Flora N Kontopidou

Athens State University, Athens, Alabama, United States

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Publications (48)121.81 Total impact

  • Leukemia & lymphoma 02/2014; · 2.40 Impact Factor
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    ABSTRACT: ABSTRACT We have analyzed the immunohistochemical expression of a wide range of molecules, along with the proliferation rate separately in the proliferation centers (PCs) and in the rest of tumor area on lymph node or spleen sections of CLL patients. Fas, FasL and c-FLIP were observed both within and outside the PCs in all cases. However only the difference in FasL expression between the PCs and the non-PC areas attained statistical significance. Median survivin expression in the PCs was higher compared to the non-PC areas. Cleaved-caspase 3 was expressed in very low levels both within and outside PCs while the BCL-2 protein was expressed in high levels in all cases in both tumor compartments. Multivariate analysis demonstrated that concurrent overexpression of Fas/FasL/c-FLIP in the PCs was correlated with worse outcome for progression free survival as well as for overall survival.
    Leukemia & lymphoma 05/2013; · 2.40 Impact Factor
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    ABSTRACT: Background. Treatment of splenic marginal zone lymphoma (SMZL) patients is not standardized. Recent data suggest that rituximab is highly effective and could be considered as initial therapy.Aim. To assess the efficacy of rituximab monotherapy in a large series of patients with SMZL and compare these results with splenectomy results.Methods. The studied population included 85 patients. Fifty-eight received rituximab at a dose of 375 mg/m(2) per week for 6 weeks as induction followed by maintenance at the same dose every 2 months for 1-2 years, whereas 27 patients were treated using splenectomy only.Results. The overall response rate to rituximab 2 months after the end of induction was 95% (complete response [CR], 45%; unconfirmed CR, 26%; partial response, 24%). The median times to hematologic and clinical response were 2 weeks and 3 weeks, respectively. Forty-three of 55 patients already completed the maintenance phase: 28 sustained their initial response, 14 improved their response, and one progressed. Eighty-five percent of splenectomized patients responded, and two were treated with rituximab as consolidation after splenectomy and achieved a CR. The 5-year overall and progression-free survival (PFS) rates for rituximab-treated and splenectomized patients were 92% and 77% (p = .09) and 73% and 58% (p = .06), respectively. Furthermore, maintenance therapy with rituximab resulted in a longer duration of response (at 5 years, PFS was 84% for patients receiving maintenance and 36% for patients without maintenance, p <.0001).Conclusions. Rituximab is a very effective and well-tolerated therapy and may be substituted for splenectomy as the first-line treatment of choice for patients with SMZL.
    The Oncologist 01/2013; · 4.10 Impact Factor
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    ABSTRACT: Background. Serum free light chains (sFLC), the most commonly detected paraprotein in CLL, were recently proposed as useful tools for the prognostication of CLL patients. Objective. To investigate the prognostic implication of sFLC and the summated FLC-kappa plus FLC-lambda in a CLL patients' series. Patients and Methods. We studied 143 CLL patients of which 18 were symptomatic and needed treatment, while 37 became symptomatic during follow-up. Seventy-two percent, 18%, and 10% were in Binet stage A, B and C, respectively. Median patients' followup was 32 months (range 4-228). Results. Increased involved (restricted) sFLC (iFLC) was found in 42% of patients, while the summated FLC-kappa plus FLC-lambda was above 60 mg/dL in 14%. Increased sFLC values as well as those of summated FLC above 60 were related to shorter time to treatment (P = 0.0005 and P = 0.000003, resp.) and overall survival (P = 0.05 and P = 0.003, resp.). They also correlated with β 2-microglobulin (P = 0.009 and P = 0.03, resp.), serum albumin (P = 0.009 for summated sFLC), hemoglobin (P < 0.001), abnormal LDH (P = 0.037 and P = 0.001, resp.), Binet stage (P < 0.05) and with the presence of beta symptoms (P = 0.004 for summated sFLC). Conclusion. We confirmed the prognostic significance of sFLC in CLL regarding both time to treatment and survival and showed their relationship with other parameters.
    Advances in Hematology 01/2013; 2013:359071.
