Papers by Aleksandar Mijovic
Transfusion Medicine, 2011
Postgraduate Medical Journal, 1992
There is experimental evidence that a portion of follicle-stimulating hormone (FSH) secretion is ... more There is experimental evidence that a portion of follicle-stimulating hormone (FSH) secretion is independent of hypothalamic influences. A 29 year old woman with familial pure gonadal dysgenesis developed myelodysplastic syndrome. Endocrine investigations showed discrepancy between serum FSH and luteinizing hormone (LH) levels. FSH levels remained elevated while LH levels decreased. The FSH to LH ratio was 10 (normal 2-2.5). The fall in LH is likely to be due to factor(s) involved directly and specifically in LH synthesis and release. Exogenous LH releasing hormone administration as well as hormonal replacement treatment increased LH levels. The FSH to LH ratio decreased to 7. This case supports the hypothesis of differential regulation of FSH and LH, and that FSH secretion is at least partly autonomous.
British Journal of Haematology, 1998
We performed flow cytometric analysis of CD34 þ cell apoptosis in 59 patients with myelodysplasti... more We performed flow cytometric analysis of CD34 þ cell apoptosis in 59 patients with myelodysplastic syndrome (MDS) or acute myeloid leukaemia (AML) secondary to MDS (MDS-AML) using annexin V-FITC, which binds to exposed phosphatidylserine on apoptotic cells. Apoptosis was significantly increased in FAB subtypes RA, RARS and RAEB (<10% blasts) (56•5% (15•1-86•5%)) compared to normal controls (18•5% (3•4-33•4%), P < 0•0001) and RAEBt/MDS-AML (16% (2•1-43•2%), P < 0•0001). There was no correlation between % apoptosis, Full blood count or cytogenetics in any disease category. Two-colour cytometric analysis of permeabilized CD34 þ cells stained with antibodies to Bcl-2, Bcl-X (anti-apoptotic), Bax and Bad (proapoptotic), demonstrated significantly higher ratios of pro-v anti-apoptotic proteins in early MDS (2•47 (1•19-9•42) compared to advanced disease (1•14 (0•06-3•32), P ¼ 0•0001). Moreover, using repeated measures of variants (ANOVA), we found that variations between individual Bcl-2-related proteins differed significantly according to disease subtype (P < 0•0005). Our results confirm that CD34 þ cell apoptosis was significantly increased in MDS subtypes RA and RARS and fell with disease progression. Early MDS was also associated with a significantly higher CD34 þ cell pro-v anti-apoptotic Bcl-2-family-protein ratio than advanced disease. Furthermore, patterns of expression of individual Bcl-2 related proteins differed significantly between different disease categories. However, no correlation between pro-v anti-apoptotic Bcl-2-family-protein ratios and the degree of apoptosis was observed.
Bone Marrow Transplantation, 2007
Blood, 2007
The use of reduced intensity conditioning regimens (RIC) has facilitated the allografting of olde... more The use of reduced intensity conditioning regimens (RIC) has facilitated the allografting of older patients while concurrently reducing the transplant-related mortality associated with allogeneic haematopoietic stem cell transplantation. At present, there is limited data available on the longer-term efficacy and safety of RIC HSCT. We performed a retrospective study on the long term outcomes of patients with haematological malignancies who received RIC HSCT at our center over an 8 year period from Jan 1997 to Dec 2005. A total of 263 adult patients received RIC HSCT, of which 135 patients (51%) survived for 2 or more years and were analysed for long-term outcomes and complications. The median recipient age among our long term survivors at HSCT was 49 years (range: 24–66), with an M: F ratio of 1.6:1 and median follow-up of 51.8 months (range 23.9–100.3). All patients received alemtuzumab (CAMPATH 1H) based RIC regimens with cyclosporin A as post-transplant GvHD prophylaxis. 61 were ...
