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Kulkarni S, Saha M, Slosberg J, Singh A, Nagaraj S, Becker L, Zhang C, Bukowski A, Wang Z, Liu G, Leser JM, Kumar M, Bakhshi S, Anderson MJ, Lewandoski M, Vincent E, Goff LA, Pasricha PJ. Age-associated changes in lineage composition of the enteric nervous system regulate gut health and disease. eLife 2023; 12:RP88051. [PMID: 38108810 PMCID: PMC10727506 DOI: 10.7554/elife.88051] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
The enteric nervous system (ENS), a collection of neural cells contained in the wall of the gut, is of fundamental importance to gastrointestinal and systemic health. According to the prevailing paradigm, the ENS arises from progenitor cells migrating from the neural crest and remains largely unchanged thereafter. Here, we show that the lineage composition of maturing ENS changes with time, with a decline in the canonical lineage of neural-crest derived neurons and their replacement by a newly identified lineage of mesoderm-derived neurons. Single cell transcriptomics and immunochemical approaches establish a distinct expression profile of mesoderm-derived neurons. The dynamic balance between the proportions of neurons from these two different lineages in the post-natal gut is dependent on the availability of their respective trophic signals, GDNF-RET and HGF-MET. With increasing age, the mesoderm-derived neurons become the dominant form of neurons in the ENS, a change associated with significant functional effects on intestinal motility which can be reversed by GDNF supplementation. Transcriptomic analyses of human gut tissues show reduced GDNF-RET signaling in patients with intestinal dysmotility which is associated with reduction in neural crest-derived neuronal markers and concomitant increase in transcriptional patterns specific to mesoderm-derived neurons. Normal intestinal function in the adult gastrointestinal tract therefore appears to require an optimal balance between these two distinct lineages within the ENS.
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Affiliation(s)
- Subhash Kulkarni
- Division of Gastroenterology, Dept of Medicine, Beth Israel Deaconess Medical CenterBostonUnited States
- Division of Medical Sciences, Harvard Medical SchoolBostonUnited States
| | - Monalee Saha
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Jared Slosberg
- Department of Genetic Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Alpana Singh
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Sushma Nagaraj
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Laren Becker
- Division of Gastroenterology, Stanford University – School of MedicineStanfordUnited States
| | - Chengxiu Zhang
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Alicia Bukowski
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Zhuolun Wang
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Guosheng Liu
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Jenna M Leser
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Mithra Kumar
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Shriya Bakhshi
- Center for Neurogastroenterology, Department of Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Matthew J Anderson
- Center for Cancer Research, National Cancer InstituteFrederickUnited States
| | - Mark Lewandoski
- Center for Cancer Research, National Cancer InstituteFrederickUnited States
| | - Elizabeth Vincent
- Department of Genetic Medicine, Johns Hopkins University – School of MedicineBaltimoreUnited States
| | - Loyal A Goff
- Department of Neuroscience, Johns Hopkins University – School of MedicineBaltimoreUnited States
- Kavli Neurodiscovery Institute, Johns Hopkins University – School of MedicineBaltimoreUnited States
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Sharma J, Arora RS, Trehan A, Bakhshi S, Hazarika M, Verma N, Malhotra P, Tripathi R, Majhi I, Lowe J, William J, Bagai P, Guilmoto C, Arora R. Diagnosis interval is the largest contributor to time to diagnosis and treatment for childhood cancer patients in India results of the InPOG-ACC-16-02 study. Pediatric Hematology Oncology Journal 2022. [DOI: 10.1016/j.phoj.2022.10.246] [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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Kalra M, Bakhshi S, Singh M, Seth R, Verma N, Jain S, Radhakrishnan V, Mandal P, Mahajan A, Arora R, Dinand V, Kapoor G, Sajid M, Thulkar S, Arora A, Taluja A, Chandra J. PET-CT vs CECT for response assessment in childhood Hodgkin Lymphoma - Subset analysis of InPOG HL-15-01 study. Pediatric Hematology Oncology Journal 2021. [DOI: 10.1016/j.phoj.2022.04.011] [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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4
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Jha J, Singh MK, Singh L, Pushker N, Lomi N, Meel R, Chosdol K, Sen S, Bakhshi S, Kashyap S. Association of TYRP1 with hypoxia and its correlation with patient outcome in uveal melanoma. Clin Transl Oncol 2021; 23:1874-1884. [PMID: 33811629 DOI: 10.1007/s12094-021-02597-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/09/2021] [Accepted: 03/12/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Molecular mechanisms of uveal melanoma development in association with high pigmentation are unclear. Tyrosinase Related Protein (TYRP1) is not only one of the important melanogenesis marker that contributes to melanin synthesis, but can also prevents the melanocyte death. The induction of melanogenesis leads to induction of HIF-1α which can affect the behavior of melanoma cells and its surrounding environment. The aim of our study was to determine the expression of TYRP1 and HIF-1α at the protein and RNA level and determine its prognostic significance. METHODS In the present study, the expression of TYRP1 and HIF-1α was investigated on 61 formalin-fixed paraffin-embedded choroidal melanoma samples by immunohistochemistry. Fresh 50 samples were validated by real-time PCR. Results were correlated with clinicopathological parameters and Kaplan-Meier was performed to determine the prognostic significance. RESULTS High immunoexpression of TYRP1 and HIF-1α was present in 61 and 54% of patients, respectively. Both TYRP1 and HIF-1α correlated well with high pigmentation and BAP1 (BRCA1 Associated Protein-1) loss (p < 0.05) at IHC level as well as transcriptional level. There was reduced metastatic free survival in patients with necrosis and this was statistically significant (p = 0.010). CONCLUSION Our findings indicate that TYRP1 can be used as a potential biomarker in the development of targeted therapy in UM. Further studies on melanogenesis markers associated with TYRP1 could provide us a better understanding in this field.
