Faculty of Medicine
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Item type:Publication, Extranodal Diffuse Large B-Cell Lymphoma of the Small Bowel in Female Patient Causing Intestinal Obstruction: A Case Report(Vilnius University Press, 2022-12-30); ; ; Diffuse large B cell lymphoma is the most common extranodal non-Hodgkin lymphoma of the small intestine accounting for more than 50% of cases. Forty percent of these cases initially present with small bowel obstruction. Therefore, the diagnosis is usually established after surgery for bowel obstruction. The treatment is then continued with a certain chemotherapy regimens. We present a case of a 46-years-old female patient with signs of small bowel obstruction due to previously undiagnosed diffuse large B-cell lymphoma. Postoperatively, the patient was treated with 7 cycles of R-CHOP protocol and complete response was achieved in the short follow-up period.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CLL-393 Outcomes of COVID-19 Infections in Patients With Hematological Malignancies in Republic of North Macedonia(Elsevier BV, 2022-10); ; Labachevska, Marija Popova - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Scrofuloderma- a rare but serious diagnostic challenge(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2024-04); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Flag-IDA regimen as salvage chemotherapy before haematopoetic stem cell transplantation in the treatment of refractory/relapsed acute myeloblastic leukaemia: single-centre experience(2011); ; ; ; Dukovski, DushkoDuring the past several decades, improvements in chemotherapeutic regimens and supportive care have resulted in signifi cant but modest progress in treating AML.Conventional chemotherapy is highly effective in the treatment of acute myeloblastic leukemia (AML). About 50-80% of adult patients with de novo acute myeloblastic leukemia achieve complete remission (CR) with currently available chemotherapy regimens consisting of antracyclines and cytarabine. However, relapse develops in more that 40% of the cases within two years, and 15-25% of patients fail to achieve complete remission because resistant to treatment or death. The management of cases with primary refractory and /or relapse disease is very diffi cult and prognosis in this subset of patients after several different chemotherapy combinations is still very poor with a CR rate 33-41%. We evaluated effi cacy and toxicity profi les of FLAG-Ida combination chemotherapy as salvage chemotherapy before hematopoietic stem cell transplantation in patients with refractory/ relapsed AML. At the University Hematology Clinic in Skopje, Macedonia, in the period 2006-2009, twenty patients with refractory/relapsed acute myeloblastic leukemia were treated with FLAG-Ida regiment. Patients were between 16-52 years old, 6 female and 14 male. They were treated with fl udarabine 30 mg/m2, cytosine arabinoside (AraC) 2 g/m2 for 5 days, Idarubicin 10 mg/m2 for 3 days, and granulocyte colony stimulating factor G-CSF 5 mikrog/kg from day 0 till neutrofi l recovery (ANC >1.0 x109/l). Complete remission were achieved in 9 patients (45%), four patients (25%) died of post chemotherapy complications, and 7 failed to achieve complete remission. Out of 9 patients who achieved complete remission, 4 went autologous bone marrow transplantation, 4 went allogeneic bone marrow transplantation, and 1 is being evaluated for the same. Major complication encountered were mucosistis, transient hepatic toxicity, fungal and bacterial infections. Our experience confi rmed that FLAG-IDA regimen is well tolerated and effective therapy in relapsed/refractory acute myeloid leukemia. FLAG-Ida is a good choice in cases with refractory/relapsed acute myeloblastic leukemia for salvage chemotherapy and it is wise to consolidate it with hematopoietic stem cell transplantation. Those patients included in the hematopoietic progenitor transplant program, clearly benefi t from allogeneic or autologous BMT, obtaining a longer disease free survival and overall survival. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 10-year experience in the treatment of multiple myeloma with autologous stem cell transplantation(2011); ; ; - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Extranodal Diffuse Large B-Cell Lymphoma of the Small Bowel in Female Patient Causing Intestinal Obstruction: A Case Report(Vilnius University Press, 2022-12-30); ; ; Diffuse large B cell lymphoma is the most common extranodal non-Hodgkin lymphoma of the small intestine accounting for more than 50% of cases. Forty percent of these cases initially present with small bowel obstruction. Therefore, the diagnosis is usually established after surgery for bowel obstruction. The treatment is then continued with a certain chemotherapy regimens. We present a case of a 46-years-old female patient with signs of small bowel obstruction due to previously undiagnosed diffuse large B-cell lymphoma. Postoperatively, the patient was treated with 7 cycles of R-CHOP protocol and complete response was achieved in the short follow-up period.