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Elitzur S, Vora A, Burkhardt B, Inaba H, Attarbaschi A, Baruchel A, Escherich G, Gibson B, Liu H, Loh M, Moorman A, Moricke A, Pieters R, Uyttebroeck A, Baird S, Bartram J, Ben-Harosh M, Bertrand Y, Buitenkamp T, Caldwell K, Drut R, Geerlinks A, Grainger J, Haouy S, Heaney N, Huang M, Ingham D, Krenova Z, Kuhlen M, Lehrnbecher T, Manabe A, Niggli F, Paris C, Revel-Vilk S, Rohrlich P, Sandeep B, Sinno M, Szczepanski T, Tamesberger M, Warrier R, Wolfl M, Nirel R, Izraeli S, Borkhardt A, Schmiegelow K. EBV-DRIVEN LYMPHOID NEOPLASMS ASSOCIATED WITH ALL MAINTENANCE THERAPY: AN INTERNATIONAL OBSERVATINAL STUDY. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00201-6] [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: 11/06/2022]
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2
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Vaid A, T. R, Batra U, Krishna VM, Rangrajan B, Narayanan P, Vora A, Advani SH. Robust Guidelines for the Management of HR+ Her2− EBC: Crucial Value of CanAssist Breast. South Asian J Cancer 2022; 11:95-96. [DOI: 10.1055/s-0042-1756179] [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: 10/15/2022] Open
Affiliation(s)
- Ashok Vaid
- Department of Medical & HematoOncology, Cancer Institute, Medanta Hospital, Gurugram, Haryana, India
| | - Raja T.
- Department of Medical Oncology & BMT, Apollo Hospital, Chennai, Tamil Nadu, India
| | - Ullas Batra
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute, New Delhi, India
| | | | - Bharath Rangrajan
- Department of Medical Oncology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
| | - Prasad Narayanan
- Department of Medical Oncology, Hemato Oncology and BMT, Cytecare Hospital, Bengaluru, Karnataka, India
| | - Amish Vora
- Department of Medical Oncology, Hope Cancer Clinic, New Delhi, India
| | - Suresh H. Advani
- Smita Memorial Hospital & Research Center, Thodupuza, Kerala, India
- Department of Medical Oncology, Sushrut Hospital, Jaslok Hospital, Nanavati Hospital, HN Reliance Hospital, SL Raheja Hospital, Mumbai, Maharashtra, India
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Stutterheim J, de Lorenzo P, van der Sluin IM, Alten J, Ancliffe P, Attarbaschi A, Aversa L, Boer JM, Biondi A, Brethon B, Diaz P, Cazzaniga G, Escherich G, Ferster A, Kotecha RS, Lausen B, Leung AW, Locatelli F, Silverman L, Stary J, Szczepanski T, van der Velden VHJ, Vora A, Zuna J, Schrappe M, Valsecchi MG, Pieters R. Minimal residual disease and outcome characteristics in infant KMT2A-germline acute lymphoblastic leukaemia treated on the Interfant-06 protocol. Eur J Cancer 2021; 160:72-79. [PMID: 34785111 DOI: 10.1016/j.ejca.2021.10.004] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The outcome of infants with KMT2A-germline acute lymphoblastic leukaemia (ALL) is superior to that of infants with KMT2A-rearranged ALL but has been inferior to non-infant ALL patients. Here, we describe the outcome and prognostic factors for 167 infants with KMT2A-germline ALL enrolled in the Interfant-06 study. METHODS Univariate analysis on prognostic factors (age, white blood cell count at diagnosis, prednisolone response and CD10 expression) was performed on KMT2A-germline infants in complete remission at the end of induction (EOI; n = 163). Bone marrow minimal residual disease (MRD) was measured in 73 patients by real-time quantitative polymerase chain reaction at various time points (EOI, n = 68; end of consolidation, n = 56; and before OCTADAD, n = 57). MRD results were classified as negative, intermediate (<5∗10-4), and high (≥5∗10-4). RESULTS The 6-year event-free and overall survival was 73.9% (standard error [SE] = 3.6) and 87.2% (SE = 2.7). Relapses occurred early, within 36 months from diagnosis in 28 of 31 (90%) infants. Treatment-related mortality was 3.6%. Age <6 months was a favourable prognostic factor with a 6-year disease-free survival (DFS) of 91% (SE = 9.0) compared with 71.7% (SE = 4.2) in infants >6 months of age (P = 0.04). Patients with high EOI MRD ≥5 × 10-4 had a worse outcome (6-year DFS 61.4% [SE = 12.4], n = 16), compared with patients with undetectable EOI MRD (6-year DFS 87.9% [SE = 6.6], n = 28) or intermediate EOI MRD <5 × 10-4 (6-year DFS 76.4% [SE = 11.3], n = 24; P = 0.02). CONCLUSION We conclude that young age at diagnosis and low EOI MRD seem favourable prognostic factors in infants with KMT2A-germline ALL and should be considered for risk stratification in future clinical trials.
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Affiliation(s)
- J Stutterheim
- Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - P de Lorenzo
- Center of Bioinformatics, Biostatistics and Bioimaging, University of Milano-Bicocca, Monza, Italy; Pediatrics, School of Medicine and Surgery, University of Milano- Bicocca, Fondazione MBBM/San Gerardo Hospital, Monza, Italy
| | - I M van der Sluin
- Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - J Alten
- Pediatrics, University Medical Center Schleswig-Holstein, Christian-Albrechts-University of Kiel, Germany
| | - P Ancliffe
- United Kingdom Children Cancer Study Group, London, United Kingdom
| | - A Attarbaschi
- St Anna Children's Hospital, Pediatric Hematology and Oncology, Austria
| | | | - J M Boer
- Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - A Biondi
- Pediatrics, School of Medicine and Surgery, University of Milano- Bicocca, Fondazione MBBM/San Gerardo Hospital, Monza, Italy
| | - B Brethon
- Department of Pediatric Hematology, University Robert Debre Hospital, APHP, Paris, France
| | - P Diaz
- Chilean National Pediatric Oncology Group, Santiago, Chile
| | - G Cazzaniga
- Tettamanti Research Center, Pediatrics, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - G Escherich
- German Cooperative Study Group for Childhood Acute Lymphoblastic Leukemia, Hamburg, Germany
| | - A Ferster
- European Organisation for Research and Treatment of Cancer Children Leukemia Group, Brussels, Belgium
| | - R S Kotecha
- Australian and New Zealand Children's Haematology/Oncology Group, Perth Children's Hospital, Perth, Australia; Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - B Lausen
- Rigshospitalet, University Hospital, Department of Pediatrics, Copenhagen, Denmark
| | - Alex Wk Leung
- The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - F Locatelli
- Department of Pediatric Haematology and Oncology, IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza University of Rome, Rome, Italy
| | - L Silverman
- Dana-Farber Cancer Institute, Pediatric Oncology, Boston, MA, USA
| | - J Stary
- Czech Working Group for Pediatric Hematology, Prague, Czech Republic
| | - T Szczepanski
- Polish Pediatric Leukemia/Lymphoma Study Group, Department of Pediatric Hematology and Oncology, Medical University of Silesia, Zabrze, Katowice, Poland
| | | | - A Vora
- United Kingdom Children Cancer Study Group, London, United Kingdom
| | - J Zuna
- CLIP, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - M Schrappe
- Berlin-Frankfurt-Miu (¨)nster Group Germany, Kiel, Germany
| | - M G Valsecchi
- Center of Bioinformatics, Biostatistics and Bioimaging, University of Milano-Bicocca, Monza, Italy
| | - R Pieters
- Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Dutch Childhood Oncology Group, Utrecht, the Netherlands
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Thirumalairaj R, Parikh PM, Agarwal A, Singh R, Krishnamurthy A, Desai SS, Maheshwari A, Mehta P, Ghafur A, Somashekhar SP, Iqbal A, Savant DN, Hussain SMA, Bhatt A, Wangdi T, Bajpai J, Ranade AA, Babu KG, Bapna A, Biswas G, Malhotra H, Krishna MV, Baral RP, Vashishtha R, Safi AJ, Agarwal S, Agarwal JP, Rathnam KK, Mohapatra PN, Kumar RV, Rajappa S, Limaye SA, Vora A, Reddy VAP, Parekh BB, Rath GK. South Asian Declaration-Consensus Guidelines for COVID-19 Vaccination in Cancer Patients. South Asian J Cancer 2021; 10:3-8. [PMID: 34430512 PMCID: PMC8378920 DOI: 10.1055/s-0041-1731909] [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] [Indexed: 12/14/2022] Open
Abstract
We provide the South Asian Declaration, containing the consensus guidelines for coronavirus disease 2019 (COVID-19) vaccination in cancer patients.