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Affiliation(s)
- J Jha
- Department of Ocular Pathology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - M K Singh
- Department of Dermatology, University of Wisconsin, Madison, USA
| | - L Singh
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - N Pushker
- Department of Ophthalmology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - N Lomi
- Department of Ophthalmology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - R Meel
- Department of Ophthalmology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - K Chosdol
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - S Sen
- Department of Ocular Pathology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - S Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - S Kashyap
- Department of Ocular Pathology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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Ahuja S, Sharma J, Gupta S, Bakhshi S, Seth R, Singh A, Bagai P, Arora RS. Patient tracking during treatment of children with cancer in India - An exploratory study. Cancer Rep (Hoboken) 2021; 5:e1359. [PMID: 33624448 PMCID: PMC9199505 DOI: 10.1002/cnr2.1359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/18/2021] [Accepted: 02/03/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Abandonment of treatment, a major cause of treatment failure in low- and middle-income countries like India, is particularly high during the diagnostic and initial phase of treatment. Tracking of patients during this risk period may reduce treatment abandonment rates and increase quality of care. AIM The primary aim was to pilot the use and check the acceptability of a tool for tracking children with cancer in New Delhi during the initial part of their treatment. Secondary aim was to estimate abandonment rates among these patients. METHODS This prospective study was carried out in two centers of North India in New Delhi and enrolled children less than 18 years diagnosed with cancer at these centers and who had registered with Cankids for social support. Parent support group (PSG) workers maintained contact with the child's family at least once a week for the first 12 weeks. Details of each contact and subsequent action were recorded in a customized book (called "You are not alone" or YANA Book). Descriptive analysis of these contacts was done in Microsoft Excel and presented in frequencies and percentages. The five-point Likert scale was used to check the acceptability of the tool among the PSG workers. RESULTS Seven PSG workers enrolled and tracked 81 patients (73% male with a median age of 6 years). During the 12-week study period, 986 contacts were attempted and three (3.7%) patients had abandoned their treatment. All PSG workers strongly agreed that the YANA book was simple to understand and use, decreased their workload, and helped provide better assistance to patients. CONCLUSION The tool for patient tracking was well accepted by the PSG workers and considered easy to use. We now plan to implement our model as a routine service at all the partnering hospitals in India.
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Affiliation(s)
- S Ahuja
- Quality Care Research and Impact, Cankids, New Delhi, India
| | - J Sharma
- Quality Care Research and Impact, Cankids, New Delhi, India
| | - S Gupta
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - S Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - R Seth
- Department of Paediatrics, Division of Paediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - A Singh
- Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - P Bagai
- Quality Care Research and Impact, Cankids, New Delhi, India
| | - R S Arora
- Quality Care Research and Impact, Cankids, New Delhi, India.,Max Super-Speciality Hospital, Medical Oncology, New Delhi, India
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Sharma D, Khan S, Bakhshi S, R A. Extracorporeal Irradiation in Pediatric Bone Sarcomas. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.590] [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: 11/17/2022]
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Singh MK, Singh L, Pushker N, Chosdol K, Bakhshi S, Meel R, Sen S, Kashyap S. Constitutive expression of c-REL in uveal melanoma patients: correlation with clinicopathological parameters and patient outcome. Clin Transl Oncol 2020; 22:1193-1204. [PMID: 31768922 DOI: 10.1007/s12094-019-02247-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/12/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Uveal melanoma (UM) is the most common intraocular cancer with a high mortality rate that requires new research in the field of prevention and treatment. c-REL is a member of the nuclear factor κB (NF-κB) transcription factor family and an emerging regulator of tumorigenesis. Therefore, the objective of the study is to evaluate the constitutive expression of c-REL in uveal melanoma patients and its prognostic significance. METHODS Detection of c-REL expression was carried out by immunohistochemistry in all 75 patients, and qRT-PCR performed on 58 fresh cases of uveal melanoma along with IL-6 status. Immunoblot was performed to validate immunohistochemistry results. Expression of c-REL protein correlated with clinicopathological parameters and overall survival of patients. RESULTS Immunohistochemistry results revealed nuclear expression of the c-REL protein (56%) in our cases. Out of 75 cases, 31 cases showed nuclear expression, and 11 cases had cytoplasmic expression. qRT-PCR showed upregulation of the REL gene in 56.89% cases at the transcriptional level. There was a statistically significant difference in the overall survival of patients with c-REL nuclear immunopositivity (p = 0.0048). On multivariate analysis, scleral invasion and c-REL nuclear expression found to be an independent prognostic factor (p < 0.05) CONCLUSIONS: To the best of our knowledge, this was the first study reporting the expression of the c-REL protein in uveal melanoma. Strong nuclear immunoexpression of c-Rel suggests NFκB pathway activation which might be involved in the progression of the disease. Differential expression of c-REL protein may be used as an attractive target for the development of anticancer strategies.
