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Jayakumar I, Gude A, Renangi M, Valliyappan S, Vellaichamy Swaminathan V, Meena S, Varla H, Chandar R, Uppuluri R, Raj R. Successful matched unrelated donor hematopoietic stem cell transplantation for infantile Wolman disease. Pediatric Hematology Oncology Journal 2023. [DOI: 10.1016/j.phoj.2022.10.251] [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: 12/12/2022] Open
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Varla H, Meena S, Swaminathan VV, Chandar R, Munnusamy MK, Ramakrishnan B, Karmegam D, Grace J, Jayakumar I, Uppuluri R, Raj R. Risk Factors for Neutropenic Sepsis Related Mortality in Children Undergoing Allogenic Hematopoietic Stem Cell Transplantation. Indian J Hematol Blood Transfus 2023; 39:1-6. [PMID: 36699434 PMCID: PMC9868024 DOI: 10.1007/s12288-021-01486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/29/2021] [Accepted: 08/19/2021] [Indexed: 01/28/2023] Open
Abstract
We aimed to analyze infections in children undergoing hematopoietic stem cell transplantation (HSCT) until engraftment. The spectrum and risk factors associated will help plan interventions to reduce mortality. We performed a retrospective analysis on the infections, associated risk factors, and mortality until engraftment in children up to 18 years of age undergoing HSCT from January 2017 to August 2020. A total of 399 children were included, with a male: female ratio of 1.9:1, with matched related donor HSCT in 36.6%, a matched unrelated donor in 18.3%, and haploidentical HSCT in 38.1% of children. Culture positive bacteremia was documented in 22.1% transplants with gram-negative bacteria (GNB) isolated in 71/88 (80%). Among the GNB, the predominant organism was Klebsiella pneumonia in 38 (53%), E.coli in 16 (22%), Pseudomonas in 9 (12%). Carbapenem resistance was documented in 24/71 (33%). The incidence of possible, probable, and proven fungal infections in the cohort was 63 (15%), 28 (7%), and 6 (1.5%), respectively. Mortality up to engraftment due to sepsis in our cohort is 3.3% (n = 13). There was a significant association between mortality and a perianal focus (30.8%, p value 0.029) and the presence of carbapenem resistance (38%, p value 0.002). Mortality among those who developed proven fungal infections was significantly higher than those with bacteremia (p value 0.004). Our study has identified fungal sepsis and carbapenem-resistant GNB sepsis as high-risk groups for mortality. Risk directed interventions in these groups would help ensure survival and optimal outcomes.
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Affiliation(s)
- Harika Varla
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | - Satishkumar Meena
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | - Venkateswaran Vellaichamy Swaminathan
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | - Rumesh Chandar
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | - Mohan Kumar Munnusamy
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | | | - Deepa Karmegam
- Department of Nursing, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | - Jerlin Grace
- Department of Nursing, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | - Indira Jayakumar
- Department of Pediatric Critical Care, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | - Ramya Uppuluri
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
| | - Revathi Raj
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Padma Complex, Anna Salai, 320, Teynampet, Chennai, 600035 India
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Swaminathan VV, Meena S, Varla H, Chandar R, Jayakumar I, Ramakrishnan B, Uppuluri R, Raj R. Hematopoietic Stem Cell Transplantation for Children With Inborn Errors of Metabolism: Single Center Experience Over Two Decades. Indian Pediatr 2022; 59:699-702. [PMID: 35762023] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We present outcome data on hematopoietic stem cell transplantation (HSCT) in children with inborn errors of metabolism (IEM). METHODS We retrospectively analyzed data on children up to 18 years of age, diagnosed with IEM, who underwent HSCT between January, 2002 and December, 2020. RESULTS 24 children, (mucopolysaccharidosis - 13, Gaucher disease - 4, X-linked adrenoleukodystrophy - 4, metachromatic leukodystrophy - 2, Krabbe disease - 1) were included. Donors were matched family donors in 24%, matched unrelated donors in 34%, and haploidentical fathers in 42% of the transplants, with engraftment in 91% of children. Overall survival was 72% (55-100%) with a median follow-up of 76.5 (10-120 ) months, and progression-free survival of 68% (MPS-76%, X-ALD -60%, Gaucher disease - 50%, and 100% in MLD and Krabbe disease). CONCLUSION HSCT is an available curative option, and early age at HSCT prevents end-organ damage.
