Faculty of Medicine
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Item type:Publication, Impact of age and comorbodity as prognostic factors on overall survival in patients with multiple myeloma(Macedonian Association of Anatomists and Morphologists, 2015); ; ; Background: Multiple myeloma is a heterogeneous disease with variable disease course, a wide range of clinical presentation and many subtypes, variable response to therapy and survival outcome that ranges from less than one year in patients with aggressive disease to more than ten years in patients with indolent disease presentation. It is very important to clearly define the risk profile of each patient during establishing the diagnosis, and to predict the eventual type of therapeutic approach, its depth, quality and length. The age >75 and presence of comorbidities at the start of therapy are risk factors which impact on the quality of life, therapy response and overall survival (OS) in patients with multiple myeloma (MM). Aim: The aim of this study was to assess the influence of the two most important risk factors in myeloma patients, ageism and comorbidities, that complicate the management of MM and at the same time OS. Patients and methods: We retrospectively analyzed a total of 296 myeloma patients (150 male and 146 female) with average age of 62 ±10.3 years. The most affected age group (58.1%) comprised patients at the age ranging between 60 and 88 years, diagnosed at the University Clinic of Hematology, Ss Cyril and Methodius University, Skopje, Macedonia in the period 2005-2015. The follow-up period was 24 months. We evaluated some parameters that could influence OS: age and comorbidity that could influence the overall clinical condition of the patient during his therapy and his eventual future disease behavior. OS was estimated on monthly basis including the period from the date of diagnosis to the time of death / time of last visit. Results: In the study group 26% of patients ≥ 65 years have survived more than 60 months, and 40% younger than 65 years have survived more than 60 months. Survival time in group ≥65 years is 18.3 months, and in group <65 years is 43.4 months. It is evident that age had a significant effect on OS in myeloma patients, and 49% of patients with no registered comorbodity preceding the diagnostic procedures had survived more than 60 months, but only 16% of patients with registered comorbidity survived more than 60 months. Survival time in patients with registered comorbodity preceding the diagnostic procedures was 59.3 months and survival time in patients with registered comorbodity before the diagnostic procedures is 10.7 months. Conclusions: The age-related changes in physiology combined with comorbid conditions, disability or frailty have important implications in the treatment of myeloma patients. Based on these risk factors our recommendation is tailored treatment for each MM patient. Key words: multiple myeloma, prognostic factors, overall survival - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IMPLICATIONS OF CHROMOSOMAL ABNORMALITIES AND BENCE-JONES PROTEINS IN MULTIPLE MYELOMA(Macedonian Association of Anatomists, 2023); ; ; ; Nevenka RidovaIntroduction: Translocations are among the main genetic events responsible for multiple myeloma (MM). Also, in two thirds of MM cases, the presence of Bence Jones proteins is observed. The aim of this study was to demonstrate the role that chromosomal abnormalities and Bence-Jones proteins play as crucial biomarkers in MM patients. Materials and Methods: This retrospective study was carried out at the University Clinic for Hematology in Skopje, North Macedonia, between January 2009 and December 2019. MM patients were divided into different treatment groups: those younger than 65 years old, without comorbidities, and eligible for autologous peripheral blood stem cells (PBSCT) were included in the Cyclophosphamide-Thalidomide-Dexamethasone (CyThalDex) protocol group. The Melphalan Prednisone Thalidomide (MPT) protocol was used in patients over the age of 65 who were unsuitable for aggressive treatment options such as PBSCT due to comorbidities and renal failure. The third group's treatment did not include new immunomodulators like thalidomide. Results: Molecular and chromosomal analyses were performed in 46 MM patients. The survival time of patients with MM concerning molecular and chromosome stratification showed that 20% of them were high-risk [hypodiploid (gain1q, loss1p) Del17p, Del13q, t(11;14) t(4;14) and multiple mutations] who survived 60 months, and the median survival time in these patients was 20.8 months. In patients with MM who had a standard risk, death outcomes were not registered during the observation period. Taking into account all MM patients included in our study, Bence Jones proteins in the urine were present in 35.8% of patients, while their presence was not observed in 64.2%. The percentage difference was statistically significant. Conclusion: The use of these critical biomarkers in the clinical background of this disease in the future can only be achieved through careful evaluation and validation in clinical trials. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IMPACT OF INITIAL RENAL INVOLVEMENT AND BENCE JONES PROTEINS IN THE URINE ON OVERALL SURVIVAL OF PATIENTS WITH MULTIPLE MYELOMA(Macedonian Association of Anatomists, 2022-03); ; ; ; Ridova, NevenkaMultiple myeloma (MM) is a cancer of plasma cells with a frequency of around 50 cases per million population (pmp)/year. This retrospective study was conducted at the University Clinic for Hematology in Skopje, North Macedonia, in the period between January 2009 and December 2019. The cohort group was consisted of 296 recently diagnosed patients with MM. According to the results of our study, in 47% of patients who did not have renal involvement (RI), the survival rate was more than 60 months. On the other side, the survival percentage in those patients who had ARI (acute renal impairment) was 9% and in those who had CRI (chronic renal impairment) only 10%. Forty percent of patients with a negative Bence Jones proteinuria survived more than 60 months. Besides, only 20% of patients with a positive Bence Jones proteinuria survived more than 60 months. Nowadays, bortezomib is generally used as a first-line drug in the treatment of MM in patients with serious RI. In conclusion, there are various research questions that can differentiate the treatment of patients with MM and RI in the near future. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Chromosomal Aberrations and Bence-Jones Proteins as a Significant Biomarkers in Multiple Myeloma(2022-05); ; ; ; Ridova, NevenkaAbstract: Multiple Myeloma (MM) is a hematological malignity associated with the proliferation and accumulation of bone marrow terminally differentiated plasma cells. The outcomes of patients with MM have dramatically improved over the past decade with the establishment of novel agents. Nonetheless, the disease presents considerable heterogeneity in clinical course, presentation, and survival. Molecular and chromosomal analyses were performed on 46 patients with MM. The survival time of patients with MM concerning molecular and chromosome stratification showed that 20% of them were with high risk [hypodiploid (gain1q, loss1p) Del17p, Del13q, t(11;14) t(4;14) and multiple mutations] who survived 60 months and the median survival time in these patients was 20.8 months. In patients with MM who had a standard risk, death outcome was not registered during the observation period. Taking into account, all MM patients included in our study, Bence Jones proteins in the urine wеre present in 35.8% of ММ patients, while in 64.2%, their presence was not observed. The percentage difference is statistically significant The utilization of these crucial biomarkers in the clinical background for this disease in the future can only be achieved through thorough evaluation and validation in clinical trials. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Fibrillary Nephropathy and Amyloidosis - Two Morphological Faces of the Myeloma Kidney(Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs, 2020); Myeloma-induced renal failure is associated with sig- nificant morbidity and mortality. Rapid intervention is critical to reverse kidney damage and improve renal function. We report two cases, one with fibrillary nephropathy and other one with kidney amyloidosis due to multiple myeloma, diagnosed by renal biopsy and treated in our department. Both patients had no other signs of multiple myeloma present, apart from acute renal failure and histological findings on renal biopsy. The renal biopsy was performed because of acute renal failure to exclude rapidly progressive glomerulo- nephritis. The histological analysis showed fibrillary glomerulopathy in one patient and kidney amyloidosis in the other, changes consistent with the diagnosis of multiple myeloma with kidney involvement. Further clinical investigation confirmed multiple myeloma and the patients treated accordingly. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Bondronat in the treatment of bone lesions in multiple myeloma(European Hematology Association, 2006); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prognostic factors in multiple myeloma(European Hematology Association, 2002); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Multiple myeloma related anemia treated with erythropetin(Turkish Society of Hematology, 2005); ; Liljana Hadzi-Pecova - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Autologous stem-cell transplantation in patients with multiple myeloma(Makedonska Akademija na Naukite i Umetnostite-Oddelenie za bioloski i medicinski nauki, 2008); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Erythropoetin in the treatment of multiple myeloma related anemia(European Hematology Association, 2004); ;
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