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    ABSTRACT: Background: The International Prognostic Index (IPS), based on the analysis of 5023 patients treated before 1992, remains the most widely accepted prognostic system for advanced Hodgkin lymphoma. Nevertheless, IPS needs to be verified in independent patient series homogeneously treated with anthracycline-based chemotherapy (mostly ABVD) with or without radiotherapy. Few validation studies have been published so far with conflicting results.Aims: To assess the applicability of IPS in a relatively large series of patients with advanced HL under treatment with ABVD or equivalent regimens.Methods: In this retrospective study, we analyzed an homogeneous series of 510 patients with advanced Hodgkin lymphoma (stage IIB / III / IV) who were diagnosed and treated with anthracycline-containing therapy in 3 participating hospitals. Complete data for all parameters of IPS were available in 416 patients (82%), while at least half of the remaining patients were suitable for pooled analysis of the IPS (<3 versus ≥ 3 or <2 versus ≥ 2). Endpoints of the study were freedom from progression (FFP) and overall survival (OS). Results: Among 510 patients, 149 (29%) had stage IIB, 212 (42%) stage III, and 149 (29%) stage IV. The frequency of adverse IPS factors were: age ≥ 45 years 30%, male gender 57%, stage IV 30%, Hb <10.5g/dl 26%, leukocytosis ≥15x109/L 24%, severe lymphocytopenia 16% and albumin <4g/dl 65%. Only 23/416 patients (6%) had ≥5 risk factors. At a median follow up time of 81 months (6-308), 153 patients had refractory disease or relapsed and 107 had died. The 5-year FFP was 70% and the 10-year OS 73%. Among individual IPS factors, only stage IV was significantly correlated with FFP (p=0.0001), while the significance of hypoalbuminemia was marginal (0.05<0.0001 and p=0.02, respectively). Overall, the IPS was a statistically significant predictor of OS (p=0.01) but not FFP (p=0.11), as shown in the table. Instead, the discriminating ability of IPS was significantly improved for both OS (p<0.0001) and FFP (p<0.0001), when 306 patients with stage IIA were incorporated in the analysis. Summary/Conclusions: In an adequately sized series of patients with truly advanced stage HL, the IPS predicted OS and -less satisfactorily- FFP, without identifying subgroups of patients with very good or very unfavorable prognosis. Other conventional, biological or functional imaging-related factors need to be co-evaluated in order to identify sizeable subgroups of patients with sufficiently poor or favorable outcomes, suitable for treatment intensification or de-escalation respectively.
    Haematologica 06/2012; 97(s1-97 (s1)):87. · 5.94 Impact Factor
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    Flora N. Kontopidou, Theoni Kanellopoulou
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    ABSTRACT: Nodular Lymphocyte-Predominant Hodgkin’s Lymphoma (NLPHL) is rare, accounting for approximately 5% of all Hodgkin’s lymphoma (HL) cases in Western countries. NLPHL and classical Hodgkin lymphoma (cHL) differ substantially in their histopathology, presenting features and clinical course. The neoplastic cell is the lymphocytic and histiocytic cell (LP cell), rather than the Reed–Sternberg (RS) cell of cHL. Unlike the RS cells, LP cells express both CD20 and CD45 (leucocyte common antigen) and are negative for CD15 and CD30. In comparison with cHL, NLPHL presents with a striking male predominance, while the disease is localized [Ann Arbor stages (AAS) I/II] in more than 80% of the patients and is rarely associated with B-symptoms and mediastinal involvement. Since this disease is so uncommon, most information concerning treatment and outcome has come from reports of single institutions or pooled, multi-institutional retrospective analyses. As a result, treatment recommendations in NLPHL are diverse and range from noncurative options, such as watchful waiting or singleagent rituximab, through involved field radiation alone or combined modality therapy.
    Haema. 01/2012; 3(3):233-242.
