Sidra Maqsood - Academia.edu (original) (raw)

Papers by Sidra Maqsood

LIAQUAT MEDICAL RESEARCH JOURNAL

Current COVID-19 pandemic has affected the entire globe. While there was no vaccine neither any s... more Current COVID-19 pandemic has affected the entire globe. While there was no vaccine neither any specific treatment, investigational use of convalescent plasma has been explored in clinical trials. A prospective multicenter study of convalescent plasma was conducted. Donors were tested for total Anti-SARS-CoV-2 antibodies by electrochemiluminescence (ECLIA) and RT-PCR for COVID-19. Enzyme Linked Immunosorbent Assay (ELISA) was used to detect semi-quantitative and quantitative IgG anti-SARS-COV-2 antibodies. IgG Immunofluorescence-based lateral flow immunoassay (LFIA) was used to recheck seronegative donors. A total of 400 donors were enrolled. Twelve donors were SARS-CoV-2 positive by RT-PCR. Nine of 12 donors had developed SARS-CoV-2 IgG antibodies, while in 3 donors antibodies were not developed. A total of 70 donors (17.5%) were deferred due to seronegative status; 64 (16%) of them did not develop antibodies when plasma collection was planned. The IgG semiquantitative ELISA was po...

International Blood Research & Reviews, 2022

A systematic approach is required to diagnose acute leukemia. Most of the cases are satisfactoril... more A systematic approach is required to diagnose acute leukemia. Most of the cases are satisfactorily diagnosed and categorized into subtypes. However, a few cases pose diagnostic dilemma secondary to immunophenotypic aberrancies which are defined as antigens that are normally restricted to a different lineage and expressed by a neoplastic population while absent from its normal non neoplastic counterpart. We report a rare case of Early T-cell Precursor Lymphoblastic Leukemia with aberrant expression of CD19. A 7-year-old boy referred to our hospital with his cervical lymph node biopsy reported as lymphoproliferative disorder. The patient was COVID-19 positive. Chest X-ray showed mild right sided pleural effusion with huge mediastinal mass. Flow cytometry on peripheral blood used to establish the diagnosis. The case is reported to improve knowledge regarding aberrant expression of markers. Hematopathology teams should be aware of this phenomenon so that appropriate workup can be done t...

OBJECTIVE To find the frequency of core binding factor acute myeloid leukaemia in our population,... more OBJECTIVE To find the frequency of core binding factor acute myeloid leukaemia in our population, and to determine its association with morphological subtypes. METHODS The retrospective study was conducted at The Indus Hospital, Karachi, and comprised data of patients aged 1-17 years who were diagnosed with acute myeloid leukaemia from July 2013 to June 2017. Data was analysed using SPSS 21. RESULTS Of the 237 patients, 137(58%) were males and 100(42%) were females. The overall mean age was 8±4.34 years. Cytogenetic testing had been performed in 212(89.45%) cases, and core binding factor was detected in 72(34%) cases. There was significant difference between the mean values of white cell count and the subtypes (p=0.000). Also the difference between core binding factor and the subtypes was significant (p=0.000). CONCLUSIONS There was found to be a significant association of core binging factor with specific subgroups of acute myeloid leukaemia.

Indian Journal of Hematology and Blood Transfusion, 2021

The overall survival of Acute Promyelocytic Leukemia (APL), reported in recent studies, is approa... more The overall survival of Acute Promyelocytic Leukemia (APL), reported in recent studies, is approaching to 90% wherein, arsenic trioxide (ATO) and all-trans retinoic acid (ATRA) are used as the mainstay of treatment with either limited or no use of anthracycline and cytarabine. This study is aimed to ascertain the outcome of children with APL using similar approach. A total of 30 patients with APL, registered from January 2015 to December 2018, were reviewed. Diagnosis was established on bone marrow aspirate and confirmed by the presence of PML-RARA translocation. Treatment protocol was based on Australian APML 4 study performed by Australian Leukemia Lymphoma Group (ALLG). Lumbar puncture was not performed as it was not part of the protocol due to the risk of bleeding. The mean age in current cohort was 9 years with 53% males. Seven (23.3%) patients died and three (10%) abandoned treatment during induction. Twenty patients completed the intensive phase of chemotherapy and all (100%) of them attained molecular remission (MR). One patient dropped out after MR whereas, 19 remain on follow up with no evidence of disease, reflecting disease free survival (DFS) of 95%. With a median follow up of 2.5 years (range 2.1–4.8 years) the 5 years Kaplan–Meier estimate of OS was 63% and 73%, with and without abandonment, respectively. Analysis of outcome according to risk groups revealed inferior outcome of high risk (HR) group (38% and 50% with and without abandonment, respectively) in contrast to standard risk (SR) group which showed better outcome (82% and 88% with and without abandonment, respectively). The attainment of 100% molecular remission and absence of relapse supports the effectiveness of this regimen. Moreover, it is found to be less toxic and therefore, can be conveniently managed in day-care settings.