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Affiliation(s)
- M K Singh
- Department of Ocular Pathology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - L Singh
- Departrment of Biosciences, JMI, New Delhi, India
| | - N Pushker
- Department of Ophthalmology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - K Chosdol
- Department of Biochemistry, AIIMS, New Delhi, India
| | - S Bakhshi
- Department of Medical Oncology, IRCH, AIIMS, New Delhi, India
| | - R Meel
- Department of Ophthalmology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - S Sen
- Department of Ocular Pathology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - S Kashyap
- Department of Ocular Pathology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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Singh M, Kashyap S, Singh L, Pushker N, Bakhshi S, Sen S. Loss of BAP-1 influences the activation of p52 and RelB proteins in the Inflammatory microenvironment of uveal melanoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz452.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Natarajan H, Kumar L, Bakhshi S, Sharma A, Velpandian T, Kabra M, Gogia A, Biswas N, Gupta Y. Imatinib induced toxicity and its influence on cytogenetic and molecular response in newly diagnosed patients with chronic myeloid leukemia. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz427.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mann M, Kumar S, Sharma A, Chauhan S, Bhatla N, Kumar S, Bakhshi S, Gupta R, Kumar L. PARP inhibition enhances cisplatin sensitivity in cervical cancer by modulating β-catenin signaling. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gaur V, Chaudhary S, Tyagi A, Bakhshi S, Sharma P, Kumar S. Differential expression of various miRNAs in pediatric cytogenetically normal acute myeloid leukemia (CN-AML). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kashyap S, Singh M, Singh L, Pushker N, Sen S, Meel R, Bakhshi S, Chawla B, Kaur J. Prognostic significance of c-Rel/p50 heterodimer in the tumor microenvironment of uveal melanoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.018] [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: 11/14/2022] Open
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Mahajan A, Arora R, Dinand V, Kalra M, Jain S, Bakhshi S, Singh M, Seth R, Verma N, Kumar A, Radhakrishnan V, Mandal P, Kapoor G, Phulkar S, Arora A, Taluja A, Chandra J. Empirical Anti-tubercular Treatment given to children with Hodgkin Lymphoma: does it impact outcomes? Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.017] [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: 10/26/2022] Open
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Arora R, Rahman R, Joe W, Bakhshi S, Radhakrishnan V, Mahajan A, Chinnaswamy G, Bhattacharya A, Swami A, Manglani M, Seth R, Singh A, De S, MS L, Raj R, Borker A, Martiniuk A, Tsimicalis A. Families of Children Newly Diagnosed With Cancer Incur Significant Out-of-Pocket Expenditure for Treatment: Report of a Multi-Site Prospective Longitudinal Study From India (INPOG-ACC-16-01). J Glob Oncol 2018. [DOI: 10.1200/jgo.18.42400] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Diagnosis of cancer in a child places considerable economic burden on families. The health expenditures are more catastrophic in resource limited countries like India where GDP spend on health is just over 1% and financing of treatment is usually out-of-pocket (OOP). Consequently parents may abandon their child's cancer treatment to ensure financial sustainability of the family. Research in this area is mostly from resource rich countries and OOP expenditure burden remains unknown in India. Aim: The objective of this study is to describe the OOP expenditure incurred by families of children (< 18 years age) with cancer being treated in India prior to and during cancer directed treatment. Methods: A prospective cost of illness study from a family household perspective was conducted in 14 centers (5 public, 5 private and 4 charitable trust sector) in 4 cities in India from 2016-2018. Baseline family demographic and socioeconomic data were collected followed by OOP expenditure incurred prior to start of treatment. For the duration of the child's treatment, a social worker contacted parents at regular intervals to record their expenditure on cancer directed treatment. Data collection was stopped when one of these happened - completion of treatment or death or progression/relapse or abandonment or transfer. Data were described descriptively and a univariate/multivariate analysis using logistic regression was done to detect factors associated with OOP expenditure. Results: 394 children (63% male, median age 5 years) with cancer (64% leukemia/lymphoma, 33% solid tumors, 3% CNS tumors) were enrolled from public (45%), charitable trust (28%) and private (27%) sector hospitals. They were symptomatic for a median duration of 6 weeks (range 0 to 104 weeks). 88% had no insurance and 73% were from families with monthly income of ≤ 10,000 rupees (≤ 159 US$). Mean OOP expenditure was Rs 209,500 (3325 US$) which is 195% of per capita income (1706 US$) of India. OOP expenditure from onset of symptoms to start of treatment was Rs 53,104 (843 US$) of which 77% was medical (15% laboratory tests, 11% medicines, 9% hospital bed costs) and 23% nonmedical (12% travel, 6% food, 3% lodging). OOP expenditure on cancer directed treatment was Rs 156,396 (2482 US$) of which 64% was medical (9% hospital bed costs, 9% supportive care drugs, 8% laboratory tests) and 36% nonmedical (19% food, 9% travel, 6% lodging). On univariate analysis age, gender, city, type of treatment facility, insurance, type of cancer, driving time and distance were significantly associated with OOP expenditure but only insurance and type of treatment facility were found significant on multivariate analysis. Conclusion: Families of children with cancer incur significant OOP expenditure prior to and during cancer directed treatment, which includes a significant portion on nonmedical expenses. Expenditure varied significantly by insurance and type of treatment facility.
