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Yadala A, Mukherjee A, Neelakandan V, Karunanithi A, Dubashi B, Menon V, Elumalai T, Bharathi D, Gundapuneedi BS, Loganathan V. Safety and Feasibility of Hippocampal Sparing Cranial Radiation in Pediatric and Adolescent Acute Lymphoblastic Leukemia Patients: A Prospective Study. Cureus 2024; 16:e62715. [PMID: 39036107 PMCID: PMC11259313 DOI: 10.7759/cureus.62715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Acute lymphoblastic leukemia (ALL) constitutes a significant portion of pediatric malignancies, with central nervous system (CNS) relapse posing a considerable threat to patient outcomes. While cranial radiation therapy (CRT) has been utilized to mitigate CNS relapse, it is associated with neurocognitive (NC) side effects. This study explores the feasibility and safety of using volumetric arc therapy (VMAT) with hippocampal sparing (HS) during cranial radiation therapy for ALL patients, aiming to reduce these side effects. Methodology This prospective observational study included pediatric and young adult patients with ALL who were in remission. HS was achieved using VMAT, and NC assessments were performed at baseline, six months, one year, and, to a limited extent, four years posttreatment. Results VMAT enabled precise hippocampal-sparing CRT with minimal dose to the hippocampus. Dosimetric analysis revealed that patients receiving 18 Gy had mean doses to planning target volume (PTV) and bilateral hippocampus of 18.9 and 9 Gy, respectively. Those receiving 12 Gy had corresponding doses of 13.3 and 7 Gy, respectively. Conformity and homogeneity indices were 0.9 and 0.1, and no brain relapses were observed among the patients in this study. NC assessments demonstrated no decline in intelligence quotient (IQ) scores over time, while only a subset of patients could be assessed at the four-year mark; telephone interviews suggested no significant cognitive decline. Conclusions This study highlights the potential of VMAT with HS as a promising approach to CRT for ALL patients in reducing the risk of NC side effects. The absence of brain relapses and preservation of NC function are encouraging findings, though larger studies are necessary to establish conclusive evidence.
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Affiliation(s)
- Ambedkar Yadala
- Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Ashutosh Mukherjee
- Radiation Oncology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Center (MPMMCC) Tata Memorial Center, Varanasi, IND
| | - Vijayaprabhu Neelakandan
- Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Arivazhagan Karunanithi
- Clinical Psychology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Biswajit Dubashi
- Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Vikas Menon
- Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Thiraviyam Elumalai
- Clinical Oncology, Cambridge University Hospitals NHS Foundation Trust, Manchester, GBR
| | - Deepak Bharathi
- Radiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Bhargav S Gundapuneedi
- Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Vignesh Loganathan
- Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
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Ganguly S, Bakhshi S. Treating Pediatric Acute Promyelocytic Leukemia in India - Key Challenges and Lessons Learned. Indian J Pediatr 2024; 91:535-536. [PMID: 38159153 DOI: 10.1007/s12098-023-05014-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Shuvadeep Ganguly
- Department of Medical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
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Krishnan S, Mahadevan A, Mungle T, Gogoi MP, Saha V. Maintenance Treatment in Acute Lymphoblastic Leukemia: A Clinical Primer. Indian J Pediatr 2024; 91:47-58. [PMID: 37493925 DOI: 10.1007/s12098-023-04687-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/15/2023] [Indexed: 07/27/2023]
Abstract
Cure rates in pediatric acute lymphoblastic leukemia (ALL) currently approach 90% in the developed world. Treatment involves 6-8 mo of intensive multi-drug chemotherapy followed by 24 mo of maintenance treatment (ALL-MT). The cornerstone of ALL-MT is the daily administration of oral 6-mercaptopurine (6MP), a purine analogue. 6MP is combined with weekly oral methotrexate (MTX), an antifolate drug, to augment therapeutic activity. Some protocols include additional chemotherapy drugs (such as vincristine and corticosteroids) during MT. The objective of ALL-MT is to ensure uninterrupted treatment at the highest tolerated doses of 6MP and MTX. This requires periodic adjustments of 6MP and MTX doses throughout treatment. Tolerance is determined through regular clinical assessments and careful monitoring of blood counts. Tolerated drug doses vary widely among patients, influenced by genetic and non-genetic factors, and require individualized dosing. Suboptimal treatment intensity in ALL-MT is associated with inferior outcomes and results from failure to treat at highest tolerated drug doses and/or interruptions in treatment due to non-adherence or toxicity. Management of MT thus requires close supervision to ensure treatment adherence, periodic drug dose modifications, and treatment to tolerance, while minimizing treatment interruptions due to toxicity. The review highlights these challenges and discusses approaches and strategies for the management of MT, focusing on the Indian context.