BMC Infectious Diseases, 2021

Background Convalescent plasma(CP) was utilized as potential therapy during COVID-19 pandemic in ... more Background Convalescent plasma(CP) was utilized as potential therapy during COVID-19 pandemic in Pakistan. The study aimed at appraisal of CP transfusion safety and usefulness in COVID pneumonia. Methods Single arm, MEURI study design of non-randomized open label trial was conducted in five centers. Patients werecategorized as moderately severe, severe, and critical. The primary endpoint was a) improvement in clinical status and change in category of disease severity; secondary endpoint was b) CP ability to halt disease progression to invasive ventilation. CP transfused to hospitalized patients. Statistical tests including median (interquartile ranges), Mann-Whitney U test, Fisher’s exact test using SPSS ver. 23, ANOVA and Chi-square test were applied for the analysis of results parameters before and after CP treatment. SOFA score was applied for multiorgan failure in severe and critical cases. Results A total of 50 adult patients; median age 58.5 years (range: 29–92 years) received...

Cancer Investigation, 2021

The study is to evaluate the impact of COVID-19 in Pediatric Oncology Units of Pakistan. Data fro... more The study is to evaluate the impact of COVID-19 in Pediatric Oncology Units of Pakistan. Data from (1 April-30 June) 2019 and (1April-30 June) 2020 for 1st and 2nd cohort respectively in order to compare the registration, abandonment rate and delay in treatment. 634 were registered cases, 379 and 255 in 1st and 2nd cohort respectively which was significant different <0.005. 77 were abandoned, 45 and 32 in 1st and 2nd cohort respectively. 59 COVID-19 positive cases, 24, 4, 27 and 4 were admitted, referred, home isolated and LAMA respectively. Delayed in treatment and reduction in new cases were observed.

National Journal of Health Sciences, 2017

Introduction: Acquired aplastic anaemia is characterized by destruction of haematopoietic stem ce... more Introduction: Acquired aplastic anaemia is characterized by destruction of haematopoietic stem cells by cytotoxic T lymphocytes. Regulatory T-cells have been reported to be suppressed in aplastic anaemia like many other autoimmune disorders. Haematopoietic response and haematological recovery after successful immunosuppressive treatment provide the most powerful evidence for the immune mediated basis of this complex disorder. Objective: The aim of this study is to determine the deficiency of CD4+ CD25+ T regulatory cells prior to ATG induction/therapy in patients of aplastic anaemia. Methods: The patients were enrolled in a dose finding study for ATG-Fresenius (Fresnious Biotec, Gernmany). Aplastic anaemia was diagnosed as per standard guidelines. Bone marrow trephine biopsy was done to assess disease severity and for classification according to Camitta classification. Flow cytometry was done using four colour flow cytometer FACSCaliber. Results: The median age of the patients was 23 years (range 7-63 years). Out of 18 patients, there were 12 (66%) males and 6 (34%) females. Of the 18 evaluable patients, the number of patients with NSAA, SAA, and VSA was 10, 5, and 3 respectively. CD4+ and CD8+ T cells, and B cells in peripheral blood were calculated. The pre-treatment average Treg frequencies in NSAA was 16.5 ± 18.8, SAA 29.1 ± 18.3 and VSAA was 12 ± 11.7 respectively. The median time from diagnosis up to the last follow-up was 1.1 years (range: 0.1 3.0). Conclusion: The study concluded that Tregs were decreased in all patients of acquired aplastic anaemia, as in other autoimmune diseases.

