Papers by Simona Stojanovska
Clinical Lymphoma Myeloma and Leukemia
Journal of Morphological Sciences, 2021
Early-stage patients with Chronic lymphocytic leukemia (CLL) are diagnosed without need for treat... more Early-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 Earlystage 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).
Clinical Lymphoma Myeloma and Leukemia
Clinical Lymphoma Myeloma and Leukemia
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Clinical Lymphoma Myeloma and Leukemia
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Journal of Morphological Sciences
International Journal of Research in Medical Sciences, Aug 25, 2021
Background: Several prognostic factors have been identified to predict the outcome of patients wi... more Background: Several prognostic factors have been identified to predict the outcome of patients with chronic lymphocytic leukemia (CLL). To predict the time to first treatment (TFT) we integrated the data of clinical and biological markers in CLL-International prognostic index (CLL-IPI). Aim of the study was the determination of the impact of CLL-IPI in prediction of TFS in CLL patents. Methods: The study was set up retrospectively and included 90 patients with CLL diagnosed and treated at the university clinic of hematology for a period of time from January 2012 to January 2020. We incorporated the data of Binet staging system, most adverse cytogenetic marker and mutational status of immunoglobulin heavy chain in CLL-IPI. The statistical data of the 90 patients showed that the median TFS for low CLL-IPI (N=24), intermediate CLL-IPI (N=40), high risk CLL-IPI (N=17) and very high risk group (N=9) according to the CLL-IPI scoring system was 20.1, 17.6, 7.1 and 5.8 months, respectively. Multivariate analysis indicated that del 17p (p<0.008) was independent prognostic factors of TFS. Conclusions: CLL-IPI is a powerful risk stratification tool for CLL patients and this system has also provided treatment recommendations for different patient risk subgroups.
Blood
Introduction: Since the first months of the COVID-19 pandemic, efforts have been made to understa... more Introduction: Since the first months of the COVID-19 pandemic, efforts have been made to understand the importance of broadly neutralising natural antibodies in determining the response to SARS-CoV-2. Previous studies have shown that allelic variants of the IGHV1-69 gene play a dominant role in protective natural antibody responses to several other viral pathogens, including influenza virus, hepatitis C virus, human immunodeficiency virus and, most notably, the SARS-CoV-2-related viruses SARS-CoV and MERS-CoV. These allelic variants are commonly known as 51p1-related and differ from the other IGHV1-69 alleles (known as hv1263-related) in the presence of a Phe54 residue in the CDR2 region. Importantly, crystallographic studies have shown that the Phe54 residue is critical for the binding of IGHV1-69 antibodies to the SARS-CoV and MERS-CoV spike proteins. In this study, we evaluated the prevalence of 51p1 and hv1263 alleles and the clonality of 51p1- and hv1263-expressing B cells in a...
Clinical Lymphoma, Myeloma & Leukemia, 2021
Clinical Lymphoma, Myeloma & Leukemia, 2021
Clinical Lymphoma Myeloma and Leukemia, 2020
Clinical Lymphoma Myeloma and Leukemia, 2020
Journal of Pharmaceutical Policy and Practice, 2020
This commentary aims to elaborate challenges in the regulatory approaches for accessing and inves... more This commentary aims to elaborate challenges in the regulatory approaches for accessing and investigating COVID-19 potential therapies either with off-label use, compassionate use, emergency use or for clinical trials. Since no therapies have been formally approved and completely effective and safe to date, the best clinical choice is acquired only after consistent and fair communication and collaboration between licensed clinicians, researchers, regulatory authorities, manufacturers and patients.
Clinical Lymphoma, Myeloma & Leukemia, 2021
Macedonian Pharmaceutical Bulletin, 2021
Acute promyelocytic leukemia (APL) is a subtype of acute leukemia (AL) with distinct cytogenetics... more Acute promyelocytic leukemia (APL) is a subtype of acute leukemia (AL) with distinct cytogenetics, clinical and biological characteristics. APL was considered as one of the most rapidly lethal forms of acute myeloblastic leukemia (AML), but recently, with the introduction of all-trans retinoic acid (ATRA) it has become the most curable subtype of AL. The main difficulty with APL is early death (ED), defined as death because of any cause within 30 days after diagnosis, and it has emerged as the most important cause of treatment failure. Our retrospective-prospective study was realized at the University Clinic for Hematology from January 2004 until December 2020. It included 46 patients with APL, according to FAB and WHO classification with confirmed molecular diagnosis. The following patients’ risk stratification factors were analyzed: age, Sanz risk score, WBC, PL, clinical presentation of the disease, levels of fibrinogen and D-dimers. During the study period, APL was diagnosed in ...