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Affiliation(s)
- Shekhar Krishnan
- Clinical Research Unit, Tata Translational Cancer Research Centre, Tata Medical Center, 14 Major Arterial Road (East-West), Newtown, Rajarhat, Kolkata, West Bengal, 700160, India.
- Department of Pediatric Hematology and Oncology, Tata Medical Center, Kolkata, India.
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester, UK.
| | - Ananya Mahadevan
- Clinical Research Unit, Tata Translational Cancer Research Centre, Tata Medical Center, 14 Major Arterial Road (East-West), Newtown, Rajarhat, Kolkata, West Bengal, 700160, India
| | - Tushar Mungle
- Clinical Research Unit, Tata Translational Cancer Research Centre, Tata Medical Center, 14 Major Arterial Road (East-West), Newtown, Rajarhat, Kolkata, West Bengal, 700160, India
| | - Manash Pratim Gogoi
- Clinical Research Unit, Tata Translational Cancer Research Centre, Tata Medical Center, 14 Major Arterial Road (East-West), Newtown, Rajarhat, Kolkata, West Bengal, 700160, India
| | - Vaskar Saha
- Clinical Research Unit, Tata Translational Cancer Research Centre, Tata Medical Center, 14 Major Arterial Road (East-West), Newtown, Rajarhat, Kolkata, West Bengal, 700160, India
- Department of Pediatric Hematology and Oncology, Tata Medical Center, Kolkata, India
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester, UK
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Jayaraman D, Sneha LM, Jeyarani G, Somayajula A, Kothandam BT, Scott JX, Gadekar A. Experience with Generic Pegylated L-asparaginase in Children with Acute Lymphoblastic Leukemia from a Tertiary Care Oncology Center in South India. South Asian J Cancer 2023; 12:371-377. [PMID: 38130281 PMCID: PMC10733070 DOI: 10.1055/s-0042-1759785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Dhaarani JayaramanBackground Acute lymphoblastic leukemia (ALL) is a common type of leukemia in children. The innovator pegylated L-asparaginase has several advantages over native L-asparaginase; however, its use in India is limited due to availability and cost. Therefore, a generic pegylated L-asparaginase can be considered as an alternative to the innovator molecule. Methods A retrospective study was conducted to assess the outcome (minimal residual disease [MRD]) and toxicity of a generic pegylated L-asparaginase (Hamsyl) at the end of induction therapy. Results Eighty-eight (80.7%) and 21 (19.3%) patients had received generic pegylated L-asparaginase and conventional asparaginase, respectively, as a part of their treatment protocol. Nearly 82% of patients had B-type ALL. Eight-one percent of children had a white blood cell count of fewer than 50,000/mm 3 . At the end of induction, 80.7% (88) of children were minimal residual disease (MRD)-negative, and at the end of augmented consolidation therapy, 20.2% were MRD-negative. Ten percent of patients exhibited allergic reactions. Two children had pancreatitis, and one child had central venous thrombosis. Conclusion The generic pegylated L-asparaginase (Hamsyl) was effective and safe for use in pediatric ALL.
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Affiliation(s)
- Dhaarani Jayaraman
- Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Latha M. Sneha
- Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Gracelin Jeyarani
- Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Alekhya Somayajula
- Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Balaji Thiruvengadam Kothandam
- Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Julius Xavier Scott
- Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - A Gadekar
- Emcure Pharma, Pune, Maharashtra, India
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Hambire C, Hambire U. Evaluation of effect of consumption of probiotics on the gingival and periodontal health status in children undergoing chemotherapy. Indian J Cancer 2023; 60:373-378. [PMID: 36861694 DOI: 10.4103/ijc.ijc_215_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Background Probiotics consist of live microbes. They do not have any adverse effects on health. They provide nutritive benefits to individuals when ingested in adequate quantities. The most common oral infections of the oral cavity are those affecting the periodontal and dental tissues. Aims and Objectives 1) To evaluate the antimicrobial role of oral probiotics against microorganisms involved in infections of periodontal and dental tissues. 2) To evaluate the state of health of gingival and periodontal tissues of children undergoing chemotherapy after the use of oral probiotics. Materials and Methods 60 children, between the age group of 3 and 15 years, undergoing chemotherapy were randomly distributed under control and probiotics administered test group for 90 days. The gingival, periodontal, and oral hygiene statuses were evaluated along with their caries activity test. The parameters were measured at 0, 15, 30, 45, 60, 75, and 90 days intervals. Statistical analysis was performed using Statistical Package for the Social Sciences version 18.0. Results The oral probiotics consumption significantly reduced the plaque accumulation between days of observation among those in the treatment group (P < 0.05). There was a significant improvement in the gingival and periodontal status in the tested group (P < 0.05). Snyder test was conducted to assess caries activity. Score 1 was found in 10 children, score 2 in eight children. Score 3 was not found in any child under the study group. Conclusion The results show that the regular consumption of oral probiotics significantly reduces plaque accumulation, calculus formation, and caries activity among the test group.