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Affiliation(s)
- Venkateswaran Vellaichamy Swaminathan
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai 600 035, Tamil Nadu. Correspondence to: Dr Venkateswaran Vellaichamy Swaminathan, Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai 600 035, Tamil Nadu.
| | - Satishkumar Meena
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai 600 035, Tamil Nadu
| | - Harika Varla
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai 600 035, Tamil Nadu
| | - Rumesh Chandar
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai 600 035, Tamil Nadu
| | - Indira Jayakumar
- Department of Pediatric Critical Care, Apollo Hospitals, Chennai 600 035, Tamil Nadu
| | | | - Ramya Uppuluri
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai 600 035, Tamil Nadu
| | - Revathi Raj
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai 600 035, Tamil Nadu
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Chandar R, Meena S, Varla H, Ramakrishnan B, Vellaichamy Swaminathan V, Uppuluri R, Raj R. Post-transplant strategies to improve relapse-free survival in childhood leukemia: Whole blood donor lymphocyte infusions and lenalidomide for inducing graft-versus-leukemia effect. Pediatr Transplant 2022; 26:e14293. [PMID: 35437875 DOI: 10.1111/petr.14293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/18/2022] [Accepted: 04/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Post-transplant graft-versus-leukemia (GVL) effect has been shown to be an important determinant of a successful outcome following hematopoietic stem cell transplantation (HSCT) in children with acute leukemia. PATIENTS AND METHODS: We performed a retrospective analysis of the children up to 18 years of age with acute leukemia who underwent HSCT between November 2002 and November 2018. GVL induction strategies included whole blood donor lymphocyte infusions (DLI) and/or lenalidomide. RESULTS A total of 134 children were included with engraftment in 125 children (93%). Acute graft-versus-host disease (GVHD) was documented in 85 (63%) children without any induction strategies. GVL induction strategies were employed in 19 children (14%); DLI (n = 12), Lenalidomide (n = 2), DLI + lenalidomide (n = 5). Among the 19, 12 children (63%) are alive without relapse; 6 children died of relapse (31%). Among the 6 who died of relapse despite induction strategies, 5/6 had ALL and one child had AML. GVL induction was effective in preventing relapse in 7/12 (58%) children with ALL and 5/6 (83%) children with AML. Relapse-free survival in the cohort is 73/134 (55%) with a median follow-up of 32 months. GVHD of any grade was significantly associated with a lower risk of relapse (p = .008). Median survival time was 160.3 days (range 132-187) in those with chronic GVHD versus 88.3 days (range 68-107) in those without (p value = .004). CONCLUSION Pre-emptive whole blood DLIs in graded aliquots, and lenalidomide are important tools for post HSCT GVL induction, which significantly impacts relapse-free survival in childhood leukemia.