Clinical Lymphoma, Myeloma & Leukemia, 2021
Context Western parts of the Republic of North Macedonia are considered endemic regions for leish... more Context Western parts of the Republic of North Macedonia are considered endemic regions for leishmaniasis. Due to the broad spectrum of hematologic manifestations of visceral leishmaniasis (VL), this anthropozoonosis may be occasionally misdiagnosed as a hematological disease. Objective We present here a patient with VL whose initial clinical and laboratory findings mimicked multiple myeloma and led us to series of diagnostic procedures for plasma cell dyscrasia. Patient Case Report A 66-year-old woman presented at our institution with a history of back pain radiating down the legs. Physical examination revealed massive splenomegaly crossing the abdominal midline. Laboratory data showed pancytopenia (Hb 91 g/L; WBC 1.8 x 109/L; PLT 26 x 109/L), and the peripheral blood smear did not show any specific findings. What led us to suspect multiple myeloma was hyperproteinemia (96 g/L) due to hypergammaglobulinemia with IgG monoclonal components (IgG 71.5 g/L). Bone marrow biopsy with bone...
Clinical Lymphoma, Myeloma & Leukemia, 2021
Context: Plasmacytoid Dendritic Cells (pDCs) are hematopoietic, type 1 interferon-producing cells... more Context: Plasmacytoid Dendritic Cells (pDCs) are hematopoietic, type 1 interferon-producing cells. Neoplastic expansion of these cells is very rare and is classified into two different malignancies: Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) and mature pDC proliferation associated with myeloid neoplasia. Objective: We present here a diagnostically challenging case of pDC proliferation associated with AML, with an unusual occurrence in a young 26-year-old male. This patient achieved complete remission with an ALL-based chemotherapy regimen in combination with a Bcl-2 inhibitor. Patient Case Report: A 26-year-old man presented to our clinic with a 1-month history of weakness, malaise and myalgia. Blood counts and peripheral blood smear showed normocytic anemia (Hb 103 g/L) and leukopenia (WBC 2.4 x 103 μ/L) with dominant lymphocytosis, which progressed to severe leukopenia (WBC 0.8 x103 μ/L) and thrombocytopenia (PLT 18 x 103 μ/L) in two weeks. Bone marrow biopsy was perform...
The concept generated by biological expression profile divided patients with diffuse large B-cell... more The concept generated by biological expression profile divided patients with diffuse large B-cell lymphoma (DLBCL) into two subtypes. This concept has been presented in the recent editions of WHO classification and became a prognostic tool. Aim of the study was introduction of new three-marker model for immunohistochemical and prognostic subclasification of patients with DLBCL. Our retrospective study enrolled 200 adult patients with DLBCL diagnosed and treated in the period between January 2013 to January 2021. They were all treated with chemoimmunotherapy with R+/-CHOP regimen and the median follow-up of the patients was 48 months. We analysed the biopsy samples immunohistochemically with the markers of germinal (BCL6) and post-germinal centre (MUM1), and the marker of apoptosis (BCL2). Using the immunohistochemical three-marker model, which consisted of BCL-2, BCL-6, and MUM1, we distributed the patients with DLBCL into 2 subgroups: germinal centre – like (GCL) and activated cent...
Context Autologous peripheral blood stem cell transplant (PBSCT) ideally should be performed in e... more Context Autologous peripheral blood stem cell transplant (PBSCT) ideally should be performed in every myeloma patient, but in the elderly, the procedure might be risky because of comorbidities, and the possibility of the organism to fully compensate possible complications. Objective Our main goal was to show that the age limit for autologous PBSCT in myeloma patients can be safely shifted upwards. Design We used conditioning with melphalan, followed by autologous PBSCT for elderly patients with myeloma, using the age limit of 65 years. Setting All patients were transplanted in the bone marrow transplant unit in the University Clinic for Hematology Skopje. They underwent standard post-transplant preventive and prophylactic measures during the period of pancytopenia. Patients or Other Participants We have done a retrospective analysis of patients with MM where autologous SCT was done. The main inclusion criteria was the diagnosis, age over 65, acceptable comorbidity profile. Intervent...
Open Access Macedonian Journal of Medical Sciences
Introduction: Since December 2019, multiple human cases of novel coronavirus infection were repor... more Introduction: Since December 2019, multiple human cases of novel coronavirus infection were reported, representing with upper respiratory symptoms (influenza-like presentation). The virus was named the Severe acute respiratory system coronavirus 2 (SARS-COV-2). Studies have reported cases of patients with COVID-19 infection, including development of several autoimmune events that suggests that infection with SARS CoV-2 may be associated with initiation of autoimmune hematological autoimmune disorders. Aim: Review the hematological autoimmune phenomenon after infection with SARS-COV-2 in order to assist into the pathogenic mechanisms, clinical manifestations and treatment of this group of patients. Materials and methods: This is a retrospective study that includes 21 patients with autoimmune diseases like secondary immune thrombocytopenia (ITP), autoimmune hemolytic anemia( AIHA) and thrombotic thrombocytopenic purpura (TTP) that have emerged after COVID-19 infection. The pat...
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Papers by Simona Stojanovska