Karanfilski, Oliver
Preferred name
Karanfilski, Oliver
Official Name
Karanfilski, Oliver
Main Affiliation
Email
oliver.karanfilski@medf.ukim.edu.mk
69 results
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Item type:Publication, Treatment of Severe Autoimmune Diseases with Autologous Hematopoietic Stem Cell Transplantation(Македонско лекарско друштво = Macedonian medical association, 2017-01-01); ; ; Cadievski, Lazar<jats:title>Abstract</jats:title> <jats:p><jats:bold>Introduction.</jats:bold> Autoimmune diseases are a family of more than 100 heterogeneous conditions that affect 5 to 8% of the world’s population. The etiology is still un-known but the disregulation of the regulatory T-lymphocytes play a central role inthe autoimmunity and the success of the long-term remission. Although conventional immunosuppression and new biological agents can provide disease control in severely affected patients, such treatments are rarely curative and alternative strategies are needed. Indeed, severe forms of systemic autoimmune diseases, such as multiple sclerosis (MS), systemic sclerosis (SSc), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), juvenile idiopathic arthritis (JIA), hematologic immune cytopenia (HIC) and Crohn’s disease are difficult to be treated. High-dose immunosuppressive therapy followed by autologous stem cells transplantation is reliable option for a successive treatment of this group of patients.</jats:p> <jats:p><jats:bold>Aim.</jats:bold> To determine the safety of the procedure of autologous stem cell transplantation in patients with autoimmune diseases and concomitant malignant hematological disorders.</jats:p> <jats:p><jats:bold>Methods.</jats:bold> During a period of 15 years (from September 2000 to September 2015) at the University Clinic of Hematology in Skopje we have treated 6 patients with autoimmune disease and concomitant hematological neoplasm. None of the patients was treated for primary autoimmune diseases. Two men and 4 women, with median age of 47 years were treated. Sjogren syndrome and multiple myeloma were found in 2 patients, polyartheritis nodosa and multiple myeloma in 1 patient, rheumatoid arthritis and acute myeloblastic leukemia in 1, systemic lupus erythematosus and non-Hodgkin lymphoma in 1; severe psoriasis and acute myeloblastic leukemia in 1 patient.</jats:p> <jats:p><jats:bold>Results.</jats:bold> All treated patients are alive after trans-planted procedure, with transplant related mortality day +100: 0.</jats:p> <jats:p><jats:bold>Conclusion.</jats:bold> Autologous stem cell transplantation is safe and recommended option for treatment ofpatients with autoimmune disease and hematologic neoplasm.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, P062 Results of RCHOP6 or RCHOP8 study in the treatment of patients with diffuse large B-cell lymphoma – single institution study(Elsevier BV, 2007-09); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MONOMORPHIC EPITHELIOTROPIC INTESTINAL T-LYMPHOMA – CASE REPORT(Scientific Foundation SPIROSKI, 2022-06-28); ; ; Karanfilska, AleksandraBackground: Monomorphic epitheliotropic intestinal T cell lymphoma (MEITL) (formerly termed enteropathy-associated T cell lymphoma, type II) is an extremely rare peripheral T-cell lymphoma that involves the malignant proliferation of a T- lymphocyte in the gastrointestinal tract. Over time, these T cells commonly spread throughout the mucosal lining of a portion of the GI tract (particularly the jejunum and ileum of the small intestine), lead to GI tract nodules and ulcerations, and cause symptoms such as abdominal pain, weight loss, diarrhea, obstruction, bleeding, and/or perforation. Its clinical, morphologic, and immunophenotypic features distinguishing it from the more common Enteropathy Associated T-Lymphoma (previously EATL type I) made it a separate entity. Case report: We present a case of a rare extremely aggressive T cell lymphoma that originates from the gastrointestinal tract, spreads to surrounding organs and is refractory to surgery and chemotherapy. We describe а case report of 79 years old patient with clinical features of acute abdomen, ileus, treated with surgery two times. During the first surgery partial resection of jejunum was performed. Pathohistology and immunоhistochemistry findings of MEITL. PET/CT scan revealed infiltration of intestinum, uterus, ovarium. During the second operation partial resection of ileum and hysterectomy with adnexectomy was performed. The patient is treated with antracycline-based regimen CHOP21 (4 cycles). Re-evaluation with second PET/CT scan revealed residual tumor on the intestinum and bladder. The patient deteriorate with acute renal failure and multi-organ failure. Despite aggressive treatment with extensive surgery and aggressive anthracycline-based chemotherapy, in a short time the tumor spread to surrounding organs (sigma, bladder). The patient survived 11 months from the initial definitive diagnosis. Conclusion: MEITL is a challenging primary intestinal T cell lymphoma to treat as the outcome is frequently poor despite surgery and chemotherapy. Most patients are elderly with co-morbidities and they usually present late rendering any therapy ineffective. Young age, early Ann-Arbor/Lugano disease stage, good performance scale status, patients receiving autologous stem cell transplantation and less bulky disease are associated with an improved survival outcome. Further research is needed to incorporate new therapeutic modalities based on molecular research for successful treatment of this aggressive lymphoma.