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Grohmann M, Todorovic M, Petersen C. PO-1890 Dosimetric comparison of modern auto-planning solutions for SRS of multiple brain metastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08341-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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2
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Todorovic M, Grohmann M, Petersen C. PD-0859 Intra-fractional motion in frameless stereotactic radiosurgery and how to deal with it. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07138-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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3
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Balint B, Pavlovic M, Todorovic M. Rapid Cytoreduction by Plateletapheresis in the Treatment of Thrombocythemia. Platelets 2020. [DOI: 10.5772/intechopen.93158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The objective of this chapter is to provide a systematic overview of current knowledge regarding therapeutic apheresis—primarily therapeutic plateletapheresis (TP)—and to summarize evidence-based practical approaches related to cytapheresis treatment of “hyperthrombocytosis” or “extreme thrombocytosis” (ETC). Our results of platelet (Plt) quantitative/qualitative analyses and evaluation of efficacy of apheresis systems/devices—on the basis of Plt removal and in vivo Plt depletion—will be presented. Our preclinical researches confirmed that in Plt concentrates, the initial ratio of discoid shapes was 70%, spherical 20%, and less valuable (dendritic/balloonized) shapes 10%—with morphological score of platelets (MSP = 300–400). After storage, the ratio of discoid and spherical shapes was decreased, while the less valuable ones progressively increased (MSP = 200). Electron microscopy has shown discoid shapes with typical ultrastructural properties. Spherical shapes with reduced electron density and peripheral location of granules/organelles were detected. Also, dendritic shapes with cytoskeletal “rearrangement,” membrane system integrity damages, and pseudopodia formations were documented. Our clinical study demonstrated that TP was useful in ETC treatment and should help prevention of “thrombo-hemorrhagic” events—until chemotherapy, antiplatelet drugs, and other medication take effect. During TP treatment, Plt count and morphology/ultrastructure were examined. Plt functions by multiplate analyzer were evaluated. We concluded that intensive TP was an effective, safe, and rapid cytoreductive treatment for ET.
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Sulzgruber P, Sinkovec H, Kazem N, Hofer F, Hammer A, Koller L, Todorovic M, Katsch F, Gall W, Duftschmid G, Heinze G, Niessner A. Adherence to cardiac rehabilitation after acute coronary syndrome and its impact on patient outcome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Secondary prevention after acute coronary syndrome (ACS) mirrors a key position in the reduction of morbidity and mortality in this highly vulnerable patient population. Especially cardiac rehabilitation proved to be one of the most beneficial therapeutic approaches for the reduction of re-events and overall modification of cardiovascular risk factors. However, profound epidemiological measures on adherence to a recommended cardiac rehabilitation after ACS remain scare, but seem of major importance in terms of preventing fatal cardiac adverse events. Therefore, we aimed to investigate adherence to cardiac rehabilitation after ACS and its impact on patient outcome from an Austrian nationwide perspective.
Methods
Within this population-based national observation all patients presenting with ACS between 04/2011 and 8/2015 in Austria were enrolled. Patient characteristics and co-morbidities were assessed via the Austrian national health insurance system and elucidated according to ICD10 definitions. Adherence to recommended cardiac rehabilitation was investigated according to health insurance documentation. Patients were followed prospectively until the primary study endpoint (= mortality) was reached. Cox Regression hazard analysis was used to investigate the impact of non-adherence to cardiac rehabilitation on patient outcome and was adjusted for a comprehensive subset of confounders within the multivariate model.
Results
During the observation period a total of 16.518 patients (median age: 64 years [54–74]; male: 68.4% [n=11.306]) met the inclusion criteria. Of alarming importance 86.6% (n=14.305) of all patients presenting with ACS did not perform any cardiac rehabilitation as recommended by current guidelines. During patient follow-up until 01/2018 a total of 1774 (10.7%) individuals died. Adherence to recommended cardiac rehabilitation had a strong an independent inverse association with mortality with an adjusted hazard ratio of 0.73 (95% CI: 0.54–0.98; p=0.036) (see Figure 1).
Conclusion
The present nationwide investigation highlighted an overall low adherence to recommended cardiac rehabilitation after ACS. Since cardiac rehabilitation after ACS was associated with a 27% risk reduction for fatal cardiovascular events during the observation period, awareness in terms of cardiac rehabilitation and associated intensified risk factor modification should be promoted, in order to prevent fatal atherothrombotic events.
Figure 1. Cumulative mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Sulzgruber
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - H Sinkovec
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - N Kazem
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - F Hofer
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A Hammer
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - L Koller
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - M Todorovic
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - F Katsch
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - W Gall
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - G Duftschmid
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - G Heinze
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A Niessner
- Medical University of Vienna, Cardiology, Vienna, Austria
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5
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Sulzgruber P, Sinkovec H, Kazem N, Hofer F, Hammer A, Koller L, Todorovic M, Katsch F, Gall W, Duftschmid G, Heinze G, Niessner A. Adherence to high-intensity statin therapy after acute coronary syndrome and its impact on patient outcome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Secondary prevention after acute coronary syndrome (ACS) mirrors a key position in the reduction of morbidity and mortality in this highly vulnerable patient population. Especially lipid lowering therapy – via high-intensity statins (atorvastatin and rosuvastatin) – proved to be one of the most beneficial therapeutic approaches for the reduction of re-events and stent thrombosis. However, profound epidemiological measures on adherence to statin intake after ACS remain scare, but seem of major importance in terms of preventing fatal cardiac adverse events. Therefore, we aimed to investigate adherence to high-intensity statin therapy after ACS and its impact on patient outcome from an Austrian nationwide perspective.
Methods
Within this population-based national observation all patients presenting with ACS between 04/2011 and 8/2015 in Austria were enrolled. Patient characteristics and co-morbidities were assessed via the Austrian national health insurance system and elucidated according to ICD10 definitions. Adherence to high-intensity statins was investigated according to handing in prescriptions for rosuvastatin and atorvastatin at local pharmacies. Patients were followed prospectively until the primary study endpoint (=mortality) was reached. Cox Regression hazard analysis was used to investigate the impact of non-adherence to high-intensity statin therapy on patient outcome and was adjusted for a comprehensive subset of confounders within the multivariate model.
Results
During the observation period a total of 23.240 patients (median age: 65 years [55–75]; male: 67.7% [n=15.728]) met the inclusion criteria. Individuals that died during the index event (n=366; 1.6%), presented with a re-ACS (n=569; 2.4%) or were lost during follow-up (n=158; 0.6%) were not included within the final analysis. Of alarming importance 66.4% (n=15.422) of all patients presenting with ACS did not take high-intensity statins as recommended by current guidelines. The highest rate of drug interruption/end of therapy was observed within the first month after the index event with more than 50% of all cases. During patient follow-up until 01/2018 a total of 3522 (15.2%) individuals died. Non-adherence to high-intensity statins had a strong an independent association with mortality with an adjusted hazard ratio of 1.16 (95% CI: 1.06–1.25; p<0.001) (see Figure 1).
Conclusion
The present nationwide investigation highlighted an overall low adherence to high-intensity statins after ACS, with the highest interruption/end of therapy rate within the first month after the index event. Since the intake of high-intensity statins after ACS was associated with a 14% risk reduction for fatal cardiovascular events during the observation period, awareness in terms of drug-adherence and intensified patient follow-up should be promoted, in order to prevent fatal atherothrombotic events.
Figure 1. Cumulative mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Sulzgruber
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - H Sinkovec
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - N Kazem
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - F Hofer
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A Hammer
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - L Koller
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - M Todorovic
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - F Katsch
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - W Gall
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - G Duftschmid
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - G Heinze
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A Niessner
- Medical University of Vienna, Cardiology, Vienna, Austria
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Sulzgruber P, Sinkovec H, Kazem N, Hofer F, Hammer A, Koller L, Todorovic M, Katsch F, Gall W, Duftschmid G, Heinze G, Niessner A. Adherence to dual anti-platelet therapy after acute coronary syndrome and its impact on patient outcome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Secondary prevention after acute coronary syndrome (ACS) mirrors a key position in the reduction of morbidity and mortality in this highly vulnerable patient population. Especially dual anti-platelet therapy (DAPT) – including aspirin plus a P2Y12 inhibitor – proved to be one of the most beneficial therapeutic approaches for the reduction of re-events and stent thrombosis. However, profound epidemiological measures on adherence to DAPT intake after ACS remain scare, but seem of major importance in terms of preventing fatal cardiac adverse events. Therefore, we aimed to investigate adherence to DAPT after ACS and its impact on patient outcome from an Austrian nationwide perspective.
