Reena Nair - Academia.edu (original) (raw)

Papers by Reena Nair

Indian Journal of Medical and Paediatric Oncology

Relapsed and refractory (RR) acute lymphoblastic leukemia (ALL) poses unique and difficult challe... more Relapsed and refractory (RR) acute lymphoblastic leukemia (ALL) poses unique and difficult challenges to a practicing clinician in India where access to novel immunotherapies is limited. Between 2017 and 2020, eight patients with B-cell ALL at our center received inotuzumab ozogamicin (IO) monotherapy on compassionate access, as salvage therapy after at least two lines of conventional therapy failure, and most often as outpatient infusion. Eight patients (21–60 years, three females) received IO. Three patients had morphologic relapse and five patients reported persistent measurable residual disease (MRD). The best response on IO therapy achieved was negative MRD in six of seven patients and complete response (CR) with persistent MRD in one. One patient died (intracranial hemorrhage) before completion of first cycle. All responding patients were transplant eligible and four patients (57%) underwent allogeneic hematopoietic cell transplantation (Allo-HCT). Median follow-up of this coh...

Indian Journal of Medical and Paediatric Oncology

We report a case of stage IV primary mediastinal B-cell lymphoma in a 27-year-old young woman, wh... more We report a case of stage IV primary mediastinal B-cell lymphoma in a 27-year-old young woman, who was refractory and chemoresistant to frontline conventional rituximab-based intensive chemotherapy and subsequent lines of conventional and immune checkpoint inhibitor-based therapies. She was successfully treated using a polatuzumab-based regimen and consolidated with an allogeneic haploidentical hematopoietic stem cell transplantation. She developed post-transplant large granular lymphocytosis that was managed conservatively. She is now relapse-free, 600 days post-transplant. The management of this patient provided several teaching points in the use of different modalities of immunotherapies in a hard-to-treat cancer and its related conditions.

Clinical Lymphoma Myeloma and Leukemia

Blood, 2021

Introduction: Pomalidomide is a third-generation immunomodulatory drug approved for relapsed and/... more Introduction: Pomalidomide is a third-generation immunomodulatory drug approved for relapsed and/or refractory Multiple Myeloma (RRMM). In the phase 3 OPTIMISMM trial, pomalidomide, bortezomib, and dexamethasone demonstrated superior efficacy in patients with RRMM. PRIME study (CTRI/2019/10/021618) is testing this combination in Newly Diagnosed Multiple Myeloma (NDMM) Aim: To determine safety of Pomalidomide in combination with Bortezomib and dexamethasone (VPD) in NDMM Study design: A prospective, single arm, phase II study from a tertiary center. Both transplant eligible and ineligible patients with NDMM aged between 18-70 years are being recruited in the study. Patients with Plasma cell leukemia, POEMS and amyloidosis were excluded. The regimen consists of weekly Bortezomib 1.3mg/sq.m (subcutaneous), Tab. Pomalidomide 2-4mg once daily for 21days, and Tab Dexamethasone 20mg twice weekly, with the cycle repeating every 28 days, 9-12 cycles. Here we report the adverse events (AE) by...

BLOOD CELL THERAPY / The official journal of APBMT, 2021

The prevailing corona virus disease 19 (COVID-19) pandemic has adversely affected the healthcare ... more The prevailing corona virus disease 19 (COVID-19) pandemic has adversely affected the healthcare services globally. Hematopoietic cell transplantation (HCT) is considered as the preferred treatment option for several hematological malignancies, and HPC collection facilities have to function continuously along with implementing safety measures. Based on the national and international guidelines, we implemented additional measures and modifications to our standard operating procedure (SOP) to ensure secure HPC collection from patients as well as donors. Here, we report our experience with HPC collection and processing from 1st January, 2020 until 31st December, 2020. We collected 59 HPC products through apheresis and 41 cryopreservation procedures. Compared to 2019, there was a 33% decrease in the number of HPC transplants and 31% reduction in HPC collection procedures. However, we report an 86% (13 procedures) increase in the cryopreservation of HPC products from related donors, as s...

