Girish Badarkhe - Academia.edu (original) (raw)
Papers by Girish Badarkhe
Journal of applied hematology, 2021
Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underly... more Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underlying mechanism involved in thrombus formations is largely unknown with limited published data. Our patient was presented with complaints of continuous headache and persistent projectile vomiting. After initial tests, a magnetic resonance imaging of the brain performed revealed cerebral venous sinus thrombosis. Anticoagulant and anticonvulsant prophylaxis was initiated, and further treatment was planned. In such rare cases, early diagnosis and management are desirable. The role of clinicians in identifying the clinically suspicious signs and symptoms can help in identifying such rare conditions before developing severe thromboembolic complications. In the present study, we report a rare case of cerebral venous thrombosis, its associated treatment, and complications in a patient diagnosed with nucleophosmin gene-mutated acute myeloid leukemia. Similar Cases Published: None.
Journal of Clinical Oncology, May 20, 2016
e19003Background: Jehovah’s Witnesses are members of a religious group founded in the 1870s in Pe... more e19003Background: Jehovah’s Witnesses are members of a religious group founded in the 1870s in Pennsylvania by Charles Taze Russell. There are an estimated 6 million Jehovah’s Witnesses worldwide. ...
Journal of Precision Oncology
Journal of Precision Oncology
South Asian Journal of Cancer
Background Cancer and its related treatments have a huge impact on a patient's quality of lif... more Background Cancer and its related treatments have a huge impact on a patient's quality of life (QOL). To measure such QOL in cancer patients, the European Organization for Research and Treatment of Cancer (EORTC) has introduced various scales/questionnaires for various cancers. In the present study, we aimed to translate and validate high-grade Non-Hodgkin's lymphoma (NHL-HG) English questionnaire (EORTC QLQ-NHL-HG29) into Hindi and Marathi (two of the most popular Indian language) to make it available for patients and the scientific community. Materials and methods The EORTC QLQ-NHL-HG29 was translated into Hindi and Marathi languages as per EORTC guidelines. The translated questionnaire was pilot-tested in a sample of 20 patients (10 for each translation) with NHL-HG. Results After procuring required approvals from EORTC, the existing QLQ-NHL-HG29 English questionnaire was translated (forward and backward) into vernacular languages (Hindi and Marathi). Later, the translati...
Iraqi Journal of Hematology, 2021
BACKGROUND: Immune thrombocytopenia (ITP) is an autoimmune hemorrhagic disorder, where autoreacti... more BACKGROUND: Immune thrombocytopenia (ITP) is an autoimmune hemorrhagic disorder, where autoreactive T-cells and/or autoantibodies destroy platelets and megakaryocytes in the spleen and bone marrow, respectively. To the best of our knowledge, this is the largest cohort of cases wherein patients were treated with novel combination therapy of a corticosteroid with an adjunct immunosuppressive agent for the treatment of ITP in adults. In cohort of 23 patients, 11 patients have no response and 12 patients have shown partial to complete response (CR) to the treatment. The primary aim of the present study was to explore the safety and efficacy of combination therapy in chronic ITP along by evaluating the toxicity associated with prolonged steroid exposure. The secondary aim was to compare the cost benefit with other available modalities for chronic ITP treatment. MATERIALS AND METHODS: A retrospective observational study was carried out by collecting data from electronic medical records of all the ITP patients treated at HCG Manavata Cancer Centre, India, between May 1, 2019, and April 30, 2020. Inclusion and exclusion criteria were strictly followed for data collection and analysis. RESULTS: Twelve (52%) of the 23 patients have shown response to the combinational therapy; 5 (22%) patients achieved a partial response (PR) and 7 (30%) achieved a CR. In the PR group, 3 patients developed thrombocytopenia and 1 switched to thrombopoietin receptor agonists, whereas in 7 CR patients, 6 have maintained it until end and 1 patient was switched to maintenance therapy. CONCLUSION: A combination of immunosuppressant and corticosteroid on ITP patients appeared to be effective, tolerable, with minimal adverse side effects, and an economical alternative. Therefore, this novel combination therapy may be an excellent alternative for the treatment of patients with ITP in clinical settings.