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Affiliation(s)
- R. Arora
- Max Super Speciality Hospital, New Delhi, India
| | - R.U. Rahman
- Max Super Speciality Hospital, New Delhi, India
| | - W. Joe
- Max Super Speciality Hospital, New Delhi, India
| | - S. Bakhshi
- Max Super Speciality Hospital, New Delhi, India
| | | | - A. Mahajan
- Max Super Speciality Hospital, New Delhi, India
| | | | | | - A. Swami
- Max Super Speciality Hospital, New Delhi, India
| | - M. Manglani
- Max Super Speciality Hospital, New Delhi, India
| | - R. Seth
- Max Super Speciality Hospital, New Delhi, India
| | - A. Singh
- Max Super Speciality Hospital, New Delhi, India
| | - S. De
- Max Super Speciality Hospital, New Delhi, India
| | - L. MS
- Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - R. Raj
- Apollo Speciality Cancer Hospital, Chennai, India
| | - A. Borker
- Asian Institute of Oncology, Mumbai, India
| | - A. Martiniuk
- The George Institute for Global Health, Sydney, Australia
- University of Sydney, Faculty of Medicine, Sydney, Australia
| | - A. Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, Canada
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Singh L, Singh M, Pushker N, Bakhshi S, Rizvi M, Sen S, Kashyap S. Immune checkpoints and T-lymphocytes as immunotherapeutic target in the treatment of sebaceous gland carcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Singh M, Meel R, Pushker N, Sen S, Chodsol K, Bakhshi S, Kashyap S. Activation of non-canonical NFκB (NC-NFκB) pathway in inflammatory environment of uveal melanoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.029] [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: 11/14/2022] Open
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Mahajan A, Arora R, Dinand V, Kalra M, Jain S, Bakhshi S, Singh M, Seth R, Verma N, Kumar A, Radhakrishnan V, Mandal P, Kapoor G, Phulkar S, Arora A, Taluja A, Chandra J. Hodgkin lymphoma in the children under 5 years of age: do they behave diiferently? Pediatric Hematology Oncology Journal 2018. [DOI: 10.1016/j.phoj.2018.11.064] [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: 11/28/2022] Open
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18
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Agarwal M, Chaudhary M, Bakhshi S, Saxena R, Dwivedi S, Kabra M, Lall M, Shukla R, Seth R. Gene copy number alterations in Indian children with acute lymphoblastic leukemia. Pediatric Hematology Oncology Journal 2018. [DOI: 10.1016/j.phoj.2018.11.006] [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: 10/27/2022] Open
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Arora R, Rahman R, Joe W, Bakhshi S, Dhawan D, Radhakrishnan V, Kalra M, Chinnaswamy G, Das A, Mudaliar S, Sangareddi S, Sharma S, Seth R, Singh A, De S, Scott J, Uppuluri R, Borker A, Sankaran H, Bagai P. Families Of Children Newly Diagnosed With Cancer Incur Significant Out-Of-Pocket Expenditure For Treatment – Report Of A Multi-Site Prospective Longitudinal Study From India (INPOG-ACC-16-01). Pediatric Hematology Oncology Journal 2018. [DOI: 10.1016/j.phoj.2018.11.038] [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: 11/29/2022] Open
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Singh L, Kashyap S, Pushker N, Bakhshi S, Sen S, Rizvi M. Expression pattern of immune checkpoints programmed death (PD-1) and programmed death-ligand (PD-L1) in retinoblastoma and its prognostic significance. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Boby E, Sharma G, Jain A, Mudassir M, Chattopadhyay P, Chopra A, Bakhshi S, Kumar J. Novel biomarker to diagnose ETV6-RUNX1 translocation in B-cell acute lymphoblastic leukemia. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx664.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mallick S, Lone M, Ramteke P, Purokait S, Gogia A, Batra A, Bakhshi S, Sharma A, Sharma M. CLINICO-PATHOLOGICAL PROFILE AND CMYC IMMUNOREACTIVITY OF ALK POSITIVE LARGE B CELL LYMPHOMA: REPORT OF NINE CASES. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Mallick
- Pathology; All India Institute of Medical Sciences; New Delhi India
| | - M.R. Lone
- Pathology; All India Institute of Medical Sciences; New Delhi India
| | - P. Ramteke
- Pathology; All India Institute of Medical Sciences; New Delhi India
| | - S. Purokait
- Pathology; All India Institute of Medical Sciences; New Delhi India
| | - A. Gogia
- Department of Medical Oncology; All India Institute of Medical Sciences; New Delhi India
| | - A. Batra
- Department of Medical Oncology; All India Institute of Medical Sciences; New Delhi India
| | - S. Bakhshi
- Department of Medical Oncology; All India Institute of Medical Sciences; New Delhi India
| | - A. Sharma
- Department of Medical Oncology; All India Institute of Medical Sciences; New Delhi India
| | - M.C. Sharma
- Pathology; All India Institute of Medical Sciences; New Delhi India
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Misra A, Chopra A, Kumar R, Bakhshi S. Diagnostic considerations in juvenile myelomonocytic leukemia in tropical settings. Int J Lab Hematol 2017; 39:e77-e79. [PMID: 28263030 DOI: 10.1111/ijlh.12626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Misra