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Affiliation(s)
- Chaitali Hambire
- Department of Pediatric Dentistry, Government Dental College and Hospital, Dhanwantarinagar, Maharashtra, India
| | - Umesh Hambire
- Government Engineering College, Aurangabad, Maharashtra, India
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Ibrahim F, Gabelloni M, Faggioni L, Padma S, Visakh AR, Cioni D, Neri E. Are Semiquantitative Methods Superior to Deauville Scoring in the Monitoring Therapy Response for Pediatric Hodgkin Lymphoma? J Pers Med 2023; 13:445. [PMID: 36983627 PMCID: PMC10055884 DOI: 10.3390/jpm13030445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/05/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Tailoring treatment in patients with Hodgkin lymphoma (HL) is paramount to maximize outcomes while avoiding unnecessary toxicity. We aimed to compare the performance of SUVmax reduction (ΔSUVmax%) and the PET ratio (rPET) versus the Deauville score (DS) for assessing the chemotherapy response in pediatric HL patients undergoing 18F-FDG PET-CT. Fifty-two patients with biopsy-proven HL (aged 8-16 years) were enrolled at baseline, interim (after the second or third chemotherapy round) and post-therapy (on completion of first-line chemotherapy). Interim and post-therapy DS, ΔSUVmax% and rPET were compared as response predictors. Patients were classified as responders or non-responders based on a 24-month clinical follow-up. Interim DS showed a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of 100%, 80.4%, 100%, 40% and 82.7%, respectively, in predicting the therapy response. Post-therapy DS showed a sensitivity, specificity, PPV, NPV and accuracy of 66.7%, 97.8%, 95.7%, 80% and 94.2%, repsectively. Interim ΔSUVmax% showed a sensitivity, specificity, PPV, NPV and accuracy of 83.3%, 82.6%, 97.4%, 38.5% and 82.7%, respectively, with a 56.3% cutoff. Post-therapy ΔSUVmax% showed a sensitivity, specificity, PPV, NPV and accuracy of 83.3%, 84.8%, 97.5%, 41.7% and 84.6%, respectively, with a 76.8% cutoff. Compared to ΔSUVmax%, DS showed a significantly higher sensitivity, specificity (p < 0.05) and NPV (p < 0.01). The sensitivity, specificity, PPV, NPV and accuracy of rPET in predicting the therapy response at 24 months were 76.1%, 100%, 100%, 35.3% and 78.8%, respectively, with a cut-off of 1.31. DS and rPET showed comparable predictive performance (p > 0.58). In conclusion, DS is an easier method with better performance than ΔSUVmax% and rPET in predicting the chemotherapy response in pediatric HL patients.