Transfusion Medicine, 2011
Transfusion Medicine, 2011
A Caucasian female, 36-year-old, became unwell and jaundiced over a period of 2 weeks. Her biliru... more A Caucasian female, 36-year-old, became unwell and jaundiced over a period of 2 weeks. Her bilirubin was 400 μmol/l; AST 848 iu/l; INR 2.99 (norm. 0.9–1.2). Plasma ammonium ranged between 115 and 185 μmol/l (normal, <40 μmol/l). Three days later (day 0), she received right liver lobe auxiliary transplant from a cadaveric donor. On day 8, she was discharged from intensive care unit; her hemoglobin was 8.2 g/dl, and the bilirubin 162 μmol/l. On day 10, bilirubin was 294 μmol/l; hemoglobin decreased to 6.1 g/l, without signs of acute hemorrhage. The ward staff requested two units of red cells.
Transfusion Medicine, 2011
British Journal of Haematology, 2000
American Journal of Hematology, 1989
After intermittent treatment with busulphan over a 7-year period for chronic myeloid leukemia (CM... more After intermittent treatment with busulphan over a 7-year period for chronic myeloid leukemia (CML) in chronic phase, a 39-year-old female developed leukocytosis in association with pure red cell aplasia (PRCA). Bone marrow examination confirmed erythroid aplasia, and culture revealed a total absence of erythroid progenitor cells. The patient then was treated with azathioprine, corticosteroids, cyclophosphamide, plasma exchange, and cyclosporin A, but she remained erythroblastopenic and transfusion dependent for more than a year, at which time a promyelocytic transformation supervened. The authors propose that this sequence of events, hitherto unreported, is a manifestation of the multistep progression of CML.
Hematology, 1998
Familial juvenile myeloid disorders are uncommon, but better understanding of their basis may lea... more Familial juvenile myeloid disorders are uncommon, but better understanding of their basis may lead to crucial advances in the study of leukemogenesis. We report a family with three siblings who died of myelodysplasia and/or acute myeloid leukemia at the age of 10, 11 and 16 years, respectively. Two children died of a fulminant generalized varicella. No somatic constitutional abnormalities were found and histories of exposure to common environmental or occupational mutagens were unremarkable. One of the two tested patients had monosomy of the chromosome 7 in all examined metaphases. Therefore, the clinical and genetic findings are consistent with the "Familial Monosomy 7". A constitutional pericentric inversion of chromosome 9 (p11q13) was detected in the karyotype of the father and both analyzed siblings. In addition, clustering of breast cancer was observed in maternal relatives. As the mode of inheritance and the molecular basis of this disease remain obscure, we believe that it is important to report new cases and attempt to study them as thoroughly as possible. We discuss possible mechanisms of familial tendency to myeloid malignancies.
The Journal of Clinical Psychiatry, 2015
Certain patients with treatment-refractory schizophrenia may be rechallenged with clozapine follo... more Certain patients with treatment-refractory schizophrenia may be rechallenged with clozapine following previous neutropenia. Evidence guiding patient selection and the effectiveness of lithium and granulocyte-colony stimulating factor (G-CSF) in rechallenge is limited, and factors associated with successful outcomes are unclear. Method: Outcomes were studied in patients rechallenged with clozapine at a tertiary referral centre between January 2007-December 2013, following one or more previous trials terminated due to neutropenia, defined as an absolute neutrophil count (ANC) <1.5 x 10 9 /L. Demographic characteristics, details of each clozapine trial including ANC and co-prescribed medication were extracted and factors associated with rechallenge outcomes examined. Results: Nineteen patients underwent clozapine rechallenge following previous neutropenia; four (21%) experienced further neutropenia, two of which were agranulocytosis. Compared to successfully rechallenged patients, unsuccessful rechallenges were significantly older (t=2.10, p=0.05), onset of neutropenia was sooner (W=10.0, p=0.03), and valproate co-prescription was more common. In addition to five patients with benign ethnic neutropenia (BEN), 8/10 patients not of an ethnicity associated with BEN also had idiopathic low neutrophil counts at baseline; lithium and G-CSF co-prescription facilitated successful rechallenge in these patients. Conclusion: In this selected population, the initial neutropenia was unlikely to be related to clozapine in a substantial proportion of cases. This group was successfully rechallenged following careful consideration of the risks and benefits, and lithium and G-CSF contributed to allowing continued clozapine therapy. In addition to Black patients, other ethnic groups can have persistently low ANC unrelated to clozapine.
transmitted, in any form or by any means, with the prior permission in writing of the publishers,... more transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licenses issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc., in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature.
Uploads
Papers by Aleksandar Mijovic