Browsing by Author "Jovanovic, Jelica (57202914654)"

Background: The occurrence of myeloproliferative neoplasms (MPNs) that evolve into each other is well-described, as is this occurrence of lymphoproliferative neoplasms (LPNs). However, less is known about rare MPN/LPN coexistence, and the aim of our study was to analyze charachteristics of these patients after long term follow-up. Methods: Fourteen patients with MPN/LPN coexistence were diagnosed and treated according to guidelines at a single university center across two decades. Results: The overall median age was 53 years (22–69). MPNs patients with subsequent LPNs had a shorter period of second malignancy development and a more aggressive course of LPN, which can cause fatal outcomes. Polycythemia vera and chronic lymphocytic leukemia were most commonly associated (36%). The JAK2V617F mutation had 2/3 and cytogenetic abnormalities occurred in 1/3 of patients. MPN/LPN coexistence cases had significantly higher thrombotic potential (42.8%) and a higher third malignancy accruement frequency (21.4%) versus those without such malignancies. Conclusions: Considering the younger ages at MPN diagnosis, it is recommended to check regularly for blood lymphocytosis or lymphadenopathy occurrences and organomegaly progression faster than expected for MPN, with the aim of timely LPN diagnoses. The presence of molecular-cytogenetic abnormalities in a majority of patients indicate possible genetic instability and increased risk of development of multiple neoplasms, thus elevating thrombotic risk. © 2024 by the authors.

Objective: Until recently, imatinib was the standard first-line treatment in chronic myeloid leukemia (CML). The inclusion of nilotinib and dasatinib as first-line options in CML raised a debate on treatment selection. The aim of our study was to analyze predictive parameters for imatinib response as the first-line treatment of CML patients. Methods: The study included 168 consecutive patients with chronic phase Philadelphia-positive CML who were diagnosed and treated with Imatinib 400 mg once daily at a single university hospital. Numerous parameters were analyzed in terms of imatinib response including comorbidities as well as occurrence of second malignancies. Results: After the median follow-up of 87 months in 61 patients (36.3%), the imatinib failure was verified. Cox regression analysis identified hepatomegaly (p = 0.001), leukocytosis ≥ 100 × 109/l (p = 0.001), blood blasts ≥ 1% (p = 0.002), and the presence of additional cytogenetic aberrations (p = 0.002) as predictors of Imatinib failure. Based on these findings, a new prognostic model was developed according to which imatinib failure had 17% (8/47) of patients in low risk, 34.9% (30/86) of patients in intermediate risk, and 76.7% (23/30) of patients in high-risk group (HR = 3.973, 95% CI for HR 2.237–7.053, p < 0.001). Conclusion: The new score allows better selection of patients who are suitable for treatment with imatinib and may guideline the clinical decision for front-line treatment of CML. © 2017 Informa UK Limited, trading as Taylor & Francis Group.

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Introduction. Additional karyotype abnormalities in the Philadelphia-positive (Ph+) clone can emerge during the progression of chronic myeloid leukemia (CML) and are of-ten associated with the resistance to treatment with tyrosine kinase inhibitors (TKI). Sometimes, during the TKI treat-ment, karyotype abnormalities can appear in the Philadelph-ia-negative (Ph-) cells as well but do not seem to adversely affect the outcome except for chromosome 7 abnormalities. Case report. The patient presented was in the chronic phase of Ph+ CML with highly diverse karyotype abnormal-ities. The abnormalities appeared in three unrelated clones during the TKIs treatment, followed by the evolution of the disease into acute myeloid leukemia (AML). The primary Ph+ clone was revealed during the chronic phase of CML, and therapy with imatinib mesylate was commenced. After a three-year hematologic and cytogenetic remission period, the evolution of the primary clone was noticed. Nilotinib was introduced, leading to a good molecular response and the disappearance/loss of the Ph+ clone with additional abnormalities but with the appearance of the Ph- clone with trisomy 8. Finally, after 5.5 years of nilotinib therapy, the Ph- clone with monosomy 7 occurred during the deep mo-lecular response for BCR-ABL. At that time, the FISH anal-ysis for trisomy 8 was negative, but the rise in blast count was noticed in the bone marrow, and the diagnosis of the secondary AML was established soon after. Conclusion. The achievement of the deep molecular response in CML patients does not rule out regular cytogenetic testing of their bone marrow. This is of crucial importance for detecting adverse karyotype abnormalities leading to the development of the myelodysplastic syndrome and AML. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Standard ELN risk stratification for thrombosis and overall survival (OS) in patients with polycythemia vera (PV) is based on advanced age and history of thrombosis. Recently, the triple A (AAA) risk model was developed for OS prediction in patients with essential thrombocythemia, which, besides rising age, incorporates high (≥8x109/L) absolute neutrophil and low(<1.7 × 109/L) lymphocyte counts. The presented multicenter international study on a large cohort of PV patients validated the findings from prior reports and demonstrated excellent prognostic properties of the triple A model with respect to both thrombosis and survival in PV. Moreover, it revealed that the addition of patient comorbidities (assessed through the Charlson comorbidity index (CCI)) to ELN and triple A score may not help to further refine the survival prognostication of these patients. Therefore, the triple A score with its simplicity seems to offer excellent balance during the initial risk assessment in PV, implicating its global applicability. © 2025 Informa UK Limited, trading as Taylor & Francis Group.

Standard ELN risk stratification for thrombosis and overall survival (OS) in patients with polycythemia vera (PV) is based on advanced age and history of thrombosis. Recently, the triple A (AAA) risk model was developed for OS prediction in patients with essential thrombocythemia, which, besides rising age, incorporates high (≥8x109/L) absolute neutrophil and low(<1.7 × 109/L) lymphocyte counts. The presented multicenter international study on a large cohort of PV patients validated the findings from prior reports and demonstrated excellent prognostic properties of the triple A model with respect to both thrombosis and survival in PV. Moreover, it revealed that the addition of patient comorbidities (assessed through the Charlson comorbidity index (CCI)) to ELN and triple A score may not help to further refine the survival prognostication of these patients. Therefore, the triple A score with its simplicity seems to offer excellent balance during the initial risk assessment in PV, implicating its global applicability. © 2025 Informa UK Limited, trading as Taylor & Francis Group.