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Antimycotic prophylaxis in stem cell recipients – single center expirience(Elsevier, 2007-09); ; ; Ivanovski Martin - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Treatment with autologous stem cell transplantation in multiple myeloma patients: A 10-year single centre experience(Walter de Gruyter GmbH, 2013); ; ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, P101 Antimycotic prophylaxis in stem cell recipients – single center expirience(Elsevier BV, 2007-09); ; ; Ivanovski, M. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, P009 “High-risk” patients with aggressive non-Hodgkin lymphoma should benefit from autologous stem cell transplantation in first remission (single-centre experience)(Elsevier BV, 2007-08); ; ; Stojanovik, A. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Case report of a rare coagulation disorder-Acquired hemophilia A(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2016); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, First Cases of Hb Agrinio Described in Patients from the Republic of Macedonia(Taylor & Francis Online, 2017-12-08); ; Previous molecular analyses of α-thalassemia (α-thal) in the Republic of Macedonia have identified the following genetic defects: –α3.7 (rightward), –(α)20.5 and – –MED I deletions and Hb Icaria [α142, Term→Lys (α2), HBA2: c.427T>A] and polyadenylation signal (polyA) [AATAAA>AATGAA (α2), HBA2: c.*92A>G] point mutations. Here, we report two unrelated patients from the Romani population in the Republic of Macedonia, homozygotes for the α2-globin gene variant Hb Agrinio [α29(B10)Leu→Pro; HBA2: c.89T>C]. To date, Hb Agrinio has been described only in individuals of Greek, Cypriot and Spanish origin. Both of our patients had early presentation of the disease (3.5 years and 2 months, respectively) with frequent blood transfusions from early infancy. They have a severe intermediate phenotype of thalassemia (Hb H disease) with hemoglobin (Hb) levels of 7.8 and 7.7 g/dL, respectively. Although the HBA2: c.89T>C mutation results in an α+ allele, the severe phenotype of the homozygotes is due to the production of hyperunstable α chains that undergo post translational precipitation. This leads to a greater degree of red cell damage and hemolytic anemia. The detection of Hb Agrinio in two unrelated families of Romani ethnic origin, may suggest it is a founder mutation in this population living in the Republic of Macedonia. Considering the severity of the clinical presentation of the homozygotes or compound heterozygotes for this rare Hb variant, a targeted molecular screening for Hb Agrinio mutation carriers should be considered in all patients of Romani ethnic origin with manifested microcytosis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Rituximab Maintenance Therapy in CD20+ B-Cell Non-Hodgkin’s Lymphoma(American Society of Hematology, 2005-11-16); ; <jats:title>Abstract</jats:title> <jats:p>Purpose: Clinical and pharmacokinetic data suggest that high serum concentrations of rituximab and prolonged exposure to rituximab are associated with higher response rates and improved quality of response. We used rituximab-maintenance therapy to target minimal residual disease, with the aim of increasing the duration of remissions achieved following initial treatment.</jats:p> <jats:p>Methods: During 2001–2005, 14 patients with CD20+ B-cell non-Hodgkin’s lymphoma (seven with diffuse large B cell lymphoma [DLBCL] and seven with follicular lymphoma [FL]) were enrolled in the study. Patients with DLBCL and FL were required to have a CR or PR, respectively, following initial treatment. The most common initial treatments were R-CHOP, R-FC or CHOP. Rituximab-maintenance therapy was administered as 375mg/m2 doses every 3 months for 2 years. Three patients with aggressive DLBCL were treated with high-dose chemotherapy/autologous stem-cell transplantation (HDT/ASCT) and received rituximab-maintenance therapy every 2 months for four doses in total.</jats:p> <jats:p>Results: Most patients had disease of Ann Arbor stage ≥ 3 (two FL patients stage I). In patients with DLBCL, median event-free and overall survivals were 22.1 months and 22.3 months, respectively, with the corresponding values being 20.6 months and 26.1 months in patients with FL. To date, 13 patients are in continuous clinical remission and only one patient has relapsed.</jats:p> <jats:p>Conclusions: Rituximab-maintenance therapy is effective and well tolerated in this setting. Recruitment for this study is ongoing and evaluation of a larger patient population, together with a longer follow-up, will determine whether this treatment approach has curative potential.</jats:p>