Hematology, Transfusion and Cell Therapy, 2020
prognosis of the illness. Lineage switching is a rare phenomenon in which ALL transforms from lym... more prognosis of the illness. Lineage switching is a rare phenomenon in which ALL transforms from lymphoid to myeloid lineage or vice versa. This situation rarely occurs especially in adults, and the prognosis is highly variable. The specific causative factors, central mechanisms involved in these phenomena are still unclear and yet to be identified. In the present case report, we are presenting a rare case of lineage switching of ALL to AML in a young adult of 19 years during chemotherapy. Case presentation A 19-year-old male was presented at our hematology center due to weakness, weight loss, and pancytopenia. Upon physical examination, he was pale, with bone pain, and referred asthenia. Other physical examinations have shown no other abnormalities. Initial laboratory tests were performed. From complete blood count (CBC) decreased total
International Journal of Hematology-Oncology and Stem Cell Research, 2021
Background: Autologous HCT in multiple myeloma is done as upfront treatment in newly diagnosed tr... more Background: Autologous HCT in multiple myeloma is done as upfront treatment in newly diagnosed transplant eligible patients after induction chemotherapy. In addition, it is standard for relapsed, aggressive non-Hodgkin lymphoma (NHL) and classical Hodgkin lymphoma (HL), and is curative in ~40% to 45% of patients. Over a decade, many efforts were made to find helpful parameters to predict an optimal time for initiating an efficient peripheral blood stem cell collection so that adequate stem cells are collected. It has been well accepted that CD34+ cell count in peripheral blood before leukapheresis is the best parameter to predict CD34 cell yield. However, white blood cell count, mononuclear cell count, and other easily obtained parameters are still used to guide the clinical practice of peripheral blood stem cell mobilization and collection. Materials and Methods: In the present study, we analyzed the correlation between peripheral blood MNC and Apheresis CD34 levels and also betwee...
Indian Journal of Medical and Paediatric Oncology, 2020
Introduction: Plerixafor is a CXCR4 antagonist which is administered along with granulocyte-colon... more Introduction: Plerixafor is a CXCR4 antagonist which is administered along with granulocyte-colony-stimulating factor (G-CSF) to mobilize hematopoietic stem cells in patients with Non-Hodgkin lymphoma (NHL) or multiple myeloma (MM), who failed the mobilization with G-CSF alone. Methodology: This was a single-center, retrospective study of the efficacy of the plerixafor and G-CSF in 32 patients with NHL (n = 11), MM (n = 11), and Hodgkin lymphoma (HL) (n = 10) who failed mobilization with G-CSF alone. Results: A median number of 1.21 × 106, 1.32 × 106, and 6.73 × 106 CD34 + cells were mobilized in patients with MM, NHL, and HL, respectively. Overall, 31 (96.8%) patients mobilized more than 2 × 106 CD34 + stem cells and 21 (33.75%) patients mobilized more than 5 × 106 CD34 + stem cells. All 32 (100%) patients underwent hematopoietic stem cell transplantation. There were no adverse drug events reported. Conclusion: This retrospective study shows that plerixafor is an effective and safe...
Journal of Experimental & Clinical Medicine, 2020
Background: Acquired aplastic anemia is an unusual disease associated with pancytopenia character... more Background: Acquired aplastic anemia is an unusual disease associated with pancytopenia characterized by hypocellular bone marrow. Aplastic anemia is an auto-immune disorder wherein patients would show a antithymocyte globulin (ATG)- induced hematological response after T-cell reduction. The combination of cyclosporine A and ATG as immunosuppressive therapy is considered as the standard treatment approach for patients with aplastic anemia. EBV infection in a patient with aplastic anemia is an unusual clinical presentation. Case Report: A 49-year-old Asian female presented to our hospital with dizziness and fatigue. The patient’s platelet count was extremely low. A hypocellular marrow with lymphocytosis was observed with the help of a bone marrow aspirate and biopsy. The patient was given cyclosporine and eltrombopag as a bridge to primary therapy, i.e. antithymocyte globulin (ATG)/allogenic transplant considering she had pancytopenia. The patient developed platelet refractoriness. E...
Journal of Applied Hematology, 2021
Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underly... more Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underlying mechanism involved in thrombus formations is largely unknown with limited published data. Our patient was presented with complaints of continuous headache and persistent projectile vomiting. After initial tests, a magnetic resonance imaging of the brain performed revealed cerebral venous sinus thrombosis. Anticoagulant and anticonvulsant prophylaxis was initiated, and further treatment was planned. In such rare cases, early diagnosis and management are desirable. The role of clinicians in identifying the clinically suspicious signs and symptoms can help in identifying such rare conditions before developing severe thromboembolic complications. In the present study, we report a rare case of cerebral venous thrombosis, its associated treatment, and complications in a patient diagnosed with nucleophosmin gene-mutated acute myeloid leukemia. Similar Cases Published: None.