Methods
Within this population-based national observation all patients presenting with ACS between 04/2011 and 8/2015 in Austria were enrolled. Patient characteristics and co-morbidities were assessed via the Austrian national health insurance system and elucidated according to ICD10 definitions. Adherence to DAPT was investigated according to handing in prescriptions for aspirin and P2Y12 inhibitors at local pharmacies. Patients were followed prospectively until the primary study endpoint (=mortality) was reached. Cox Regression hazard analysis was used to investigate the impact of non-adherence to DAPT on patient outcome and was adjusted for a comprehensive subset of confounders within the multivariate model.
Results
During the observation period a total of 22.331 patients (median age: 65 years [55–75]; male: 69.7% [n=15.176]) met the inclusion criteria. Patients presenting with the indication for oral anticoagulation (n=2165; 9.7%), individuals that died during the index event (n=151; 0.7%), patients that presented with a re-ACS (n=396; 1.7%) or those who were lost during follow-up (n=96; 0.4%) were not included within the final analysis. Of alarming importance 70.7% (n=15.792) of all patients presenting with ACS did not take DAPT as recommended by current guidelines. The highest rate of drug interruption/end of therapy was observed within the first month after the index event with almost 50% of all cases. During patient follow-up until 14 months after the index event 513 individuals died. Non-adherence to DAPT proved a strong an independent association with mortality with an adjusted hazard ratio of 1.25 (95% CI: 1.09–1.41; p<0.001). (see Figure 1)
Conclusion
The present nationwide investigation highlighted an overall low adherence to DAPT after ACS, with the highest interruption/end of therapy rate within the first month after the index event. Since the intake of DAPT after ACS was associated with a 20% risk reduction for fatal cardiovascular events during the observation period, awareness in terms of drug-adherence and intensified patient follow-up should be promoted, in order to prevent fatal atherothrombotic events.
Figure 1. Cumulative Mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Sulzgruber
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - H Sinkovec
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - N Kazem
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - F Hofer
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A Hammer
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - L Koller
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - M Todorovic
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - F Katsch
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - W Gall
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - G Duftschmid
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - G Heinze
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A Niessner
- Medical University of Vienna, Cardiology, Vienna, Austria
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Wright AA, Todorovic M, Murtaza M, St John JA, Ekberg JA. Macrophage migration inhibitory factor and its binding partner HTRA1 are expressed by olfactory ensheathing cells. Mol Cell Neurosci 2019; 102:103450. [PMID: 31794879 DOI: 10.1016/j.mcn.2019.103450] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/10/2019] [Accepted: 11/27/2019] [Indexed: 01/10/2023] Open
Abstract
Macrophage migration inhibitory factor (MIF) is an important regulator of innate immunity with key roles in neural regeneration and responses to pathogens, amongst a multitude of other functions. The expression of MIF and its binding partners has been characterised throughout the nervous system, with one key exception: the primary olfactory nervous system. Here, we showed in young mice (postnatal day 10) that MIF is expressed in the olfactory nerve by olfactory ensheathing glial cells (OECs) and by olfactory nerve fibroblasts. We also examined the expression of potential binding partners for MIF, and found that the serine protease HTRA1, known to be inhibited by MIF, was also expressed at high levels by OECs and olfactory fibroblasts in vivo and in vitro. We also demonstrated that MIF mediated segregation between OECs and J774a.1 cells (a monocyte/macrophage cell line) in co-culture, which suggests that MIF contributes to the fact that macrophages are largely absent from olfactory nerve fascicles. Phagocytosis assays of axonal debris demonstrated that MIF strongly stimulates phagocytosis by OECs, which indicates that MIF may play a role in the response of OECs to the continual turnover of olfactory axons that occurs throughout life.
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Affiliation(s)
- A A Wright
- Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Queensland, Australia; Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - M Todorovic
- Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
| | - M Murtaza
- Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Queensland, Australia; Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - J A St John
- Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Queensland, Australia; Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - J A Ekberg
- Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Queensland, Australia; Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
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8
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Ilincic B, Djeric M, Todorovic M, Sudji J, Zeravica R, Cabarkapa V. Metabolic phenotype and glomerular filtration rate among the non-diabetic obese individuals. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Yao R, Murtaza M, Velasquez JT, Todorovic M, Rayfield A, Ekberg J, Barton M, St John J. Olfactory Ensheathing Cells for Spinal Cord Injury: Sniffing Out the Issues. Cell Transplant 2018; 27:879-889. [PMID: 29882418 PMCID: PMC6050914 DOI: 10.1177/0963689718779353] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Olfactory ensheathing cells (OECs) are glia reported to sustain the continuous axon extension and successful topographic targeting of the olfactory receptor neurons responsible for the sense of smell (olfaction). Due to this distinctive property, OECs have been trialed in human cell transplant therapies to assist in the repair of central nervous system injuries, particularly those of the spinal cord. Though many studies have reported neurological improvement, the therapy remains inconsistent and requires further improvement. Much of this variability stems from differing olfactory cell populations prior to transplantation into the injury site. While some studies have used purified cells, others have used unpurified transplants. Although both preparations have merits and faults, the latter increases the variability between transplants received by recipients. Without a robust purification procedure in OEC transplantation therapies, the full potential of OECs for spinal cord injury may not be realised.
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Affiliation(s)
- R Yao
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - M Murtaza
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia.,2 Menzies Health Institute Queensland, Griffith Health Centre, Griffith University, Gold Coast, Queensland, Australia
| | - J Tello Velasquez
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - M Todorovic
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia.,2 Menzies Health Institute Queensland, Griffith Health Centre, Griffith University, Gold Coast, Queensland, Australia
| | - A Rayfield
- 2 Menzies Health Institute Queensland, Griffith Health Centre, Griffith University, Gold Coast, Queensland, Australia
| | - J Ekberg
- 2 Menzies Health Institute Queensland, Griffith Health Centre, Griffith University, Gold Coast, Queensland, Australia
| | - M Barton
- 2 Menzies Health Institute Queensland, Griffith Health Centre, Griffith University, Gold Coast, Queensland, Australia
| | - J St John
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Brisbane, Queensland, Australia.,2 Menzies Health Institute Queensland, Griffith Health Centre, Griffith University, Gold Coast, Queensland, Australia
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Wright AA, Todorovic M, Tello-Velasquez J, Rayfield AJ, St John JA, Ekberg JA. Enhancing the Therapeutic Potential of Olfactory Ensheathing Cells in Spinal Cord Repair Using Neurotrophins. Cell Transplant 2018; 27:867-878. [PMID: 29852748 PMCID: PMC6050907 DOI: 10.1177/0963689718759472] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Autologous olfactory ensheathing cell (OEC) transplantation is a promising therapy for
spinal cord injury; however, the efficacy varies between trials in both animals and
humans. The main reason for this variability is that the purity and phenotype of the
transplanted cells differs between studies. OECs are susceptible to modulation with
neurotrophic factors, and thus, neurotrophins can be used to manipulate the transplanted
cells into an optimal, consistent phenotype. OEC transplantation can be divided into 3
phases: (1) cell preparation, (2) cell administration, and (3) continuous support to the
transplanted cells in situ. The ideal behaviour of OECs differs between these 3 phases; in
the cell preparation phase, rapid cell expansion is desirable to decrease the time between
damage and transplantation. In the cell administration phase, OEC survival and integration
at the injury site, in particular migration into the glial scar, are the most critical
factors, along with OEC-mediated phagocytosis of cellular debris. Finally, continuous
support needs to be provided to the transplantation site to promote survival of both
transplanted cells and endogenous cells within injury site and to promote long-term
integration of the transplanted cells and angiogenesis. In this review, we define the 3
phases of OEC transplantation into the injured spinal cord and the optimal cell behaviors
required for each phase. Optimising functional outcomes of OEC transplantation can be
achieved by modulation of cell behaviours with neurotrophins. We identify the key growth
factors that exhibit the strongest potential for optimizing the OEC phenotype required for
each phase.