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Affiliation(s)
- Raja Thirumalairaj
- Department of Medical Oncology, Apollo Cancer Center, Teynampet, Chennai, India
| | - Purvish M Parikh
- Department of Oncology, Integrated Academic Society of Clinical Oncology, Mumbai Oncocare Centers, Mumbai, Maharashtra, India
| | - Amit Agarwal
- Department of Medical Oncology, BLK Superspecilaity Hospital, Delhi, India
| | - Randeep Singh
- Department of Molecular Oncology Society, Narayana Health, Delhi, India
| | | | - Sharad S Desai
- Department of Surgical Oncology, Mahatma Gandhi Cancer Hospital, Miraj, Maharashtra, India
| | - Amita Maheshwari
- Divison of Gynecologic Oncology, Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Prashant Mehta
- Department of Medical Oncology/Hematoncology/BMT, Asian Institute of Medical Sciences, Faridabad, India
| | - Abdul Ghafur
- Department of Infectious Diseases, Apollo Cancer Institute, Chennai, India
| | - S P Somashekhar
- Department of Surgical Oncology, MHEPL, Manipal Comprehensive Cancer Center, Manipal Hospital, Bengaluru, India
| | - Ahamed Iqbal
- Oncology and Radiotherapy Department, Teaching Hospital, Batticaloa, Sri Lanka
| | | | - Syed Md Akram Hussain
- Department of Radiotherapy, Square Oncology and Radiotherapy Centre, Dhaka, Bangladesh
| | - Amit Bhatt
- Department of Medical Oncology, Avinash Cancer Clinic, Pune, India
| | - Tashi Wangdi
- Oncology Department, JDWNR Hospital and KGUMS, Thimphu, Bhutan
| | - Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | | | - K Govind Babu
- Department of Medical and Pediatric Oncology, St. Johns Medical College and Hospital, HCG Hospitals, Bangalore, India
| | - Ajay Bapna
- Department of Medical Oncology, BMCHRC, Jaipur, Rajasthan, India
| | - Ghanshyam Biswas
- Department of Medical Oncology, Sparsh Hospital and Sum Hospital, Bhubaneswar, Odisha, India
| | - Hemant Malhotra
- Department of Medical Oncology, Sri Ram Cancer Center, Mahatma Gandhi Medical College Hospital, Jaipur, Rajasthan, India
| | - M Vamshi Krishna
- Department of Medical Oncology and Hematology, Institute of Oncology, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Rajendra Prasad Baral
- Department of Medical Oncology, Norvic International Hospital and Om Hospital and Research Center, Kathmandu, Nepal
| | - Rajesh Vashishtha
- Department of Radiation Oncology, Max Super Speciality Hospital, Bathinda, Punjab, India
| | - Ahmad Javid Safi
- Afghanistan Cancer Foundation and Covid-19 Control Command Centre, Kabil, Afghanistan
| | - Sharmila Agarwal
- Department of Radiotherapy, Jaslok Hospital, Mumbai, Maharashtra, India
| | - J P Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Krishna Kumar Rathnam
- Department of Medical Oncology, Meenakshi Mission Hospital and Research Centre, Madurai, India
| | - P N Mohapatra
- Department of Medical Oncology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Rajeev Vijay Kumar
- Department of Oncology, BGS Gleneagles Global Hospital, Bangalore, India
| | - Senthil Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Center, Hyderabad, India
| | - Sewanti Atul Limaye
- Department of Oncology and Oncology Research, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
| | - Amish Vora
- Department of Oncology, H.O.P.E. Oncology Cancer Clinic, PSRI Hospital, New Delhi, India
| | - Vijay A P Reddy
- Department of Radiation Oncology, Apollo Cancer Institute, Hyderabad, India
| | - Bhavesh B Parekh
- Department of Oncology, Shalby Cancer and Research Institute, Ahmedabad, Gujrat, India
| | - G K Rath
- National Cancer Center, Delhi, India
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Prabhash K, Vora A, Limaye S, Sahoo T, Batra U, Patil S, Patil V, Noronha V, Bhosale B, Raut N, Warrier N, Vaswani B, Babu G, Gore A, Rohatgi N, Bondarde S. Treatment of advanced non-small-cell lung cancer: First line, maintenance, and second line– Indian consensus statement update(Under the aegis of Lung Cancer Consortium Asia, Indian Cooperative Oncology Network, Indian Society of Medical and Pediatric Oncology, Molecular Oncology Society, and Association of Physicians of India). Cancer Res Stat Treat 2021. [DOI: 10.4103/crst.crst_61_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Singhal M, Sahoo TP, Aggarwal S, Singhvi A, Kaushal V, Rajpurohit S, Parthasarthi KM, Vora A, Ganvir M, Gupta S, Parikh PM. Practical consensus recommendations on ovarian suppression in early breast cancer (adjuvant). South Asian J Cancer 2020; 7:151-155. [PMID: 29721484 PMCID: PMC5909295 DOI: 10.4103/sajc.sajc_125_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)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Substantial survival benefits exist for patients with early-stage breast cancer who undergo treatment with single-modality ovarian suppression, but its value is uncertain. Expert oncologist discussed to determine whether additional benefits exist with ovarian suppression plus multiple adjuvant therapy which provides a new treatment option that reduces the risk of recurrence in early breast cancer. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- M Singhal
- Department of Medical Oncology, Indraprastha Apollo Hospital, New Delhi, India
| | - T P Sahoo
- Department of Medical Oncology, Chirayu Cancer Hospital, Bhopal, Madhya Pradesh, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - A Singhvi
- Department of Medical Oncology, Choitram Hospital, Indore, Madhya Pradesh, India
| | - V Kaushal
- Department of Radiation Oncology, RCC, Rohtak, Haryana, India
| | - S Rajpurohit
- Department of Medical Oncology, RGCI, New Delhi, India
| | - K M Parthasarthi
- Department of Medical Oncology, Dharamshila Cancer Hospital, New Delhi, India
| | - A Vora
- Department of Medical Oncology, Hope Clinic, New Delhi, India
| | - M Ganvir
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - S Gupta
- Department of Medical Oncology, Tata Memorial Center, Mumbai, Maharashtra, India
| | - Purvish M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
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Gupta S, Singh M, Vora A, Babu G, Walia M, Nautial V, Saha R, Smruti BK, Sharma JB, Koul R, Parikh PM, Aggarwal S. Practical consensus recommendations on duration of adjuvant hormonal therapy in breast cancer. South Asian J Cancer 2020; 7:142-145. [PMID: 29721482 PMCID: PMC5909293 DOI: 10.4103/sajc.sajc_122_18] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Optimization of adjuvant systemic therapy in women with early-stage hormone receptor-positive breast cancer includes the consideration of chemotherapy and duration of hormone therapy. Adjuvant hormonal therapy significantly improves long-term survival of breast cancer patients with hormone receptor-positive disease. Despite the proven clinical efficacy of tamoxifen and aromatase inhibitors, many breast cancer survivors either fail to take the correct dosage at the prescribed frequency (adherence) or discontinue therapy (persistence). Expert oncologist discussed on the duration of adjuvant hormonal therapy for improvement of OS and quality of life of breast cancer patients by providing reduction in recurrence and mortality. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- S Gupta
- Department of Medical Oncology, Tata Memorial Center, Mumbai, Maharashtra, India
| | - M Singh
- Department of Medical Oncology, Mahaveer Cancer Sansthan, Patna, Bihar, India
| | - Amish Vora
- Department of Medical Oncology, Hope Clinic, New Delhi, India
| | - G Babu
- Department of Medical Oncology, KMIO, Bengaluru, Karnataka, India
| | - M Walia
- Department of Medical Oncology, Max Hospital, New Delhi, India
| | - V Nautial
- Department of Medical Oncology, Jolly Grant Himalayan Institute, Dehradoon, Uttarakhand, India
| | - R Saha
- Department of Medical Oncology, Max Hospital, New Delhi, India
| | - B K Smruti
- Department of Medical Oncology, Bombay Hospital, Mumbai, Maharashtra, India
| | - J B Sharma
- Department of Medical Oncology, Action Balajee Cancer Hospital, New Delhi, India
| | - R Koul
- Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - Purvish M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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8
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Abdoli S, Hessler D, Vora A, Smither B, Stuckey H. Descriptions of diabetes burnout from individuals with Type 1 diabetes: an analysis of YouTube videos. Diabet Med 2020; 37:1344-1351. [PMID: 31168875 DOI: 10.1111/dme.14047] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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] [Accepted: 06/04/2019] [Indexed: 01/02/2023]
Abstract
AIM The purpose of the study was to analyse self-descriptions of diabetes burnout in individuals with Type 1 diabetes via YouTube videos. METHODS In this qualitative descriptive study, a systematic approach was used to search YouTube videos with a title, description or content specifically about diabetes burnout dated between 2007 and 2017. Irrelevant or duplicated videos were excluded using eligibility criteria. All videos meeting inclusion criteria (n = 32) from individuals with Type 1 diabetes were transcribed verbatim and analysed using a qualitative content analysis approach. Descriptive statistics were used to analyse video characteristics. RESULTS The four major themes associated with diabetes burnout were: (i) feeling mentally drained and physically tired of dealing with self-care; (ii) experiencing a detachment from self, diabetes care and support system; (iii) being powerless and paralysed to 'climb out' of diabetes burnout; and (iv) contributing potential factors to diabetes burnout. CONCLUSIONS Self-descriptions of diabetes burnout suggest that it is a combination of emotions and behaviours on a spectrum from exhaustion to detachment accompanied by an overwhelming sense of powerlessness. More studies are needed to further clarify diabetes burnout and its distinction from, or overlap with, other related psychosocial concepts in diabetes care.