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Affiliation(s)
- Rumesh Chandar
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai, India
| | - Satishkumar Meena
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai, India
| | - Harika Varla
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai, India
| | | | | | - Ramya Uppuluri
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai, India
| | - Revathi Raj
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, Chennai, India
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Ravichandran N, Uppuluri R, Vellaichamy Swaminathan V, Melarcode Ramanan K, Meena S, Varla H, Chandar R, Jayakumar I, Raj R. Management of Peripheral T-Cell Lymphoma in Children and Adolescents Including STAT 3 Mutation Hyper-IgE Syndrome: One Size Does Not Fit All. J Pediatr Hematol Oncol 2022; 44:e849-e854. [PMID: 34862350 DOI: 10.1097/mph.0000000000002364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022]
Abstract
Peripheral T-cell lymphoma (PTCL) is a rare form of lymphoma in children with limited published data on treatment and lack of a uniformly accepted treatment algorithm. We retrospectively analyzed the data in children up to 18 years of age diagnosed to have PTCL from January 2016 to June 2020. The study included six children with a median age of 10 years, the youngest being a 7-month-old girl. According to the WHO-PTCL classification, three had PTCL-not otherwise specified (NOS), 2 had hepatosplenic TCL, and 1 had subcutaneous panniculitis-like TCL. All children had presented with advanced disease, 4 in St. Jude stage IV, 2 in St. Jude stage III. Three children received CHOEP chemotherapy including cyclophosphamide, doxorubicin, vincristine, prednisone, etoposide, while 1 child received CHOP. Two children received induction as per acute lymphoblastic leukemia followed by Bendamustine. Two patients succumbed to progressive disease, the infant with PTCL-NOS and 1 child with hepatosplenic TCL. Three children were in remission (median follow up of 44 mo). One child with PTCL-NOS Stage IV had an underlying STAT3 mutated hyperimmunoglobulin E syndrome and was in remission 12 months post a matched unrelated donor hematopoietic stem cell transplantation. He had grade 4 skin graft versus host disease and required extracorporeal photopheresis and ibrutinib, to which he had responded. CHOEP chemotherapy is well-tolerated and subcutaneous panniculitis-like TCL has the best prognosis thus far.
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Affiliation(s)
- Nikila Ravichandran
- Departments of Pediatric Hematology, Oncology, Blood and Marrow Transplantation
| | - Ramya Uppuluri
- Departments of Pediatric Hematology, Oncology, Blood and Marrow Transplantation
| | | | | | - Satishkumar Meena
- Departments of Pediatric Hematology, Oncology, Blood and Marrow Transplantation
| | - Harika Varla
- Departments of Pediatric Hematology, Oncology, Blood and Marrow Transplantation
| | - Rumesh Chandar
- Departments of Pediatric Hematology, Oncology, Blood and Marrow Transplantation
| | - Indira Jayakumar
- Pediatric Critical Care, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Revathi Raj
- Departments of Pediatric Hematology, Oncology, Blood and Marrow Transplantation
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Swaminathan VV, Uppuluri R, Meena SK, Varla H, Chandar R, Ramakrishnan B, Jayakumar I, Raj R. Treosulfan-Based Conditioning in Matched Family, Unrelated and Haploidentical Hematopoietic Stem Cell Transplantation for Genetic Hemophagocytic Lymphohistiocytosis: Experience and Outcomes over 10 Years from India. Indian J Hematol Blood Transfus 2022; 38:84-91. [PMID: 35125715 PMCID: PMC8804033 DOI: 10.1007/s12288-021-01422-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/16/2021] [Accepted: 02/24/2021] [Indexed: 01/03/2023] Open
Abstract
We aimed to analyze data in children with primary hemophagocytic lymphohistiocytosis (HLH) who underwent hematopoietic stem cell transplantation (HSCT). We performed a retrospective study where children up to 18 years, with primary HLH and who underwent HSCT from January 2011 to December 2019, were included. Twenty-five children with genetic HLH underwent HSCT, including variants (Griscelli syndrome (GS2) 7, Chediak-Higashi syndrome (CHS) 2, XIAP mutation 2). Donors were matched family 8 (32%), umbilical cord blood unit 3 (12%), matched unrelated 2 (8%), haploidentical HSCT 12 (48%), (TCR alpha/beta depletion 2 and post-transplant cyclophosphamide 10). With treosulfan-based conditioning, engraftment was achieved in 23/25 (92%) transplants (100% in haplo-HSCT), with sustained complete chimerism in 87%. Disease-free survival was noted in 2/3 children with stable mixed chimerism. Graft-versus-host disease (GVHD) of grade I/II was noted in 6 (24%), grade III in 3 (13%); chronic limited skin GVHD in 2 (12%) children. Overall survival was 72% (87.5% in matched donor, 66.7% in the haplo-HSCT), 71% in GS2, 50% in CHS, 100% in XIAP. HSCT is curative in primary HLH with acceptable disease-free survival with mixed chimerism. Haplo-HSCT is a viable option for those without matched family or unrelated donors.