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Affiliation(s)
- A A Wright
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia
| | - M Todorovic
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia.,2 Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - J Tello-Velasquez
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia
| | - A J Rayfield
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia.,2 Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - J A St John
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia.,2 Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - J A Ekberg
- 1 Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia.,2 Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
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Antic D, Milic N, Nikolovski S, Todorovic M, Bila J, Djurdjevic P, Andjelic B, Djurasinovic V, Sretenovic A, Smiljanic M, Vukovic V, Jelicic J, Mihaljevic B. COMPARATIVE ANALYSIS OF PREDICTIVE MODELS FOR THROMBOEMBOLIC EVENTS IN LYMPHOMA PATIENTS. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- D. Antic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - N. Milic
- Department for Medical Statistics and Informatics, Medical Faculty, Belgrade; Belgrade Serbia
| | - S. Nikolovski
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - M. Todorovic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - J. Bila
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - P. Djurdjevic
- Clinic for hematology; Clinical Center Kragujevac; Kragujevac Serbia
| | - B. Andjelic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - V. Djurasinovic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - A. Sretenovic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - M. Smiljanic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - V. Vukovic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - J. Jelicic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
| | - B. Mihaljevic
- Clinic for Hematology; Clinical Center Serbia; Belgrade Serbia
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Markovic O, Andjelic B, Tarabar O, Todorovic M, Filipovic B, Stanisavljevic D, Bila J, Antic D, Marisavljevic D, Mihaljevic B. Late relapse of Hodgkin's lymphoma - is it different in clinical characteristics and outcome? J BUON 2017; 22:481-486. [PMID: 28534373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the clinical characteristics, prognostic factors, therapy and outcomes of patients with very late relapse (>5 years) of Hodgkin's lymphoma (HL). METHODS We retrospectively reviewed the database of all relapsed patients with HL treated between 1999 and 2009 and compared the clinical characteristics and survival of patients who relapsed before and after 5 years of follow up. RESULTS Among the group of 102 patients with relapsed HL 16 (15.68%) patients had very late relapse of disease. Median time to very late relapse was 86 months (range 61- 199). On relapse most of these patients (11; 68.5%) were in advanced clinical stage. Eleven (68.75%) patients with very late relapse were treated with high dose chemotherapy and autologous stem cell transplantation (ASCT). Second complete response was achieved in 13 (81.25%) patients. At a median follow up of 4.5 years after therapy, 13 (81.25%) patients are still alive (10 without disease and 3 with disease), while 3 patients died (2 from HL, and 1 from brain tumor). There was no significant difference between patients with very late relapse and patients who relapse earlier in terms of initial clinical parameters. Median overall survival of patients with very late relapse was significantly longer than in patients with earlier relapse (p=0.001), but survival calculated from the time оf relapse was not significantly different between these two groups of patients (p=0.83). CONCLUSION An open question that remains is whether high dose therapy and ASCT is necessary in most patients with very late relapse of disease. Individualization of therapy in patients with very late relapse of HL is mandatory, tailored on risk factors and comorbidities.
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Balint B, Stanojevic I, Todorovic M, Stamatovic D, Pavlovic M, Vojvodic D. Relative frequency of immature CD34+/CD90+ subset in peripheral blood following mobilization correlates closely and inversely with the absolute count of harvested stem cells in multiple myeloma patients. VOJNOSANIT PREGL 2017. [DOI: 10.2298/vsp170505090b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Stem cells (SCs) guarantee complete/longterm bone marrow (BM) repopulation after SC-transplants. The aim of the study was to evaluate absolute count of total SCs (determined by ISHAGE-sequential-gating protocol ? SCish) and relative frequency of immature CD34+/CD90+ (CD90+SCish) subset in peripheral blood (PB) as predictive factors of mobilization and apheresis product (AP) quality. Methods. Mobilization included chemotherapy and granulocytegrowth- factor (G-CSF). Harvesting was performed by Spectra- Optia-IDL-system. The SCsish were determined as a constitutional part of CD34+ cells in the ?stem-cell-region? using FC- 500 flow-cytometer. In this study, the original ISHAGEsequential- gating protocol was modified by introduction of anti-CD90-PE monoclonal-antibody into the analysis of CD90 expression on SCish (CD90+SCish). The results were presented as a percentage of SCish per nucleated-cell count, absolute SCish count in ?L of the PB or the AP, percentage of the CD90+SCish expressed to SCish and absolute CD90+SCish count in ?L of the PB or the AP. Results. The absolute count of total SCish and CD90+SCish was significantly higher (p = 0.0007 and p = 0.0266, respectively) in the AP than in the PB samples. The CD90+SCish/total SCish indexes from PB were higher than indexes from the AP (p = 0.039). The relative frequency of CD90+SCish showed a highly significant inverse correlation with the absolute count of total SCish in both, the PB and AP (p = 0.0003 and p = 0.0013 respectively). The relative frequency of CD90+SCish from the PB also showed a significant (p = 0.0002) inverse relationship with total SCish count in the AP. Patients with less than 10% CD90+SCish in the PB had evidently higher (p = 0.0025) total SCish count in the AP. Conclusion. We speculate that lower CD90+SCish yield in the AP is not a consequence of an inferior collection efficacy, but most likely a result of several still not fully resolved immature SC cytomorphological/ biophysical features. Therefore, following the mobilization by chemotherapy G-CSF, some logical questions appear ? whether we should follow the absolute count of total SCish, or, whether we should test for relative frequency of CD90+SCish prior to harvesting. To reach the final conclusions, it is essential to conduct further controlled and larger investigations concerning the correlation of circulating and harvested SCs with patients' hematopoietic recovery.
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Affiliation(s)
| | - Ivan Stanojevic
- The University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Institute for Medical Research, Belgrade
| | | | - Dragana Stamatovic
- The University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Clinic for Hematology, Belgrade
| | - Mirjana Pavlovic
- Department of Computer and Electrical Engineering and Computer Science, FAU, VL, USA
| | - Danilo Vojvodic
- The University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Institute for Medical Research, Belgrade
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14
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Därr R, Nambuba J, Del Rivero J, Janssen I, Merino M, Todorovic M, Balint B, Jochmanova I, Prchal JT, Lechan RM, Tischler AS, Popovic V, Miljic D, Adams KT, Prall FR, Ling A, Golomb MR, Ferguson M, Nilubol N, Chen CC, Chew E, Taïeb D, Stratakis CA, Fojo T, Yang C, Kebebew E, Zhuang Z, Pacak K. Novel insights into the polycythemia-paraganglioma-somatostatinoma syndrome. Endocr Relat Cancer 2016; 23:899-908. [PMID: 27679736 PMCID: PMC5096964 DOI: 10.1530/erc-16-0231] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 09/27/2016] [Indexed: 12/14/2022]
Abstract
Worldwide, the syndromes of paraganglioma (PGL), somatostatinoma (SOM) and early childhood polycythemia are described in only a few patients with somatic mutations in the hypoxia-inducible factor 2 alpha (HIF2A). This study provides detailed information about the clinical aspects and course of 7 patients with this syndrome and brings into perspective these experiences with the pertinent literature. Six females and one male presented at a median age of 28 years (range 11-46). Two were found to have HIF2A somatic mosaicism. No relatives were affected. All patients were diagnosed with polycythemia before age 8 and before PGL/SOM developed. PGLs were found at a median age of 17 years (range 8-38) and SOMs at 29 years (range 22-38). PGLs were multiple, recurrent and metastatic in 100, 100 and 29% of all cases, and SOMs in 40, 40 and 60%, respectively. All PGLs were primarily norepinephrine-producing. All patients had abnormal ophthalmologic findings and those with SOMs had gallbladder disease. Computed tomography (CT) and magnetic resonance imaging revealed cystic lesions at multiple sites and hemangiomas in 4 patients (57%), previously thought to be pathognomonic for von Hippel-Lindau disease. The most accurate radiopharmaceutical to detect PGL appeared to be [18F]-fluorodihydroxyphenylalanine ([18F]-FDOPA). Therefore, [18F]-FDOPA PET/CT, not [68Ga]-(DOTA)-[Tyr3]-octreotate ([68Ga]-DOTATATE) PET/CT is recommended for tumor localization and aftercare in this syndrome. The long-term prognosis of the syndrome is unknown. However, to date no deaths occurred after 6 years follow-up. Physicians should be aware of this unique syndrome and its diagnostic and therapeutic challenges.
