires further studies. We should all have in mind the risk of development of hematologic autoimmune disorders in infected patiens - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THIRD ALLOGENEIC SIBLING TRANSPLANTATION FOR ACUTE MYELOID LEUKEMIA: A CASE REPORT(2005-06); ; ; The most frequent therapeutic dilemma after leukemia relapse is allowing any further attempt at leukemia eradication, or whether to offer only palliative treatment. Remission induction for AML re lapsing after HSCT can be achieved in about 40% of patients. We present a case of 34 years female patient with AML FAB /1.12 with no cytogenetic abnormalities diagnosed in April 1998. After two induction chemotherapy cycles (ARA-C 100mg/m) days 1-7 and Doxorubicin 50mg/m' days 1,3,5) and consolidation with one cycle of high dose chemotherapy (ARA-C 2x500 mg/m' days 1-6 and Doxorubicin 50mglm' days 4-6) complete remission was achieved. First allogeneic sibling transplantation was preformed from fresh bone marrow as source of stem cells and Bu-Cy conditioning, followed by conventional GVHD prophylaxis with MTX+ Cyclosporine. After 24 months disease relapse was registered. The patient was treated with induction chemotherapy with two more cycles of DAE regimen followed by second allogeneic transplant from the same donor with peripheral blood progenitors (PBPC). Two years after the second transplant third re lapse was registered. Remission was achieved with L6 chemotherapy regimen with low dose cytarabine and thioguanine. After that, third allogeneic sibling transplantation was performed with Bu-Cy conditioning, PBPC as source and no GVHD prophylaxis. The patient is still +180 days in CR after the third allogeneic transplantation with good quality of life. At the end we can conclude that leukemia relapse after stem cell transplantation still remains a significant cause of treatment failure in patients with acute leukemia. The success of multiple transplants depends very much on the time interval from the first transplantation, the intensity of prior the therapy, the risk of high mortality rate due to increased regimen toxicity (RR1) as well as undelaying disease and patient performance status prior transplantation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MULTI-DAY INFUSION OF AUTOLOGOUS CRYOPRESERVED PERIPHERAL BLOOD PROGENITOR CELLS IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES -TNE INFLUENCE ON ENGRAFTMENT TOXICITY(2005-06); ; Peripheral blood progenitor cells (PBPC) are increasingly used as source of stem cells in both autologous and allogeneic settings for patients with hematological malignancies. Based on previously non-randomized studies for enhanced engraftment during multi-day infusion of cryopreserved PBPC in the autologous transplantation, some transplant centers infuse harvests over 3 days. To evaluate the benefit of fractionated infusions of PBPC we included 37 patients with hematological malignancies (AML 11, NHL 9, HD 9, MM 6, ALL 2) treated with high-dose chemotherapy (HD1) followed by autologous stem cell trans· plantation (ASC1) at Department of hematology, Skopje, Macedonia. The patients were randomized to receive cryopreserved PBPC concentrates divided over 1,2 or more than 3 days. PBPC were mobilized with high-dose VPI6 2g/m' for AML patients, intermediate-dose cyclophosphamide 1-2 g/m' for lymphoproliferative malignancies and/or G-CSF 5microgrlkg alone. PBPC concentrates were cryopreserved with 5% DMSO solutions using controlled rate freezing procedures (Nicole plus PC Espace 330. Patients received daily G-CSF 10microgr/kg i,v over 30 min beginning 4h after the infusion of the first aliquot of PBPCs. The median amount of infused PBPC solution was 430 ml (240- 780ml). Engraftment was registered for Ne>0.5xl <Y/L on day + 10 (8- 14) and for Plt>20xl0'1L on day + 13 (8-20) with no sasystical difference between groups that received I, 2 or more than 3 days infusions of PBPCs. Transfusion requirements were for Er 2 doses (0-4) and Plt 14 doses (O-33). The statistical data revealed that infusion related toxicity was similar for all groups of patients. At the end we can conclude that multi-day infusion of PBPC harvests does not influence the engraftment or reduce toxicity. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PREVENTION OF HEUTROPENIC FEVER DURING ADMINISTRATIOH OF HIGH DOSE VP-16 PLUS G-CSF FOR MOBIUZATION OF PBSC-THE EFACIENCY OF PROPHYLACTIC AHTlBIOTIC TREATMENT(2005-06); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Adverse effects of thalidomide administration, in patients with myeloma multiplex?(ScopeMed, 2014-04); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HCT-CI Predicts Survival in Autologous Stem Cell Transplantation in Myeloma Patients – Center Experience(Elsevier BV, 2018-09); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Hematologic Autoimmune Manifestation Secondary to Coronavirus Disease 19 Infection – A Single-Center Experience(Scientific Foundation SPIROSKI, 2021-09-11); ; ; <jats:p>Introduction: Since December 2019, multiple human cases of novel coronavirus infection were reported, representing with upper respiratory symptoms (influenza-like presentation). The virus was named the Severe acute respiratory system coronavirus 2 (SARS-COV-2). Studies have reported cases of patients with COVID-19 infection, including development of several autoimmune events that suggests that infection with SARS CoV-2 may be associated with initiation of autoimmune hematological autoimmune disorders. Aim: Review the hematological autoimmune phenomenon after infection with SARS-COV-2 in order to assist into the pathogenic mechanisms, clinical manifestations and treatment of this group of patients. Materials and methods: This is a retrospective study that includes 21 patients with autoimmune diseases like secondary immune thrombocytopenia (ITP), autoimmune hemolytic anemia( AIHA) and thrombotic thrombocytopenic purpura (TTP) that have emerged after COVID-19 infection. The patients were diagnosed and treated at the University Clinic of Hematology for a period of time from January 2020 to April 2021. Results: The most common hematologic autoimmune disorder was ITP in 13 cases (62%) followed by AIHA in 5 cases (24%) and TTP in 3 individuals (14%). The mean time of onset of the hematologic auto-immune presentations was 18,4 ± 10,3 days. The therapy of this conditions in patients with COVID-19 infection requires an individualized approach to achieve a precise balance between the risk of severe bleeding and of thromboembolic events. Conclusion: Causal relationship between COVID-19 infection and these autoimmune events still requires further studies. We should all have in mind the risk of development of hematologic autoimmune disorders in infected patients. </jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, AML-259: Autologous Stem Cell Transplantation in Patients with Acute Myeloid Leukemia: Single Center Experience(Elsevier BV, 2020-09); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CLL-132: Mutational Status of IGVH in Correlation with Genetic Abnormalities of Patients with Chronic Lymphocytic Leukemia in Macedonia - A Single-Centre Experience(Elsevier BV, 2020-09); ; ; Ivanovski, Martin - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Multidrug Resistant Bacterial Isolates in Hematopoietic Stem Cell Recipients-Single Center Experience(Elsevier BV, 2019-09); ; ; ; Cadievski, Lazar