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Affiliation(s)
- S Abdoli
- College of Nursing, University of Tennessee, Knoxville
| | - D Hessler
- Department of Family & Community Medicine, University of California, San Francisco, CA
| | - A Vora
- Graduate School of Medicine, University of Tennessee, Knoxville
- Endocrinology Consultants of East Tennessee, University of Tennessee, Knoxville
| | - B Smither
- Oak Ridge Associated Universities, Oak Ridge TN
| | - H Stuckey
- Public Health Sciences and Humanities, Penn State University, Hershey, PA, USA
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Bhattacharyya G, Malhotra H, Babu K, Ranade A, Vora A, Biswas G, Basu S. Prostatic cancer androgen deprivation therapy and bone health in carcinoma prostate. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.042] [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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Vora A, Varghese A, Kachwala Y, Bhaskar M, Laddha A, Jamal A, Yadav P. Eugenia jambolana extract reduces the systemic exposure of Sitagliptin and improves conditions associated with diabetes: A pharmacokinetic and a pharmacodynamic herb-drug interaction study. J Tradit Complement Med 2018; 9:364-371. [PMID: 31453133 PMCID: PMC6702134 DOI: 10.1016/j.jtcme.2018.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 05/27/2018] [Revised: 09/29/2018] [Accepted: 10/02/2018] [Indexed: 12/20/2022] Open
Abstract
Eugenia jambolana (EJ) is an Indian traditional herb widely used for the treatment of diabetes mellitus. This herb is globally marketed as single or multi herb formulations. Many diabetes patients consume EJ extract oral hypoglycemic drugs together. This calls for a need to assess risks versus benefit of this co-administration. In present investigation, pharmacodynamic and pharmacokinetic interactions of aqueous extract of EJ seeds at the dose of 400 mg/kg are studied with 10 mg/kg of oral hypoglycaemic drug sitagliptin (SITA) by co-administrating them for 28 days in streptozotocin (STZ) induced diabetic rats. The pharmacokinetic parameters of SITA were determined using HPLC-ESI-MS/MS and it was found that the combination treatment reduces the systemic exposure of SITA by showing 38.70% reduction in concentration maximum (Cmax) and 22.40% reduction in area under curve (AUC). Despite low levels of SITA, the combination demonstrated a significant reduction in blood glucose level when compared with individual drug and individual extract administered groups during pharmacodynamic study. In addition, the liver function, the kidney function and the lipid parameters were found to be significantly improved and beneficial effects were found with respect to food intake and water intake and urine output in case of combination treatment groups when compared with individual treatment groups. Histopathological examination of pancreatic tissue suggests its significant recovery of having normal acinus with better cell protection in combination treatment. In conclusion, the combination treatment demonstrated reduced systemic exposure of SITA without compromising on its antihyperglycemic activity and improvement in conditions associated with diabetes.
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Affiliation(s)
- A Vora
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, India
| | - A Varghese
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, India
| | - Y Kachwala
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, India
| | - M Bhaskar
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, India
| | - A Laddha
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, India
| | - A Jamal
- Central Council for Research in Unani Medicine, Ministry of Ayush, Government of India, India
| | - P Yadav
- Central Council for Research in Unani Medicine, Ministry of Ayush, Government of India, India
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12
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Mcdonough S, Aiyer A, Velasco Roth A, Menezes J, Vora A, Schulz J, Degrandpre J, Mina E, Shaw J. P2.01-99 Can NGS NSCLC Testing Be Implemented Without in House Expertise? Clinical Utility of the First FDA-Approved Lung Cancer NGS End-To-End Solution. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1153] [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]
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Bhattacharyya G, Malhotra H, Babu G, Vora A, Shahid T, Misra Ghosh S. Relationship between depressive symptoms at social cognitive processing in partners of long term breast cancer survivors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy296.007] [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: 11/14/2022] Open
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Vora A, Chatterjee S, Upadhyay A, Hazarika N, Bhattacharya G. Personalised nutritional care during chemotherapy using survey on taste changes during chemotherapy: First experience from tertiary chemotherapy day care center in Northern India. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.041] [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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Nair R, Kakroo A, Bapna A, Gogia A, Vora A, Pathak A, Korula A, Chakrapani A, Doval D, Prakash G, Biswas G, Menon H, Bhattacharya M, Chandy M, Parihar M, Vamshi Krishna M, Arora N, Gadhyalpatil N, Malhotra P, Narayanan P, Nair R, Basu R, Shah S, Bhave S, Bondarde S, Bhartiya S, Nityanand S, Gujral S, Tilak TVS, Radhakrishnan V. Management of Lymphomas: Consensus Document 2018 by an Indian Expert Group. Indian J Hematol Blood Transfus 2018; 34:398-421. [PMID: 30127547 PMCID: PMC6081314 DOI: 10.1007/s12288-018-0991-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 12/20/2022] Open
Abstract
The clinical course of lymphoma depends on the indolent or aggressive nature of the disease. Hence, the optimal management of lymphoma needs a correct diagnosis and classification as B cell, T-cell or natural killer (NK)/T-cell as well as indolent or high-grade type lymphoma. The current consensus statement, developed by experts in the field across India, is intended to help healthcare professionals manage lymphomas in adults over 18 years of age. However, it should be noted that the information provided may not be appropriate to all patients and individual patient circumstances may dictate alternative approaches. The consensus statement discusses the diagnosis, staging and prognosis applicable to all subtypes of lymphoma, and detailed treatment regimens for specific entities of lymphoma including diffuse large B-cell lymphoma, Hodgkin's lymphoma, follicular lymphoma, T-cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, Burkitt's lymphoma, and anaplastic large cell lymphoma.