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Histological and immunohistochemichemical study of malignant lymphomas in Macedonia - Study of 222 cases(Macedonian Association of Pathology, 2013); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IS CD38 EXPRESSION STILL RELEVANT PROGNOSTIC FACTOR IN CHRONIC LYMPHOCYTIC LEUKEMIA?(Radiance Research Academy, 2014-08); ; ; ; Introduction: There is a decade of investigations into the role of CD38 in B cell chronic lymphocytic leukemia (B-CLL). Significant percentage of CLL patients expressed transmembrane glycoprotein- CD38 on the surface of leukemic cells. Several published studies suggested that CD38 is accepted as a dependable marker of unfavorable prognosis and as an indicator of activation and proliferation of CLL cells. The aims of the present study were to establish the predictive value of the CD38 expression and to examine the relationship between CD38 positivity and other established prognostic markers in Macedonian CLL patients. Material and methods: Peripheral blood samples from 100 consecutive treatment naïve CLL patients were analyzed by flow cytometry for CD38 expression on CD5/19 leukemic cells. Various patients established prognostic characteristics and molecular markers were studied in correlation to time to treatment (TTT). The Kaplan-Meier method was used to construct survival curves, and the log-rank statistic was used to compare these curves. Results: CD38 was expressed in 61 % of the patients. Patients with high CD38 expression (30% or more) with high value of B2M and advance disease according to Binet had significantly shorter survival times (p= 0 .00001) and (p=0.00033) respectively. Multivariate analyses showed that CD38 expression is an important prognostic factor for shorter TTT associated high B2M level (P .000002), age(P.00000), gender(P.00000), lower hemoglobin level (P.00008 ),hepatomegaly (P.00086). Conclusion: CD38 expression identified a group of patients with aggressive disease that was considered by traditional staging to be early-stage disease (Rai stages 0-II or Binet A). Patients with CD38 samples have significantly aggressive disease regardless of their clinical stage. But today in era of molecular and genetics markers when CD38 is loosing it prognostic value in CLL patients prognosis, we propose serial analyses of the percentage of CD38+cells to be done, resembling indicators of leukemic cell proliferation and may signal clone evolution to a more aggressive state. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Immunoblastic morphology as a possible prognostic indicator for the outcome of the patients with diffuse large B cell lymphoma in era of the rituximab based treatment: single centre experience(Medip Academy, 2013-05); ; ; ; Dukovski, DushkoRecently the results from one large prospective study indicated that immunoblastic morphology and not immunohistohemical features predict the outcome of the Diffuse large B lymphoma (DLBL). In order to investigate the prediction value of the immunoblastic morphology (IB) as a possible prognostic indicator for the outcome of our DLBL patient treated with the Rituximab (R)-CHOP regimen we conducted a retrospective study. Our study enrolled 192 DLBL patients diagnosed and treated at the University Clinic of Hematology in the period between February 2002 and December 2007. They were all treated with R-CHOP regimen and the median follow-up of the patient was 36 months. We analyzed the biopsy samples immunohistochemically for markers of germinal center (BCL6), postgerminal center (MUM1) and apoptosis (BCL2).The patients were categorized as DLBL(132; 68.7%), IB(60; 31.2). The median overall survival time (OS) were 59.3 months in DLBL group and 42.2 months in IB group, and time to treatment (TT) were 56.8 and 30.6 months respectively for the IB group. The DLBL and IB groups were comparable regarding the age, gender distributions and all others already established prognostic parameters as performance status, advanced IPI, albumin level except for the low IPI 0-2 which was statistically associated with the DLBL group (p=.024). Our results did not show any statistical survival advantage and better outcome for the patient classified as DLBL when treated with R-CHOP and indicate that immunohistohemical markers do not really reflect the molecular diversity of the tumor. Our work shows that IB morphology is a major risk factor in DLBL patients treated with RCHOP. Therefore this morphology appears to capture some adverse molecular events that a currently hard to detect with routine diagnostic procedures.