- DR BRAIRCH, Laboratory Oncology, AIIMS New Delhi, New Delhi, India
| | - A Chopra
- DR BRAIRCH, Laboratory Oncology, AIIMS New Delhi, New Delhi, India
| | - R Kumar
- DR BRAIRCH, Laboratory Oncology, AIIMS New Delhi, New Delhi, India
| | - S Bakhshi
- IRCH, Medical Oncology, AIIMS, New Delhi, India
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Tiwari P, Biswas B, Bakhshi S, Kumar L. 517P Primitive neuroectodermal tumor of kidney: analysis of 20 cases. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw597.017] [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: 11/14/2022] Open
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Tiwari P, Biswas B, Bakhshi S, Kumar L. 517P Primitive neuroectodermal tumor of kidney: analysis of 20 cases. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00675-x] [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: 11/30/2022] Open
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26
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Natarajan H, Kumar L, Bakhshi S, Sharma A, Velpandian T, Gogia A, Gupta Y. 335O Imatinib trough levels: A potential biomarker to predict cytogenetic and molecular response in newly diagnosed patients with chronic myeloid leukemia. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00493-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kumar A, Biswas B, Biswas A, Bakhshi S. 506PD Ewing Sarcoma family tumors of vertebral column treated with uniform chemotherapy protocols: Experience from a tertiary cancer care center. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00664-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Gupta V, Gogia A, Mehta P, Kumar L, Sharma A, Bakhshi S, Thulkar S, Sharma M, Mallick S, Sahoo R, Malik P. 356P Early stage natural killer/T cell lymphoma with local tumor invasiveness treated with a uniform SMILE protocol: An institutional study from India. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw586.025] [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: 11/14/2022] Open
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29
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Natarajan H, Kumar L, Bakhshi S, Sharma A, Velpandian T, Gogia A, Gupta Y. 335O Imatinib trough levels: A potential biomarker to predict cytogenetic and molecular response in newly diagnosed patients with chronic myeloid leukemia. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw586.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kumar A, Biswas B, Biswas A, Bakhshi S. 506PD Ewing Sarcoma family tumors of vertebral column treated with uniform chemotherapy protocols: Experience from a tertiary cancer care center. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw597.006] [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: 11/12/2022] Open
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31
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Reddy R, Pathania S, Kapil A, Bakhshi S. Review of spectrum and sensitivity of bacterial bloodstream isolates in children with malignancy: A retrospective analysis from a single center. Indian J Cancer 2016; 51:425-7. [PMID: 26842147 DOI: 10.4103/0019-509x.175363] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Febrile neutropenia is a life-threatening emergency in pediatric cancer patients. Its management is based on established guidelines that emphasize on prompt action. Consideration of local microbiologic spectrum and its susceptibility is pivotal in devising a rational protocol. AIMS To study the spectrum of bacterial isolates and its antibiotic sensitivity profile in bloodstream infections (BSIs) of pediatric cancer patients. SETTINGS AND DESIGN Retrospective study. MATERIALS AND METHODS This study was conducted at a tertiary cancer center for pediatric cancer patients. Blood culture samples sent during the evaluation of patients with clinical diagnosis of febrile neutropenia during the year of 2013 were analyzed. The microbiological and antibiotic sensitivity patterns were studied. RESULTS A total of 27 isolates represented BSIs out of 412 blood cultures sent (6.5%). These were predominantly Gram-negative (92%) with Klebsiella contributing to the majority of them. Extended spectrum beta-lactamase production was seen in 59% of all isolates. Multidrug resistance phenotype was seen in 48%, extreme drug resistance in 32% and pan drug resistance in 16% of Gram-negative isolates. Klebsiella predominated in all of these isolates. Mortality resulted in 15% isolates, majorly contributed by Klebsiella. Colistin was the most sensitive antibiotic (75% sensitivity) and in significant number of cases the only salvage option. CONCLUSION Gram-negative bacteria are the most common etiologic agents. The emergence of drug resistant strains of Klebsiella and the poor sensitivity of most of these strains to common first choice empiric agents is alarming. Low prevalence of Gram-positive organisms questions the routine use of empiric vancomycin.