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Affiliation(s)
- Venkateswaran Vellaichamy Swaminathan
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, 600035 India
| | - Ramya Uppuluri
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, 600035 India
| | - Satish Kumar Meena
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, 600035 India
| | - Harika Varla
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, 600035 India
| | - Rumesh Chandar
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, 600035 India
| | | | - Indira Jayakumar
- Department of Pediatric Critical Care, Apollo Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, 600035 India
| | - Revathi Raj
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, 600035 India
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Meena SK, Chandar R, Varla H, Swaminathan VV, Uppuluri R, Jayakumar I, Ramakrishnan B, Raj R. Treatment free remission in pediatric CML. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2022.03.025] [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: 10/18/2022] Open
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Varla H, Meena SK, Chandar R, Swaminathan VV, Uppuluri R, Jayakumar I, Lakshmanan V, Raj R. Extracorporeal photopheresis in the management of graft versus host disease in children– Single centre experience from India. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2022.03.120] [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: 10/18/2022] Open
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Raj R, Swaminathan VV, Meena S, Varla H, Chandar R, Ramakrishnan B, Uppuluri R. Ruxolitinib as front-line therapy in graft versus host disease: Efficacy and safety in children. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2021.11.007] [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: 10/19/2022] Open
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Varla H, Meena SK, Chandar R, Swaminathan VV, Uppuluri R, Jayakumar I, Raj R. Improved outcomes in immunosuppressive therapy in children with severe aplastic anemia with the addition of Eltrombopag. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2022.03.027] [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: 10/18/2022] Open
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Meena SK, Chandar R, Varla H, Swaminathan VV, Uppuluri R, Jayakumar I, Ramakrishnan B, Raj R. Tacrolimus offers an effective GVHD prophylaxis with a tolerable toxicity profile in pediatric hematopoietic stem cell transplantation. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2022.03.131] [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] Open
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Varla H, Meena SK, Chandar R, Swaminathan VV, Uppuluri R, Jayakumar I, Lakshmanan V, Raj R. Haematopoietic stem cell transplantation in rare transfusion dependant haematological conditions –A single center experience. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2022.03.121] [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: 11/25/2022] Open
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Varla H, Meena SK, Chandar R, Swaminathan VV, Uppuluri R, Jayakumar I, Lakshmanan V, Raj R. The outcome of children with graft failure post hematopoietic stem cell transplantation- Experience from a tertiary referral center in southern India. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2022.03.032] [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: 11/25/2022] Open
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Thankamony P, Nirmal G, Chandar R, Nair AKR, Veeramoni Iyer Mriduladevi P. Differentiated thyroid carcinoma in children: A retrospective analysis of 125 pediatric cases from a single institution in India. Pediatr Blood Cancer 2021; 68:e29076. [PMID: 33900677 DOI: 10.1002/pbc.29076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Thyroid carcinoma (TC) is extremely rare in children. We assessed the clinicopathological features, outcomes, recurrence pattern, and associated risk factors of differentiated thyroid carcinoma (DTC). METHODS Children aged ≤14 years, pathologically diagnosed as DTC at a tertiary cancer institute between January 1998 and December 2015 were retrospectively analyzed. Survival outcomes were estimated using the Kaplan-Meier method. RESULTS During 18 years, 125 children with DTC were treated with a male:female ratio of 1:2.3. The median age was 12 years (2-14 years). Anterior neck swelling was the commonest presentation (72.8%). Histopathology revealed papillary thyroid carcinoma (PTC) in 123 children (98.4%). Extrathyroidal extension was seen in 32 children (25.6%). Sixty-eight children (54.4%) had nodal metastases and seven had distant metastasis. Relapse developed in 12 children. All were salvaged with subsequent surgery and radioiodine therapy. Eight children had persistent disease and one had a second malignant neoplasm. The median follow-up period was 9 years 1 month (1-20 years). Five-year recurrence-free survival (RFS) was 94.8% and 5-year overall survival was 100%. Larger tumors (p-value = .001), extrathyroidal extension (p-value = .001), and nodal metastasis (p-value = .022) were significant predictors for RFS in univariate analysis. CONCLUSIONS Pediatric DTC showed aggressive behavior characterized by a high rate of extrathyroidal extension and nodal and pulmonary metastasis. Persistent disease should be distinguished from recurrent disease as DTCs with metastatic disease remain stable for long time and usually respond well to radioiodine therapy. Our study reaffirmed favorable prognosis despite aggressive presentation and even after relapse.