Journal of Cancer Therapy, 2020
Plerixafor is a stem cell mobilising agent, and when administered along with G-CSF has been shown... more Plerixafor is a stem cell mobilising agent, and when administered along with G-CSF has been shown to improve CD34+ stem cell collections in lymphoma and multiple myeloma patients compared to G-CSF alone. Patients who failed to mobilize <2.0 × 10 6 cells/kg on Day 1 collection received Plerixafor and G CSF for further collections. Study population was divided into two groups as plerixafor yes (PY) who are poor mobilizers and Plerixafor No (PN) who are good mobilizers. Out of 49 patients, 28 patients were in PY group and 21 patients in PN group. Median value of apheresis CD34 of day 1 was 1.75 (range 0.258 to 8.52) in PY group and 2.63 (range 1.06 to 6.29) in PN group and that of day 2 was 3.845 (range 0.317 to 13.89) in PY group and 3.18 (range 0.88 to 6.348) in PN group. Median value of total apheresis CD34 was 8.10 (range 4.33 to 18.66) in PY group and 7.58 (range 4.06 to 9.8) in PN group. Median day of neutrophil engraftment was 11.5 (range 9-22) in PY group and 11 (range 9-36) in PN group whereas median day of platelet engraftment was 14 (range 9-98) in PY group and 13 (range 11-98) in PN group. It can be concluded that the use of plerixafor not only enabled poor mobilizers of Lymphoma and Multiple Myeloma to collect adequate stem cells to proceed to ASCT, but also had early neutrophil and platelet engraftment which was comparable with good mobilizers.
Journal of Clinical Oncology, 2016
e19002Background: The dose of PBSCs infused is critical to the success and the rate of hematopoie... more e19002Background: The dose of PBSCs infused is critical to the success and the rate of hematopoietic recovery after auto-SCT. Approximately 20% patients mobilize < 2 x 10^ 6/kg CD34+ cells per kg w...
Journal of Clinical Oncology, 2016
e19003Background: Jehovah’s Witnesses are members of a religious group founded in the 1870s in Pe... more e19003Background: Jehovah’s Witnesses are members of a religious group founded in the 1870s in Pennsylvania by Charles Taze Russell. There are an estimated 6 million Jehovah’s Witnesses worldwide. ...
Journal of Clinical Oncology, 2016
e12569Background: We evaluated the effects of metronomic chemo (MC) on survival outcomes in refra... more e12569Background: We evaluated the effects of metronomic chemo (MC) on survival outcomes in refractory MBC population. Methods: 28 subjects with treatment refractory (21) and treatment naive (7) MBC were included in an open label single arm efficacy study of MC. Patients were given a chemotherapy regimen of Tab. Cyclophosphamide 50mg once daily and Tab. Methotrexate 2.5mg twice in a week for 3 months or until the progression of their disease whichever was earlier. Patients were assessed for treatment response using RECIST Criteria (v 1.1) and duration of PFS and OS. Monitoring of S. VEGF and TSP levels were done to correlate the RR. Data were analysed using chi square test for proportions and Kaplan Meir Survival analysis. Results: The mean age of the study population was 51.5 ±14.2 years. The mean duration of MC was 123.89 ±97.6 days. Overall 71.4% had PD and 28.6% had SD. 55.6% with treatment naive MBC had SD compared to 15.8% of treatment refractory MBC (χ2 = 4.7, p = 0.03). There was a significant imp...
Indian Journal of Pharmacology, 2016
Erythema multiforme (EM) is an acute, self-limited, Type IV hypersensitivity reactions associated... more Erythema multiforme (EM) is an acute, self-limited, Type IV hypersensitivity reactions associated with infections and drugs. In this case of acute promyelocytic leukemia, EM diagnosed during the induction phase was mistakenly attributed to vancomycin used to treat febrile neutropenia during that period. However, the occurrence of the lesions of EM again during the consolidation phase with arsenic trioxide (ATO) lead to a re-evaluation of the patient and both the Naranjo and World Health Organization-Uppsala Monitoring Centre scale showed the causality association as &amp;amp;amp;quot;probable.&amp;amp;amp;quot; The rash responded to topical corticosteroids and antihistamines. This rare event of EM being caused by ATO may be attributed to the genetic variation of methyl conjugation in the individual which had triggered the response, and the altered metabolic byproducts acted as a hapten in the subsequent keratinocyte necrosis.
