Amzai, Gazmend
Preferred name
Amzai, Gazmend
Official Name
Amzai, Gazmend
Main Affiliation
Email
gazmend.amzai@medf.ukim.edu.mk
17 results
Now showing 1 - 10 of 17
- Some of the metrics are blocked by yourconsent settings
Item type:Publication, Chronic lymphocytic leukemia following successfull treatment of Hodgkin’s lymphoma: report of two patients(Македонско лекарско друштво = Macedonian Medical Association, 2017); ; ; ; Arif LatifiOver the past few decades, introducing effective therapy, improved staging procedures, and significant improvement of supportive measures, significantly improved the prospects for patients with Hodgkin's lymphoma, leading to a 75-90% cure rate. Hodgkin's lymphoma survivors are at high risk of developing a large variety of second malignant neoplasms. It is crucial to maintain awareness regarding this issue. The subsequent development of Chronic Lymphocytic Leukemia (CLL) in patients after successful treatment of Hodgkin's lymphoma (HL) is an extremely rare possibility. The relationship between these two lymphoproliferative disorders is unclear. Herein we describe two cases of CLL, developed in previously treated patients with HL, with characterization of two distinct lymphoproliferative disease in these two patients. We also systematically reviewed the existing literature on this very rare occurrence of treatment-induced second hematological malignancies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Long-Term Efficacy of Treatment in Elderly Patients With Hodgkin Lymphoma: A Retrospective Analysis(Elsevier BV, 2024-09); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HL-210 Long-Term Efficacy of Treatment in Elderly Patients With Hodgkin Lymphoma: A Retrospective Analysis(Elsevier BV, 2024-09); ; ; Genadieva Stavrik, Sonja - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Overall survival in myelodysplastic syndromes: a cohort study(Quest Journals, 2014-12-25); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PRIMARY BREAST LYMPHOMA – CASE REPORT(Macedonian Association of Anatomists and Morphologists, 2021-02); ; ; Introduction: The entity "Primary breast lymphoma" (PBL) refers to a malignant lymphoma occurring primarily in the breast, without the prior presence of lymphoma in the lymph nodes. Case presentation: We present a case of a 40-year-old woman with PBL of the right breast and an enlarged right axillary node and thrombosis of the right arm. The pathological diagnosis (made in the Institute of Pathology, "Ss. Cyril and Methodius" University, Skopje, Republic of Macedonia) was Non-Hodgkin's lymphoma (aggressive B-cell type). According to the Ann Arbor staging system, the stage was IIE. The patient was treated in the University Clinic of Hematology, "Ss. Cyril and Methodius" University, Skopje, Republic of Macedonia). She received 8 cycles of CHOP protocol. (Rituximab was ceased due to a very severe allergic reaction). After finishing with chemotherapy she was in remission with almost complete restitution of the breast and arm. At a follow-up period of 5 years, the patient has survived with no evidence of disease. Conclusion: This strongly suggests that central nervous system (CNS) prophylaxis should be associated with systemic chemotherapy in localized PBL. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Milestones in Hematology and Oncology: From Fatal to Curable Disease. Progress in the management of patients with Hodgkin’s lymphoma in the Republic of North Macedonia: experience from 40 years of population-based study(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences, 2022-07-13); Background: The comprehensive management of patients with Hodgkin's lymphoma (HL) is a success story in contemporary oncology. Over the past decades, the survival rate of patients with HL has significantly improved. The objective of this analysis is to evaluate and document the progress in the management of Hodgkin's lymphoma in patients in our country, reflected in their vital statistics, over time periods defined by the respective standard of treatment. Material and methods: The present study is designed as a retrospective-prospective study. We analyzed different modalities of treatment and compared 5 and 10-year overall survival rates in a total of 588 Hodgkin's lymphoma patients treated at the University Clinic for Hematology in Skopje during two consecutive time periods, before 2000 and after 2000. The entire observation period is from 1980 to 2020. All patients are above the age of 14, with a documented histopathological diagnosis of Hodgkin's lymphoma and with evaluable medical documentation, including clinical and laboratory data on their initial condition, the administered therapy, as well as the clinical follow-up of the patients. Results: The basic clinical features of the analyzed population across the two periods correlate with those reported in the relevant medical literature, with only slight deviations. Ten-year overall survival rates improved by 31.7% through the two calendar periods. During the last two decades of the previous century (1980-2000) the initial treatment options were COPP and COPP-like regimens for the vast majority of patients (94.7%), leading to disease remission in 80% of them. After 2000, 95.8% of de novo diagnosed patients have been treated with ABVD chemotherapy as a frontline choice and the complete response rate is 88.4%. We confirmed the superiority of ABVD in terms of efficacy, improved tumor and disease control, as well as its long-term clinical outcome. While in the past we had very limited options for relapsed/refractory HL patients, the analysis of the results of HL