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Affiliation(s)
| | | | | | - S Bakhshi
- Department of Medical Oncology, All Institute of Medical Sciences, New Delhi, India
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Batra A, Dhawan D, Bakhshi S. Psychosocial quality of life in 30 survivors of bilateral retinoblastoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw386.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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33
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Natarajan H, Kumar L, Bakhshi S, Sharma A, Kabra M, Velpandian T, Gogia A, Shastri S, Gupta Y. Do MDR1 & CYP3A5 genetic polymorphisms influence the risk of cytogenetic relapse in patients with chronic myeloid leukemia on imatinib therapy? Ann Oncol 2016. [DOI: 10.1093/annonc/mdw375.31] [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: 11/14/2022] Open
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Abstract
Annual influenza immunisation is the recommended practice for people such as the elderly, for whom influenza poses a substantial risk of serious illness and death. Influenza vaccines are effective in preventing, or ameliorating influenza, reducing complications and mortality (Department of Health, 2001, 2002). In long-stay residential accommodation, influenza immunisation should prevent rapid spread of infection causing outbreaks (Communicable Disease Centre, 2003). This paper reports on two outbreaks of influenza that occurred in vaccinated elderly in residential institutions. In both outbreaks the isolated virus strain was included in the composition of the influenza vaccine for that winter season. Suboptimal protection against influenza may be provided in the vaccinated elderly, due to declining competency of the ageing immune system. Furthermore, the occurrence in the late winter of these outbreaks may demonstrate waning immunity following immunisation early in the season.
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Affiliation(s)
- OM Etuwewe
- Public Health Medicine, Birmingham and Solihull Health Protection Unit, Health Protection Agency, Bartholomew House, 142 Hagley Road, Birmingham B16 9PA
| | - H. May
- Public Health Medicine, Birmingham and Solihull Health Protection Unit, Health Protection Agency, Bartholomew House, 142 Hagley Road, Birmingham B16 9PA
| | | | - A. Wood
- Community Infection control team, University Hospital, Birmingham
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Gupta R, Chandgothia M, Dahiya M, Bakhshi S, Sharma A, Kumar L. Multi-drug resistance protein 1 as prognostic biomarker in clinical practice for acute myeloid leukemia. Int J Lab Hematol 2016; 38:e93-7. [PMID: 27321806 DOI: 10.1111/ijlh.12529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R Gupta
- All India Institute of Medical Sciences, New Delhi, India.
| | - M Chandgothia
- All India Institute of Medical Sciences, New Delhi, India
| | - M Dahiya
- All India Institute of Medical Sciences, New Delhi, India
| | - S Bakhshi
- All India Institute of Medical Sciences, New Delhi, India
| | - A Sharma
- All India Institute of Medical Sciences, New Delhi, India
| | - L Kumar
- All India Institute of Medical Sciences, New Delhi, India
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Srivastava R, Batra A, Tyagi A, Dhawan D, Ramakrishnan L, Bakhshi S. Adiponectin correlates with obesity: A study of 159 childhood acute leukemia survivors from India. Indian J Cancer 2016; 52:195-7. [PMID: 26853401 DOI: 10.4103/0019-509x.175824] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Acute lymphoblastic leukemia survivors are predisposed to obesity. However, the exact underlying mechanisms are not known. AIMS The study was done to assess the role of biomarkers of obesity in acute leukemia survivors. SETTINGS AND DESIGNS This is a cross-sectional study conducted at All India Institute of Medical Sciences in survivors of acute leukemia who had completed treatment at least 1 year before enrollment in this study. MATERIALS AND METHODS Obesity was studied by determining the body mass index. Potential biomarkers were studied by assessing serum leptin, resistin, and adiponectin by enzyme-linked immunosorbant assay, and the results were compared in obese versus nonobese survivors. STATISTICAL ANALYSIS Descriptive analysis for baseline demographic factors and Student's t-test for comparing the mean levels of biomarkers among the obese and nonobese survivors. RESULTS One hundred and fifty-nine acute leukemia patients were enrolled in this study with a median follow-up of 36.8 months. The median age was 10 (range: 3-18) years, and 123 (77.3%) patients were males. The overall prevalence of overweight/obesity was 26.4%, and this was similar in acute myeloid leukemia and acute lymphoblastic leukemia sub-groups (26.2% vs. 27.3%, P = 0.9). Mean serum leptin and resistin were similar in obese and nonobese leukemia survivors (3.7 vs. 2.85 pg/mL, P = 0.064; 8.01 vs. 9.33 ng/mL, P = 0.36). However, mean serum adiponectin was significantly lower in obese leukemia survivors (7.97 vs. 11.5 μg/mL, P = 0.023). CONCLUSIONS Obese leukemic survivors had lower serum adiponectin levels than nonobese survivors. However, serum resistin and leptin levels were similar in the two groups.