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Affiliation(s)
- Reena Nair
- Department of Clinical Hematology, Tata Medical Center (TMC), New Town, Rajarhat, Kolkata, West Bengal 700 160 India
| | | | - Ajay Bapna
- Bhagwan Mahavir Cancer Hospital Research Center (BMCHRC), Jaipur, India
| | - Ajay Gogia
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | | | - Anu Korula
- Christian Medical College (CMC), Vellore, India
| | | | - Dinesh Doval
- Rajiv Gandhi Cancer Institute and Research Centre (RGCI), New Delhi, Delhi India
| | - Gaurav Prakash
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ghanashyam Biswas
- Sparsh Hospital American Oncology Institute (AOI), Bhubaneswar, India
| | - Hari Menon
- Cytecare Cancer Hospitals, Bangalore, India
| | | | - Mammen Chandy
- Department of Clinical Hematology, Tata Medical Center (TMC), New Town, Rajarhat, Kolkata, West Bengal 700 160 India
| | - Mayur Parihar
- Department of Clinical Hematology, Tata Medical Center (TMC), New Town, Rajarhat, Kolkata, West Bengal 700 160 India
| | | | - Neeraj Arora
- Department of Clinical Hematology, Tata Medical Center (TMC), New Town, Rajarhat, Kolkata, West Bengal 700 160 India
| | | | - Pankaj Malhotra
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | - Rekha Nair
- Regional Cancer Centre (RCC), Thiruvananthapuram, India
| | - Rimpa Basu
- Department of Clinical Hematology, Tata Medical Center (TMC), New Town, Rajarhat, Kolkata, West Bengal 700 160 India
| | - Sandip Shah
- Vedant Institute of Medical Sciences, Ahmedabad, India
| | - Saurabh Bhave
- Department of Clinical Hematology, Tata Medical Center (TMC), New Town, Rajarhat, Kolkata, West Bengal 700 160 India
| | | | | | - Soniya Nityanand
- Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
| | | | | | - Vivek Radhakrishnan
- Department of Clinical Hematology, Tata Medical Center (TMC), New Town, Rajarhat, Kolkata, West Bengal 700 160 India
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Bhattacharyya GS, Malhotra H, Vora A, Biswas G. Impact of adrenergic and prostanoid inhibitors used chronobiologically on outcomes in patients with metastatic renal cell carcinoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e16581] [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: 11/20/2022] Open
Affiliation(s)
| | - Hemant Malhotra
- Birla Cancer Center, SMS Medical College Hospital, Jaipur, India
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Bhattacharyya G, Malhotra H, Govindbabu K, Biswas G, Vora A, Shahid T. P2.01-023 Reasons for Withholding Systemic Therapy in Stage IV NSCLC: Comparison of Years 2004 to 2007 and 2010 to 2013. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1125] [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]
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Eiser C, Stride CB, Vora A, Goulden N, Mitchell C, Buck G, Adams M, Jenney MEM. Prospective evaluation of quality of life in children treated in UKALL 2003 for acute lymphoblastic leukaemia: A cohort study. Pediatr Blood Cancer 2017; 64. [PMID: 28475268 DOI: 10.1002/pbc.26615] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 08/07/2016] [Revised: 03/19/2017] [Accepted: 03/27/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) from diagnosis until end of treatment for children with acute lymphoblastic leukaemia was investigated, examining effects of age, gender, risk-stratified treatment regimen, and therapy intensity (one vs. two 'delayed intensifications' [DIs]). METHOD In a multi-centre prospective study, parents reported their child's generic and disease-specific HRQoL and their own care-giving burden at five time points. From 1,428 eligible patients, 874 parents completed questionnaires at least once during treatment. RESULTS At each time point, generic HRQoL was significantly lower than equivalent norm scores for healthy children. HRQoL decreased significantly at the start of treatment, before recovering gradually (but remained below pre-treatment levels). Parents reported that older children worried more about side effects and their appearance, but showed less procedural anxiety than younger children. Concern for appearance was greater among girls than boys. Compared to Regimen B (i.e. additional doxorubicin during induction and additional cyclophosphamide and cytarabine during consolidation chemotherapy), patients receiving Regimen A had fewer problems with pain and nausea. There were no statistically significant differences in HRQoL by number of DI blocks received. INTERPRETATION HRQoL is compromised at all stages of treatment, and is partly dependent on age. The findings increase understanding of the impact of therapy on children's HRQoL and parental care-giving burden, and will contribute to the design of future trials.
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Affiliation(s)
- C Eiser
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - C B Stride
- Department of statistics, Management School, Conduit Road, University of Sheffield, Sheffield, United Kingdom
| | - A Vora
- Department of Paediatric Haematology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, United Kingdom
| | - N Goulden
- Department of paediatric haematology, Great Ormond Street Hospital, London, United Kingdom
| | - C Mitchell
- Department of Paediatric Haematology/Oncology, John Radcliffe Hospital, Oxford, United Kingdom
| | - G Buck
- Clinical Trial Service Unit, University of Oxford, Oxford, United Kingdom
| | - M Adams
- Department of Paediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom
| | - M E M Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom
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Bhattacharyya G, Babu G, Parikh P, Vora A, Biswas G, Malhotra H. Autonomic neuropathy in geriatric patients with gynecologic cancer receiving taxanes and platinum chemotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.042] [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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Bhattacharyya GS, Malhotra H, Babu KG, Vora A, Barman T. Disorders of taste (dysgeusia) in head and neck cancer patients on concomitant CT/RT. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e18199] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18199 Background: Head & Neck cancer is a major problem in India and developing countries related to use of tobacco. Locally advanced oral cavity cancers form a majority of cancers of this region. Common method of treatment of this region is to use concomitant radiation with chemotherapy and/or biotherapy. One of the side effects of regional treatment is loss of taste or dysfunction of taste. This although common has not been properly evaluated or reported. Its impact although conceivable is not used in dietary modifications or tailoring treatment. Methods: Taste discrimination was assessed using high medium and low concentration of sweet salty sour and bitter tasting solution. Cross-sectional observational study was designed to describe the prevalence of taste dysfunction in a group of Head & Neck cancer survivors with oral cancers. Survivors were required to be disease free for at least 3 months symptomatically and imaging wise. Only patients found fit on cognitive assessments as well as capable of comprehending language were asked to fill a simple seven question graded chart. Results: Non parametric approach was done for taste score. Descriptive statistics were used for taste scores and self-reported taste changes. 90 patients were included. Age group 49y – 80y. 58 patients were above the age of 65y. 1/3rd of the patients were females. All patients were locally advanced patient and the commonest site was oral cavity and oro-pharynx – 80%. Participants performed poorly on the taste test. The commonest disturbance in taste was in sweet and sour. 20% of patients had bitter and metallic taste in mouth. 1/3rd of patients had no taste. Patients with maintained taste did not lose weight. Long term taste dysfunction persisted in about 30% of patients. Conclusions: Head & Neck cancer survivors have taste dysfunctions. Taste recognition is demonstrated at low and high concentrations as well as persistent bitter and metallic phantom taste. It may persist for long periods of time. Recognizing this problem is important so the clinicians can help survivor scope with the problem.
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Affiliation(s)
| | - Hemant Malhotra
- Birla Cancer Center, SMS Medical College Hospital, Jaipur, India
| | - K Govind Babu
- Kidwai Memorial Institute of Oncology, Bangalore, India
| | | | - Tapati Barman
- Medica Superspecialty Hospital, Mukundapur, Kolkata, India
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O'Hare P, Lucchini G, Cummins M, Veys P, Potter M, Lawson S, Vora A, Wynn R, Peniket A, Kirkland K, Pearce R, Perry J, Amrolia PJ. Allogeneic stem cell transplantation for refractory acute myeloid leukemia in pediatric patients: the UK experience. Bone Marrow Transplant 2017; 52:825-831. [DOI: 10.1038/bmt.2017.3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/26/2016] [Accepted: 11/02/2016] [Indexed: 12/28/2022]
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22
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Parikh PM, Ranade AA, Govind B, Ghadyalpatil N, Singh R, Bharath R, Bhattacharyya GS, Koyande S, Singhal M, Vora A, Verma A, Hingmire S. Lung cancer in India: Current status and promising strategies. South Asian J Cancer 2016; 5:93-5. [PMID: 27606289 PMCID: PMC4991145 DOI: 10.4103/2278-330x.187563] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- P M Parikh
- Asian Cancer Institute, KJ Somaiya Ayurvihar, Mumbai, Maharashtra, India
| | - A A Ranade
- Avinash Cancer Clinic, Pune, Maharashtra, India
| | - Babu Govind
- Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | | | - R Singh
- HCG Cancer Center, New Delhi, India
| | - R Bharath
- Kovai Hospital, Coimbatore, Tamil Nadu, India
| | | | - S Koyande
- Indian Cancer Society, Mumbai, Maharashtra, India
| | - M Singhal
- Indraprastha Apollo Hospital, New Delhi, India
| | - A Vora
- Max Hospital, New Delhi, India
| | - A Verma
- Max Hospital, New Delhi, India
| | - S Hingmire
- Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
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Vora A, Bhargava A. A Cross-sectional Cohort Analyses Assessing Response to Levosalbutamol Bronchodilatory Cough Formulations in Outpatient Community Settings of India: 'BUS' analyses. J Assoc Physicians India 2016; 64:45-48. [PMID: 27762515] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Cough is significant health problem with greater implication for impaired quality of life. Acute and chronic cough due to infective (viral/bacterial), allergic conditions or bronchial asthma including cough variant asthma are often treated with combination of mucolytics, expectorants and bronchodilators. Bronchodilators reduces cough sensitivity, promotes clearance of cough secretions while reducing protrusive inflammatory mediator release. AIMS AND OBJECTIVES To further understand the clinical utility and safety of Bronchodilatory cough formulations (BCF) containing Levosalbutamol in real world settings. MATERIAL AND METHODS A prospective, cross sectional, cohort analyses (Bronchodilatory coUgh formulary Survey, BUS) assessing Levosalbutamol cough formulations utilization at 40 centers involving general and consultant physicians across India. RESULTS Consecutive prescription records (n=1367) involving Levosalbutamol were collated for analyses. Baseline demographics included adults (21%) and children (79%) with mean age 11.1 yrs, male (60%) and female(40%). Levosalbutamol BCF was commonly prescribed for LRTI (69.7%), AECB (14.8%), Bronchial asthma (8.5%), Allergic rhinitis (5%). The predominant risk factors in both adults and children included smoking and allergic rhinitis respectively. In most cases cough severity was assessed utilizing Fisman scale score (0-4). Mean cough score improved from baseline score of 3 to 0.8 with parallel improvement in associated symptoms of wheeze and sputum. Antibiotics were prescribed in most of LRTI or acute exacerbation cases with purulent sputum. Side effects noted included tremor (1%), palpitation (0.9%), vomiting (0.7%) that were mild and transient in most cases with none requiring treatment withdrawal. In two cases (0.1%), further treatment with nebulization and antibiotics were provided. CONCLUSIONS Levosalbutamol containing Bronchodilatory Cough formulation remains as safe and effective option for adults and children while managing acute or chronic cough primarily due to allergic rhinitis, bronchial asthma or COPD.