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    ABSTRACT: BACKGROUND: Myelodysplastic syndromes (MDS) are hematopoietic stem cell malignancies characterized by ineffective blood cell production. Most MDS patients eventually become red blood cell (RBC) transfusion dependent, risking iron overload, which may lead to cardiac and hepatic failure. Due to increase risk of complications, hematologists do not recommend liver biopsy to assess liver iron concentration and use other non-invasive methods such as serum ferritin level. Liver transient elastography (TE, Fibrocan®-Echosens Paris) is an exciting new technology that allows the estimation of hepatic fibrosis through the measurement of liver stiffness. AIMS: Our aim was to explore possible associations of liver stiffness measured with TE with transfusion overload and ferritin levels in a group of patients with MDS. METHODS: All patients with MDS attending our outpatient hematological clinic from June 2010 to April 2011 were included in the study. Patients with other causes of chronic liver disease were excluded. The monitoring of transfusion burden was made through blood bank transfusion tracking data. We performed TE in all patients. The following variables were collected the same day of TE evaluation: serum ferritim, hemoglobin, platelets count, serum aminotransferases, gammaglutamiltransferase (GGT), total bilirubin level. RESULTS: Twenty patients with MDS syndrome were studied. Seventeen (85%) were male, whereas mean age was 74 years (range, 60-87 years). Mean BMI was 24.46 Kg/m2. Mean TE values were 13.68 kPa (range, 3.6-70.7 kPa). The mean ferritin level was 1603 ng/mL. Eleven patients (55%) were diagnosed with high risk MDS and mean TE values were 16.77 kPa in this subgroup. Five patients were receiving iron chelation for a mean of 30 months therapy before TE evaluation. In the group without any chelation treatment, mean TE value was 16.23 kPa (range, 4.8-70.7kPa) while 6 patients had TE value above 12 kPa. However, in the group receiving chelation treatment, the mean TE value was 6.02 kPa (range, 3.6-7.8 kPa), [P=0.23]. Demographic data and transfusion overload were not found to be correlated with TE values (P=0.56). Serum ferritin levels were found to be related to log-transformed TE value (P = 0.004). GGT levels were found to affect TE values (P<0.001). CONCLUSIONS: In the current study, liver stiffness was found to be correlated with ferritin serum level. TE could be a promising non-invasive tool for the assessment of chelation therapy on liver fibrosis in patients with MDS syndromes and post-transfusion iron overload.
    62nd AASLD; 11/2011
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    ABSTRACT: We describe here the rare coexistence, at the time of diagnosis, of a myeloproliferative neoplasm (MPN) and non-Hodgkin's lymphoma (NHL) in a 74-year-old patient who presented with thrombocytosis and signs of portal hypertension on physical examination. Abdominal computed tomography scan demonstrated extensive portal vein system thrombosis. Secondary causes of thrombocytosis were excluded. JAK2 V617F mutation was present in the peripheral blood, while bone marrow biopsy revealed marginal zone B-cell lymphoma. Molecular analysis failed to detect BCR-ABL rearrangement in peripheral blood cells. Simultaneous occurrence of MPN and NHL was diagnosed. This case may be of interest not only due to the rare coexistence of PMN and NHL, but also because of the undetermined clinical significance of JAK2 mutation in this subset of patients.
    Anticancer research 04/2011; 31(4):1467-9. · 1.71 Impact Factor
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    ABSTRACT: The optimal treatment approach for patients with mantle cell lymphoma (MCL) is not well defined. Intensive therapeutic regimens result in high response rates and prolonged progression-free survival but at the expense of significant toxicity. We report here our results of the administration of rituximab plus chlorambucil (R-Chl) as first line treatment in patients with MCL. Twenty consecutively diagnosed patients were treated with this combination in which an induction and a maintenance arm were included. During induction, rituximab was administered at a dose of 375 mg/m(2) on day 1, while chlorambucil was given afterward at a dose of 10 mg/day for 10 consecutive days for eight cycles and then as a single agent for an additional four cycles. Maintenance consisted of rituximab administration every 2 months for 1 year. Most patients had indolent disease features such as a low mantle-cell international prognostic index (MIPI) score. The overall response rate was 95% (90% CR, 5% PR). Among patients in CR, 78% presented a molecular remission. The 3-year progression-free survival was 89%. There were no serious side effects. These results show that the R-Chl combination could be an effective therapeutic option as first line treatment in MCL, especially for patients with indolent disease characteristics.