Frontiers in Oncology, 2022

IntroductionDespite high cure rates with standard treatment, 30% patients with Hodgkin lymphoma d... more IntroductionDespite high cure rates with standard treatment, 30% patients with Hodgkin lymphoma develop relapsed or refractory (R/R) disease. Salvage therapy followed by autologous hematopoietic cell transplantation (HCT) is considered standard of care. Brentuximab Vedotin (Bv) in combination with Bendamustine (B) has been tested in the salvage setting with promising results.Materials and MethodologyWe conducted a single centre retrospective chart review of patients who received BBv salvage therapy to determine its activity and safety in patients with R/R classical Hodgkin lymphoma (HL). Between May 2011- December 2019, 179 patients were diagnosed with R/R HL.ResultsThirty patients received BBv [median age: 30 (15-59) years, females (n=15)]. Primary refractory disease in 19 patients (63%), and 26 patients (87%) had advanced stage at treatment. Most patients received BBv after 2 prior lines of therapy [n=16 (53%)]. The median number of cycles of BBv were 3 (1-6). The number of BBv cy...

ADVANCES IN CELL AND GENE THERAPY, 2021

Haploidentical peripheral blood hematopoietic cell transplantation has become the preferred alter... more Haploidentical peripheral blood hematopoietic cell transplantation has become the preferred alternative donor transplant program in most centers in India, owing to its logistic and cost advantages. This is a retrospective analysis of 59 patients with high‐risk hematological malignancies who underwent haploidentical transplant in three different centers, using myeloablative conditioning and unmanipulated stem cell graft. GVHD prophylaxis was post‐transplant Cyclophosphamide (PTCy D + 3, D + 4) along with Tacrolimus and Mycophenolate Mofetil (D + 5 onwards). The median CD34 cell dose was 5.8 x 106 cells/kg. Neutrophils engrafted in 50 (83%) patients [median time D + 16 (range: 12‐38)] and platelets engrafted in 42 patients (70%) [median time D + 17 (range: 12‐50)]. Acute GVHD developed in 25 (41.7%) patients [Gr III/IV in 9] and Chronic GVHD in 15 (38.5%). 100‐day mortality was 33.8%. With a median follow‐up duration of 6.2 months (range: 0.4‐50.8 months), the relapse rate, treatment‐related mortality (TRM), and estimated 4‐year overall survival are 10.0%, 43.3%, and 38.0%, respectively. For the 31 deaths: causes included engraftment failure (n = 7), GVHD (n = 7), persistent disease (n = 1), relapsed disease (n = 5), bacterial sepsis (n = 5), viral pneumonia (n = 1), infection (n = 3), secondary graft failure (n = 2). TRM outcomes have reduced over time with experience. Myeloablative conditioning and haploidentical transplantation by a post‐transplant cyclophosphamide approach is feasible in a resource‐constrained setting, despite higher rates of GVHD and infection‐related mortality.

Clinical Lymphoma Myeloma and Leukemia, 2018

Blood, 2020

Background: There is a lack of a uniform approach in the treatment of Classical Hodgkin lymphoma ... more Background: There is a lack of a uniform approach in the treatment of Classical Hodgkin lymphoma (CHL) in adolescents and young adults (AYA). Age cutoffs are arbitrary and based on institutional experience. Chemotherapy using ABVD (Adriamycin Bleomycin Vinblastine Dacarbazine) is the standard of care in most centers for the management of adult CHL. Children and adolescents have been managed with more chemo intense approaches like the EURONET protocol, with better Event-free survival (EFS) outcomes while reducing the need for radiation therapy (RT). There is a knowledge gap regarding the optimum treatment in the AYA group and this pertains to strategies to improve EFS while addressing increasing concerns of acute toxicities and long-term complications of therapy, RT especially. We share the retrospective experience of our center where young adults and adolescents received two different strategies based on an age cutoff alone, resulting in different outcomes. Methodology: A retrospect...