Hemoglobin, 2012
The thalassemias are the most common single gene disorder known to mankind. The phenotype of thal... more The thalassemias are the most common single gene disorder known to mankind. The phenotype of thalassemia depends upon the underlying gene defect in addition to many modulating factors. As the literature describes, inheritance of a β(0) genotype in the homozygous state results in the development of β-thalassemia (β-thal) major with key clinical features being transfusion dependency, physical abnormalities and iron overload. IVS-1-5 (G&amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;C) is the severe β(+) allele whose homozygosity results in severe β-thal. We describe a patient who was asymptomatic until screened and was found to have mild anemia. Detailed analysis revealed the presence of the IVS-I-5 mutation in a homozygous state that was unlikely to present as a transfusion independent state. The study of such cases emphasizes the complexity of genetic interactions that underlie the phenotype of β-thal and highlight the importance of the regulation of Hb F production in β-thal syndromes. Simultaneous inheritance of some loci that modulate Hb F levels probably causes high levels of total hemoglobin (Hb) and to be transfusion independent.
Critical Care Nurse, 2011
BackgroundPatients in neurological critical care units often have lengthy stays that require exte... more BackgroundPatients in neurological critical care units often have lengthy stays that require extended vascular access and invasive hemodynamic monitoring. The traditional approach for these patients has relied heavily on central venous and pulmonary artery catheters. The aim of this study was to evaluate peripherally inserted central catheters as an alternative to central venous catheters in neurocritical care settings.MethodsData on 35 patients who had peripherally inserted central catheters rather than central venous or pulmonary artery catheters for intravascular access and monitoring were collected from a prospective registry of neurological critical care admissions. These data were cross-referenced with information from hospital-based data registries for peripherally inserted central catheters and subarachnoid hemorrhage.ResultsComplete data were available on 33 patients with Hunt-Hess grade IV–V aneurysmal subarachnoid hemorrhage. Catheters remained in place a total of 649 day...
Journal of applied hematology, 2021
Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underly... more Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underlying mechanism involved in thrombus formations is largely unknown with limited published data. Our patient was presented with complaints of continuous headache and persistent projectile vomiting. After initial tests, a magnetic resonance imaging of the brain performed revealed cerebral venous sinus thrombosis. Anticoagulant and anticonvulsant prophylaxis was initiated, and further treatment was planned. In such rare cases, early diagnosis and management are desirable. The role of clinicians in identifying the clinically suspicious signs and symptoms can help in identifying such rare conditions before developing severe thromboembolic complications. In the present study, we report a rare case of cerebral venous thrombosis, its associated treatment, and complications in a patient diagnosed with nucleophosmin gene-mutated acute myeloid leukemia. Similar Cases Published: None.
Journal of Clinical Oncology, May 20, 2016
e19003Background: Jehovah’s Witnesses are members of a religious group founded in the 1870s in Pe... more e19003Background: Jehovah’s Witnesses are members of a religious group founded in the 1870s in Pennsylvania by Charles Taze Russell. There are an estimated 6 million Jehovah’s Witnesses worldwide. ...
Journal of Precision Oncology
Journal of Precision Oncology
South Asian Journal of Cancer
Background Cancer and its related treatments have a huge impact on a patient's quality of lif... more Background Cancer and its related treatments have a huge impact on a patient's quality of life (QOL). To measure such QOL in cancer patients, the European Organization for Research and Treatment of Cancer (EORTC) has introduced various scales/questionnaires for various cancers. In the present study, we aimed to translate and validate high-grade Non-Hodgkin's lymphoma (NHL-HG) English questionnaire (EORTC QLQ-NHL-HG29) into Hindi and Marathi (two of the most popular Indian language) to make it available for patients and the scientific community. Materials and methods The EORTC QLQ-NHL-HG29 was translated into Hindi and Marathi languages as per EORTC guidelines. The translated questionnaire was pilot-tested in a sample of 20 patients (10 for each translation) with NHL-HG. Results After procuring required approvals from EORTC, the existing QLQ-NHL-HG29 English questionnaire was translated (forward and backward) into vernacular languages (Hindi and Marathi). Later, the translati...
