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    Preliminary results of introducing the method multiparameter flow cytometry in patients with acute leukemia in Republic of Macedonia
    (ID Design 2012/DOOEL Skopje, 2008-12-05)
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    Hadzi-Pecova, Liljana
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    Abstract Background. In this paper we present the initial results of introducing the method of multiparameter flow cytometry (MPF) in patients with acute leukemia in the Republic of Macedonia. Aim. The aim of our study is to improve the diagnosis and management of acute leukemia, to establish the correct lineage assignment of the blast cells and to select effective treatment strategy for each single acute leukemia patient. Material and methods. A total of 44 adult (>15 years) patients (from initially 45 tested) with acute leukemia who were consecutively admitted at the Clinic of Hematology-Skopje from January through June 2008, were enrolled in this study. The MPF was introduced for the first time in the Republic of Macedonia and was performed at the Institute for Immunobiology and Human Genetics, Faculty of Medicine-Skopje. Results. Our results showed that morphology and cytochemistry established lineage in 39 of patients, but not in 5 cases that presented as acute leukemia, of which 4 were assigned as myeloid and in one nonhematopoietic malignancy was indicated. Furthermore immunophenotyping change the lineage assigned based on morphology and cytochemistry in one case from lymphoid to myeloid. Results from our study showed that routine immunophenotyping improved the diagnosis in 6 (13.3%) cases. The exact lineage assignment of the blasts cells guides to implementation of specific molecular analyses in some subtypes of acute leukemia and their further definition, which is essential for more appropriate single patient therapeutic decisions. Conclusion. Our data support routine implementation of MPF in the diagnostic evaluation of acute leukemia.
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    FLOW CYTOMETRY DIAGNOSIS OF (CD4+/CD8+) T CELL LYMPHOBLASTIC LEUKEMIA ASSOCIATED WITH NORMAL KARYOTYPE - CASE REPORT
    (Radiance Research Academy, 2013-04)
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    Ivanovski, Martin
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    Dukovski, Dushko
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    Simjanovska-Popova, Marija
    Adult T-cell leukemia/lymphoma (ATLL) is a peripheral T-cell neoplasm caused by human T-cell lymphotropic virus type I (HTLV-I). The neoplastic cells are highly pleomorphic and are usually CD4+ and CD8- phenotypically, but some rare cases have unusual immmunophenotype presented by co-expression of CD4/CD8 double positive cells. We present a rare case of a patient with T cell lymphoblastic leukemia associated with double-positive (CD4+/CD8+) blast cells. The diagnose was accessed with multiparameter immunophenotyping by flow cytometry analyses of bone marrow, and for the first time in our country, we confirmed isolated relapse of double-positive (CD4+/CD8+) T cell lymphoblastic leukemia in CNS
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    Minimal screening analysis based algorithm for diagnosis and clinical stratification of patients with acute myeloid leukaemia (AML): single centre experience
    (Macedonian Academy of Sciences and Arts, 2012-07)
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    Ivanovski, Martin
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    Hadzi-Pecova, Liljana
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    Dukovski, Dushko
    A b s t r a c t: In this paper we present our results from a study designed in order to establish and standardize a diagnostic algorithm for acute myeloid leukaemia (AML) in the Republic of Macedonia. A total of 146 consecutive adult patients (> 15 years) were enrolled in the study. First, we determined the correct lineage assignment of the blast cells and evaluated the incidence of the favourable PML/RARα, AML1/ETO, CBFβ/MYH11 genetic markers among the AML cases. Additionally, the obtained results were correlated with patients’ age, comorbidities, and performance status, and each single AML patient was stratified to effective treatment strategy. Our results showed that morphology and cytochemistry established a lineage in 132 (89.1%) of the patients, but not in 16 cases that presented as acute leukaemia, of which 7 were assigned as myeloid, and in two a non-haematopoietic malignancy was indicated with immunophenotyping. Mulitparameter flow cytometry immunophenotyping also changed the assigned lineage based on morphology and cytochemistry in 5 (3.3%) of the patients from lymphoid to myeloid and improved diagnosis in 21 (14.1%) cases. By using a reverse transcriptase-polymerase chain reaction (RT-PCR) essay 28 (23.1%) patients were classified in the prognostically favourable AML genetic group; 8 patients expressed the fusion transcript PML/RARα, 5 AML1/ETO and 15 CBFβ/MYH11. Moreover, analyses of the age, performance status and comorbidities further stratified an additional 12.5% of the patients to a different risk-adapted therapy. The applied minimal screening-analysis-based diagnostic algorithm enabled improved and more precise diagnosis and clinical stratification in 37.2 % of AML patients from our study group.
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    The influence of the iodinate contrast medium during CT: Single center experience - Development of two competitive in-house methods for automated quantification of DDSB
    (Macedonian Pharmaceutical Association, 2019)
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    Dilevska, Ivana
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    Kroneis, Thomas
    DNA damage induced by ionizing radiation may ultimately lead to cell death or initiate cancer cells development. Today it is difficult to estimate what the actual damage to the human body will be, given the fact that today in the world the number of diagnostic procedures using radiation and iodine contrast media is increasing, and the existence of a number of factors that can affect the radiation dose in vivo. At the same time, development of new methods is required, which can determine in a much shorter time what will be the effect of diagnostic radiation on the DNA molecule. For these purposes we develop two competitive inhouse methods for automated quantification of DNA double strand brakes (DDSB) in peripheral blood lymphocytes: immunofluorescence determining of γH2AX with stained microscopic slides and determining the occurrence of DDSB with the flow cytometry. Our initial results shown that computed tomography (CT) can cause damage in the DNA molecule in the form of DDSB, the existence of linear dependence with the increase in low and high range of CTDI and the number of γH2AX, and that iodine contrast media can increase the occurrence of DNA double strand brakes.