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Affiliation(s)
- A Vora
- Asst. Hon. and In Charge, Dept. of Chest and TB, Dr. R.N. Cooper Muni. Gen. Hospital
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24
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Vora A, Kapoor A, Nair M, Lokhandwala Y, Narsimhan C, Ravikishore AG, Dwivedi SK, Namboodiri N, Hygriv R, Saxena A, Nabar A, Garg S, Bardoloi N, Yadav R, Nambiar A, Pandurangi U, Jhala D, Naik A, Nagmallesh, Rajagopal S, Selvaraj R, Arora V, Thachil A, Thomas J, Panicker G. Clinical presentation, management, and outcomes in the Indian Heart Rhythm Society-Atrial Fibrillation (IHRS-AF) registry. Indian Heart J 2016; 69:43-47. [PMID: 28228305 PMCID: PMC5319007 DOI: 10.1016/j.ihj.2016.06.006] [Citation(s) in RCA: 14] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 05/22/2016] [Accepted: 06/10/2016] [Indexed: 11/08/2022] Open
Abstract
Aim A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes. Methods A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed. Results The average age of Indian AF patients was 54.7 years. There was a marginal female preponderance – 51.5% females and 48.5% males. At baseline, 20.4% had paroxysmal AF; 33% had persistent AF; 35.1% had permanent AF and 11% had first AF episode. At one-year follow-up, 45.6% patients had permanent AF. Rheumatic valvular heart disease (RHD) was present in 47.6% of patients. Hypertension, heart failure, coronary artery disease, and diabetes were seen in 31.4%, 18.7%, 16.2%, and 16.1%, respectively. Rate control was the strategy used in 75.2% patients, digoxin and beta-blockers being the most frequently prescribed rate-control drugs. Oral anticoagulation (OAC) drugs were used in 70% of patients. The annual mortality was 6.5%, hospitalization 8%, and incidence of stroke 1%. Conclusions In India, AF patients are younger and RHD is still the most frequent etiology. Almost two-third of the patients have persistent/permanent AF. At one-year follow-up, there is a significant mortality and morbidity in AF patients in India.
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Affiliation(s)
- A Vora
- Arrhythmia Associates, Mumbai, India.
| | - A Kapoor
- Department of Cardiology, Sanjay Gandhi Post-Graduate Institute, Lucknow, India
| | - M Nair
- Holy Family Hospital, New Delhi, India
| | | | - C Narsimhan
- Division of Electrophysiology, Care Hospital, Hyderabad, India
| | | | - S K Dwivedi
- Department of Cardiology, King George Medical University, Lucknow, India
| | - N Namboodiri
- Department of Cardiology, Sri Chitra Trinumal Hospital, Trivandrum, India
| | - R Hygriv
- KIMS Hospitals, Hyderabad, India
| | - A Saxena
- Cardiac Pacing & Electrophysiology, Fortis Escorts Hospital, New Delhi, India
| | - A Nabar
- Department of Cardiology, KEM Hospital, Mumbai, India
| | - S Garg
- Maulana Azad Medical College, New Delhi, India
| | - N Bardoloi
- Cardiology Department, Apollo Hospital, Guwahati, India
| | - R Yadav
- Department of Cardiology, AIIMS Hospital, New Delhi, India
| | - A Nambiar
- Cardiology, Baby Memorial Hospital, Kozhikode, India
| | | | - D Jhala
- Lilavati Hospital, Mumbai, India
| | - A Naik
- Division of Electrophysiology, CIMS Hospital, Ahmedabad, India
| | - Nagmallesh
- M.S. Ramaiah Memorial Hospital, Bengaluru, India
| | - S Rajagopal
- Department of Cardiology, Railway Hospital, Chennai, India
| | - R Selvaraj
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - V Arora
- Division of Electrophysiology, Max Superspeciality Hospital, Delhi, India
| | - A Thachil
- Division of Electrophysiology, Lisie Hospital, Kochi, India
| | - J Thomas
- Frontier Lifeline Hospital, Chennai, India
| | - G Panicker
- Quintiles Cardiac Safety Services, Mumbai, India
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Driessen EMC, de Lorenzo P, Campbell M, Felice M, Ferster A, Hann I, Vora A, Hovi L, Escherich G, Li CK, Mann G, Leblanc T, Locatelli F, Biondi A, Rubnitz J, Schrappe M, Silverman L, Stary J, Suppiah R, Szczepanski T, Valsecchi M, Pieters R. Outcome of relapsed infant acute lymphoblastic leukemia treated on the interfant-99 protocol. Leukemia 2016; 30:1184-7. [PMID: 26369984 DOI: 10.1038/leu.2015.246] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- E M C Driessen
- Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - P de Lorenzo
- Interfant-99 Trial Data Center, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Monza, Italy
| | - M Campbell
- Chilean National Pediatric Oncology Group, PINDA, Roberto del Rio Hospital, Universidad de Chile, Santiago, Chile
| | - M Felice
- Department of Pediatric Hematology/Oncology, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - A Ferster
- Department of Hemato-Oncology, Hôpital Unviversitaire des Enfants Reine Fabiola (ULB), Brussels, Belgium
| | - I Hann
- UK Children's Cancer Study Group, Great Ormond Street Hospital for Children, London, UK
| | - A Vora
- Department of Paediatric Haematology, Sheffield Children's Hospital, Sheffield, UK
| | - L Hovi
- Nordic Society of Paediatric Haematology and Oncology, University of Helsinki, Helsinki, Finland
| | - G Escherich
- University Medical Center Hamburg-Eppendorf, Clinic of Pediatric Hematology and Oncology, Hamburg, Germany
| | - C K Li
- Hong Kong Paediatric Haematology and Oncology Study Group, Prince of Wales Hospital, Hong Kong, China
| | - G Mann
- St. Anna Children's Cancer Research Institute and St. Anna Children's Hospital, Department of Pediatrics, Medical University School, Vienna, Austria
| | - T Leblanc
- Departement of Pediatric Hematology, Hôpital Robert-Debré, Paris, fort he FRALLE group, Paris, France
| | - F Locatelli
- Associazione Italiana Ematologia Oncologia Pediatrica, Italy Bambino Gesù Children's Hospital, Rome, Italy
| | - A Biondi
- Associazione Italiana Ematologia Oncologia Pediatrica, Italy Bambino Gesù Children's Hospital, Rome, Italy
| | - J Rubnitz
- St Jude Children's Research Hospital, Memphis, TN, USA
| | - M Schrappe
- Berlin-Frankfurt-Münster Study Group, Hannover, Germany
| | - L Silverman
- Dana-Farber Cancer Institute ALL Consortium, Boston, MA, USA
| | - J Stary
- Czech Pediatric Haematology, Prague, Czech Republic
| | - R Suppiah
- Australian and New Zealand Children's Haematology and Oncology Study Group, North Adelaide, Australia
| | - T Szczepanski
- Polish Pediatric Leukemia and Lymphoma Study Group, and Department of Pediatric Hematology and Oncology, Zabrze, Medical University of Silesia, Katowice, Poland
| | - M Valsecchi
- Interfant-99 Trial Data Center, Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Monza, Italy
| | - R Pieters
- Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group, The Hague, the Netherlands
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Jenkinson S, Kirkwood AA, Goulden N, Vora A, Linch DC, Gale RE. Impact of PTEN abnormalities on outcome in pediatric patients with T-cell acute lymphoblastic leukemia treated on the MRC UKALL2003 trial. Leukemia 2016; 30:39-47. [PMID: 26220040 PMCID: PMC4705426 DOI: 10.1038/leu.2015.206] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/29/2015] [Accepted: 07/22/2015] [Indexed: 12/21/2022]
Abstract
PTEN gene inactivation by mutation or deletion is common in pediatric T-cell acute lymphoblastic leukemia (T-ALL), but the impact on outcome is unclear, particularly in patients with NOTCH1/FBXW7 mutations. We screened samples from 145 patients treated on the MRC UKALL2003 trial for PTEN mutations using heteroduplex analysis and gene deletions using single nucleotide polymorphism arrays, and related genotype to response to therapy and long-term outcome. PTEN loss-of-function mutations/gene deletions were detected in 22% (PTEN(ABN)). Quantification of mutant level indicated that 67% of mutated cases harbored more than one mutant, with up to four mutants detected, consistent with the presence of multiple leukemic sub-clones. Overall, 41% of PTEN(ABN) cases were considered to have biallelic abnormalities (mutation and/or deletion) with complete loss of PTEN in a proportion of cells. In addition, 9% of cases had N- or K-RAS mutations. Neither PTEN nor RAS genotype significantly impacted on response to therapy or long-term outcome, irrespective of mutant level, and there was no evidence that they changed the highly favorable outcome of patients with double NOTCH1/FBXW7 mutations. These results indicate that, for pediatric patients treated according to current protocols, routine screening for PTEN or RAS abnormalities at diagnosis is not warranted to further refine risk stratification.