patients treated with various therapeutic approaches in the latter period, defines BEACOPP as the preferred choice. High-dose chemotherapy, followed by autologous hematopoietic stem cell graft, as a strategy for our R/R patients in the timeframe after 2000, ensures a 5-year overall survival for 51% of them, whereas 45% of the patients survive more than 10 years. Conclusion: This analysis from our Hodgkin's lymphoma database illustrates that there has been tremendous improvement in the long-term survival rates since the turn of this century. At our institution we strive to implement positive trends in practice, as suggested by relevant guidelines, regarding the evolution and progress in the diagnostic workup, treatment, and the overall management of patients with Hodgkin's disease. The objective would be to secure favorable vital statistics for our patient population, now reaching 83.5% at 10 years, which closely correlates with the data of more developed countries and centers. In future clinical trials we will also evaluate the efficacy of brentuximab-vedotin and new PD-1 blocking antibodies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, NGAL and Cystatin C: Two possible early markers of diabetic nephropathy in patients with type 2 diabetes mellitus(Македонско лекарско друштво = Macedonian Medical Association, 2020-12); ; ; ; Introduction. Diabetic nephropathy (DN) is a progressive renal impairment characterized by impaired renal architecture and function and is one of the leading causes of permanent renal impairment. Patients with DN have a high mortality rate, which is primarily due to cardiovascular complications. In everyday practice in the Republic of North Macedonia, serum creatinine, microalbuminuria and glomerular filtration rate are used to detect DN. However, these standard tests do not always allow for detection of initial DN damage. Aim. The aim of this study was to investigate the role of NGAL (in urine) and Cystatin C (in serum) values as adjunctive testing of existing markers (microalbuminuria and creatinine) in unmasking early structural and functional renal impairment in asymptomatic patients with type 2 diabetes mellitus (DM type 2). Methods. This was a prospective, observational (6-month follow-up) study, involving 60 patients aged 35-70 years. The first two groups were patients with diagnosed DM type 2 for a minimum of 5 years, 15 patients diagnosed with DM type 2 with diabetic nephropathy and 15 patients without diabetic nephropathy. The third group consisted of healthy respondents (30). In addition to standard biochemical analyses, the three groups were also examined for body fluid concentrations of NGAL (architect urine NGAL) and Cystatin C (nephelometry), as well as standard biomarkers for renal nephropathy (serum creatinine and microalbumin). Results. The respondents from the three analyzed groups did not differ significantly in terms of gender structure (p=0.71) and age (p=0.068). The study found that (the core values) baseline creatinine, microalbuminuria, NGAL and Cystatin C serum levels were higher in patients diagnosed with DM type 2 and diabetic nephropathy (DN) compared to those with diabetes and without diabetic nephropathy in healthy trials. Also, after 6 months of follow-up, it was proven that in patients diagnosed with DM type 2 and DN all four parameters were higher with confirmed significance unlike the group of patients with DM type 2 without DN. In the group with diabetes and diabetic nephropathy, during the re-evaluation after 6 months of monitoring we registered a non-significant increase in the biomarker NGAL p=0.16), and a significant increase in the biomarker Cystatin C (p=0.016). There was a statistically significant correlation between baseline creatinine values and baseline control values of Cystatin C (p<0.0001), creatinine and NGAL values after a 6-month re-evaluation (p=0.014), all of which were positive. The correlation between the two biomarkers NGAL and Cystatin C were statistically insignificant in the first measurements (p=0.160), and were significant and direct positive on the second measurements, after 6 months (r=0.536, p=0.039). The two markers changed in direct proportion to the serum, with the increasing of one marker in the serum. Also, the other biomarker increased, and vice versa. Conclusion. NGAL and Cystatin C, biomarkers of renal impairment, are correlated with decreased renal function in patients with DM type 2, suggesting that NGAL and Cystatin C may be used as adjunctive tests to existing ones (creatinine and microalbuminuria) to unmask early renal dysfunction. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CIRS-G score as a rapid way to determine the overall multimorbidity burden and to select optimal and individualized therapy in newly diagnosed eldery CLL patients(Македонско лекарско друштво = Macedonian Medical Association, 2020); ; ; ; Slobodanka Trpkovska TerzievaIntroduction. Chronic lymphocytic leukemia (CLL) is the most common lymphoproliferative disorder in the elderly population. Many of these patients have multiple comorbidities, which might influence the choice of an adequate upfront chemoimmunotherapy option. The Cumulative Illness Rating Scale for Geriatrics (CIRS-G) score seems to be a reliable tool for assessment of the burden of comorbidity in elderly cancer patients. Objectives. The primary objective of our study was to assess the distribution of CIRS score status in CLL patients in real clinical practice. The secondary objective was to analyze which treatment option was used, and the effects it produced in each patients’ group, classified according to the