Blood, 2021

INTRODUCTION: Literature on acute myeloid Leukemia (AML) from low and middle income countries (LM... more INTRODUCTION: Literature on acute myeloid Leukemia (AML) from low and middle income countries (LMIC) like India indicate lower uptake of intensive treatment (29%) and higher induction mortality (25%) (Philip C, BJH 2015). This is attributable to delayed presentation, higher infection burden, multi-drug resistant organism (MDRO) infections, poor nutritional status, access to care, and high costs driven by 'out-of-pocket expenditures', among other reasons. AIM: To determine the clinical profile, cause and costs of care of patients who die during Induction therapy of newly diagnosed AML. METHODOLOGY: This is a retrospective chart review of newly diagnosed AML patients who died during Induction therapy. Induction mortality was defined as death within 60 days from the date of initiation of therapy for newly diagnosed AML. Secondary and therapy related AML were excluded from the study. Demographic and clinical profiling and analyses of the cause of death was undertaken. RESULTs: B...

Clinical Case Reports, 2020

We report a case of Plasmablastic Lymphoma occurring in a 45-year-old HIV-negative woman involvin... more We report a case of Plasmablastic Lymphoma occurring in a 45-year-old HIV-negative woman involving extra nodal sites including ovary, breast and adrenal glands. Prognostic outcomes are generally dismal. On relapse, she received conventional as well as novel therapies and is disease free now, two years post allogenic haploidentical transplantation.

Journal of Immunotherapy and Precision Oncology, 2021

In India, cancer immunotherapy is in an ''infantile stage'' in 2020. The first evidence-based mee... more In India, cancer immunotherapy is in an ''infantile stage'' in 2020. The first evidence-based meeting on immuno-oncology was held in India on February 24, 2018. A special interest group was formed. at this meeting, and they adopted the ''Mumbai Resolution,'', and established the Immuno-Oncology Society of India (I-OSI. This Society is dedicated to the academic pursuit and growth of this field in India. The I-OSI was registered on November 2, 2018, and become the first legal entity in this regard in the country, with a view to promote and advance the scientific knowledge and research in immune-oncology. The Society serves as a platform to share, learn, and further advance understanding of immuno-oncology to help the ultimate beneficiary-the patients. The executive members of I-OSI are eminent faculties who include:

Clinical Lymphoma Myeloma and Leukemia, 2020

Clinical Lymphoma Myeloma and Leukemia, 2020

Journal of Clinical Oncology, 2020

e19515 Background: Acute Myeloid Leukemia (AML) is a highly heterogeneous disease. High throughpu... more e19515 Background: Acute Myeloid Leukemia (AML) is a highly heterogeneous disease. High throughput sequencing (HTS) has led to the discovery of a number of recurrently mutated genes in AML & has provided a detailed molecular landscape of the disease. This information is now extensively utilised & interpreted in AML. Methods: Retrospective analysis of 47 patients with newly diagnosed AML for those who had both cytogenetic and targeted HTS information at diagnosis, [median age: 44y (12-80y); 24 females] & treated at Tata Medical Center, India between 2013-2019. HTS was performed using Illumina Trusight myeloid panel and/or Thermo Fisher Scientific Oncomine Myeloid panel, and mutation data from the common 28 genes were used. Patients were stratified by European Leukemia Net (ELN) 2010 and 2017 guidelines. Standard of care clinical outcome data was available for all patients. Results: 45 of 47 patients had mutations. The most frequently mutated gene was FLT3 (n = 13, 28.9%), followed by...

ESMO Open, 2020

IntroductionThere is evidence of under-representation of women in leadership roles and publicatio... more IntroductionThere is evidence of under-representation of women in leadership roles and publications in oncology. However, there is little knowledge about their perceptions of professional environment, unique challenges and opportunities compared with male counterparts. The problem is more prominent in lower-income and middle-income countries like India and merits exploration.Materials and methodsA survey, ‘Exploratory Study on the Challenges of Female Oncologists in India’, was conducted among oncology professionals. We included questions on demography, working team details, role at work, perceived challenges for advancement of career, gender-related values brought into the team and the measures for improvement of gender disparity. Lead authorship data were collected from two Indian oncology journals.ResultsOf the 324 respondents, 198 (61.1%) were women. Majority of the respondents were medical oncologists (46.3%), ≤45 years old (69.4%) and working in universities and corporate hosp...