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Affiliation(s)
- S Jenkinson
- Department of Haematology, UCL Cancer Institute, London, UK
| | - A A Kirkwood
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
| | - N Goulden
- Department of Haematology, Great Ormond Street Hospital, London, UK
| | - A Vora
- Department of Haematology, Sheffield Children's Hospital, Sheffield, UK
| | - D C Linch
- Department of Haematology, UCL Cancer Institute, London, UK
| | - R E Gale
- Department of Haematology, UCL Cancer Institute, London, UK
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Vora A, Londhe V, Pandita N. Herbosomes enhance the in vivo antioxidant activity and bioavailability of punicalagins from standardized pomegranate extract. J Funct Foods 2015. [DOI: 10.1016/j.jff.2014.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Vora A, Lokhandwala Y, Naik A, Chopra A, Wander G, Verma J, Jaswal A, Srikanthan V, Kahali D, Singh B, Sahu S, Radhakrishnan R. Profiling arrhythmia & heart failure patients in India – The panarrhythmia & heart failure registry. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.359] [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: 11/26/2022] Open
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Rath GK, Parikh PM, Hukku S, Rajan B, Kumar S, Malhotra H, Vuthaluru S, Sharma DN, Vora A, Shukla DK, Kaur T, Gandhi AK. Indian Council of Medical Research consensus document for the management of buccal mucosa cancer. Indian J Med Paediatr Oncol 2014; 35:136-9. [PMID: 25197174 PMCID: PMC4152629 DOI: 10.4103/0971-5851.138953] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Goura Kishor Rath
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Purvish M Parikh
- Department of Medical Oncology, Precision Medicine and Clinical Research, Asian Institute of Oncology, Somaiya Hospital, Mumbai, India
| | - Shelley Hukku
- Department of Radiation Oncology, BLK Super Speciality Hospital, New Delhi, India
| | - Balakrishnan Rajan
- Department of Radiation Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Sandeep Kumar
- Department of Surgery, All India Institute of Medical Sciences, Bhopal, India
| | - Hemant Malhotra
- Division of Medical Oncology, Department of Medicine, RK Birla Cancer Center, SMS Medical College Hospital, Jaipur, India
| | - Seenu Vuthaluru
- Department of Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Daya Nand Sharma
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Amish Vora
- Department of Medical Oncology, Max Super Speciality Hospital, Saket, New Delhi, India
| | | | - Tanvir Kaur
- Indian Council of Medical Research, New Delhi, India
| | - Ajeet Kumar Gandhi
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
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Autorino R, Sotelo R, Sanchez-Salas R, Matei D, Castillo O, Aron M, Parsons J, Vora A, Sutherland D, Núñez Bragayrac L, Ahallal Y, Amparore D, Ferro M, Chopra S, Hwang J, Volpe A, Derweesh I, Samavedi S, Bandi G, Jensen J, Patel N, Muruve N, De Cobelli O, Cathelineau X, Patel V, Porpiglia F, Mottrie A. PE83: Robotic simple prostatectomy: A large multi-institutional multi-national analysis. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/s1569-9056(14)50114-5] [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: 10/24/2022]
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Advani SH, Parikh P, Patil V, Agarwal JP, Chaturvedi P, Vaidya A, Rathod S, Noronha V, Joshi A, Jamshed A, Bhattacharya GS, Gupta S, Desai C, Pai P, Laskar S, Ramesh A, Mohapatra PN, Vaid AK, Deshpande M, Ranade AA, Vora A, Baral R, Hussain MA, Rajan B, Dcruz AK, Prabhash K. Guidelines for treatment of recurrent or metastatic head and neck cancer. Indian J Cancer 2014; 51:89-94. [DOI: 10.4103/0019-509x.137896] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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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Nehra A, Vora A, Pandey A, Naithani R, Gupta A. DLBCL in elderly: A single centre experience from north India. J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.086] [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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33
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Vora A, Kaur D, Chaturvedi H, Nehra A, Anand A, Kabra V, Kadyaprath G, Chaudhary A, Mohindra T, Bora P, Pandey A. Comprehensive geriatric assessment in cancer patients in India: a first effort in a tertiary cancer centre in northern India. J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.125] [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: 11/28/2022]
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34
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Jenkinson S, Koo K, Mansour MR, Goulden N, Vora A, Mitchell C, Wade R, Richards S, Hancock J, Moorman AV, Linch DC, Gale RE. Impact of NOTCH1/FBXW7 mutations on outcome in pediatric T-cell acute lymphoblastic leukemia patients treated on the MRC UKALL 2003 trial. Leukemia 2013; 27:41-7. [PMID: 22814294 DOI: 10.1038/leu.2012.176] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 06/27/2012] [Indexed: 12/24/2022]
Abstract
Activating mutations in the NOTCH1 pathway are frequent in pediatric T-cell acute lymphoblastic leukemia (T-ALL) but their role in refining risk stratification is unclear. We screened 162 pediatric T-ALL patients treated on the MRC UKALL2003 trial for NOTCH1/FBXW7 gene mutations and related genotype to response to therapy and long-term outcome. Overall, 35% were wild-type (WT) for both genes (NOTCH1(WT)FBXW7(WT)), 38% single NOTCH1 mutant (NOTCH1(Single)FBXW7(WT)), 3% just FBXW7 mutant (NOTCH1(WT)FBXW7(MUT)) and 24% either double NOTCH1 mutant (NOTCH1(Double)FBXW7(WT)) or mutant in both genes (NOTCH1(MUT)FBXW7(MUT)), hereafter called as NOTCH1±FBXW7(Double). There was no difference between groups in early response to therapy, but NOTCH1±FBXW7(Double) patients were more likely to be associated with negative minimal residual disease (MRD) post-induction than NOTCH1(WT)FBXW7(WT) patients (71% versus 40%, P=0.004). Outcome improved according to the number of mutations, overall survival at 5 years 82%, 88% and 100% for NOTCH1(WT)FBXW7(WT), NOTCH1(Single)FBXW7(WT) and NOTCH1±FBXW7(Double) patients, respectively (log-rank P for trend=0.005). Although 14 NOTCH1±FBXW7(Double) patients were classified as high risk (slow response and/or MRD positive), only two had disease progression and all remain alive. Patients with double NOTCH1 and/or FBXW7 mutations have a very good outcome and should not be considered for more intensive therapy in first remission, even if slow early responders or MRD positive after induction therapy.