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Affiliation(s)
- Firuz Ibrahim
- Department of Nuclear Medicine and PET-CT, Burjeel Medical City, Abu Dhabi 92510, United Arab Emirates
| | - Michela Gabelloni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | | | - Arun R. Visakh
- Department of Nuclear Medicine, VPS Lakeshore Hospital, Kochi 682040, Kerala, India
| | - Dania Cioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
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Iqbal A. Outcomes of Induction Therapy in Patients With Acute Myeloid Leukemia During the COVID-19 Pandemic: A Retrospective Study From a Tertiary Cancer Center. Cureus 2022; 14:e29940. [DOI: 10.7759/cureus.29940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
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8
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Sasi A, Ganguly S, Sharma S, Singh R, Verma V, Bisht R, Kalra D, Satapathy S, Bakhshi S. Adaptation of the Patient Reported Outcome Measurement Information System (PROMIS) tool for childhood cancer in India: A qualitative study. Psychooncology 2022; 31:1671-1680. [PMID: 36004944 DOI: 10.1002/pon.6017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/30/2022] [Accepted: 08/11/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND To fill the gap in patient-reported outcome (PRO) assessment in children with cancer in India, we planned to adapt domains from the HealthMeasures Patient Reported Outcomes Measurement Information System (PROMIS) tool. This study attempted to identify and pool outcomes relevant to children with cancer and their caregivers in Northern India. METHODS The study was qualitative and conducted through focussed group discussions (FGDs) and in-depth interviews of children with cancer and their caregivers. Content analysis of transcripts from the sessions was done. The collected themes were collated with existing item banks of the PROMIS tool and new concepts unique to our population were compiled. RESULTS A set of three FGDs and 14 interviews each for children and their caregivers were conducted. Following content analysis, 121 themes were identified including 10 new concepts. Themes pertaining to the physical domain were cited most. The theme distribution across the three domains was similar among children and caregivers. In the survivor cohort, the relative frequency of mention of psychological and social themes was higher compared to the whole cohort. Themes pertaining to mobility, cognitive dysfunction and peer relationships were more common among survivors. CONCLUSIONS This qualitative study in children with cancer and their caregivers in India has facilitated a better understanding of the issues pertaining to cancer care that are of most importance to its stake holders. The themes collected may be used to formulate a PRO tool uniquely tailored for use in this population.
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Affiliation(s)
- Archana Sasi
- Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Shuvadeep Ganguly
- Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Shubhangi Sharma
- Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Ritika Singh
- Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Vasudha Verma
- Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Reema Bisht
- Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Devanshi Kalra
- Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sujata Satapathy
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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High treatment related mortality due to infection remains a major challenge in the management of high-grade B-cell Non-Hodgkin Lymphoma in children in developing countries: Experience from a tertiary cancer center in Eastern India. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2022. [DOI: 10.1016/j.phoj.2022.03.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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10
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Chatterjee A, Pal A, Paul S. A Novel Compound Plumercine from Plumeria alba Exhibits Promising Anti-Leukemic Efficacies against B Cell Acute Lymphoblastic Leukemia. Nutr Cancer 2022; 74:2565-2580. [PMID: 35102802 DOI: 10.1080/01635581.2021.2010777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The current study was focused to evaluate the antioxidant and the anti-cancerous properties of Plumeria alba. Plumeria alba was chosen due to its existing medicinal values. Antioxidant assays like Superoxide radical scavenging assay, Nitrous Oxide radical scavenging assay, were performed, on the methanolic and ethyl acetate extracts of the plant, that depicts the pro-oxidant nature of the extract. Further, they were tested to check cell viability on B cell Acute Lymphoblastic Leukemia (ALL) Cell line (NALM 6), human lung cancer cell line (A549), T cell Acute Lymphoblastic Leukemia cell line (MOLT4), and PBMC isolated from normal donors utilizing MTT assay. Robust anti-proliferative activity was observed in the case of NALM 6 followed by A549, MOLT4, whereas negligible activity was observed in the case of PBMC. Intrigued by this finding, in silico docking was performed using three bioactive compounds namely Plumericine, Isoplumericine, and 13-O-p-Coumaroylplumieride, unique to Plumeria sp. They were docked against five different cyclins and Cdk proteins responsible for ALL. The compounds have shown satisfactory results and their druggability and ADMET properties were checked further. Plumercine turned out to be the most competent compound and hence can be considered as a potential leukemic drug candidate in the future.