BMC Cancer, 2020

Background Classical MPNs including ET and PMF have a chronic course and potential for leukaemic ... more Background Classical MPNs including ET and PMF have a chronic course and potential for leukaemic transformation. Timely diagnosis is obligatory to ensure appropriate management and positive outcomes. The aim of this study was to determine the mutational profile, clinical characteristics and outcome of ET and PMF patients in Pakistani population. Methods This was a prospective observational study conducted between 2012 and 2017 at NIBD. Patients were diagnosed and risk stratified according to international recommendations. Response to treatment was assessed by IWG criteria. Results Of the total 137 patients analysed, 75 were ET and 62 were PMF. JAK2 positivity was seen in 51 cases (37.2%), CALR in 41 cases (29.9%), while triple-negative in 17 (12.4%) cases. None of the patients in the present study were MPL positive. Overall survival for patients with ET and PMF was 92.5 and 86.0% respectively and leukaemia free survival was 100 and 91.6% respectively, at a median follow-up of 12 mon...

Cancer Management and Research, 2019

Background: Nilotinib (Tasigna®) is a second-generation tyrosine kinase inhibitor that shows fast... more Background: Nilotinib (Tasigna®) is a second-generation tyrosine kinase inhibitor that shows faster and deeper molecular responses (MR) in comparison to Imatinib as initial therapy in chronic phase chronic myeloid leukemia (CML). Efficacy and safety data for nilotinib in the Asian population is scarce, particularly in Pakistan. We aimed to determine the MR to nilotinib and its safety profile in patients with chronic phase CML. Patients and methods: This observational study was conducted among 173 patients with newly diagnosed CML presenting in the chronic phase. Most patients (50.1%) had a high Sokal score at diagnosis. All patients received nilotinib 600 mg/day. The hematological and molecular responses were assessed at 3 and 6 months respectively and thereafter at 6-monthly intervals. Long-term event free survival (EFS), transformation free survival (TFS), overall survival (OS) and adverse events were observed. Results: Cumulative incidence of major MR (MMR) was 86% and deep MR (DMR ie MR 4.0 and MR4.5) was 39%. Early MMR and DMR after 6 months of therapy were achieved by 74.9% and 37% of patients, respectively. Two-year EFS, TFS and OS rates for all patients were 91.9%, 92% and 92.3%, respectively. At median follow-up of 24 months, 81% and 49% of patients sustained MMR and DMR, respectively. The main adverse events were weight gain (4.6%) and abdominal pain (4%). Conclusion: This study showed promising results in terms of achievement of early and sustained DMR in chronic phase CML, therefore, we recommend nilotinib as frontline treatment in Pakistani population.

Journal of oncology, 2018

Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, ... more Most of the hematological disorders are heterogenous with regard to morphology, immunophenotype, and genetic rearrangements. Multiple recurrent chromosomal aberrations have been identified by conventional cytogenetic analysis, which is now widely recognized as one of the most important diagnostic and prognostic determinants in these patients. Though rarer, complex karyotype has been associated with worst prognosis. A total of 1185 bone marrow or peripheral blood cytogenetics samples were taken with different hematological diseases. They included both benign and malignant disease entities. In each case, cells were cultured and conventional cytogenetic analysis was performed. Among 1185 subjects, 41 (3.4%) patients possessed complex cytogenetic abnormalities. Out of these 41, 33 (80%) were males. The mean age was 37 years (median age 39 years). Myelodysplastic syndromes had the most numbers of complex karyotypes (8%), followed by acute myeloid leukemia (7%) and acute lymphoblastic leu...

Indian Journal of Hematology and Blood Transfusion, 2016

Objectives The purpose of this study is to evaluate the association of MASCC score (Multinational... more Objectives The purpose of this study is to evaluate the association of MASCC score (Multinational Association for Supportive Care in Cancer Score) in patients with febrile neutropenia (as resultant treatment of hematological disorders) for risk assessment of morbidity and mortality. Patients and methods Patients presenting with Febrile Neutropenia from November 2011 till December 2013 were enrolled in the study. Initially all patients were hospitalized and their MASCC score was calculated, however those with high risk stayed in hospital till full ANC recovery while low risk group was discharged earlier and keenly followed as outpatient while being on prophylactic oral antibiotics. The MASCC risk-index score was calculated and patients with risk score [21 were regarded as low-risk while \21 were labeled as high-risk. Results On the basis of 226 febrile neutropenia patient 132(58.4 %) were categorized as low risk while 94(41.5 %) as high risk patients according to MASCC risk index score. In low risk group 123(93 %) had uncomplicated infection while 9(7 %) had complicated infections. There was no mortality documented in low risk group while eight patients died in high risk group. Conclusion In this study we correctly predicted outcome of 123(93 %) low risk group patients. The study had positive predictive value of 93 % with both sensitivity and specificity of 65 and 75 % respectively. The MASCC risk score is a valuable tool in determining the outcome in patients with febrile neutropenia. Keywords MASCC score Á Hematological disorders Á High-risk febrile neutropenia Á Low-risk febrile neutropenia & M. Taj