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Affiliation(s)
- S Jenkinson
- Department of Haematology, UCL Cancer Institute, London, UK
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35
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Bond J, Hough R, Moppett J, Vora A, Mitchell C, Goulden N. 'Stroke-like syndrome' caused by intrathecal methotrexate in patients treated during the UKALL 2003 trial. Leukemia 2012; 27:954-6. [PMID: 23149600 DOI: 10.1038/leu.2012.328] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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36
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Clarke SA, Skinner R, Guest J, Darbyshire P, Cooper J, Vora A, Urquhart T, Jenney M, Powell J, Eiser C. Clinical outcomes and health-related quality of life (HRQOL) following haemopoietic stem cell transplantation (HSCT) for paediatric leukaemia. Child Care Health Dev 2011; 37:571-80. [PMID: 21143268 DOI: 10.1111/j.1365-2214.2010.01182.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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: 11/28/2022]
Abstract
BACKGROUND Haemopoietic stem cell transplantation (HSCT) is a life-saving but intensive procedure associated with potentially severe adverse late effects. We aimed to determine morbidity and health-related quality of life (HRQOL) in a sample of survivors aged 8-18 years at least 1 year post HSCT for paediatric acute leukaemia, compared with a non-transplanted group of survivors matched for age, gender, initial disease and time since treatment. METHODS Families (N = 54; HSCT n= 29) recruited from four UK centres completed measures of child behaviour and school attendance, HRQOL and finances. Mothers completed measures of their own well-being. Clinical outcome data were extracted from medical records. RESULTS Children in the HSCT group had significantly more late effects and had received more tests for vision, bone, dental and skin health, and thyroid, lung, and gonadal function than the non-transplanted group. HRQOL scores for the HSCT group were significantly lower in all domains compared with the non-transplanted group and population norms, but were not significantly related to clinical indices. Mothers in the HSCT group had significantly poorer mental well-being than population norms. CONCLUSION Significant morbidity and compromised HRQOL was found in survivors of HSCT. The burden of caring for a child after HSCT has a continuing toll on mothers' well-being.The importance of counselling families about possible long-term consequences is emphasized.
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Affiliation(s)
- S-A Clarke
- Department of Psychology, University of Sheffield, Sheffield, UK.
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Madureira ABM, Eapen M, Locatelli F, Teira P, Zhang MJ, Davies SM, Picardi A, Woolfrey A, Chan KW, Socié G, Vora A, Bertrand Y, Sales-Bonfim CM, Gluckman E, Niemeyer C, Rocha V. Analysis of risk factors influencing outcome in children with myelodysplastic syndrome after unrelated cord blood transplantation. Leukemia 2010; 25:449-54. [PMID: 21135856 DOI: 10.1038/leu.2010.285] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We describe 70 children with myelodysplastic syndrome (MDS) (refractory cytopenia (n=31) and refractory anemia with excess blasts (n=30) or blasts in transformation (n=9)) who received umbilical cord blood (UCB) transplantation with a single UCB unit and a myeloablative conditioning regimen. Approximately 20% of children had secondary MDS. Median age at transplantation was 7 years and the median follow-up was 3 years. The day-60 probability of neutrophil recovery was 76%; recovery was faster after transplantation of matched or 1-locus mismatched UCB, irradiation-containing conditioning regimen, cell dose >6 × 10(7)/kg and monosomy 7. Risks of treatment failure (recurrent disease or death) were lower in patients with monosomy 7 and transplantations after 2001. The 3-year disease-free survival (DFS) was 50% for transplantations after 2001 compared with 27% for the earlier period (P=0.018). Transplantations after 2001 occurred within 6 months after diagnosis and used UCB units with higher cell dose. DFS was highest in patients with monosomy 7 (61%) compared with other karyotypes (30%), P=0.017. These data suggest that transplantation of mismatched UCB graft is an acceptable alternative for children without a matched sibling or suitably matched unrelated adult donor.
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Affiliation(s)
- A B M Madureira
- Eurocord Office, Hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris, Paris, France
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39
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Carroll T, Vora A, McMahon J. Fanconi Anaemia and Oral Cancer: UK Standards of Care Recommendations. Clin Oncol (R Coll Radiol) 2010. [DOI: 10.1016/j.clon.2010.08.016] [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]
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Abstract
Acute basophilic leukemia (ABL) is a rare form of leukemia. The diagnostic criteria have recently been described. Morphological evidence for basophilic lineage is required for its classification. However the criteria for remission status and standard therapy is not established. Here we have described an atypical case of ABL and reviewed the literature to high light issues regarding diagnosis and management, which need further discussion.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Blood Cells/pathology
- Bone Marrow Examination
- Child
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 8
- Humans
- Immunophenotyping
- Leukemia, Basophilic, Acute/classification
- Leukemia, Basophilic, Acute/diagnosis
- Leukemia, Basophilic, Acute/genetics
- Remission Induction
- Translocation, Genetic
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Affiliation(s)
- Tulika Seth
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi--110029, India.
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Bharti K, Vora A, Vajifdar B. Isolated right ventricular cardiomyopathy of unknown etiology. J Assoc Physicians India 2008; 56:1000-1001. [PMID: 19326510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Karanth NV, Vora A, Mishra B, Karanth P, Prabhash K, Pai VR, Parikh PM, Gujral S. Plasma cell dyscrasia presenting as ascites and omental mass. J Clin Oncol 2008; 26:1379-81. [PMID: 18323560 DOI: 10.1200/jco.2007.12.7738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Affiliation(s)
- Narayan V Karanth
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
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Walker K, Badawi N, Hamid CH, Vora A, Halliday R, Taylor C, Shi E, Roy GT, Simpson E, Holland AJA. A population-based study of the outcome after small bowel atresia/stenosis in New South Wales and the Australian Capital Territory, Australia, 1992-2003. J Pediatr Surg 2008; 43:484-8. [PMID: 18358286 DOI: 10.1016/j.jpedsurg.2007.10.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [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: 11/28/2022]
Abstract
PURPOSE The purpose of the study was to describe the incidence, epidemiology, and survival of infants with small bowel atresia/stenosis in New South Wales (NSW) and the Australian Capital Territory (ACT), Australia. METHODS A population-based cohort study was conducted of infants diagnosed with small bowel atresia/stenosis in NSW and the ACT from 1992 to 2003. Data were obtained from the prospectively collated NSW and ACT Neonatal Intensive Care Units' data collection. Individual risk factors for mortality were assessed using the chi(2) test. RESULTS The incidence of small bowel atresia/stenosis in NSW and the ACT was 2.9 per 10,000 births. Of 299 infants identified with small bowel atresia, 13 were stillborn. Of the 286 live born infants, most (52%) were delivered preterm (<37 weeks' gestation) with an 87% survival, whereas 48% were term with a 98% survival. More than half the infants (54%) had an associated birth defect. The overall mortality was 8%. Prematurity and low birth weight were identified as independent risk factors for mortality (P < .001). CONCLUSIONS This study of small bowel atresia/stenosis provides population-based outcomes for clinicians and families. It is important to investigate infants with small bowel atresia for associated birth defects. Although the mortality rate has decreased over the last 50 years, it remains substantial at 8% and is higher in premature and low birth weight infants.
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Affiliation(s)
- Karen Walker
- Department of Paediatrics and Child Health, Grace Centre for Newborn Care, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW 2145, Australia.
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Abstract
Experimental studies using models of multiple sclerosis (MS) indicate that rapid and extensive remyelination of inflammatory demyelinated lesions is not only possible, but is the normal situation. The presence of completely remyelinated MS lesions has been noted in numerous studies and routine limited sampling of post mortem MS material suggests that remyelination may be extensive in the early stages but eventually fails. However, visual macroscopic guided sampling tends to be biased towards chronic demyelinated lesions. Here we have extensively sampled cerebral tissue from two MS cases to investigate the true extent of remyelination. Sections were cut from 185 cerebral tissue blocks and stained with haematoxylin and eosin (H&E), luxol fast blue and cresyl fast violet (LFB/CFV) and anti-myelin oligodendrocyte glycoprotein, human leucocyte antigen-DR (HLA-DR) and 200 kDa neurofilament protein antibodies. Demyelinated areas were identified in 141 blocks, comprising both white matter (WMLs) and/or grey matter lesions. In total, 168 WMLs were identified, 22% of which were shadow plaques, 73% were partially remyelinated and only 5% were completely demyelinated. The average extent of lesion remyelination for all WMLs investigated was 47%. Increased density of HLA-DR(+) macrophages and microglia at the lesion border correlated significantly with more extensive remyelination. Results from this study of two patients with long standing disease suggest that remyelination in MS may be more extensive than previously thought.