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Affiliation(s)
- Roland Därr
- Section on Medical NeuroendocrinologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Joan Nambuba
- Section on Medical NeuroendocrinologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Jaydira Del Rivero
- Section on Medical NeuroendocrinologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Ingo Janssen
- Section on Medical NeuroendocrinologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Maria Merino
- Laboratory of PathologyNational Institutes of Health, Bethesda, Maryland, USA
| | - Milena Todorovic
- Institute of HematologyClinical Center of Serbia and Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Bela Balint
- Institute of Transfusiology and Hemobiology of Military Medical Academy and Institute for Medical ResearchUniversity of Belgrade, Belgrade, Serbia
| | - Ivana Jochmanova
- Section on Medical NeuroendocrinologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
- 1st Department of Internal MedicineFaculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovakia
| | - Josef T Prchal
- Division of HematologyUniversity of Utah, Salt Lake City, Utah, USA
| | - Ronald M Lechan
- Tupper Research Institute and Department of MedicineDivision of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USA
| | - Arthur S Tischler
- Department of Pathology and Laboratory MedicineTufts Medical Center, Boston, Massachusetts, USA
| | - Vera Popovic
- Institute of EndocrinologyClinical Center of Serbia, Medical Faculty, University Belgrade, Belgrade, Serbia
| | - Dragana Miljic
- Institute of EndocrinologyClinical Center of Serbia, Medical Faculty, University Belgrade, Belgrade, Serbia
| | - Karen T Adams
- Section on Medical NeuroendocrinologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - F Ryan Prall
- Department of OphthalmologyEugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alexander Ling
- Department of Radiology and Imaging SciencesClinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Meredith R Golomb
- Division of Child NeurologyDepartment of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michael Ferguson
- Riley Hospital for Children at Indiana University HealthIndianapolis, Indiana, USA
| | - Naris Nilubol
- Endocrine Oncology BranchNational Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Clara C Chen
- Division of Nuclear MedicineDepartment of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Emily Chew
- Division of Epidemiology and Clinical ApplicationsNational Eye Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - David Taïeb
- Department of Nuclear MedicineLa Timone University Hospital & CERIMED & Inserm UMR1068 Marseille Cancerology Research Center, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France
| | - Constantine A Stratakis
- Division of Intramural ResearchEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Tito Fojo
- Medical Oncology BranchNational Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Chunzhang Yang
- Neuro-Oncology BranchCenter for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Electron Kebebew
- Endocrine Oncology BranchNational Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Zhengping Zhuang
- Neuro-Oncology BranchCenter for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Karel Pacak
- Section on Medical NeuroendocrinologyEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
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15
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Antic D, Milic N, Nikolovski S, Todorovic M, Bila J, Djurdjevic P, Andjelic B, Djurasinovic V, Sretenovic A, Vukovic V, Jelicic J, Hayman S, Mihaljevic B. Development and validation of multivariable predictive model for thromboembolic events in lymphoma patients. Am J Hematol 2016; 91:1014-9. [PMID: 27380861 DOI: 10.1002/ajh.24466] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 06/29/2016] [Accepted: 07/01/2016] [Indexed: 12/22/2022]
Abstract
Lymphoma patients are at increased risk of thromboembolic events but thromboprophylaxis in these patients is largely underused. We sought to develop and validate a simple model, based on individual clinical and laboratory patient characteristics that would designate lymphoma patients at risk for thromboembolic event. The study population included 1,820 lymphoma patients who were treated in the Lymphoma Departments at the Clinics of Hematology, Clinical Center of Serbia and Clinical Center Kragujevac. The model was developed using data from a derivation cohort (n = 1,236), and further assessed in the validation cohort (n = 584). Sixty-five patients (5.3%) in the derivation cohort and 34 (5.8%) patients in the validation cohort developed thromboembolic events. The variables independently associated with risk for thromboembolism were: previous venous and/or arterial events, mediastinal involvement, BMI>30 kg/m(2) , reduced mobility, extranodal localization, development of neutropenia and hemoglobin level < 100g/L. Based on the risk model score, the population was divided into the following risk categories: low (score 0-1), intermediate (score 2-3), and high (score >3). For patients classified at risk (intermediate and high-risk scores), the model produced negative predictive value of 98.5%, positive predictive value of 25.1%, sensitivity of 75.4%, and specificity of 87.5%. A high-risk score had positive predictive value of 65.2%. The diagnostic performance measures retained similar values in the validation cohort. Developed prognostic Thrombosis Lymphoma - ThroLy score is more specific for lymphoma patients than any other available score targeting thrombosis in cancer patients. Am. J. Hematol. 91:1014-1019, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Darko Antic
- Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia; Belgrade
- Medical Faculty; Department for internal medicine, University of Belgrade; Belgrade
| | - Natasa Milic
- Department for Medical Statistics and Informatics; Medical Faculty, University of Belgrade; Belgrade
- Division of Nephrology and Hypertension; Department of Internal Medicine, Mayo Clinic; Rochester Minnesota
| | - Srdjan Nikolovski
- Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia; Belgrade
| | - Milena Todorovic
- Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia; Belgrade
- Medical Faculty; Department for internal medicine, University of Belgrade; Belgrade
| | - Jelena Bila
- Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia; Belgrade
- Medical Faculty; Department for internal medicine, University of Belgrade; Belgrade
| | - Predrag Djurdjevic
- Clinic for Hematology, Clinical Centre Kragujevac; Kragujevac
- Medical Faculty; Department for internal medicine, University of Kragujevac; Kragujevac
| | - Bosko Andjelic
- Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia; Belgrade
- Medical Faculty; Department for internal medicine, University of Belgrade; Belgrade
| | | | | | - Vojin Vukovic
- Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia; Belgrade
| | - Jelena Jelicic
- Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia; Belgrade
| | - Suzanne Hayman
- Division of Hematology; Department of Internal Medicine, Mayo Clinic; Rochester
| | - Biljana Mihaljevic
- Clinic for Hematology, Lymphoma Center, Clinical Centre Serbia; Belgrade
- Medical Faculty; Department for internal medicine, University of Belgrade; Belgrade
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16
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Savic A, Balint B, Urosevic I, Rajic N, Todorovic M, Percic I, Popovic S. Syngeneic peripheral blood stem cell transplantation with immunosuppression for hepatitis-associated severe aplastic anemia. Turk J Haematol 2016; 27:294-8. [PMID: 27263745 DOI: 10.5152/tjh.2010.52] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hepatitis-associated aplastic anemia occurs in up to 10% of all aplastic anemia cases. Syngeneic bone marrow transplantation is rare in patients with severe aplastic anemia and usually requires pre-transplant conditioning to provide engraftment. We report on a 29-year-old male patient with hepatitis-associated severe aplastic anemia who had a series of severe infectious conditions before transplantation, including tracheal inflammation. Life-threatening bleeding, which developed after bronchoscopy, was successfully treated with activated recombinant factor VII and platelet transfusions. Syngeneic peripheral blood stem cell transplantation using immunosuppressive treatment with antithymocyte globulin and cyclosporin A without high-dose pre-transplant conditioning was performed, followed by complete hematologic and hepatic recovery.
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Affiliation(s)
- Aleksandar Savic
- Hajduk Veljkova 1-3 21000 Novi Sad, Serbia, Phone: +381 21 484 3963 E-mail:
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17
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Solberg T, Robar J, Gevaert T, Todorovic M, Howe J. SU-F-P-05: Initial Experience with an Independent Certification Program for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. Med Phys 2016. [DOI: 10.1118/1.4955712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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18
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Leuci V, Maione F, Rotolo R, Giraudo E, Sassi F, Migliardi G, Todorovic M, Gammaitoni L, Mesiano G, Giraudo L, Luraghi P, Leone F, Bussolino F, Grignani G, Aglietta M, Trusolino L, Bertotti A, Sangiolo D. Lenalidomide normalizes tumor vessels in colorectal cancer improving chemotherapy activity. J Transl Med 2016; 14:119. [PMID: 27149858 PMCID: PMC4857418 DOI: 10.1186/s12967-016-0872-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 04/20/2016] [Indexed: 12/19/2022] Open
Abstract
Background Angiogenesis inhibition is a promising approach for treating metastatic colorectal cancer (mCRC). Recent evidences support the seemingly counterintuitive ability of certain antiangiogenic drugs to promote normalization of residual tumor vessels with important clinical implications. Lenalidomide is an oral drug with immune-modulatory and anti-angiogenic activity against selected hematologic malignancies but as yet little is known regarding its effectiveness for solid tumors. The aim of this study was to determine whether lenalidomide can normalize colorectal cancer neo-vessels in vivo, thus reducing tumor hypoxia and improving the benefit of chemotherapy. Methods We set up a tumorgraft model with NOD/SCID mice implanted with a patient-derived colorectal cancer liver metastasis. The mice were treated with oral lenalidomide (50 mg/Kg/day for 28 days), intraperitoneal 5-fluorouracil (5FU) (20 mg/Kg twice weekly for 3 weeks), combination (combo) of lenalidomide and 5FU or irrelevant vehicle. We assessed tumor vessel density (CD146), pericyte coverage (NG2; alphaSMA), in vivo perfusion capability of residual vessels (lectin distribution essay), hypoxic areas (HP2-100 Hypoxyprobe) and antitumor activity in vivo and in vitro. Results Treatment with lenalidomide reduced tumor vessel density (p = 0.0001) and enhanced mature pericyte coverage of residual vessels (p = 0.002). Perfusion capability of tumor vessels was enhanced in mice treated with lenalidomide compared to controls (p = 0.004). Accordingly, lenalidomide reduced hypoxic tumor areas (p = 0.002) and enhanced the antitumor activity of 5FU in vivo. The combo treatment delayed tumor growth (p = 0.01) and significantly reduced the Ki67 index (p = 0.0002). Lenalidomide alone did not demonstrate antitumor activity compared to untreated controls in vivo or against 4 different mCRC cell lines in vitro. Conclusions We provide the first evidence of tumor vessel normalization and hypoxia reduction induced by lenalidomide in mCRC in vivo. This effect, seemingly counterintuitive for an antiangiogenic compound, translates into indirect antitumor activity thus enhancing the therapeutic index of chemotherapy. Our findings suggest that further research should be carried out on synergism between lenalidomide and conventional therapies for treating solid tumors that might benefit from tumor vasculature normalization.