Iraqi Journal of Hematology, 2021
BACKGROUND: Immune thrombocytopenia (ITP) is an autoimmune hemorrhagic disorder, where autoreacti... more BACKGROUND: Immune thrombocytopenia (ITP) is an autoimmune hemorrhagic disorder, where autoreactive T-cells and/or autoantibodies destroy platelets and megakaryocytes in the spleen and bone marrow, respectively. To the best of our knowledge, this is the largest cohort of cases wherein patients were treated with novel combination therapy of a corticosteroid with an adjunct immunosuppressive agent for the treatment of ITP in adults. In cohort of 23 patients, 11 patients have no response and 12 patients have shown partial to complete response (CR) to the treatment. The primary aim of the present study was to explore the safety and efficacy of combination therapy in chronic ITP along by evaluating the toxicity associated with prolonged steroid exposure. The secondary aim was to compare the cost benefit with other available modalities for chronic ITP treatment. MATERIALS AND METHODS: A retrospective observational study was carried out by collecting data from electronic medical records of all the ITP patients treated at HCG Manavata Cancer Centre, India, between May 1, 2019, and April 30, 2020. Inclusion and exclusion criteria were strictly followed for data collection and analysis. RESULTS: Twelve (52%) of the 23 patients have shown response to the combinational therapy; 5 (22%) patients achieved a partial response (PR) and 7 (30%) achieved a CR. In the PR group, 3 patients developed thrombocytopenia and 1 switched to thrombopoietin receptor agonists, whereas in 7 CR patients, 6 have maintained it until end and 1 patient was switched to maintenance therapy. CONCLUSION: A combination of immunosuppressant and corticosteroid on ITP patients appeared to be effective, tolerable, with minimal adverse side effects, and an economical alternative. Therefore, this novel combination therapy may be an excellent alternative for the treatment of patients with ITP in clinical settings.
Hematology, Transfusion and Cell Therapy, 2020
prognosis of the illness. Lineage switching is a rare phenomenon in which ALL transforms from lym... more prognosis of the illness. Lineage switching is a rare phenomenon in which ALL transforms from lymphoid to myeloid lineage or vice versa. This situation rarely occurs especially in adults, and the prognosis is highly variable. The specific causative factors, central mechanisms involved in these phenomena are still unclear and yet to be identified. In the present case report, we are presenting a rare case of lineage switching of ALL to AML in a young adult of 19 years during chemotherapy. Case presentation A 19-year-old male was presented at our hematology center due to weakness, weight loss, and pancytopenia. Upon physical examination, he was pale, with bone pain, and referred asthenia. Other physical examinations have shown no other abnormalities. Initial laboratory tests were performed. From complete blood count (CBC) decreased total
International Journal of Hematology-Oncology and Stem Cell Research, 2021
Background: Autologous HCT in multiple myeloma is done as upfront treatment in newly diagnosed tr... more Background: Autologous HCT in multiple myeloma is done as upfront treatment in newly diagnosed transplant eligible patients after induction chemotherapy. In addition, it is standard for relapsed, aggressive non-Hodgkin lymphoma (NHL) and classical Hodgkin lymphoma (HL), and is curative in ~40% to 45% of patients. Over a decade, many efforts were made to find helpful parameters to predict an optimal time for initiating an efficient peripheral blood stem cell collection so that adequate stem cells are collected. It has been well accepted that CD34+ cell count in peripheral blood before leukapheresis is the best parameter to predict CD34 cell yield. However, white blood cell count, mononuclear cell count, and other easily obtained parameters are still used to guide the clinical practice of peripheral blood stem cell mobilization and collection. Materials and Methods: In the present study, we analyzed the correlation between peripheral blood MNC and Apheresis CD34 levels and also betwee...
Indian Journal of Medical and Paediatric Oncology, 2020
Introduction: Plerixafor is a CXCR4 antagonist which is administered along with granulocyte-colon... more Introduction: Plerixafor is a CXCR4 antagonist which is administered along with granulocyte-colony-stimulating factor (G-CSF) to mobilize hematopoietic stem cells in patients with Non-Hodgkin lymphoma (NHL) or multiple myeloma (MM), who failed the mobilization with G-CSF alone. Methodology: This was a single-center, retrospective study of the efficacy of the plerixafor and G-CSF in 32 patients with NHL (n = 11), MM (n = 11), and Hodgkin lymphoma (HL) (n = 10) who failed mobilization with G-CSF alone. Results: A median number of 1.21 × 106, 1.32 × 106, and 6.73 × 106 CD34 + cells were mobilized in patients with MM, NHL, and HL, respectively. Overall, 31 (96.8%) patients mobilized more than 2 × 106 CD34 + stem cells and 21 (33.75%) patients mobilized more than 5 × 106 CD34 + stem cells. All 32 (100%) patients underwent hematopoietic stem cell transplantation. There were no adverse drug events reported. Conclusion: This retrospective study shows that plerixafor is an effective and safe...