Journal of Clinical Oncology, 2013

e20686 Background: Drug resistant organisms are a very common cause of infections in critically i... more e20686 Background: Drug resistant organisms are a very common cause of infections in critically ill patients in India. Surveillance Cultures is part of a multi-factorial approach to control MDRO[Multi-Drug Resistant Organisms]. Colonization surveillance may have the potential to improve empiric antimicrobial treatment in a critical care setting. Methods: Design: Retrospective. Setting: Newly started Comprehensive Cancer Center in Eastern part of India. Period: Dec 2011 - Jan 2013. Review of fecal surveillance cultures of patients undergoing intensive chemotherapy for hematological cancers or haemopoietic stem cell transplant. Fecal Surveillance cultures were done prior to Intensive Chemotherapy using a method based on Landman D et al (J Clin Microbiol 2005). Results: 48 patients [35 male,13 female] admitted with diagnoses of AML(22), ALL(6), APL(1), Acute Mixed Lineage Leukemia(1), MDS(1), Hodgkin Lymphoma(1), DLBCL(1), Fanconi Anemia(1), Multiple Myeloma(4), and Myeloproliferative ...

Indian Journal of Hematology and Blood Transfusion, 2020

Transfusion-dependent E-Beta (EB) thalassemia is one of the major causes of hereditary hemoglobin... more Transfusion-dependent E-Beta (EB) thalassemia is one of the major causes of hereditary hemoglobinopathies in India. Hydroxyurea has been tried for HbF induction and amelioration of the transfusion frequency in EB thalassemia. The primary objective of this retrospective study, conducted between January 2017 and December 2018, was to determine the efficacy of thalidomide in reducing transfusion frequency in patients with EB thalassemia who have failed a reasonable trial of hydroxyurea. Of the 21 patients studied, 15 (71.4%) attained transfusion independence (complete responders) and 1 (4.7%) attained partial response (50% decrease in transfusion requirement) while 5 (23.9%) were non-responders. 12 patients attained their response within 1 month, 2 patients achieved within 1-3 months, and 1 patient beyond 3 months. Median time to transfusion independence in complete responders was 1 month. The median time on thalidomide for the complete responders and partial responders was 16.48 months. No major grade 3/4 toxicities were documented. This approach needs larger randomised controlled studies. Thalidomide is a safe and effective strategy at reducing or abrogating transfusion requirement in patients with EB thalassemia. This approach requires further testing in systematic clinical trials.

Blood, 2019

Background and Objectives:Cancer associated malnutrition and cachexia is an important determinant... more Background and Objectives:Cancer associated malnutrition and cachexia is an important determinant of the patient's short and long term outcomes. This prospective study was conducted to determine the association between cachexia at diagnosis and overall survival of patients with aggressive B-cell non-Hodgkin's Lymphoma (ABNHL) Methods:This investigator initiated single centre prospective observational study was conducted at the Tata Medical Center, Kolkata, India between Jan 2015 and Mar 2019 after IRB approval. Patients diagnosed with ABNHL receiving standard of care chemo-immunotherapy were eligible. This study was supported by an educational research grant from Baxter to our institution. All patients who consented to participate were screened for cachexia at entry using a modified Subjective Global Assessment (SGA) tool (1). Baseline clinical factors of prognostic importance including stage, IPI score, etc. were recorded. All statistical analysis was carried out using EpiI...

Clinical Lymphoma Myeloma and Leukemia, 2019

acute GVHD that lead to death and 2 patients relapsed after transplantation. In the second group,... more acute GVHD that lead to death and 2 patients relapsed after transplantation. In the second group, only 1 patient had grade 3 acute GVHD with favorable outcome after extracorporeal photopheresis (ECP) and immunosuppressive therapy and 1 patient relapsed both medullar and extramedullary on day +266, starting 7 days course Azacitidin and Donor Lymphocyte Infusion (DLI). The neutrophil recovery for the second group was similar to the MSD patients from the first group. The study groups survival rate was 66.6%, NRM in the first group was 28% and 0% for the second one. Conclusions: We report 28% NRM in the group with standard GVHD prophylaxis and 0% NRM in the PTCy group. It seems PTCy in days +3, +4 is associated with a lower rate of NRM and improved survival in patients undergoing alloHSCT for AML.