Hematology & Transfusion International Journal, 2015

The Myelodysplastic syndromes (MDS) are clonally evolved bone marrow disorders leading to the bon... more The Myelodysplastic syndromes (MDS) are clonally evolved bone marrow disorders leading to the bone marrow failure, peripheral cytopenia and a propensity for progression to acute myeloid leukemia (AML). To observe the trend and outcome of MDS in Pakistani population, a retrospective data analysis was carried out in National Institute of Blood Diseases & Bone Marrow Transplantation, from January 2010 to December 2014. Fifty-two MDS or MDS/MPN cases were analyzed out of which 39(75%) were males. Median age at the time of diagnosis was 60years. Secondary/t-MDS was observed in 2(3.8%) cases while others were de-novo MDS. Low intensity treatment was offered to 16(30.7%) cases out of which 5(31.25%) cases responded to treatment. Full HLA matched related donor allogenic HSCT was unsuccessfully attempted in 2(3.8 %) cases. At the time of analysis only 19cases were alive after a median follow up 10months (range 2months to 48months). Median progression free survival was 1.9months for very high risk, 6Months for high risk, 12.8months for intermediate risk and 39 Months for very low and low risk while median overall survival was 3 months for very high risk, 8.5 months for high risk and 18.7 months for intermediate risk. All patients were alive in very low and low risk category when study was concluded.

Journal of oncology, 2015

Background. Febrile neutropenia is the consequence of treatment of hematological disorders. The f... more Background. Febrile neutropenia is the consequence of treatment of hematological disorders. The first-line empirical treatment should cover the prevalent microorganism of the institute. The aim of study was to establish the effectiveness of current practices used at the institution and to review the culture sensitivity pattern of isolated microorganisms. Patients and Methods. Data was recorded and analyzed prospectively for 226 hospitalized patients of febrile neutropenia from January 2011 till December 2013. Results. Out of 226 cases, 173 were males and 53 were females. Clinically documented infections were 104 (46.01%) and microbiologically documented infections were 80 (35.39%), while 42 (18.58%) had pyrexia of undetermined origin. Gram negative infections accounted for 68 (85%) and Escherichia coli was the commonest isolate. Gram positive microorganisms were isolated in 12 (15%) cases and most common was Staphylococcus aureus. First-line empirical treatment with piperacillin/taz...

Research Article, 2017

Acquired aplastic anaemia is characterized by destruction of haematopoietic stem cells by cytotox... more Acquired aplastic anaemia is characterized by destruction of haematopoietic stem cells by cytotoxic T lymphocytes. Regulatory T-cells have been reported to be suppressed in aplastic anaemia like many other autoimmune disorders. Haematopoietic response and haematological recovery after successful immunosuppressive treatment provide the most powerful evidence for the immune mediated basis of this complex disorder

Cancer Management and Research

Early and sustained deep molecular response achieved with nilotinib in high Sokal risk chronic myeloid leukemia patients, 2019

Objectives The purpose of this study is to evaluate the association of MASCC score (Multinational... more Objectives
The purpose of this study is to evaluate the
association of MASCC score (Multinational Association
for Supportive Care in Cancer Score) in patients with
febrile neutropenia (as resultant treatment of hematological
disorders) for risk assessment of morbidity and mortality.
Patients and methods
Patients presenting with Febrile
Neutropenia from November 2011 till December 2013
were enrolled in the study. Initially all patients were hos-
pitalized and their MASCC score was calculated, however
those with high risk stayed in hospital till full ANC
recovery while low risk group was discharged earlier and
keenly followed as out-patient while being on prophylactic
oral antibiotics. The MASCC risk-index score was calcu-
lated and patients with risk score >21 were regarded as
low-risk while
< 21 were labeled as high-risk.
Results
On the basis of 226 febrile neutropenia patient
132(58.4 %) were categorized as low risk while
94(41.5 %) as high risk patients according to MASCC risk
index score. In low risk group 123(93 %) had
uncomplicated infection while 9(7 %) had complicated
infections. There was no mortality documented in low risk
group while eight patients died in high risk group.
Conclusion
In this study we correctly predicted outcome
of 123(93 %) low risk group patients. The study had pos-
itive predictive value of 93 % with both sensitivity and
specificity of 65 and 75 % respectively. The MASCC risk
score is a valuable tool in determining the outcome in
patients with febrile neutropenia.
Keywords
MASCC score
Hematological disorders
High-risk febrile neutropenia
Low-risk febrile
neutropenia