CIRS score. Methods. In our prospective, single-center study, we focused on CLL patients that were referred to the University Clinic for Hematology in Skopje between 2017 and 2019. Comorbidity was assessed by the CIRS-G score in all patients included in our study (n=56) prior to the process of deciding on the most adequate treatment option. Results. The median age was 69 (±9.4) years. Comorbidities were identified in 80.4% of the study population, with an average CIRS score of 3.9. The three most common comorbidities were related to involvement of the vascular system (41.1%), endocrine-metabolic disorders (32.1%), and respiratory system disorders (17.9%). Only 16.1% of the patients had only 1 affected organ or system, other than hematological issues, while 64% of the patients had ≥2 affected systems. In 33.9% of the study patient cohort, the watch and wait initial approach was the standard of care. We considered 66.1% of patients to be requiring treatment, as follows: chemotherapy (chlorambucil, fludarabine+cyclophosphamide, bendamustine) only (30.4%), rituximab-based therapy (33.9%), and 1.8% of patients, due to the high comorbidity burden, were eligible only for supportive care. There was a stable trend of correlation between the CIRS score assessment and the treatment option prescribed (rs=0.7188, p<0.000001). Conclusions. The comorbidity status is a major consideration when treating elderly patients with CLL. Our study shows that comorbidity is quite a common feature in CLL patients and that it is increasing with age. CIRS is helpful in identifying the best treatment combination for the patients, that will enhance achieving long-term control of CLL, maintaining an optimal quality of life level. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CALCITONIN NEGATIVE MEDULLARY THYROID CANCER - IMPORTANCE OF MONITORING THE PATIENTS WITH THYROID NODULES IN TIMELY DIAGNOSIS AND TREATMENT: A CASE REPORT(SHMSHM - AAMD, 2023-12); ; Proseva B, TatjanaThe main types of thyroid cancer are follicular, papillary, anaplastic and medullary. Medullary carcinoma is a rarest of them, that originates from the malignant proliferation of parafollicular C cells. The most of them are associated with high levels of calcitonin and carcinoembryonic acid (CEA). Calcitonin-negative medullary carcinoma of the thyroid is an extremely rare entity that is characterized by classic medullary carcinoma of the thyroid morphology without raised serum calcitonin levels. Fine needle biopsy (FNAB)is a diagnostic test done in people with suspected thyroid cancer and it is very important fortimely diagnosis and treatment of medullar thyroid cancer, especially when calcitonin and CEA levels are in normal levels. Case presentation: A 35-yearold woman visited an endocrinologist due to swelling on the left side of the neck. Thyroid ultrasound showed hypoechogenic, heterogenic nodule in the left lobe with dimensions 29x28x35mmand calcifications. Laboratory tests were normal: TSH 3,0 mlU/ml; fT4 14,3 pmol/l; ATPO 20IU/ml; Human thyroglobulin 35IU/ml; Calcitonin 4,5pg/ml; CEA 0.742ng/ml. The FNAB were performed,with cytological finding for Classification group I. Four months after tne FNAB was repeatedand Hürthlecells were found, cytological founding for classification group III. CT of the neck were performed preoperatively and it showed hypodense nodule (slightly smaller than 4 cm) with numerous calcifications, and no significantly lymph nodes enlarged.Left lobectomy was performed with histopathological findings for Medullar thyroid carcinoma. Immunohistochemical tumor cells were positive for Chromogranin A, CD56, focally for Thyroglobulin and CK 19, and negative for S-100 and NSE.Conclusion: Calcitonin normal levels doesn’t exclude medullar carcinoma. Follow-up and monitoring of the patients with thyroid nodules is very importantfor timely diagnosied and treatment of medullar carcinoma. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Association of prognostic fa ctors with overall survival in myelodysplastic syndromes: a cohort study(SHMSHM - AAMD, 2015); ; ; ; Background: Myelodysplastic syndromes (MDS) are heterogeneous disorders in terms of clinical presentation, laboratory findings and life expectancies. A lot of studies have been conducted to determine factors that can refine the prediction of prognosis in MDS. Aim: Our aim was to evaluate which prognostic factors had an impact on overall survival (OS) in MDS. Methods: we conducted retrospective cohort study of 154 adult patients (81 male, 73 female) with MDS who presented to the University Clinic of Hematology, Ss Cyril and Methodius University, Skopje, Macedonia, from January 2011 to June 2014. Data on demographics, FAB classification, treatment and outcome were collected. Results: Age and gender had no influence on OS (p=.80847 and p=.974895, respectfully). Different FAB subtypes had an impact on OS (p = .00757). Bone marrow (BM) blast percentage correlated significantly with OS (p= .028026). Hemoglobin, platelet count and absolute neutrophil count (ANC) did not influence OS (p=. 179970, p= .386355 and p= .972602, respectfully). Transfusion did not influence OS (p= .445856). Albumins had no impact on OS (p=.559900). Lactate dehydrogenase (LDH) and comorbidities influenced OS (p= .018895 and p= .02278, respectfully). Leukemic transformation was noticed in 7 (4.5%) patients. Mortality was 35.1%. Conclusions: FAB subtypes, BM blast percentage, LDH and comorbidities are independent predictors on OS and should be considered for future revisions of International Prognostic Scoring System in order to refine the prediction of prognosis in MDS.