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Affiliation(s)
| | - Amrita Pal
- Department of Botany, University of Calcutta, Kolkata, India
| | - Santanu Paul
- Department of Botany, University of Calcutta, Kolkata, India
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Lymphoma subtypes in India: a tertiary care center review. Clin Exp Med 2021; 21:315-321. [PMID: 33481141 DOI: 10.1007/s10238-021-00683-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/08/2021] [Indexed: 12/24/2022]
Abstract
Lymphomas are a group of neoplasm arising from immune cells with varied clinical presentation, molecular profile, morphology and immunophenotype. The epidemiology and response to treatment varies among patients from different geographical locations. We analyze the demographic characteristics of lymphomas in a tertiary care center of India over a period of five years. This was a retrospective study including cases from 2015 to 2019 which were classified according to WHO classification 2017. A total of 4115 lymphoma cases were diagnosed. Hodgkin lymphomas (HL) comprised 30.35% (n = 1249), and non-Hodgkin lymphoma (NHL) was 69.65% (n = 2866). Site of presentation was nodal in 64.76% cases, and 35.23% were extranodal. There was an overall male predominance. Among the NHLs, B-cell type comprised of 84.08% and 15.38% was T- and NK cell lymphomas. Mature B cell lymphomas comprised 82.41% with predominant being diffuse large B cell lymphoma type (42.53%) followed by follicular lymphoma (10.81%) and small lymphocytic lymphoma (6.10%). Among the T-cell type, PTCL NOS (2.65%) was the predominant subtype followed by ALK positive anaplastic large cell lymphoma (ALCL-ALK+) (2.44%), extranodal NK-T cell lymphoma (2.02%) and others. Classical type was predominant type (97.91%) among HL, and 2.08% were nodular lymphocyte predominant type. Among the classical HL, nodular sclerosis (28.1%) and mixed cellularity (32.18%) co-dominated. Our study indicates that the Indian population differs in the prevalence, presentation and the subtyping among various lymphomas. Higher prevalence of Hodgkin lymphoma, DLBCL, ALK + ALCL and immature cell neoplasm was noted.
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Mehrvar A, Tashvighi M, Nourian M, Mehrvar N, Ghorbani R, Sadeghi Y, Alebouyeh M, Faranoush M. Childhood Hodgkin Lymphoma in Iran; survival and outcome. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2020. [DOI: 10.1016/j.phoj.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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13
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Kulkarni U, George B. Access to hematopoietic stem-cell transplantation in India. J Postgrad Med 2020; 65:1-4. [PMID: 30693869 PMCID: PMC6380131 DOI: 10.4103/jpgm.jpgm_391_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- U Kulkarni
- Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - B George
- Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India
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14
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Srinivasan R, Thomas S. Rapid Weight Gain: An Unusual Presentation of Leukemia. Indian J Med Paediatr Oncol 2020. [DOI: 10.4103/ijmpo.ijmpo_241_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AbstractNeurological manifestations of leukemia can be due to direct effects of the malignancy or due to the indirect effects of infection or therapy. An 11-year-old boy presented with recent-onset weight gain with papilledema and a history of tuberculosis contact. Neuroimaging and initial microscopic examination of the cerebrospinal fluid (CSF) did not aid in the diagnosis of central nervous system leukemia. He was started on antitubercular treatment yet deteriorated. Repeat CSF analysis when subjected to cytospin and flow cytometry confirmed the diagnosis of B cell acute lymphoblastic leukemia (ALL). Although there have been reports of relapsed ALL presenting as obesity, isolated rapid changes in weight at initial presentation are a very rare and unusual manifestation of ALL. To the best of our knowledge, this is the first such report.
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Affiliation(s)
- Ranjini Srinivasan
- Department of Paediatrics, St John’s Medical College Hospital, Bengaluru, Karnataka, India
| | - Sarita Thomas
- Department of Paediatrics, St John’s Medical College Hospital, Bengaluru, Karnataka, India
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Gehlot S, Gupta A, Gupta R. SDCT-AuxNet θ: DCT augmented stain deconvolutional CNN with auxiliary classifier for cancer diagnosis. Med Image Anal 2020; 61:101661. [PMID: 32066066 DOI: 10.1016/j.media.2020.101661] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 12/13/2022]
Abstract
Acute lymphoblastic leukemia (ALL) is a pervasive pediatric white blood cell cancer across the globe. With the popularity of convolutional neural networks (CNNs), computer-aided diagnosis of cancer has attracted considerable attention. Such tools are easily deployable and are cost-effective. Hence, these can enable extensive coverage of cancer diagnostic facilities. However, the development of such a tool for ALL cancer was challenging so far due to the non-availability of a large training dataset. The visual similarity between the malignant and normal cells adds to the complexity of the problem. This paper discusses the recent release of a large dataset and presents a novel deep learning architecture for the classification of cell images of ALL cancer. The proposed architecture, namely, SDCT-AuxNetθ is a 2-module framework that utilizes a compact CNN as the main classifier in one module and a Kernel SVM as the auxiliary classifier in the other one. While CNN classifier uses features through bilinear-pooling, spectral-averaged features are used by the auxiliary classifier. Further, this CNN is trained on the stain deconvolved quantity images in the optical density domain instead of the conventional RGB images. A novel test strategy is proposed that exploits both the classifiers for decision making using the confidence scores of their predicted class labels. Elaborate experiments have been carried out on our recently released public dataset of 15114 images of ALL cancer and healthy cells to establish the validity of the proposed methodology that is also robust to subject-level variability. A weighted F1 score of 94.8% is obtained that is best so far on this challenging dataset.