    Leukemia & lymphoma 03/2011; 52(3):387-93. · 2.40 Impact Factor
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    ABSTRACT: BACKGROUND Persistent PET positivity following 2 cycles of ABVD (PET-2) is a strong unfavorable prognostic factor in advanced HL. Progression Free Survival is approximately 95% vs 15% for patients with negative vs positive PET-2 respectively. The evaluation of PET-2 is based on well defined, though arbitrary, criteria, which require prospective validation. Whether PET-2-based early treatment modification can improve prognosis is unknown. However, it is known that the continuation of ABVD after a positive PET-2 is associated with an unacceptably high risk of treatment failure. AIMS (1) To analyze patients with advanced stage HL who were evaluated by PET-2 after ABVDx2 in relation to the final response; (2) To analyze the impact of PET-2 on subsequent treatment plan; (3) To make an attempt to validate current criteria for PET-2 positivity. PATIENTS AND METHODS We present a retrospective study of 26 patients with advanced stage HL (25/26 younger than 60 years). Advanced stage was defined as stage IIB with mediastinal bulk and/or E-disease, stage III or IV according to the German Hodgkin Study Group (GHSG) definition. PET-2 was evaluated using the established 5-grade scale (see below). RESULTS Median age of the patients was 28 years (19-72), 69% were men, 77% had nodular sclerosis, 3, 10 and 13 had stage II, III and IV respectively, and 70% had B-symptoms. The median value of IPS was 2.5 (0-5). 81% of the patients (21/26) had a negative PET-2: It was completely negative in 10 patients; 8 patients had residual uptake <liver; 3 patients developed new sites with an alternative explanation available and regression of the initial sites of disease (to uptake <liver). PET-2-Negative Patients: A final PET examination was available in15 patients (too early for 6 patients): 14/15 were PET-neg, but 1/15 developed frankly progressive disease at the end of treatment. At a median follow up of 13 months, only 1/14 PET-neg patients had relapsed. Overall 2/21 patients have failed so far: 1/10 with completely negative PET-2 and 1 out of 8 patients, who had mild (<liver) residual FDG uptake. PET-2-Negative Patients: Among 5 PET-2 positive patients, only one was switched to BEACOPP-escalatedx6 (continuous CR for 16 months) and 4 continued n ABVD (2 converted to PET-neg and remain in CR and 2 progressed at 4 and 7 months). If all of the 26 above patients have been treated with BEACOPP-escalatedx6-8, they would have had received 156-208 chemo cycles. In fact, only 1 patient received 6 cycles of BEACOPP-escalated; at most 30 cycles would have been administered, if all PET-2 positive patients had been switched to BEACOPP-escalated. CONCLUSIONS According to our preliminary data, current criteria for PET-2 evaluation appear to be valid. During this initial phase of incorporation of PET-2 in treatment strategy, a negative result appeared to be reassuring. However, the treating physicians tended to be reluctant to make early modifications in the treatment plan, in the case of positive PET-2. A more homogeneous strategy according to predefined interim PET ositivity criteria might prevent overtreatment and, hopefully result to improved outcome in advanced HL.
    Haematologica 96(s2), 322, 2011. 01/2011; 96:322.
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    ABSTRACT: Patients with autoimmune disorders seem to have an elevated risk of lymphoma, especially non-Hodgkin's lymphoma (NHL). The increased risk has been attributed to the disturbance of immune function found in these patients or to the immunosuppressive therapy used to treat the autoimmune disorders. However, little information exists about the estimated baseline risk for lymphoma in patients with primary biliary cirrhosis (PBC). In this case report, we describe a female patient who developed nodal diffuse large B-cell lymphoma ten years following PBC diagnosis. Twenty five additional case reports (19 NHL and 4 Hodgkin's disease (HD), 2 without data about NHL or Hodgkin's disease) predominantly females were identified in the English literature. B-cell lymphoma was the most common NHL type reported but beyond that no clear predisposition for any specific lymphoma subtype was documented. PBC usually preceded lymphoma diagnosis. Fifteen cases had extranodal localization and the most common site was the liver.
    Annals of Gastroenterology 01/2011; 24(2):125-128.
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    Annals of Gastroenterology 01/2011; 24(2):140-141.
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    T Kanellopoulou, F N Kontopidou, S P Dourakis
    Archives of Hellenic Medicine 01/2011; 28(6):814-818.
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    ABSTRACT: Primary effusion lymphoma (PEL) is a rare non-Hodgkin's lymphoma (NHL) mostly occurring in HIV-positive patients. It is characterized by the development of effusion in one or more body cavities, with no tumor masses and a positive human herpes virus-8 (HHV8) status. It has a poor survival profile and no optimal treatment is yet defined. We report two HIV-negative, HHV8-positive patients with PEL of the pleural cavity who achieved a durable remission after pleurodesis with bleomycin and no systemic therapy. We also perform a review of the relevant literature regarding the clinical data, treatment, and survival of PEL in HIV-negative patients.