The Myelodysplastic syndromes (MDS) are clonally evolved bone marrow disorders leading to the b... more The Myelodysplastic syndromes (MDS) are clonally evolved bone marrow disorders leading to the bone marrow failure, peripheral cytopenia and a propensity for progression to acute myeloid leukemia (AML). To observe the trend and outcome of MDS in Pakistani population, a retrospective data analysis was carried out in National Institute of Blood Diseases & Bone Marrow Transplantation, from January 2010 to December 2014. Fifty-two MDS or MDS/MPN cases were analyzed out of which39 (75%) were males. Median age at the time of diagnosis was 60 years. Secondary/t-MDS was observed in 2 (3.8%) cases while others were de-novo MDS. Low intensity treatment was offered to 16 (30.7%) cases out of which 5 (31.25%) cases responded to treatment. Full HLA matched related donor allogenic HSCT was unsuccessfully attempted in 2 (3.8 %) cases. At the time of analysis only 19cases were alive after a median follow up 10 months (range 2 months to 48 months). Median progression free survival was 1.9 months for very high risk, 6 Months for high risk, 12.8 months for intermediate risk and 39 Months for very low and low risk while median overall survival was 3 months for very high risk, 8.5 months for high risk and 18.7 months for intermediate risk. All patients were alive in very low and low risk category when study was concluded.

Keywords: Myelodysplastic syndrome; Prognostic scoring; Treatment outcome

LIAQUAT MEDICAL RESEARCH JOURNAL

International Blood Research & Reviews, 2022

Indian Journal of Hematology and Blood Transfusion, 2021

BMC Infectious Diseases, 2021

Cancer Investigation, 2021

National Journal of Health Sciences, 2017

BMC Cancer, 2020

Cancer Management and Research, 2019

Journal of oncology, 2018

Indian Journal of Hematology and Blood Transfusion, 2016

Hematology & Transfusion International Journal, 2015

Journal of oncology, 2015

Research Article, 2017

Cancer Management and Research

Early and sustained deep molecular response achieved with nilotinib in high Sokal risk chronic myeloid leukemia patients, 2019

Objectives The purpose of this study is to evaluate the association of MASCC score (Multinational... more Objectives
The purpose of this study is to evaluate the
association of MASCC score (Multinational Association
for Supportive Care in Cancer Score) in patients with
febrile neutropenia (as resultant treatment of hematological
disorders) for risk assessment of morbidity and mortality.
Patients and methods
Patients presenting with Febrile
Neutropenia from November 2011 till December 2013
were enrolled in the study. Initially all patients were hos-
pitalized and their MASCC score was calculated, however
those with high risk stayed in hospital till full ANC
recovery while low risk group was discharged earlier and
keenly followed as out-patient while being on prophylactic
oral antibiotics. The MASCC risk-index score was calcu-
lated and patients with risk score >21 were regarded as
low-risk while
< 21 were labeled as high-risk.
Results
On the basis of 226 febrile neutropenia patient
132(58.4 %) were categorized as low risk while
94(41.5 %) as high risk patients according to MASCC risk
index score. In low risk group 123(93 %) had
uncomplicated infection while 9(7 %) had complicated
infections. There was no mortality documented in low risk
group while eight patients died in high risk group.
Conclusion
In this study we correctly predicted outcome
of 123(93 %) low risk group patients. The study had pos-
itive predictive value of 93 % with both sensitivity and
specificity of 65 and 75 % respectively. The MASCC risk
score is a valuable tool in determining the outcome in
patients with febrile neutropenia.
Keywords
MASCC score
Hematological disorders
High-risk febrile neutropenia
Low-risk febrile
neutropenia

Keywords: Myelodysplastic syndrome; Prognostic scoring; Treatment outcome