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Affiliation(s)
- V Leuci
- Department of Oncology, University of Torino, Turin, Italy.,Laboratory of Medical Oncology-Experimental Cell Therapy, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - F Maione
- Laboratory of Transgenic Mouse Models, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - R Rotolo
- Department of Oncology, University of Torino, Turin, Italy.,Laboratory of Medical Oncology-Experimental Cell Therapy, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - E Giraudo
- Laboratory of Transgenic Mouse Models, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy.,Department of Science and Drug Technology, University of Torino, Turin, Italy
| | - F Sassi
- Laboratory of Translational Cancer Medicine, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - G Migliardi
- Laboratory of Translational Cancer Medicine, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - M Todorovic
- Laboratory of Medical Oncology-Experimental Cell Therapy, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - L Gammaitoni
- Laboratory of Medical Oncology-Experimental Cell Therapy, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - G Mesiano
- Laboratory of Medical Oncology-Experimental Cell Therapy, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - L Giraudo
- Laboratory of Medical Oncology-Experimental Cell Therapy, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - P Luraghi
- Laboratory of Cancer Stem Cell Research, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - F Leone
- Department of Oncology, University of Torino, Turin, Italy.,Division and Laboratory of Medical Oncology, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - F Bussolino
- Department of Oncology, University of Torino, Turin, Italy.,Laboratory of Vascular Oncology, Candiolo Cancer Institute, Candiolo, Turin, Italy
| | - G Grignani
- Division and Laboratory of Medical Oncology, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - M Aglietta
- Department of Oncology, University of Torino, Turin, Italy.,Division and Laboratory of Medical Oncology, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - L Trusolino
- Department of Oncology, University of Torino, Turin, Italy.,Laboratory of Translational Cancer Medicine, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - A Bertotti
- Department of Oncology, University of Torino, Turin, Italy.,Laboratory of Translational Cancer Medicine, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy
| | - D Sangiolo
- Department of Oncology, University of Torino, Turin, Italy. .,Laboratory of Medical Oncology-Experimental Cell Therapy, Candiolo Cancer Institute-FPO- IRCCS, Candiolo, Turin, Italy.
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Antic D, Milic N, Todorovic M, Bila J, Andjelic B, Djurasinovic V, Sretenovic A, Vukovic V, Jelicic J, Nikolovski S, Mihaljevic B. OC-07 - Decoding risk for thromboembolic events in lymphoma patients. Thromb Res 2016; 140 Suppl 1:S171. [PMID: 27161679 DOI: 10.1016/s0049-3848(16)30124-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION There are few prediction tools for estimating the risk of thrombosis but they are based on studies performed on hospitalized medical patients without cancer or on hospitalized neutropenic cancer patients without special consideration to lymphoma patients. AIM Aim of our study was to determine incidence of thromboembolic (TE) events in patients with non Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL) and chronic lymphocytic leukemia (CLL)/ small lymphocytic lymphoma (SLL) who were hospitalized to the lymphoma department in the Clinic of hematology, Clinical Center Serbia, Belgrade and Clinic of hematology, Clinical Center Kragujevac. Also, we assessed 2 predictive models (Padua and Khorana score) and create new model for the identification of lymphoma patients at risk for thromboembolism. MATERIALS AND METHODS We reviewed all medical records of patients with with NHL, HL and CLL/SLL diagnosed and treated at two previously mentioned institution between January 2006 and December 2014. RESULTS The study population included 1820 eligible lymphoma patients. Of all the patients included in the study, 99 (5.4%) developed at least one TE during a follow-up period of 3 months from the end of therapy. In the final multivariate analysis, the following variables were independently associated with risk of TE: previous VTE and/or arterial events, reduced mobility (ECOG 2-4), obesity (BMI >30 kg/m(2)), extranodal localization, mediastinum involvement, development of neutropenia during therapy and hemoglobin level less than 100g/L. Subsequently, we assigned points for the risk model based on the regression coefficients obtained from the final model and developed Thrombosis Lymphoma (ThroLy) score consisting of all significant variables from the multivariate analysis. The Throly score was arrived at by assigning 2 points for all parameters with an OR >5 in multivariate regression analyses (e.g., previous VTE and arterial events, mediastinum involvement, and BMI) and 1 point for rest all other significant variables. Finally, population were divided into 3 risk categories for TE based on the score from the risk model: low (score 0-1), intermediate (score 2-3) and high (score >3). High risk score had a positive predictive value (probability of TE in those designated high risk) of 65.2%. CONCLUSIONS Significance of our investigation is development of score that help phisicians to recruit lymphoma patients at risk for development of thromboembolic complications. Also, we can say that our score is dynamic allowing us to change approach during different phase of therapy and is not limited to outpatient settings or with some complicated laboratory analysis.
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Affiliation(s)
- D Antic
- Clinic for hematology, Clinical Center Serbia, Belgrade; Medical faculty
| | - N Milic
- Institute for medical statistics, Medical faculty; University of Belgrade; Serbia
| | - M Todorovic
- Clinic for hematology, Clinical Center Serbia, Belgrade; Medical faculty
| | - J Bila
- Clinic for hematology, Clinical Center Serbia, Belgrade; Medical faculty
| | - B Andjelic
- Clinic for hematology, Clinical Center Serbia, Belgrade; Medical faculty
| | | | - A Sretenovic
- Clinic for hematology, Clinical Center Serbia, Belgrade
| | - V Vukovic
- Clinic for hematology, Clinical Center Serbia, Belgrade
| | - J Jelicic
- Clinic for hematology, Clinical Center Serbia, Belgrade
| | - S Nikolovski
- Clinic for hematology, Clinical Center Serbia, Belgrade
| | - B Mihaljevic
- Clinic for hematology, Clinical Center Serbia, Belgrade; Medical faculty
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20
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Todorovic M, Timotijevic I, Crnic K. Chronic Pain, Affective Spectrum Disorders and Treatment with Antidepressants. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30990-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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21
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Todorovic M, Balint B, Andjelic B, Mihaljevic B. Multiple malignancies in a female patient with common variable immunodeficiency syndrome. Singapore Med J 2015; 55:e162-4. [PMID: 25631905 DOI: 10.11622/smedj.2014147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We herein present the case of a 55-year-old woman with a previous history of malignancies--uterine adenocarcinoma, basal cell carcinoma (which occurred twice consecutively), recurrent respiratory infections due to common variable immunodeficiency (CVID), and systemic granulomatous disease diagnosed at a later age. The patient suffered from diffuse large B cell lymphoma (DLBCL), which was successfully treated with R-CHOP chemotherapy, and continued with immunoglobulin supplementation. The patient was free of lymphoma and infectious complications for over 20 months despite her persistent immunodeficiency, but eventually developed colorectal adenocarcinoma. To the best of our knowledge, this is the first reported case of CVID associated with multiple solid tumours and DLBCL.
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Affiliation(s)
- Milena Todorovic
- Clinic for Hematology, Clinical Center of Serbia, 11000 Belgrade, Serbia.
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22
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Matejic S, Miletic M, Milosevic M, Jaksic V, Todorovic M, Vitosevic K, Zaric R. The prospect of exhumation and identification of the people who are still listed as missing in armed conflict happened in Kosovo and Metohija 1998/99. Praxis Med 2015. [DOI: 10.5937/pramed1503039m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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23
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Djurasinovic V, Jelicic J, Bila J, Andjelic B, Antic D, Vukovic V, Todorovic M, Mihaljevic B. Nutritional Status of Lymphoma Patients-Does It Matter? Ann Oncol 2014. [DOI: 10.1093/annonc/mdu356.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Andjelic B, Antic D, Jakovic L, Todorovic M, Bogdanovic A, Djurasinovic V, Bila J, Mihaljevic B. A single institution experience on 314 newly diagnosed advanced Hodgkin lymphoma patients: the role of ABVD in daily practice. Eur J Haematol 2014; 93:392-9. [DOI: 10.1111/ejh.12364] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Bosko Andjelic
- Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia
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Mihaljevic B, Vukovic V, Smiljanic M, Milic N, Todorovic M, Bila J, Andjelic B, Djurasinovic V, Jelicic J, Antic D. Single-center experience in the treatment of primary testicular lymphoma. Oncol Res Treat 2014; 37:239-42. [PMID: 24853782 DOI: 10.1159/000362399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 03/13/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Primary testicular lymphoma (PTL) is a rare and highly aggressive extranodal non-Hodgkin's lymphoma. PATIENTS AND METHODS We evaluated the clinical and histopathological features and outcomes of 10 PTL patients treated in the period of 2003-2013 with multimodal therapy (rituximab, CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), intrathecal prophylaxis, irradiation of the contralateral testis) following orchiectomy. RESULTS Complete remission was achieved in 8 patients after first-line therapy while 2 patients had disease progression. The median follow-up duration was 30 months (range 6-110 months). Relapse occurred in 3 patients. 1 patient relapsed in the contralateral testis, while the other 2 patients relapsed to the skin and the central nervous system (CNS), respectively. The time to relapse was 2, 8, and 9 months. Patients with disease progression and relapse received ESHAP (etoposide, methylprednisolone, cytarabine, and cisplatin) as salvage treatment, except for 1 patient who was treated with palliative radiotherapy. After second-line therapy, only 1 patient had a short partial remission of 2 months. The median overall survival was 48 months, and the mean progression-free survival was 36 months (the median was not reached). CONCLUSIONS We evaluated 10 patients with PTL treated with rituximab plus CHOP, prophylactic intrathecal chemotherapy, and prophylactic irradiation of the contralateral testis, resulting in good outcome and low incidence of relapse in the contralateral testis; however, the benefit of intrathecal chemotherapy is not yet confirmed.