    Anticancer research 01/2010; 30(1):271-6. · 1.71 Impact Factor
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    ABSTRACT: We present a cohort of 22 patients with type 2 dendritic cell (DC2) acute leukemia (or blastic plasmacytoid dendritic cell neoplasm-BPDCN, as it has been recently named), diagnosed in Greece over the past 12-year period, according to the main clinical and immunophenotypic features of this entity. Four additional cases are discussed, classified as leukemia of ambiguous lineage (LAL), because of the simultaneous detection of a CD56 negative DC2 population and of a second myeloid precursor cell population. The morphological features and cytogenetic findings of the typical BPDCN cases were similar to those previously described. Acute lymphoblastic leukemia-type chemotherapeutic regimens were more efficient in controlling the disease. Immunophenotyping of typical BPDCN cases revealed CD4(+), CD56(+), HLA-DR(+) and CD123(bright) neoplastic cells, in the absence of major B-, T- and myeloid-associated markers, while the phenotype of the four cases characterized as LAL highlights the risk of misdiagnosis. Based on our experience, we propose a flow cytometric algorithmic approach for the distinction of typical BPDCN from certain types of acute myeloid leukemia, but also for the identification of acute myeloid leukemia, admixed with CD56 negative DC2 cells, which could be misdiagnosed as BPDCN.
    Leukemia research 09/2009; 34(4):438-46. · 2.36 Impact Factor
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    ABSTRACT: Early-stage gastric mucosa-associated lymphoid tissue lymphoma (GML) is considered a localized disease with an indolent course. Circulating malignant cells have been detected in other early-stage indolent lymphomas by molecular methods. We investigated the incidence of occult blood disease in early-stage GML patients, its impact on clinical outcome, and the similarity between blood and gastric lymphocytic clones. Sixty-two patients with localized GML were included in the study; 51 of them had Helicobacter pylori infection. Monoclonality was investigated by leader polymerase chain reaction. Sequencing was performed for the immunoglobulin variable gene (VH) analysis. Blood involvement was absent in all patients by conventional staging methods. In the whole group of 62 patients, the incidence of blood IgH rearrangement was 45%, and this did not correlate with baseline patient characteristics. The monoclonal blood and gastric products of five patients were sequenced and compared with each other. Clonal identity was evident in four of five patients. The VH3 gene was the most frequently used, both in the blood and in the stomach. Early-stage GML is not a truly localized disease because half the patients had a circulating clone, probably identical to the gastric one. The clinical significance of occult blood disease and the potential appropriate intervention need to be further investigated.
    The Oncologist 03/2009; 14(2):148-54. · 4.10 Impact Factor
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    ABSTRACT: In the present study, we assessed the clinical and pathological data of 76 patients with the diagnosis of non-gastric extranodal marginal zone B-cell lymphoma. The most commonly affected sites were salivary glands, skin, ocular adnexa, lung, intestine and Waldeyer's ring. Ann Arbor stage I disease was present in 39 patients (51%), stage II in 10 (13%) and stage IV in 27 (36%). In 17 cases (21%), the lymphoma presented at multiple mucosal sites. Lymph node and bone marrow involvement were present in 21% and 16%, respectively. Most cases were in the low or low-intermediate risk group. Treatment was heterogeneous and included chlorambucil in 59% either alone or in combination with other agents. Complete and partial remission was achieved in 79% and 7%, respectively, with an overall response rate of 86%. The 5- and 10-year overall survival and cause-specific survival rates were 94%, 82% and 95%, 91%, respectively. The 5- and 10-year progression free survival was 56% and 41%, respectively. The only feature associated with inferior outcome was disease localisation to the lung.
    Leukemia & lymphoma 01/2009; 49(12):2308-15. · 2.40 Impact Factor
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    ABSTRACT: Splenectomy has traditionally been considered as a standard first line treatment for splenic marginal zone lymphoma (SMZL) conferring a survival advantage over chemotherapy. However it carries significant complications, especially in elderly patients. The purpose of this retrospective study was to report our experience on the efficacy of Rituximab as first line treatment in 16 consecutive SMZL patients, diagnosed in our department. The diagnosis was established using standard criteria. Patients' median age was 57 years (range, 48-78). Prior to treatment initiation all patients had splenomegaly, nine had anemia, five lymphocytosis, five neutropenia and six thrombocytopenia. Rituximab was administered at a dose of 375 mg/m2/week for 6 consecutive weeks. The overall response rate was 100%. After treatment, all patients had a complete resolution of splenomegaly along with restoration of their blood counts. Eleven patients (69%) achieved a CR, three (19%) unconfirmed CR and two (12%) a PR. Among the complete responders seven patients had also a molecular remission. The median time to clinical response was 3 weeks (range, 2-6). Rituximab maintenance was given to 12 patients. Eleven of them had no evidence of disease progression after a median follow-up time of 28.5 months (range, 14-36), while two out of four patients who did not receive maintenance, relapsed 7 and 24 months after the completion of induction treatment. Median follow-up time for the entire series was 29.5 months (range, 15-81). No deaths were recorded during the follow-up period. Therapy was well tolerated. The present study demonstrates that rituximab is an effective treatment for SMZL and could be considered as a substitute or alternative to splenectomy.