Journal of Experimental & Clinical Medicine, 2020
Background: Acquired aplastic anemia is an unusual disease associated with pancytopenia character... more Background: Acquired aplastic anemia is an unusual disease associated with pancytopenia characterized by hypocellular bone marrow. Aplastic anemia is an auto-immune disorder wherein patients would show a antithymocyte globulin (ATG)- induced hematological response after T-cell reduction. The combination of cyclosporine A and ATG as immunosuppressive therapy is considered as the standard treatment approach for patients with aplastic anemia. EBV infection in a patient with aplastic anemia is an unusual clinical presentation. Case Report: A 49-year-old Asian female presented to our hospital with dizziness and fatigue. The patient’s platelet count was extremely low. A hypocellular marrow with lymphocytosis was observed with the help of a bone marrow aspirate and biopsy. The patient was given cyclosporine and eltrombopag as a bridge to primary therapy, i.e. antithymocyte globulin (ATG)/allogenic transplant considering she had pancytopenia. The patient developed platelet refractoriness. E...
Journal of Applied Hematology, 2021
Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underly... more Association of cancer and thrombotic complications in acute leukemia is not uncommon. The underlying mechanism involved in thrombus formations is largely unknown with limited published data. Our patient was presented with complaints of continuous headache and persistent projectile vomiting. After initial tests, a magnetic resonance imaging of the brain performed revealed cerebral venous sinus thrombosis. Anticoagulant and anticonvulsant prophylaxis was initiated, and further treatment was planned. In such rare cases, early diagnosis and management are desirable. The role of clinicians in identifying the clinically suspicious signs and symptoms can help in identifying such rare conditions before developing severe thromboembolic complications. In the present study, we report a rare case of cerebral venous thrombosis, its associated treatment, and complications in a patient diagnosed with nucleophosmin gene-mutated acute myeloid leukemia. Similar Cases Published: None.
Journal of Cancer Therapy, 2020
Plerixafor is a stem cell mobilising agent, and when administered along with G-CSF has been shown... more Plerixafor is a stem cell mobilising agent, and when administered along with G-CSF has been shown to improve CD34+ stem cell collections in lymphoma and multiple myeloma patients compared to G-CSF alone. Patients who failed to mobilize <2.0 × 10 6 cells/kg on Day 1 collection received Plerixafor and G CSF for further collections. Study population was divided into two groups as plerixafor yes (PY) who are poor mobilizers and Plerixafor No (PN) who are good mobilizers. Out of 49 patients, 28 patients were in PY group and 21 patients in PN group. Median value of apheresis CD34 of day 1 was 1.75 (range 0.258 to 8.52) in PY group and 2.63 (range 1.06 to 6.29) in PN group and that of day 2 was 3.845 (range 0.317 to 13.89) in PY group and 3.18 (range 0.88 to 6.348) in PN group. Median value of total apheresis CD34 was 8.10 (range 4.33 to 18.66) in PY group and 7.58 (range 4.06 to 9.8) in PN group. Median day of neutrophil engraftment was 11.5 (range 9-22) in PY group and 11 (range 9-36) in PN group whereas median day of platelet engraftment was 14 (range 9-98) in PY group and 13 (range 11-98) in PN group. It can be concluded that the use of plerixafor not only enabled poor mobilizers of Lymphoma and Multiple Myeloma to collect adequate stem cells to proceed to ASCT, but also had early neutrophil and platelet engraftment which was comparable with good mobilizers.
Journal of Clinical Oncology, 2016
e19002Background: The dose of PBSCs infused is critical to the success and the rate of hematopoie... more e19002Background: The dose of PBSCs infused is critical to the success and the rate of hematopoietic recovery after auto-SCT. Approximately 20% patients mobilize < 2 x 10^ 6/kg CD34+ cells per kg w...