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Peric V, Jovanovic A, Rasic D, Todorovic M, Lazic S, Djikic D, Novakovic T, Sipic M, Aleksovski D, Dejanovic B, Sovrlic B. Differences in the clinical characteristics of patients with dilated cardiomyopathy, depending on the presence of preserved left ventricular contractile reserve assessed by exercise stress-echo-cardiography. Praxis Med 2014. [DOI: 10.5937/pramed1402009p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Pavlovic D, Todorovic M, Mladenovic S, Milosavljevic P. 10.5937/sjm9-5538 = The role of quality methods in improving education process: Case study. Serb J Management 2014. [DOI: 10.5937/sjm9-5538] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Smiljanic M, Milosevic R, Antic D, Andjelic B, Djurasinovic V, Todorovic M, Bila J, Bogdanovic A, Mihaljevic B. Orbital and ocular adnexal Mucosa-Associated Lymphoid Tissue (MALT) lymphomas: a single-center 10-year experience. Med Oncol 2013; 30:722. [PMID: 24026660 DOI: 10.1007/s12032-013-0722-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 08/28/2013] [Indexed: 11/29/2022]
Abstract
Orbital and ocular andexal Mucosa-Associated Lymphoid Tissue Lymphoma (MALT) or ocular adnexal MALT lymphoma (OAML) is the most common of all eye non-Hodgkin lymphomas. Autoimmune inflammatory disorders and chronic infections are important etiological factors and CD5 and CD43 (sialophorin) tumor markers are significant negative prognostic factors. Disease signs and symptoms can occur a long time before diagnosis. Varieties of treatment options are available. The aim of this retrospective analysis was to compare the efficiency of different treatment options and to investigate disease outcome. Twenty OAML patients, diagnosed in the Clinic of Hematology, Clinical Centre of Serbia, between 2003 and 2013, were enrolled. In most cases, OAML developed in the eighth decade with greater incidence in the male population. Median age was 67.5 years. The median period between the appearance of local signs and symptoms and diagnosis was 7 months. The dominant sign at presentation was swelling of involved tissue (40%). The most common was orbital involvement (55%). All patients had localized disease. Observed laboratory parameters on presentation showed low disease activity. Sialophorin prognostic significance was not registered. Our patients were initially treated differently but there was no significant difference in progression-free survival (PFS) due to initial treatment option (p = 0.2957). Median PFS was 22 months (3-89), and 5-year PFS was 60%. Median overall survival (OS) was 43 months (1-105) and 5-year OS 95%. Eight patients (40%) relapsed and one patient died due to non-hematological complications. In our experience, most modern induction treatment options appear to result in the same, favorable outcome.
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Affiliation(s)
- M Smiljanic
- Clinic of Hematology, Clinical Centre of Serbia, Belgrade, Serbia,
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Tribius S, Sommer J, Prosch C, Bajrovic A, Muenscher A, Blessmann M, Kruell A, Petersen C, Todorovic M, Tennstedt P. Xerostomia after radiotherapy. What matters--mean total dose or dose to each parotid gland? Strahlenther Onkol 2013; 189:216-22. [PMID: 23354440 DOI: 10.1007/s00066-012-0257-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/19/2012] [Accepted: 10/17/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE Xerostomia is a debilitating side effect of radiotherapy in patients with head and neck cancer. We undertook a prospective study of the effect on xerostomia and outcomes of sparing one or both parotid glands during radiotherapy for patients with squamous cell carcinoma of the head and neck. METHODS AND MATERIALS Patients with locally advanced squamous cell carcinoma of the head and neck received definitive (70 Gy in 2 Gy fractions) or adjuvant (60-66 Gy in 2 Gy fractions) curative-intent radiotherapy using helical tomotherapy with concurrent chemotherapy if appropriate. Group A received < 26 Gy to the left and right parotids and group B received < 26 Gy to either parotid. RESULTS The study included 126 patients; 114 (55 in group A and 59 in group B) had follow-up data. There were no statistically significant differences between groups in disease stage. Xerostomia was significantly reduced in group A vs. group B (p = 0.0381). Patients in group A also had significantly less dysphagia. Relapse-free and overall survival were not compromised in group A: 2-year relapse-free survival was 86% vs. 72% in group B (p = 0.361); 2-year overall survival was 88% and 76%, respectively (p = 0.251). CONCLUSION This analysis suggests that reducing radiotherapy doses to both parotid glands to < 26 Gy can reduce xerostomia and dysphagia significantly without compromising survival. Sparing both parotids while maintaining target volume coverage and clinical outcome should be the treatment goal and reporting radiotherapy doses delivered to the individual parotids should be standard practice.
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Affiliation(s)
- S Tribius
- Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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Stanojkovic Z, Balint B, Antic A, Todorovic M, Ostojic G, Pavlovic M. Clinical efficacy of riboflavin and ultraviolet light inactivated fresh frozen plasma evaluated with INR-quantification. Transfus Apher Sci 2012; 47:33-7. [DOI: 10.1016/j.transci.2012.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 01/16/2012] [Accepted: 03/12/2012] [Indexed: 10/28/2022]
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Todorovic M, Balint B, Andjelic B, Stanisavljevic D, Kurtovic NK, Radisavljevic Z, Mihaljevic B. Outcome prediction of advanced mantle cell lymphoma by international prognostic index versus different mantle cell lymphoma indexes: one institution study. Med Oncol 2011; 29:2212-9. [DOI: 10.1007/s12032-011-0136-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 12/05/2011] [Indexed: 10/14/2022]
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Balint B, Stamatovic D, Todorovic M, Elez M, Vojvodic D, Pavlovic M, Cucuz-Jokic M. Autologous transplant in the treatment of severe aplastic anemia--a case report. Transfus Apher Sci 2011; 45:137-41. [PMID: 21871837 DOI: 10.1016/j.transci.2011.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The initial use of immunosuppressive therapy (IST) in severe aplastic anemia (sAA) or reapplication of IST-centered methods following disease relapse is successful only in well-selected patients. The potential treatment by autologous stem cell (SC) transplant in sAA is still an innovative/pioneering therapeutic approach. To our best knowledge, this is the second published case of autologous SC transplant in sAA. The aim of this work was to optimize mobilization and timing for SC harvesting - using our own controlled-rate cryopreservation - with higher CD34(+)/CD90(+) subset yield and recovery in order to obtain complete and long-term hematopoietic reconstitution following autologous SC transplant. We report a 35 year-old sAA male patient who initially underwent IST using rabbit ATG and Cyclosporine A (CsA). He was supportive transfusion dependent for the whole period of IST-phase. After the second IST-cycle, polymorphonuclear (PMN) cell count increase (>2.0 × 10(9)/L) was observed, when SC mobilization, two large volume leukapheresis procedures and following autologous transplant were performed. The yields of harvested CD34(+) and CD34(+)/CD90(+) cells were 5.75 × 10(6)/kgbm and 1.7 × 10(6)/kgbm, respectively. The quantity of applied CD34(+) and CD34(+)/CD90(+) cells in autologous SC transplant were 5.45 × 10(6)/kgbm (7-AAD(CD34)(+)(viability)=95.42%) and 1.63 × 10(6)/kgbm (7-AAD(CD34)(+)(/CD90)(+)(viability)=95.42%), respectively. Hematopoietic reconstitution registered due to second month after autologous SC transplant and he is 24 months in complete medullar, hematological and clinical remission, with normal cytogenetic status - applying only continuous CsA therapy. The results obtained strongly confirm that in sAA, with no allogeneic SC donor, autologous transplant can result in a successful clinical outcome. We suggest that CD34(+)/CD90(+) subset count in peripheral blood and/or cell-harvest could be more valuable predictive factor than total CD34(+) quantity of optimized collection-timing and superior treatment efficacy of autologous SC transplant in sAA.
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Affiliation(s)
- Bela Balint
- Institute for Medical Research, University of Belgrade, Serbia.
