Faculty of Medicine
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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, CHRONIC LYMPHOCYTIC LEUKEMIA ARISING IN A PATIENT WITH HODGKIN LYMPHOMA TREATED WITH PERIPHERAL BLOOD STEM CELL TRANSPLANTATION - Case report(Macedonian Association of Anatomists, 2022-06); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PREDICTIVE INSTRUMENT FOR ASYMPTOMATIC EARLY-STAGE CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS-SINGLE CENTRE EXPERIENCE(Macedonian Association of Anatomists, 2021-12-28); ; ; ; Stojanovska, SimonaEarly-stage patients with Chronic lymphocytic leukemia (CLL) are diagnosed without need for treatment, managed with following. The distinct course of the disease is diverse, and planing treatment is barely projected at diagnosis. The aim of the study was first-time evaluation of international prognostic score to predict time to first treatment (TFT) in patients with early stage CLL (International Prognostic Score for Early-stage CLL IPS-E). Retrospective study of asymptomatic patients with CLL at early stage of disease in a period of time from January 2011 to January 2021. The median follow-up was 60 months (1-120 months). Individual patient data from 120 treatment-naïve CLL patients with Binet A stage were analyzed to composed International Prognostic Score for Early-stage CLL and correlated with Time to treatment failure (TTF). Using IPS-E patients were distributed in three groups: low risk with 7, 5%, intermediate risk with 44 % and high risk patients 49%. Average TFS was 29, 3 months for low risk group, 28, 6 months for intermediate-risk group and 27,1 months for high-risk group. Using prognostic nomogram we calculated 5 years probability of survival for low, intermediate and high risk group: 73%, 72% and 70% respectively with projected median survival of 9, 1 year for low risk group and 9, 0 year, 8, 9 years for intermediate and high risk groups. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gene repertoire of IGHV-IGHD-IGHJ rearrangements in Macedonian patients with chronic lymphocytic leukemia-single centre experience(Medip Academy, 2016-12-28)Background: B-cell chronic lymphocytic leukemia (CLL) is a clinically heterogeneous disease with many patients surviving for decades with watch and wait strategy or no treatment, whereas others surrender to their disease despite therapy. In recent years, new molecular prognostic factors came to light that have significantly improved the stratification of the CLL patients. One of the most important molecular predictors, the immunoglobulin VH gene mutational status, divides CLL into two prognostic groups, depending on the presence or absence of somatic hypermutation, where unmutated U-CLL are associated with remarkably worse prognosis than mutated U-CLL. The aim of the study was evaluation of rearrangement of IG genes profile in Macedonian CLL patients in line with facts that there are some geographic linked variations in IG genes. Methods: In this study, mutational status and configuration of IGHV-IGHD-IGHJ rearrangements in 70 treatment naïve CLL patients were analyzed using reverse transcriptase– polymerase chain reaction (RT-PCR) and sequencing methodology at the center for bimolecular pharmaceutical analyses, faculty of pharmacy, Skopje, Macedonia. Results: Our evaluation have shown that 52.8% patients belonged to the U-CLL subset, whereas 47.1% belonged to the M-CLL subset. The most frequently expressed IGHV subgroup was IGHV3 (41.4%), followed by IGHV1 and IGHV4 (28.5%), IGHV5 (1.4%). In the IGHD and IGHJ sets most frequently expressed was IGHD3 (55.7%), IGHJ6 gene (37.1%) respectively. Conclusions: Our evaluation of mutational status on IGVH, IGDH, and IGJH gene in Macedonian CLL patients resulted with data which are consubstantial to those from Mediterranean area and West Balkan - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Analysis of Prognostic Factors As Predictors of Treatment Free Survival in Patients with Chronic Lymphocytic Leukemia-Single Centre Experience(2021-08); ; ; ; Krstevska-Balkanov, SvetlanaIntroduction: Chronic lymphocytic leukemia (CLL) is a heterogeneous clonal lymphoproliferative disease originating from activated B lymphocytes that have experienced antigen. The clinical course is very heterogeneous. Some patients never look for treatment, as opposed to others who live and die with an aggressive illness. This clinical heterogeneity is likely a reflection of molecular and cellular heterogeneity, on the basis of which patients with CLL can be divided into subgroups with different clinical-biological characteristics. Aim of the study: Evaluation of prognostic factors in terms of treatment free survival, prognosis and adequate therapeutic approach in patients with CLL. Material and methods: The study is set as retrospective, it includes 300 patients with CLL diagnosed and treated at the University Clinic of Hematology in the period of 10 years (January 2009 - January 2019). The study was performed at the University Clinic for Hematology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia. We evaluate several prognostic factors in terms of treatment free survival. All results were processed with the statistical program SPSS18 software program. Results: The multivariate Cox Proportional model of Treatment free survival of CLL patients confirmed ECOG, Rai Stage, and spleen size that influence on treatment free survival.. Concusion: In our study, multivariate analysis of treatment free survival and overall survival showed ECOG performance status 0,1 and 2 as a factor influencing both overall survival and treatment free survival - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of reproducibility of prognostic index and nomogram in prognosis, and therapeutically approach of patients with Chronic Lymphocytic Leukemia-single centre experience(Science Publishing Group, 2014);