Faculty of Medicine

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Author: search.filters.author.Ivanovski M

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    Frequency of multidrug resistant bacterial isolates in stem cell transplant recipients-single center experience
    (Macedonian Academy of Sciences and Arts, 2017)
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    Cevreska L
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    Evaluation of the JAK2V617F Mutational Burden in Patients with Philadelphia Chromosome Negative Myeloproliferative Neoplasms: A Single-center Experience
    (Macedonian Academy of Sciences and Arts / Sciendo, 2019-12-21)
    Popova-Labachevska M
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    Cevreska L
    The identification of the JAK2V617F mutation in several distinct myeloproliferative neoplasms (MPNs) raised the question how one single mutation incites expression of at least three different clinical phenotypes, i.e., polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). In order to further evaluate already published data on the correlation between mutant JAK2V617F allele burden and specific hematological and clinical parameters, we tested the level of the JAK2 mutation in 134 JAK2+ patients with different MPNs. The patients were diagnosed according to the 2008 WHO criteria and followed for a median of 48 months. The JAK2 V617F quantification was done with a real time polymerase chain reaction (real time-PCR) method. The median allele burden was lowest in ET (25.8%), followed by 34.6% in PV and 51.8% in PMF patients (p<0.01). There was statistically significant association between the mutational load of 10.0-50.0% and blood count parameters in the PV patients (p<0.05). In PMF patients the mutational load was in correlation with older age and leukocyte count that were higher in patients with the mutational load of 10.0-50.0% and >50.0% compared to those with a mutational load of <10.0%. There were no statistically significant associations between the allele burden and blood counts in the ET cohort. Our study confirmed an association between the JAK2V617F allele burden and the distinct MPN phenotypes, indicating unfavorable prognosis in patients with a higher JAK2 allele burden. Our results suggest that JAK2 quantification should be incorporated in the diagnostic work-up of MPN patients as a useful tool for optimal treatment decision.
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    Role of Prognostic Nomogram and Survival Index in Prognosis and the Outcome of Patients with Chronic Lymphocytic Leukemia - A Single Center Experience
    (Longdom Group SA, 2018)
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    Cevreska L
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    Ivanovski M
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    Popova-Labachevska M
    Introduction: Chronic lymphocytic leukemia (CLL) in its clinical course is a heterogeneous clonal lymphoproliferative disease. Some patients live without the need for therapy for decades, while in others the clinical course is aggressive. Research focuses on the identification of biological factors that affect this heterogeneity. Clinical systems for division by stages Rai and Binet cannot identify whether the patient will have an indolent or progressive course of the disease. At Texas University, "MD Anderson Cancer Center" with statistical analysis, several independent features have been identified that predict the overall survival and a model composed of several independent parameters with which patients are divided into 3 risk groups has been created. A nomogramprognostic model has been created that estimates the mean survival and predicts a probable total of five and ten years of survival using the six variables. Aim of the study: Evaluation of the applicability of the prognostic index and nomogram in terms of overall survival, prognosis in patients with CLL diagnosed and treated at the University's clinic for hematology in a period of ten years. Material and methods: The study is set up retrospectively and includes 300 patients with CLL diagnosed and treated at the University Clinic of Hematology for a period of 10 years. The CLL diagnosis was made according to the recommendations of the CLL International Working Group (IWCLL). Clinical stratification was done as part of the prognostic index, and the nomogram was implemented according to the RAI system. With the help of the prognostic index, patients were stratified into three prognostic risk groups (low, intermediate, high risk), and according to the prognostic nomogram, the median survival and the probable five and ten years total survival were assessed. Results: The multivariate Cox Proportional model has confirmed ECOG and ALC that they affect the overall survival time. The estimated mean-median probability of 5-year survival according to the prognostic nomogram in patients with CLL is 77.5%, and the estimated Probability for 10-year survival according to the prognosis nomogram is 50.0%. Conclusion: The evaluation determined that the prognostic index and nomogram are reproducible in patients with CLL diagnosed and treated in R. Macedonia. Characteristics that predict total survival and survival without therapy have been identified.
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