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Affiliation(s)
- Priyakumari Thankamony
- Department of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Garima Nirmal
- Department of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Rumesh Chandar
- Department of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Anila K R Nair
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Gopakumar KG, Thankamony P, Rajeswari B, Chandar R. Resolution of Cytomegalovirus Pneumonia in a Child with Acute Leukemia Without Antiviral Pharmacotherapy; The Need to Tailor your Approach. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_9_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- KG Gopakumar
- Department of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | | | - Binitha Rajeswari
- Department of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Rumesh Chandar
- Department of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
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Thankamony P, Chandar R, Kattoor J, Nair RK. Pediatric Primary Ovarian Angiosarcoma: From Rarity to a Realization. J Pediatr Adolesc Gynecol 2018; 31:629-631. [PMID: 30179666 DOI: 10.1016/j.jpag.2018.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/18/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Angiosarcoma is an uncommon high-grade sarcoma in children. Visceral angiosarcoma involving the ovary is extremely rare. Because of the lack of recurrent cytogenetic alterations, histopathological identification of this uncommon tumor in unusual sites like the ovary demands pathologic expertise. Complete surgical resection and radiotherapy are the chief treatment modalities determining survival, with chemotherapy contributing a minor role. CASE We discuss a 11-year-old prepubertal girl who presented with primary angiosarcoma of the ovary. SUMMARY AND CONCLUSION Early realization of such exceptional presentations of these tumors is needed to achieve the best treatment outcome.
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Affiliation(s)
| | - Rumesh Chandar
- Department of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Jayasree Kattoor
- Department of Pathology, Regional Cancer Centre, Trivandrum, Kerala, India
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Chandar R, Gopakumar KG, Appanraj P, Thankamony P. Pulmonary cavitation, odontoid lytic lesion, and B symptoms: Early suspicion of the fine line between Hodgkin lymphoma and tuberculosis. Pediatr Blood Cancer 2018; 65:e27355. [PMID: 30039910 DOI: 10.1002/pbc.27355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/20/2018] [Accepted: 06/20/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Rumesh Chandar
- Department of Pediatric Oncology, Regional Cancer Centre, Trivandrum, India
| | | | - Priya Appanraj
- Department of Imageology, Regional Cancer Centre, Trivandrum, India
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Chandar R, Seetharam S, Gopakumar KG, Appanraj P, Cs G, Rajeswari B, Nair M, Thankamony P. Paraneoplastic Demyelinating Sensorimotor Neuropathy Delaying the Diagnosis of an Underlying Acute Lymphoblastic Leukemia in a Child. J Oncol Pract 2018; 14:629-631. [PMID: 30133345 DOI: 10.1200/jop.18.00200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gopakumar KG, Rajeswari B, Chandar R, Krishnankutty Nair R, Thankamony P. Spontaneous intramedullary hematoma and leukemic deposit in spinal cord causing acute onset paraplegia in a child with acute lymphoblastic leukemia. Pediatr Blood Cancer 2018; 65:e27075. [PMID: 29667755 DOI: 10.1002/pbc.27075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/06/2018] [Indexed: 11/07/2022]
Affiliation(s)
| | - Binitha Rajeswari
- Department of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Rumesh Chandar