Indian Journal of Medical and Paediatric Oncology

Relapsed and refractory (RR) acute lymphoblastic leukemia (ALL) poses unique and difficult challe... more Relapsed and refractory (RR) acute lymphoblastic leukemia (ALL) poses unique and difficult challenges to a practicing clinician in India where access to novel immunotherapies is limited. Between 2017 and 2020, eight patients with B-cell ALL at our center received inotuzumab ozogamicin (IO) monotherapy on compassionate access, as salvage therapy after at least two lines of conventional therapy failure, and most often as outpatient infusion. Eight patients (21–60 years, three females) received IO. Three patients had morphologic relapse and five patients reported persistent measurable residual disease (MRD). The best response on IO therapy achieved was negative MRD in six of seven patients and complete response (CR) with persistent MRD in one. One patient died (intracranial hemorrhage) before completion of first cycle. All responding patients were transplant eligible and four patients (57%) underwent allogeneic hematopoietic cell transplantation (Allo-HCT). Median follow-up of this coh...

Indian Journal of Medical and Paediatric Oncology

We report a case of stage IV primary mediastinal B-cell lymphoma in a 27-year-old young woman, wh... more We report a case of stage IV primary mediastinal B-cell lymphoma in a 27-year-old young woman, who was refractory and chemoresistant to frontline conventional rituximab-based intensive chemotherapy and subsequent lines of conventional and immune checkpoint inhibitor-based therapies. She was successfully treated using a polatuzumab-based regimen and consolidated with an allogeneic haploidentical hematopoietic stem cell transplantation. She developed post-transplant large granular lymphocytosis that was managed conservatively. She is now relapse-free, 600 days post-transplant. The management of this patient provided several teaching points in the use of different modalities of immunotherapies in a hard-to-treat cancer and its related conditions.

Clinical Lymphoma Myeloma and Leukemia

Blood, 2021

Introduction: Pomalidomide is a third-generation immunomodulatory drug approved for relapsed and/... more Introduction: Pomalidomide is a third-generation immunomodulatory drug approved for relapsed and/or refractory Multiple Myeloma (RRMM). In the phase 3 OPTIMISMM trial, pomalidomide, bortezomib, and dexamethasone demonstrated superior efficacy in patients with RRMM. PRIME study (CTRI/2019/10/021618) is testing this combination in Newly Diagnosed Multiple Myeloma (NDMM) Aim: To determine safety of Pomalidomide in combination with Bortezomib and dexamethasone (VPD) in NDMM Study design: A prospective, single arm, phase II study from a tertiary center. Both transplant eligible and ineligible patients with NDMM aged between 18-70 years are being recruited in the study. Patients with Plasma cell leukemia, POEMS and amyloidosis were excluded. The regimen consists of weekly Bortezomib 1.3mg/sq.m (subcutaneous), Tab. Pomalidomide 2-4mg once daily for 21days, and Tab Dexamethasone 20mg twice weekly, with the cycle repeating every 28 days, 9-12 cycles. Here we report the adverse events (AE) by...

BLOOD CELL THERAPY / The official journal of APBMT, 2021

The prevailing corona virus disease 19 (COVID-19) pandemic has adversely affected the healthcare ... more The prevailing corona virus disease 19 (COVID-19) pandemic has adversely affected the healthcare services globally. Hematopoietic cell transplantation (HCT) is considered as the preferred treatment option for several hematological malignancies, and HPC collection facilities have to function continuously along with implementing safety measures. Based on the national and international guidelines, we implemented additional measures and modifications to our standard operating procedure (SOP) to ensure secure HPC collection from patients as well as donors. Here, we report our experience with HPC collection and processing from 1st January, 2020 until 31st December, 2020. We collected 59 HPC products through apheresis and 41 cryopreservation procedures. Compared to 2019, there was a 33% decrease in the number of HPC transplants and 31% reduction in HPC collection procedures. However, we report an 86% (13 procedures) increase in the cryopreservation of HPC products from related donors, as s...