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Antic D, Smiljanic M, Bila J, Jankovic S, Todorovic M, Andjelic B, Mihaljevic B. Hypothalamic dysfunction in a patient with primary lymphoma of the central nervous system. Neurol Sci 2011; 33:387-90. [PMID: 21822693 DOI: 10.1007/s10072-011-0726-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 07/19/2011] [Indexed: 10/17/2022]
Abstract
A 60-year-old woman with no previous history of chronic disease or malignancy presented with intense back and left leg pain and sleep disturbances. The patient had been treated unsuccessfully for the past 6 months with analgetics. Magnetic resonance imaging showed a soft tissue tumor in the L5-S1 region that involved the spinal canal, and a pathohistological analysis of the tumor specimen confirmed the presence of non-Hodgkin, diffuse large B cell lymphoma. After the diagnosis was confirmed, malaise, nausea, and vomiting developed. Multislice computed tomography of the endocranium showed focal infiltration of the hypothalamus and lateral ventricle; dissemination of a systemic lymphoma was excluded. Therapy was initiated as per the De Angelis protocol. After intravenous and intrathecal administration of metotrexate, the patient developed signs of central diabetes insipidus, which responded to therapy with an antidiuretic hormone analog. Despite the obvious infiltration of the hypothalamus, we cannot exclude an idiosyncratic effect of methotrexate on the central diabetes insipidus.
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Affiliation(s)
- Darko Antic
- Clinic for Hematology, Clinical Center Serbia, Koste Todorovica 2, 11000 Belgrade, Serbia.
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Suvajdzic N, Djurdjevic P, Todorovic M, Perunicic M, Stojanović R, Novkovic A, Mihaljevic B. Clinical characteristics of patients with lymphoproliferative neoplasms in the setting of systemic autoimmune diseases. Med Oncol 2011; 29:2207-11. [PMID: 21755372 DOI: 10.1007/s12032-011-0022-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Accepted: 06/28/2011] [Indexed: 12/19/2022]
Abstract
Clinical features of 40 lymphoproliferative neoplasm patients in the setting of systemic autoimmune diseases managed in the Clinic of Hematology during 1994-2006 were analyzed retrospectively. The classification of systemic autoimmune disease patients was as follows: 15 systemic lupus erythematosus--SLE, 11 rheumatoid arthritis--RA, 12 Sjögren's syndrome--SS, 1 scleroderma, and 1 dermatomyositis. Patients comprised 31 women and 9 men of mean age 55 years (range 33-76). Systemic autoimmune diseases preceeded the development of lymphoproliferative neoplasms in 37/40 (92.5%) patients. Mean latency period between the onset of systemic autoimmune diseases and lymphoproliferative neoplasms occurrence was significantly longer in RA (113 months) than in SLE (75 months) and SS patients (65 months)--P < 0.05. The most frequent lymphoproliferative neoplasms were non-Hodgkin's lymphoma--NHL (35/40; 88%), diffuse large B-cell lymphoma (DBCL)--12 (34%), follicular lymphoma (FC)--7 (20%), small lymphocytic (SL), and marginal zone lymphoma (MZL)--5 (14%) each. The primary site of NHL was extranodal in 18/35 (51.5%) cases. Advanced disease on diagnosis (III + IV clinical stages), constitutional symptoms, and bulky disease were diagnosed in 27/35 (77%), 26/35 (74%), and 3/35 (8.5%) patients, respectively. The overall survival (OS) was as follows (months): DBCL-12, FC-63, SLL-60, and MZL-48. There was no association between the lymphoproliferative neoplasm histological subtype and the systemic autoimmune diseases type or antirheumatic treatment P > 0.05. Our findings are in line with earlier reports showing a high proportion of patients with advanced disease, constitutional symptoms, extranodal manifestations, high grade histology, and low OS in the systemic autoimmune diseases setting.
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Affiliation(s)
- Nada Suvajdzic
- Clinic of Hematology, Clinical Center of Serbia, Dr. Koste Todorovica 2, 11000 Belgrade, Republic Serbia.
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Balint B, Pavlovic M, Todorovic M, Jevtic M, Ristanovic E, Ignjatovic L. The use of original ex vivo immunoadsorption and “multi-manner” apheresis in ABO/H-mismatched kidney transplants—A phase II clinical study. Transfus Apher Sci 2010; 43:141-8. [DOI: 10.1016/j.transci.2010.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ramah A, Todorovic M. P03-254 - Antidepressants in treatment of opiate post-detoxication depressive syndrome. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71308-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kaur S, Cogan NOI, Ye G, Baillie RC, Hand ML, Ling AE, McGearey AK, Kaur J, Hopkins CJ, Todorovic M, Mountford H, Edwards D, Batley J, Burton W, Salisbury P, Gororo N, Marcroft S, Kearney G, Smith KF, Forster JW, Spangenberg GC. Genetic map construction and QTL mapping of resistance to blackleg (Leptosphaeria maculans) disease in Australian canola (Brassica napus L.) cultivars. Theor Appl Genet 2009; 120:71-83. [PMID: 19821065 DOI: 10.1007/s00122-009-1160-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 09/18/2009] [Indexed: 05/18/2023]
Abstract
Genetic map construction and identification of quantitative trait loci (QTLs) for blackleg resistance were performed for four mapping populations derived from five different canola source cultivars. Three of the populations were generated from crosses between single genotypes from the blackleg-resistant cultivars Caiman, Camberra and (AV)Sapphire and the blackleg-susceptible cultivar Westar(10). The fourth population was derived from a cross between genotypes from two blackleg resistant varieties (Rainbow and (AV)Sapphire). Different types of DNA-based markers were designed and characterised from a collection of 20,000 EST sequences generated from multiple Brassica species, including a new set of 445 EST-SSR markers of high value to the international community. Multiple molecular genetic marker systems were used to construct linkage maps with locus numbers varying between 219 and 468, and coverage ranging from 1173 to 1800 cM. The proportion of polymorphic markers assigned to map locations varied from 70 to 89% across the four populations. Publicly available simple sequence repeat markers were used to assign linkage groups to reference nomenclature, and a sub-set of mapped markers were also screened on the Tapidor x Ningyou (T x N) reference population to assist this process. QTL analysis was performed based on percentage survival at low and high disease pressure sites. Multiple QTLs were identified across the four mapping populations, accounting for 13-33% of phenotypic variance (V (p)). QTL-linked marker data are suitable for implementation in breeding for disease resistance in Australian canola cultivars. However, the likelihood of shifts in pathogen race structure across different geographical locations may have implications for the long-term durability of such associations.
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Affiliation(s)
- S Kaur
- Biosciences Research Division, Department of Primary Industries, Victorian AgriBiosciences Centre, La Trobe University Research and Development Park, Bundoora, VIC, 3083, Australia
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Milosevic R, Todorovic M, Balint B, Jevtic M, Krstic M, Ristanovic E, Antonijevic N, Pavlovic M, Perunicic M, Petrovic M, Mihaljevic B. Splenectomy with chemotherapy vs surgery alone as initial treatment for splenic marginal zone lymphoma. World J Gastroenterol 2009; 15:4009-15. [PMID: 19705496 PMCID: PMC2731951 DOI: 10.3748/wjg.15.4009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the clinical characteristics of splenic marginal-zone lymphoma (SMZL) following antigen expression and the influence of therapeutic approaches on clinical outcome and overall survival (OS).
METHODS: A total of 30 patients with typical histological and immunohistochemical SMZL patterns were examined. Splenectomy plus chemotherapy was applied in 20 patients, while splenectomy as a single treatment-option was performed in 10 patients. Prognostic factor and overall survival rate were analyzed.
RESULTS: Complete remission (CR) was achieved in 20 (66.7%), partial remission (PR) in seven (23.3%), and lethal outcome due to disease progression occurred in three (10.0%) patients. Median survival of patients with a splenectomy was 93.0 mo and for patients with splenectomy plus chemotherapy it was 107.5 mo (Log rank = 0.056, P > 0.05). Time from onset of first symptoms to the beginning of the treatment (mean 9.4 mo) was influenced by spleen dimensions, as measured by computerized tomography and ultra-sound (t = 2.558, P = 0.018). Strong positivity (+++) of CD20 antigen expression in splenic tissue had a positive influence on OS (Log rank = 5.244, P < 0.05). The analysis of factors interfering with survival (by the Kaplan-Meier method) revealed that gender, general symptoms, clinical stage, and spleen infiltration type (nodular vs diffuse) had no significant (P > 0.05) effects on the OS. The expression of other antigens (immunohistochemistry) also had no effect on survival-rate, as measured by a χ2 test (P > 0.05).
CONCLUSION: Initial splenectomy combined with chemotherapy has been shown to be beneficial due to its advanced remission rate/duration; however, a larger controlled clinical study is required to confirm our findings.