Journal of Clinical Oncology, 2016
e19003Background: Jehovah’s Witnesses are members of a religious group founded in the 1870s in Pe... more e19003Background: Jehovah’s Witnesses are members of a religious group founded in the 1870s in Pennsylvania by Charles Taze Russell. There are an estimated 6 million Jehovah’s Witnesses worldwide. ...
Journal of Clinical Oncology, 2016
e12569Background: We evaluated the effects of metronomic chemo (MC) on survival outcomes in refra... more e12569Background: We evaluated the effects of metronomic chemo (MC) on survival outcomes in refractory MBC population. Methods: 28 subjects with treatment refractory (21) and treatment naive (7) MBC were included in an open label single arm efficacy study of MC. Patients were given a chemotherapy regimen of Tab. Cyclophosphamide 50mg once daily and Tab. Methotrexate 2.5mg twice in a week for 3 months or until the progression of their disease whichever was earlier. Patients were assessed for treatment response using RECIST Criteria (v 1.1) and duration of PFS and OS. Monitoring of S. VEGF and TSP levels were done to correlate the RR. Data were analysed using chi square test for proportions and Kaplan Meir Survival analysis. Results: The mean age of the study population was 51.5 ±14.2 years. The mean duration of MC was 123.89 ±97.6 days. Overall 71.4% had PD and 28.6% had SD. 55.6% with treatment naive MBC had SD compared to 15.8% of treatment refractory MBC (χ2 = 4.7, p = 0.03). There was a significant imp...
Indian Journal of Pharmacology, 2016
Erythema multiforme (EM) is an acute, self-limited, Type IV hypersensitivity reactions associated... more Erythema multiforme (EM) is an acute, self-limited, Type IV hypersensitivity reactions associated with infections and drugs. In this case of acute promyelocytic leukemia, EM diagnosed during the induction phase was mistakenly attributed to vancomycin used to treat febrile neutropenia during that period. However, the occurrence of the lesions of EM again during the consolidation phase with arsenic trioxide (ATO) lead to a re-evaluation of the patient and both the Naranjo and World Health Organization-Uppsala Monitoring Centre scale showed the causality association as &amp;amp;amp;quot;probable.&amp;amp;amp;quot; The rash responded to topical corticosteroids and antihistamines. This rare event of EM being caused by ATO may be attributed to the genetic variation of methyl conjugation in the individual which had triggered the response, and the altered metabolic byproducts acted as a hapten in the subsequent keratinocyte necrosis.
Hemoglobin, 2012
The thalassemias are the most common single gene disorder known to mankind. The phenotype of thal... more The thalassemias are the most common single gene disorder known to mankind. The phenotype of thalassemia depends upon the underlying gene defect in addition to many modulating factors. As the literature describes, inheritance of a β(0) genotype in the homozygous state results in the development of β-thalassemia (β-thal) major with key clinical features being transfusion dependency, physical abnormalities and iron overload. IVS-1-5 (G&amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;C) is the severe β(+) allele whose homozygosity results in severe β-thal. We describe a patient who was asymptomatic until screened and was found to have mild anemia. Detailed analysis revealed the presence of the IVS-I-5 mutation in a homozygous state that was unlikely to present as a transfusion independent state. The study of such cases emphasizes the complexity of genetic interactions that underlie the phenotype of β-thal and highlight the importance of the regulation of Hb F production in β-thal syndromes. Simultaneous inheritance of some loci that modulate Hb F levels probably causes high levels of total hemoglobin (Hb) and to be transfusion independent.
Critical Care Nurse, 2011
BackgroundPatients in neurological critical care units often have lengthy stays that require exte... more BackgroundPatients in neurological critical care units often have lengthy stays that require extended vascular access and invasive hemodynamic monitoring. The traditional approach for these patients has relied heavily on central venous and pulmonary artery catheters. The aim of this study was to evaluate peripherally inserted central catheters as an alternative to central venous catheters in neurocritical care settings.MethodsData on 35 patients who had peripherally inserted central catheters rather than central venous or pulmonary artery catheters for intravascular access and monitoring were collected from a prospective registry of neurological critical care admissions. These data were cross-referenced with information from hospital-based data registries for peripherally inserted central catheters and subarachnoid hemorrhage.ResultsComplete data were available on 33 patients with Hunt-Hess grade IV–V aneurysmal subarachnoid hemorrhage. Catheters remained in place a total of 649 day...