Frontiers in Oncology, 2022

IntroductionDespite high cure rates with standard treatment, 30% patients with Hodgkin lymphoma d... more IntroductionDespite high cure rates with standard treatment, 30% patients with Hodgkin lymphoma develop relapsed or refractory (R/R) disease. Salvage therapy followed by autologous hematopoietic cell transplantation (HCT) is considered standard of care. Brentuximab Vedotin (Bv) in combination with Bendamustine (B) has been tested in the salvage setting with promising results.Materials and MethodologyWe conducted a single centre retrospective chart review of patients who received BBv salvage therapy to determine its activity and safety in patients with R/R classical Hodgkin lymphoma (HL). Between May 2011- December 2019, 179 patients were diagnosed with R/R HL.ResultsThirty patients received BBv [median age: 30 (15-59) years, females (n=15)]. Primary refractory disease in 19 patients (63%), and 26 patients (87%) had advanced stage at treatment. Most patients received BBv after 2 prior lines of therapy [n=16 (53%)]. The median number of cycles of BBv were 3 (1-6). The number of BBv cy...

ADVANCES IN CELL AND GENE THERAPY, 2021

Haploidentical peripheral blood hematopoietic cell transplantation has become the preferred alter... more Haploidentical peripheral blood hematopoietic cell transplantation has become the preferred alternative donor transplant program in most centers in India, owing to its logistic and cost advantages. This is a retrospective analysis of 59 patients with high‐risk hematological malignancies who underwent haploidentical transplant in three different centers, using myeloablative conditioning and unmanipulated stem cell graft. GVHD prophylaxis was post‐transplant Cyclophosphamide (PTCy D + 3, D + 4) along with Tacrolimus and Mycophenolate Mofetil (D + 5 onwards). The median CD34 cell dose was 5.8 x 106 cells/kg. Neutrophils engrafted in 50 (83%) patients [median time D + 16 (range: 12‐38)] and platelets engrafted in 42 patients (70%) [median time D + 17 (range: 12‐50)]. Acute GVHD developed in 25 (41.7%) patients [Gr III/IV in 9] and Chronic GVHD in 15 (38.5%). 100‐day mortality was 33.8%. With a median follow‐up duration of 6.2 months (range: 0.4‐50.8 months), the relapse rate, treatment‐related mortality (TRM), and estimated 4‐year overall survival are 10.0%, 43.3%, and 38.0%, respectively. For the 31 deaths: causes included engraftment failure (n = 7), GVHD (n = 7), persistent disease (n = 1), relapsed disease (n = 5), bacterial sepsis (n = 5), viral pneumonia (n = 1), infection (n = 3), secondary graft failure (n = 2). TRM outcomes have reduced over time with experience. Myeloablative conditioning and haploidentical transplantation by a post‐transplant cyclophosphamide approach is feasible in a resource‐constrained setting, despite higher rates of GVHD and infection‐related mortality.

Clinical Lymphoma Myeloma and Leukemia, 2018

Blood, 2020

Background: There is a lack of a uniform approach in the treatment of Classical Hodgkin lymphoma ... more Background: There is a lack of a uniform approach in the treatment of Classical Hodgkin lymphoma (CHL) in adolescents and young adults (AYA). Age cutoffs are arbitrary and based on institutional experience. Chemotherapy using ABVD (Adriamycin Bleomycin Vinblastine Dacarbazine) is the standard of care in most centers for the management of adult CHL. Children and adolescents have been managed with more chemo intense approaches like the EURONET protocol, with better Event-free survival (EFS) outcomes while reducing the need for radiation therapy (RT). There is a knowledge gap regarding the optimum treatment in the AYA group and this pertains to strategies to improve EFS while addressing increasing concerns of acute toxicities and long-term complications of therapy, RT especially. We share the retrospective experience of our center where young adults and adolescents received two different strategies based on an age cutoff alone, resulting in different outcomes. Methodology: A retrospect...