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Affiliation(s)
| | | | | | | | | | - S 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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Arora R, Mardakis S, Tsimicalis A, Bakhshi S, Arora A, Anis H. The costs experienced by caregivers of children being treated for cancer in New Delhi, India. Pediatric Hematology Oncology Journal 2016. [DOI: 10.1016/j.phoj.2016.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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38
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Mehta P, Kumar L, Raina V, Sharma A, Bakhshi S, Gogia A, Sahoo R, Pabbi S, Chopra A, Kumar R. 285O High dose (18 g/m2) versus low dose (12 g/m2) cytosine arabinoside as consolidation for acute myeloid leukemia: A phase 3 study: An interim analysis. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv526.01] [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: 11/14/2022] Open
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39
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Batra A, Pushker N, Venkatesh P, Bakhshi S. 507P Visual outcomes and ocular coherence tomography in patients with intraocular retinoblastoma with eye preservation. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv535.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Yekta A, Khabazkhoob M, Hashemi H, Bakhshi S, Ostadimoghaddam H, Heravian J, Rezvan F, Yekta R. Comparison of corneal topographic indices of keratoconus versus normal eyes by using pentacam imaging. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- A.A. Yekta
- Optometry; Mashhad University of Medical Sciences; Mahhad Iran
| | - M. Khabazkhoob
- Noor Ophtalmology Research Center; Noor Eye Hospital; Tehran Iran
| | - H. Hashemi
- Noor Ophthalmology Research Center; Noor Eye Hospital; Tehran Iran
| | - S. Bakhshi
- Optometry; Mashhad University of Medical Sciences; Mashhad Iran
| | | | - J. Heravian
- Optometry; Mashhad University of Medical Sciences; Mashhad Iran
| | - F. Rezvan
- Noor Ophthalmology Research Center; Noor Eye Hospital; Tehran Iran
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Sultania M, Shukla N, Deo S, Bakhshi S, Sharma D, Thulkar S. 3424 Clinical profile, treatment patterns and outcome of head and neck sarcomas in a tertiary care cancer centre. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31897-4] [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: 11/30/2022]
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42
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Nataraj V, Bakhshi S, Khan S, Rastogi S, Agarwala S. 3442 Timing of relapse and Surgery post relapse is predictive of survival in relapsed osteosarcoma patients - an observational study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31915-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Batra A, Patekar M, Bakhshi S. Short stature in retinoblastoma survivors: a cross-sectional study of 138 patients. Clin Transl Oncol 2015; 18:381-4. [PMID: 26286069 DOI: 10.1007/s12094-015-1380-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/05/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE Short stature has been reported in pediatric cancer survivors. Data on retinoblastoma survivors are limited. We conducted a cross-sectional study to assess the height in retinoblastoma survivors. METHOD The recorded height was compared with median height for age and sex as per the Indian Academy of Pediatrics. Z-score less than -2 was considered short statured. RESULT Thirty percent of the survivors were short statured. The mean height was shorter than the mean 50th percentile height (119.7 ± 14.8 vs 128.7 ± 15 cm, p < 0.001). Previous chemotherapy showed a trend toward association (p = 0.09). CONCLUSION Short stature affects a significant number of retinoblastoma survivors.
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Affiliation(s)
- A Batra
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - M Patekar
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - S Bakhshi
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Iqbal N, Shukla NK, Deo SVS, Agarwala S, Sharma DN, Sharma MC, Bakhshi S. Prognostic factors affecting survival in metastatic soft tissue sarcoma: an analysis of 110 patients. Clin Transl Oncol 2015; 18:310-6. [DOI: 10.1007/s12094-015-1369-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 07/20/2015] [Indexed: 12/27/2022]
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Affiliation(s)
- S Soni
- Laboratory Oncology unit, All India Institute of Medical Sciences, New Delhi, India
| | - A Chopra
- Laboratory Oncology unit, All India Institute of Medical Sciences, New Delhi, India.
| | - S Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - A Vishwanath
- Laboratory Oncology unit, All India Institute of Medical Sciences, New Delhi, India
| | - D Verma
- Laboratory Oncology unit, All India Institute of Medical Sciences, New Delhi, India
| | - S Rai
- Laboratory Oncology unit, All India Institute of Medical Sciences, New Delhi, India
| | - R Kumar
- Laboratory Oncology unit, All India Institute of Medical Sciences, New Delhi, India
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Bakhshi S, Srivastava R, Pushpam D, Dhawan D. Indicators of malnutrition in children with cancer: A study of 690 patients from a tertiary care cancer center. Indian J Cancer 2015; 52:199-201. [DOI: 10.4103/0019-509x.175825] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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47
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Biswas B, Rastogi S, Khan SA, Shukla NK, Deo SVS, Agarwala S, Mohanti BK, Sharma MC, Vishnubhatla S, Bakhshi S. Developing a prognostic model for localized Ewing sarcoma family of tumors: A single institutional experience of 224 cases treated with uniform chemotherapy protocol. J Surg Oncol 2014; 111:683-9. [PMID: 25557999 DOI: 10.1002/jso.23861] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 11/14/2014] [Accepted: 11/14/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Data on patients with localized Ewing sarcoma family of tumors (ESFT) who have received a uniform chemotherapy protocol are minimal. METHODS This is a single institutional review of patients with ESFT treated between June 2003 and November 2011. RESULTS 224/374 (60%) patients with ESFT presented with localized disease; median age was 15 years (range: 0.1-55). Ninety-nine patients underwent surgery of which 50 received adjuvant radiotherapy; 80 patients received radical radiotherapy following neoadjuvant chemotherapy. At median follow-up of 40.2 months (range: 1.3-129), 5-year EFS, OS, and local-control-rate, were 36.8 ± 3.6%, 52.4 ± 4.3%, and 63 ± 4.3%, respectively. In multivariate analysis, tumor diameter > 8 cm (P = 0.03), symptom duration > 4 months (P = 0.04), and WBC > 11 × 10(9) /L (P = 0.003) predicted inferior EFS; spine/abdomino-pelvic primary (P = 0.009) and WBC > 11 × 10(9) /L (P = 0.003) predicted inferior OS. Tumor size > 8 cm (P = 0.03) and radical radiotherapy as local treatment (P = 0.01) predicted inferior local-control-rate. CONCLUSION Prognostic hazard models for EFS and OS based on significant prognostic factors suggested that patients with combination of ESFT of spine/abdomino-pelvic region and baseline WBC > 11 × 10(9) /L had inferior OS (hazard ratio 4.44, P < 0.001) while patients with combination of ESFT with symptom duration > 4 months, tumor diameter > 8 m and baseline WBC > 11 × 10(9) /L had inferior EFS (hazard ratio 3.89, P = 0.002).