- Department of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | | | - Priyakumari Thankamony
- Department of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Mullanfiroze K, Boddu D, Chandar R, Nair M, Priya Kumari T. Severity of clinical manifestations of dengue infection in pediatric oncology during maximum immunosuppression: Does it change the clinical course? Pediatric Hematology Oncology Journal 2017. [DOI: 10.1016/j.phoj.2017.11.099] [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: 11/25/2022] Open
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Srinivasaraghavan R, Krishnamurthy S, Chandar R, Mahadevan S, Chandrashekar L, Rajesh NG. Immunoglobulin A nephropathy in association with generalized inflammatory peeling skin syndrome. Pediatr Dermatol 2015; 32:244-7. [PMID: 25196305 DOI: 10.1111/pde.12374] [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: 11/26/2022]
Abstract
We describe an 8-year-old girl born to second-degree consanguineous parents with complaints of recurrent episodes of hematuria for 6 months. She had generalized peeling of the skin since birth and recurrent purulent cutaneous infections. The clinical presentation and histopathology of the skin biopsy specimen were consistent with the inflammatory variant of peeling skin syndrome (PSS). She also had a single ventricle with pulmonary stenosis, for which a bidirectional Glenn shunt had been placed. The renal biopsy specimen showed immunoglobulin A (IgA) nephropathy. She responded well to enalapril and steroids, with a decrease in proteinuria. IgA nephropathy has not been previously reported in PSS. Complications such as IgA nephropathy in children with PSS would help to further delineate the diverse clinical presentations and the clinical course of this rare dermatosis. We discuss the mechanisms that could explain this hitherto unreported association.
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Affiliation(s)
- Rangan Srinivasaraghavan
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Calzetti D, Lee JC, Sabbi E, Adamo A, Smith LJ, Andrews JE, Ubeda L, Bright SN, Thilker D, Aloisi A, Brown TM, Chandar R, Christian C, Cignoni M, Clayton GC, Silva RD, Mink SED, Dobbs C, Elmegreen BG, Elmegreen DM, Evans AS, Fumagalli M, III JSG, Gouliermis DA, Grebel EK, Herrero A, Hunter DA, Johnson KE, Kennicutt RC, Kim H, Krumholz MR, Lennon D, Levay K, Martin C, Nair P, Nota A, Östlin G, Pellerin A, Prieto J, Regan MW, Ryon JE, Schaerer D, Schiminovich D, Tosi M, Dyk SDV, Walterbos R, Whitmore BC, Wofford A. LEGACY EXTRAGALACTIC UV SURVEY (LEGUS) WITH THEHUBBLE SPACE TELESCOPE. I. SURVEY DESCRIPTION. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-6256/149/2/51] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Srinivasaraghavan R, Krishnamurthy S, Chandar R, Cassandrini D, Mahadevan S, Bruno C, Santorelli FM. Acitretin-responsive ichthyosis in Chanarin-Dorfman syndrome with a novel mutation in the ABHD5/CGI-58 gene. Pediatr Dermatol 2014; 31:612-4. [PMID: 23756328 DOI: 10.1111/pde.12170] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 11/30/2022]
Abstract
Chanarin-Dorfman syndrome (CDS) is a rare nonlysosomal neutral lipid storage disorder characterized by congenital ichthyosis, lipid vacuoles in leukocytes (Jordan's anomaly), and hepatomegaly. The authors herein report an 18-month-old boy with ichthyosis and hepatomegaly diagnosed with CDS and confirmed to have a novel c.506-3C>G mutation in the ABHD5/CGI-58 gene. Our case also illustrates that retinoids such as acitretin could be useful in the treatment of skin manifestations in CDS even in the presence of liver derangement.
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Affiliation(s)
- Rangan Srinivasaraghavan
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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