    Hematological Oncology 10/2007; 25(3):127-31. · 2.04 Impact Factor
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    ABSTRACT: Primary cutaneous marginal zone lymphoma (PCMZL) is an indolent disease. Treatment options include excision, local irradiation, interferon-alpha or chemotherapy. We present two patients with PCMZL and multiple skin lesions successfully treated with intralesional administration of the anti-CD20 monoclonal antibody rituximab. The first presented with four red skin lesions and the second with two. Biopsy of the largest lesion revealed marginal zone B-cell lymphoma in both patients. There was no evidence of systemic involvement in either patient. Both patients were treated with intralesional rituximab for 18 consecutive weeks. Skin lesions gradually regressed. Apart from mild local pain during the injection, no other adverse effects were observed. In conclusion, rituximab can be safely administered intralesionally in patients with PCMZL and can produce disease remission.
    European Journal Of Haematology 11/2006; 77(4):300-3. · 2.55 Impact Factor
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    ABSTRACT: A better understanding of the biology and pathogenesis of hematological malignancies has led to the development of immunotherapeutic and immunoregulatory drugs. Many of these agents have revolutionized the current treatment modalities, while others are under investigation. Rituximab (anti-CD20 antibody) has been established as the gold standard of treatment for aggressive B-cell lymphomas in combination with CHOP and has shown significant activity as monotherapy in the treatment of indolent B-cell lymphomas. In follicular lymphomas the combination of Rituximab with chemotherapy improves the outcome compared to chemotherapy alone. CD 20-based radioimmunotherapy, with the advantage of the bystander effect, represents an additional therapeutic alternative in B-cell lymphomas and may produce tumor regression in Rituximab resistant patients. The anti-CD52 monoclonal antibody, alemtuzumab, further expands the armamentarium against lymphoid malignancies producing high response rates in these entities. Antibody-targeted chemotherapy such as gemtuzumab ozogamicin, consisting of an anti-CD33 antibody combined to calicheamicin, has shown efficacy in the treatment of refractory acute myeloid leukemia; exact indications, timing and dosing schedule for optimized efficacy remain to be determined. Interferons have proven significant activity in cutaneous lymphomas, hairy cell leukemia and chronic myelogenous leukemia by mechanisms that are not fully elucidated. Thalidomide, by acting as an immunomodulatory and antiangiogenic agent can modulate neoplastic cells microenvironment and lead to disease control in multiple myeloma as well as in numerous other hematological malignancies. Bortezomib, a proteasome inhibitor, displays significant anti-tumor activity, especially in multiple myeloma and lymphoproliferative disorders. The addition of these agents in therapeutic regimens has improved considerably the treatment of hematological malignancies.
    Current Topics in Medicinal Chemistry 07/2006; 6(16):1657-1686. · 3.70 Impact Factor

Publication Stats

378 Citations
121.81 Total Impact Points

Institutions

  • 2011
    • Athens State University
      Athens, Alabama, United States
    • Hippokration General Hospital, Athens
      Athínai, Attica, Greece
  • 1996–2011
    • National and Kapodistrian University of Athens
      • • Division of Hematology
      • • Faculty of Medicine
      • • Division of Internal Medicine V
      • • Department of Medicine
      Athens, Attiki, Greece
    • Laiko Hospital
      Athínai, Attica, Greece
  • 2009
    • University of Crete
      • Department of Haematology
      Retimo, Crete, Greece
  • 1998
    • Κωνσταντοπούλειο νοσοκομείο Νέας Ιωνίας (Η Αγία Όλγα)
      Athínai, Attica, Greece