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Affiliation(s)
- Bivas Biswas
- Department of Medical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Gupta SK, Chopra A, Singh S, Kumar R, Bakhshi S, Kumar L, Sharma A. Absence of CD9 expression in acute myeloid leukemia: possible correlation with t(8;21). Int J Lab Hematol 2014; 37:e56-8. [PMID: 25263263 DOI: 10.1111/ijlh.12296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S K Gupta
- Lab Oncology Unit, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Iqbal N, Shukla N, Deo S, Agarwala S, Sharma M, Bakhshi S. Evaluation of Outcome and Prognostic Factors in Synovial Sarcoma: a Single Large Institutional Study of 139 Cases. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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50
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Biswas B, Rastogi S, Khan SA, Shukla NK, Deo SVS, Agarwala S, Sharma DN, Thulkar S, Vishnubhatla S, Pathania S, Bakhshi S. Hypoalbuminaemia is an independent predictor of poor outcome in metastatic Ewing's sarcoma family of tumours: a single institutional experience of 150 cases treated with uniform chemotherapy protocol. Clin Oncol (R Coll Radiol) 2014; 26:722-9. [PMID: 24919857 DOI: 10.1016/j.clon.2014.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 09/03/2013] [Revised: 03/28/2014] [Accepted: 05/12/2014] [Indexed: 01/30/2023]
Abstract
AIMS Data on metastatic Ewing's sarcoma family of tumours (ESFT) with uniform chemotherapy protocol are minimal. MATERIALS AND METHODS This was a single institutional patient review of patients treated between June 2003 and November 2011 and evaluated on an intent-to-treat analysis. All patients received uniform chemotherapy: neoadjuvant chemotherapy (NACT), surgery and/or radiotherapy as local treatment followed by adjuvant chemotherapy. Local treatment was offered if the patient achieved a complete response and/or a partial response at both the primary and the metastatic site. RESULTS In total, 150/374 (40%) ESFT patients were metastatic, with a median age of 15 years (range: 2-50); a tumour diameter of 10 cm (range: 1.8-26). Most common metastatic sites were lung only (53; 35%), bone only (35; 23%) and combined bone/lung (25; 17%). Twenty patients underwent surgery; 55 patients received radical radiotherapy after NACT. After a median follow-up of 26.1 months (range: 1.6-101.6), 5 year event-free survival (EFS), overall survival and local control rate (LCR) were 9.1 ± 3.3%, 16.9 ± 5.2% and 31.8 ± 7.9%, respectively. Univariate analysis showed serum albumin ≤3.4 g/dl (P < 0.001) to predict inferior EFS. Tumour size >8 cm (P = 0.05), haemoglobin ≤10 g/dl (P = 0.04), hypoalbuminaemia (P = 0.003) and radical radiotherapy as local treatment (P = 0.03) predicted inferior overall survival. No factor significantly predicted LCR, although age ≤15 years (P = 0.08) and radical radiotherapy as local treatment (P = 0.09) had a trend towards inferior LCR. Hypoalbuminaemia was the only prognostic factor to predict EFS on multivariate analysis. CONCLUSION This was the largest study of metastatic ESFT from Asia and identified a unique prognostic factor. In view of dismal prognosis with conventional chemotherapy in metastatic ESFT with hypoalbuminaemia, palliative intent therapy may be a potential therapeutic alternative for this subgroup of patients, especially in resource-challenged situations.
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Affiliation(s)
- B Biswas
- Department of Medical Oncology, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Rastogi
- Department of Orthopedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S A Khan
- Department of Orthopedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - N K Shukla
- Department of Surgical Oncology, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S V S Deo
- Department of Surgical Oncology, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Agarwala
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - D N Sharma
- Department of Radiotherapy, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Thulkar
- Department of Radiodiagnosis, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Vishnubhatla
- Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Pathania
- Department of Medical Oncology, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Bakhshi
- Department of Medical Oncology, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
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