Blood, 2021

INTRODUCTION: Literature on acute myeloid Leukemia (AML) from low and middle income countries (LM... more INTRODUCTION: Literature on acute myeloid Leukemia (AML) from low and middle income countries (LMIC) like India indicate lower uptake of intensive treatment (29%) and higher induction mortality (25%) (Philip C, BJH 2015). This is attributable to delayed presentation, higher infection burden, multi-drug resistant organism (MDRO) infections, poor nutritional status, access to care, and high costs driven by 'out-of-pocket expenditures', among other reasons. AIM: To determine the clinical profile, cause and costs of care of patients who die during Induction therapy of newly diagnosed AML. METHODOLOGY: This is a retrospective chart review of newly diagnosed AML patients who died during Induction therapy. Induction mortality was defined as death within 60 days from the date of initiation of therapy for newly diagnosed AML. Secondary and therapy related AML were excluded from the study. Demographic and clinical profiling and analyses of the cause of death was undertaken. RESULTs: B...

Clinical Case Reports, 2020

We report a case of Plasmablastic Lymphoma occurring in a 45-year-old HIV-negative woman involvin... more We report a case of Plasmablastic Lymphoma occurring in a 45-year-old HIV-negative woman involving extra nodal sites including ovary, breast and adrenal glands. Prognostic outcomes are generally dismal. On relapse, she received conventional as well as novel therapies and is disease free now, two years post allogenic haploidentical transplantation.

Journal of Immunotherapy and Precision Oncology, 2021

In India, cancer immunotherapy is in an ''infantile stage'' in 2020. The first evidence-based mee... more In India, cancer immunotherapy is in an ''infantile stage'' in 2020. The first evidence-based meeting on immuno-oncology was held in India on February 24, 2018. A special interest group was formed. at this meeting, and they adopted the ''Mumbai Resolution,'', and established the Immuno-Oncology Society of India (I-OSI. This Society is dedicated to the academic pursuit and growth of this field in India. The I-OSI was registered on November 2, 2018, and become the first legal entity in this regard in the country, with a view to promote and advance the scientific knowledge and research in immune-oncology. The Society serves as a platform to share, learn, and further advance understanding of immuno-oncology to help the ultimate beneficiary-the patients. The executive members of I-OSI are eminent faculties who include:

Clinical Lymphoma Myeloma and Leukemia, 2020

Clinical Lymphoma Myeloma and Leukemia, 2020

Journal of Clinical Oncology, 2020

e19515 Background: Acute Myeloid Leukemia (AML) is a highly heterogeneous disease. High throughpu... more e19515 Background: Acute Myeloid Leukemia (AML) is a highly heterogeneous disease. High throughput sequencing (HTS) has led to the discovery of a number of recurrently mutated genes in AML & has provided a detailed molecular landscape of the disease. This information is now extensively utilised & interpreted in AML. Methods: Retrospective analysis of 47 patients with newly diagnosed AML for those who had both cytogenetic and targeted HTS information at diagnosis, [median age: 44y (12-80y); 24 females] & treated at Tata Medical Center, India between 2013-2019. HTS was performed using Illumina Trusight myeloid panel and/or Thermo Fisher Scientific Oncomine Myeloid panel, and mutation data from the common 28 genes were used. Patients were stratified by European Leukemia Net (ELN) 2010 and 2017 guidelines. Standard of care clinical outcome data was available for all patients. Results: 45 of 47 patients had mutations. The most frequently mutated gene was FLT3 (n = 13, 28.9%), followed by...

ESMO Open, 2020

IntroductionThere is evidence of under-representation of women in leadership roles and publicatio... more IntroductionThere is evidence of under-representation of women in leadership roles and publications in oncology. However, there is little knowledge about their perceptions of professional environment, unique challenges and opportunities compared with male counterparts. The problem is more prominent in lower-income and middle-income countries like India and merits exploration.Materials and methodsA survey, ‘Exploratory Study on the Challenges of Female Oncologists in India’, was conducted among oncology professionals. We included questions on demography, working team details, role at work, perceived challenges for advancement of career, gender-related values brought into the team and the measures for improvement of gender disparity. Lead authorship data were collected from two Indian oncology journals.ResultsOf the 324 respondents, 198 (61.1%) were women. Majority of the respondents were medical oncologists (46.3%), ≤45 years old (69.4%) and working in universities and corporate hosp...