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Affiliation(s)
- Shiv Gehlot
- SBILab, Department of ECE, IIIT-Delhi, New Delhi, 110020, India
| | - Anubha Gupta
- SBILab, Department of ECE, IIIT-Delhi, New Delhi, 110020, India.
| | - Ritu Gupta
- Laboratory Oncology Unit, Dr. B.R.A.IRCH, AIIMS, New Delhi 110029, India.
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Bhat GR, Bhat A, Verma S, Sethi I, Shah R, Sharma V, Dar KA, Abrol D, Kaneez S, Kaul S, Ganju R, Kumar R. Association of newly identified genetic variant rs2853677 of TERT with non-small cell lung cancer and leukemia in population of Jammu and Kashmir, India. BMC Cancer 2019; 19:493. [PMID: 31126249 PMCID: PMC6533689 DOI: 10.1186/s12885-019-5685-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 05/08/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Telomere genetics has recently been emerged as an important field in molecular oncology. Various genome-wide association studies in different population groups have revealed that polymorphisms in Telomere maintenance gene (TERT) gene located on 5p15.33 is associated with susceptibility to leukemia and lung cancer risk. However, association of TERT with leukemia and lung cancer risk in north Indian population groups is still unknown. This study observed the association between genetic variant rs2853677 of TERT and leukemia and lung cancer in the state of Jammu and Kashmir, India. METHODS A total of 781 subjects, out of which 381 cases (203 leukemic patients and 178 non-small cell lung cancer patients NSCLC) and 400 healthy controls were recruited for the study. Genetic variant rs2853677of TERT was detected using the real-time and Taqman Chemistry. Hardy-Weinberg Equilibrium was assessed using the chi square test. The allele and genotype- specific risks were estimated as odds ratio with 95% confidence interval. RESULTS We observed that variant rs2853677 was strongly associated with lung cancer and leukemia risk with an odds ratio (OR) =1.8 (1.03-3.2 at 95% CI); p value (adjusted) = 0.03; odds ratio (OR) =2.9 (1.4-5.5.at 95% CI); p value (adjusted) = 0.002, respectively. CONCLUSION The results of this study suggested that rs2853677 of TERT signifies association in multiple cancers and suggests that it can become potential marker for diagnosis of non-small cell lung cancer and leukemia. The study will provide an insight in understanding the genetic etiology and highlights the role of telomere-associated pathways in non-small cell lung cancer and leukemia. However, it would be quite interesting to explore the contribution of this variant in other cancers as well.
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Affiliation(s)
- Gh Rasool Bhat
- Cancer Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Amrita Bhat
- Cancer Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Sonali Verma
- Cancer Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Itty Sethi
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Ruchi Shah
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Varun Sharma
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Khursheed A Dar
- Chest Disease Hospital, Government Medical College, Srinagar, India
| | - Deepak Abrol
- Department of Radiotherapy, Government Medical College, Jammu, India
| | - Subiya Kaneez
- Department of Radiotherapy, Government Medical College, Srinagar, India
| | - Sandeep Kaul
- Department of surgical Oncology, Shri Mata Vaishno Devi Narayana Super speciality hospital, kata, India
| | - Ramesh Ganju
- Department of Pathology, College of Medicine, The OHIO State University, Columbus, USA
| | - Rakesh Kumar
- Cancer Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India.
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Sarkar MK, Vadivel V, Raja MRC, Kar Mahapatra S. Investigation of phytochemical constituents of anti-leukemic herbal drugs used by the traditional healers of Purulia, Birbhum and Bankura districts of West Bengal. Nat Prod Res 2019; 34:3388-3393. [DOI: 10.1080/14786419.2019.1566818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Monaj Kumar Sarkar
- Chemical Biology Lab (ASK-II-409), School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamilnadu, India
| | - Vellingiri Vadivel
- Chemical Biology Lab (ASK-II-409), School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamilnadu, India
| | - Mamilla R. Charan Raja
- Medicinal Chemistry and Immunology Lab (ASK-II-406) School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamilnadu, India
| | - Santanu Kar Mahapatra
- Medicinal Chemistry and Immunology Lab (ASK-II-406) School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamilnadu, India
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