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Affiliation(s)
- R Patani
- Department of Cellular and Molecular Neuroscience, UK MS Tissue Bank, Division of Neuroscience, Imperial College London, Charing Cross Hospital Campus, London, UK
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45
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Vora A. Approach to management of atrial fibrillation in the Indian scenario. J Assoc Physicians India 2007; 55 Suppl:30-32. [PMID: 18368864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Raina V, Sharma A, Vora A, Shukla NK, Deo SVS, Dawar R. Primary gastrointestinal non Hodgkin's lymphoma chemotherapy alone an effective treatment modality: experience from a single centre in India. Indian J Cancer 2006; 43:30-5. [PMID: 16763360 DOI: 10.4103/0019-509x.25773] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Gastrointestinal tract (GI) is the most frequently involved extra nodal site in non-Hodgkin's lymphoma (NHL). Surgery, radiotherapy and chemotherapy (CT) have been used mostly in various combinations, but lately chemotherapy alone has emerged as an effective option. The purpose of this study is to evaluate efficacy of CT alone in treatment of primary GI-NHL and to compare the results with combined CT+surgery. SETTING AND DESIGN Retrospective analysis of case records of GI NHL patients. MATERIALS AND METHODS Over a 15-year period (1986-2000), 77 new cases of primary GI-NHL were registered at our center. GI-NHL was defined according to standard criteria. All patients received chemotherapy. RESULTS The median age was 32 years (Range 9-80). Endoscopy / CT guided biopsies were performed in 42% (32) of patients for the purpose of diagnosis. Laparotomy was done in 58% (45) of patients to establish a diagnosis or as primary or debulking treatment. Stomach and intestines were involved in 47% (36) and 53% (41) patients respectively. Early stage disease was present in 37% (29). Seventy eight percent of tumors were intermediate to high grade, 43% (33) received only CT while 57% (44) received CT+surgery. Five years EFS and OS were: 72% and 65% for all patients; 72% and 67% for CT only group; 60% and 64% for CT+surgery group (P=.05). Four patients died of neutropenic infection. CONCLUSION Organ-preservation strategy using chemotherapy alone (CT) can be successfully employed in a significant number of patients with primary GI-NHL.
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Affiliation(s)
- Vinod Raina
- Departments of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
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48
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Arora B, Parikh PM, Nair R, Vora A, Gupta S, Sastry P, Menon H, Bakshi A, Kumar P, Goyal L. Status of geriatric oncology in India: A national multicentric survey of oncology professionals. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.16035] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
16035 Background: Elderly cancer patients are underrepresented in cancer services utilization and clinical research in India. National data on providers’ knowledge, attitude and practices with regard to elderly cancer patients is sparse and is urgently required to address needs of this vulnerable and growing population. Methods: A self administered questionnaire was mailed to nationally representative sample of practicing oncologists all over India. 112 Oncologists (Medical Oncologists-51%; Radiation Oncologists-25%; Surgical Oncologists-20%; allied fields-4%) responded out of 250 mailed Questionnaires. Results: A designated Geriatric Oncology unit is in existence in very few (<5%) centers. Majority (51%) considered patients with chronological age of >60 years as elderly for India. Although 75% of elderly patients receive some therapy, only 50% of potentially curable patients and a similar percentage of potentially incurable patients receive standard of care. Also, 50% patients require modification in their treatment and only two-third of treated patients complete therapy. The existent barriers to treatment included poor performance status (53%), advanced stage (16%), and co-morbidities (15%). Only 51% Oncologists always discussed and 28% always enrolled elderly patients in clinical trials. Standard of care and evidence based recommendations for elderly patients were felt to be lacking by 49% and 92% of respondents respectively. The need of separate trials for elderly and a separate discipline of Geriatric Oncology was voiced by 93% and 89% of respondents respectively. Major differences in treatment practice between medical oncologists and non medical oncologists are shown in table . Conclusions: Treatment practices and accrual of elderly cancer patients in clinical trials in India is far from optimal. Formation of a National Geriatric Oncology society and creation of designated Geriatric oncology services at key centers may enhance the understanding and clinical care of this population. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- B. Arora
- Tata Memorial Hospital, Mumbai, India
| | | | - R. Nair
- Tata Memorial Hospital, Mumbai, India
| | - A. Vora
- Tata Memorial Hospital, Mumbai, India
| | - S. Gupta
- Tata Memorial Hospital, Mumbai, India
| | - P. Sastry
- Tata Memorial Hospital, Mumbai, India
| | - H. Menon
- Tata Memorial Hospital, Mumbai, India
| | - A. Bakshi
- Tata Memorial Hospital, Mumbai, India
| | - P. Kumar
- Tata Memorial Hospital, Mumbai, India
| | - L. Goyal
- Tata Memorial Hospital, Mumbai, India
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49
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Biswas G, Parikh PM, Nair R, Bhagwat R, Bakshi A, Prabhash K, Vora A, Gupta S, Pai VR, Menon H, Sastry PSRK. Rituximab (anti-CD20 monoclonal antibody) in lymphoproliferative malignancies: Tata Memorial experience. J Assoc Physicians India 2006; 54:29-33. [PMID: 16649735] [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] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Rituximab has been used extensively in lymphoproliferative disorders. We evaluated the results of 64 consecutive patients treated between 2001 and 2004 at our institution. This included 54 males and 10 females. The median age was 54 years (range 17 to 85 years). One-fourth of patients were above 60 years. The histology was aggressive NHL in 35, indolent NHL in 22 and 7 cases were diagnosed as CLL. Among NHL, sixteen were in early stage (I/II) and the remaining forty-one were in advanced stage (III/IV) of disease. B symptoms were present in 47% of cases. A total of 33 were de novo cases and 31 were previously treated. Rituximab monotherapy was used in 17 cases. Rituximab was used in combination with chemotherapy in the other 47 cases. Infusional toxicity included anaphylaxis in one, hypotension in one and minor infusional reactions in four others. The patient who developed anaphylaxis required discontinuation of further Rituximab. Growth factors were used in 25 patients. Febrile neutropenia occurred in 19 patients. The overall RR (CR + PR) was 72%. One patient had stable disease and progressive disease was documented in 17 patients. A total of seven patients died, three due to progressive disease, three due to chemotherapy related toxicity and one due to an unrelated cause. We conclude that Rituximab is a valuable addition to the treatment armamentarium of lymphoproliferative disorders.
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Affiliation(s)
- G Biswas
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
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50
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Mitchell CD, Richards SM, Kinsey SE, Lilleyman J, Vora A, Eden TOB. Benefit of dexamethasone compared with prednisolone for childhood acute lymphoblastic leukaemia: results of the UK Medical Research Council ALL97 randomized trial. Br J Haematol 2005; 129:734-45. [PMID: 15952999 DOI: 10.1111/j.1365-2141.2005.05509.x] [Citation(s) in RCA: 231] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Corticosteroids are an essential component of treatment for acute lymphoblastic leukaemia (ALL). Prednisolone is the most commonly used steroid, particularly in the maintenance phase of therapy. There is increasing evidence that, even in equipotent dosage for glucocorticoid effect, dexamethasone has enhanced lymphoblast cytotoxicity and penetration of the central nervous system (CNS) compared with prednisolone. Substitution of dexamethasone for prednisolone in the treatment of ALL might, therefore, result in improved event-free and overall survival. Children with newly diagnosed ALL were randomly assigned to receive either dexamethasone or prednisolone in the induction, consolidation (all received dexamethasone in intensification) and continuation phases of treatment. Among 1603 eligible randomized patients, those receiving dexamethasone had half the risk of isolated CNS relapse (P = 0.0007). Event-free survival was significantly improved with dexamethasone (84.2% vs. 75.6% at 5 years; P = 0.01), with no evidence of differing effects in any subgroup of patients. The use of 6.5 mg/m(2) dexamethasone throughout treatment for ALL led to a significant decrease in the risk of relapse for all risk-groups of patients and, despite the increased toxicity, should now be regarded as part of standard therapy for childhood ALL.
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Affiliation(s)
- C D Mitchell
- Paediatric Haematology/Oncology, John Radcliffe Hospital, Oxford, UK.
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