Journal of Clinical Oncology, 2013

e20686 Background: Drug resistant organisms are a very common cause of infections in critically i... more e20686 Background: Drug resistant organisms are a very common cause of infections in critically ill patients in India. Surveillance Cultures is part of a multi-factorial approach to control MDRO[Multi-Drug Resistant Organisms]. Colonization surveillance may have the potential to improve empiric antimicrobial treatment in a critical care setting. Methods: Design: Retrospective. Setting: Newly started Comprehensive Cancer Center in Eastern part of India. Period: Dec 2011 - Jan 2013. Review of fecal surveillance cultures of patients undergoing intensive chemotherapy for hematological cancers or haemopoietic stem cell transplant. Fecal Surveillance cultures were done prior to Intensive Chemotherapy using a method based on Landman D et al (J Clin Microbiol 2005). Results: 48 patients [35 male,13 female] admitted with diagnoses of AML(22), ALL(6), APL(1), Acute Mixed Lineage Leukemia(1), MDS(1), Hodgkin Lymphoma(1), DLBCL(1), Fanconi Anemia(1), Multiple Myeloma(4), and Myeloproliferative ...

Indian Journal of Hematology and Blood Transfusion, 2020

Transfusion-dependent E-Beta (EB) thalassemia is one of the major causes of hereditary hemoglobin... more Transfusion-dependent E-Beta (EB) thalassemia is one of the major causes of hereditary hemoglobinopathies in India. Hydroxyurea has been tried for HbF induction and amelioration of the transfusion frequency in EB thalassemia. The primary objective of this retrospective study, conducted between January 2017 and December 2018, was to determine the efficacy of thalidomide in reducing transfusion frequency in patients with EB thalassemia who have failed a reasonable trial of hydroxyurea. Of the 21 patients studied, 15 (71.4%) attained transfusion independence (complete responders) and 1 (4.7%) attained partial response (50% decrease in transfusion requirement) while 5 (23.9%) were non-responders. 12 patients attained their response within 1 month, 2 patients achieved within 1-3 months, and 1 patient beyond 3 months. Median time to transfusion independence in complete responders was 1 month. The median time on thalidomide for the complete responders and partial responders was 16.48 months. No major grade 3/4 toxicities were documented. This approach needs larger randomised controlled studies. Thalidomide is a safe and effective strategy at reducing or abrogating transfusion requirement in patients with EB thalassemia. This approach requires further testing in systematic clinical trials.

Blood, 2019

Background and Objectives:Cancer associated malnutrition and cachexia is an important determinant... more Background and Objectives:Cancer associated malnutrition and cachexia is an important determinant of the patient's short and long term outcomes. This prospective study was conducted to determine the association between cachexia at diagnosis and overall survival of patients with aggressive B-cell non-Hodgkin's Lymphoma (ABNHL) Methods:This investigator initiated single centre prospective observational study was conducted at the Tata Medical Center, Kolkata, India between Jan 2015 and Mar 2019 after IRB approval. Patients diagnosed with ABNHL receiving standard of care chemo-immunotherapy were eligible. This study was supported by an educational research grant from Baxter to our institution. All patients who consented to participate were screened for cachexia at entry using a modified Subjective Global Assessment (SGA) tool (1). Baseline clinical factors of prognostic importance including stage, IPI score, etc. were recorded. All statistical analysis was carried out using EpiI...

Clinical Lymphoma Myeloma and Leukemia, 2019

acute GVHD that lead to death and 2 patients relapsed after transplantation. In the second group,... more acute GVHD that lead to death and 2 patients relapsed after transplantation. In the second group, only 1 patient had grade 3 acute GVHD with favorable outcome after extracorporeal photopheresis (ECP) and immunosuppressive therapy and 1 patient relapsed both medullar and extramedullary on day +266, starting 7 days course Azacitidin and Donor Lymphocyte Infusion (DLI). The neutrophil recovery for the second group was similar to the MSD patients from the first group. The study groups survival rate was 66.6%, NRM in the first group was 28% and 0% for the second one. Conclusions: We report 28% NRM in the group with standard GVHD prophylaxis and 0% NRM in the PTCy group. It seems PTCy in days +3, +4 is associated with a lower rate of NRM and improved survival in patients undergoing alloHSCT for AML.