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Todorovic M, Cremers F. INTRODUCING GAFCHROMIC EBT FOR QA OF BLOOD IRRADIATION DEVICES. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72970-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sretenovic M, Colovic M, Jankovic G, Suvajdzic N, Mihaljevic B, Colovic N, Todorovic M, Atkinson HDE. More than a third of non-gastric malt lymphomas are disseminated at diagnosis: a single center survey. Eur J Haematol 2009; 82:373-80. [PMID: PMID: 19141118 DOI: 10.1111/j.1600-0609.2009.01217.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mucosa-associated lymphoid tissue (MALT) lymphomas are extranodal B-cell tumors that generally follow an indolent course. The gastrointestinal tract is the most common site of MALT lymphoma, comprising 50% of all cases. The tissue lesions are often localized, have high therapeutic response rates with late relapses with a long overall survival (OS). The patients with non-gastric lesions may follow a different clinical course and many of them present with disseminated disease. This study reports a series of 51 patients with non-gastric MALT lymphoma. Twenty patients (39.2%) presented with disseminated disease, seven (13.7%) patients had two MALT mucosal sites involved and eight (15.7%) had involvement of three or more mucosal sites. At presentation, 17 (33.3%) patients had the lymph node and 12 (23.5%) the bone marrow involvement. Following various combinations of treatment, complete remission was achieved in 40 (81.6%), and partial remission in three of the 49 treated patients with no difference in response rates between different disease stages. Relapse occurred in 12/43 (27.9%) patients among whom eight (18.6%) recurred in the presenting organ system. Five patients (9.8%) died because of a rapid disease progression after a median follow-up of 56 months; two patients with primary lung lesions, 1 patient with secondary intestinal disease, and 2 patients suffered transformation to diffuse large B-cell lymphoma. No significant difference in survival was found between localized and disseminated disease (log rank 0.05, df = 1, P = 0.81). A patient age > or = 60 yr at diagnosis and presentation with the nodal disease were found to be statistically significant negative prognostic factors (P < 0.05). Median OS was not reached after 145 months of follow-up, with the estimated OS being 88% at 2 yr, and 78% at 5 yr.
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Brunckhorst E, Sheng X, Todorovic M, Becker J, Cremers F. Characterisation of MCP-600D and MCP-700D thermoluminescence detectors and their applicability for photoneutron detection. Radiat Prot Dosimetry 2008; 131:513-520. [PMID: 18922825 DOI: 10.1093/rpd/ncn251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This paper presents the characteristics of two high-sensitive LiF:Mg,Cu,P thermoluminescence detectors (TLDs) named MCP-600D and MCP-700D [thermoluminescence detector (TLD) Poland]. Furthermore, the applicability of both detectors used as a paired system for photoneutron detection in a high-energy photon field at a linear accelerator is shown. For MCP-600D and MCP-700D, the batch homogeneity is within 22 and 14%, respectively (2 SD). Correction for the individual response of each TLD leads to a reproducibility of 5 and 4%, respectively Both TLD types reveal a linear detector response to dose up to 4 Gy. The energy dependence for both is within 2% for 4 and 6 MV photons. For a 15 MV photon beam, the MCP-600D shows a higher response (10%); compared with the MCP-700D (2%). The MCP-600D is capable of detecting extra doses due to photoneutrons in a 15 MV photon exposure; however, the signal for an open field of the used linear accelerator is in the order of the reproducibility. Using a kind of albedo technique allows detection of photoneutrons in the open photon field anyhow. The neutron detection limit is 10 microGy neutron dose per 1 Gy photon dose. Reproducibility of the TLDs, however, requires more than 10 detectors to determine results with an uncertainty of <5%.
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Affiliation(s)
- E Brunckhorst
- Department of Radiotherapy and Radio-Oncology, Center for Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
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Todorovic M, Balint B, Jevtic M, Suvajdzic N, Ceric A, Stamatovic D, Markovic O, Perunicic M, Marjanovic S, Krstic M. Primary gastric mucosa associated lymphoid tissue lymphoma: Clinical data predicted treatment outcome. World J Gastroenterol 2008; 14:2388-93. [PMID: 18416467 PMCID: PMC2705095 DOI: 10.3748/wjg.14.2388] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM: To determine clinical characteristics and treatment outcome of gastric lymphoma after chemotherapy and immuno-chemotherapy.
METHODS: Thirty four patients with primary gastric mucosa associated lymphoid tissue (MALT) lymphoma (Ann Arbor stages I to IV) were enrolled. All had upper gastric endoscopy, abdominal ultrasonography, CT and H pylori status assessment (histology and serology). After anti-H pylori treatment and initial chemotherapy, patients were re-examined every 4 mo.
RESULTS: Histological regression of the lymphoma was complete in 22/34 (64.7%) and partial in 9 (26.5%) patients. Median follow up time for these 31 responders was 60 mo (range 48-120). No regression was noted in 3 patients. Among the 25 (73.5%) H pylori positive patients, the eradication rate was 100%.
CONCLUSION: Using univariate analysis, predictive factors for overall survival were international prognostic index (IPI) score, hemoglobin level, erythrocyte sedimentation rate (ESR), and platelet numbers (P < 0.005). In addition to this, Cox proportion hazard model differentiate IPI score, ESR, and platelets as predictors of survival.
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Herzen J, Todorovic M, Cremers F, Platz V, Albers D, Bartels A, Schmidt R. Dosimetric evaluation of a 2D pixel ionization chamber for implementation in clinical routine. Phys Med Biol 2007; 52:1197-208. [PMID: 17264380 DOI: 10.1088/0031-9155/52/4/023] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this paper we present the results of a dosimetric evaluation of a 2D ionization chamber array with the objective of its implementation for quality assurance in clinical routine. The pixel ionization chamber MatriXX (Scanditronix Wellhofer, Germany) consists of 32x32 chambers with a distance of 7.6 mm between chamber centres. The effective depth of measurement under the surface of the detector was determined. The dose and energy dependence, the behaviour of the device during its initial phase and its time stability as well as the lateral response of a single chamber of the detector in cross-plane and diagonal directions were analysed. It could be shown, that the detector's response is linear with dose and energy independent. Taking the lateral response into account, two different dose profiles, for a pyramidal and an IMRT dose distribution, were applied to compare the data generated by a treatment planning system with measurements. From these investigations it can be concluded that the detector is a suitable device for quality assurance and 2D dose verifications.
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Affiliation(s)
- J Herzen
- Department of Radiotherapy and Radio-Oncology, Center for Diagnostic Imaging and Image Guided Therapy, Radiological Physics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, DE-20251 Hamburg, Germany.
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Abstract
The capability of the new GafChromic EBT prototype B for external beam dose verification is investigated in this paper. First the general characteristics of this film (dose response, postirradiation coloration, influence of calibration field size) were derived using a flat-bed scanner. In the dose range from 0.1 to 8 Gy, the sensitivity of the EBT prototype B film is ten times higher than the response of the GafChromic HS, which so far was the GafChromic film with the highest sensitivity. Compared with the Kodak EDR2 film, the response of the EBT is higher by a factor of 3 in the dose range from 0.1 to 8 Gy. The GafChromic EBT almost does not show a temporal growth of the optical density and there is no influence of the chosen calibration field size on the dose response curve obtained from this data. A MatLab program was written to evaluate the two-dimensional dose distributions from treatment planning systems and GafChromic EBT film measurements. Verification of external beam therapy (SRT, IMRT) using the above-mentioned approach resulted in very small differences between the planned and the applied dose. The GafChromic EBT prototype B together with the flat-bed scanner and MatLab is a successful approach for making the advantages of the GafChromic films applicable for verification of external beam therapy.
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Affiliation(s)
- M Todorovic
- Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
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Golubovic Z, Mitkovic M, Macukanovic-Golubovic L, Micic I, Stojiljkovic P, Kutlesic-Stojanovic K, Lesic A, Bumbasirevic M, Stamenic S, Karalejic S, Todorovic M, Visnjic A. Treatment of Gonarthrosis by Total Knee Arthroplasty. BIOTECHNOL BIOTEC EQ 2006. [DOI: 10.1080/13102818.2006.10817393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Cremers F, Todorovic M, Rades D, Albers D, Schönborn T, Schmidt R. 356 An ultrasonic-based (US-based) patient positioning system (I-Beam): first experiences. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)81332-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fischer M, Todorovic M, Cremers F, Schmidt R. SU-FF-T-397: Characteristics of a Double-Focused μMLC. Med Phys 2005. [DOI: 10.1118/1.1998196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Todorovic M, Fischer M, Cremers F, Schmidt R. SU-FF-T-241: Evaluation of EBT GafChromic Film for External Beam Dose Verification. Med Phys 2005. [DOI: 10.1118/1.1997969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Todorovic M, Aleksic S, Stojanovic M, Timotijevic I. Clozapine dosage and WBC count correlation. Eur Psychiatry 1998. [DOI: 10.1016/s0924-9338(99)80450-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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