1.A case of histoplasmosis in a patient with MDS/MPN-U.
Pulkit RASTOGI ; Prashant SHARMA ; Narender KUMAR ; Shivaprakash M RUDRAMURTHY ; Neelam VARMA ; Subhash VARMA
Blood Research 2016;51(3):206-207
No abstract available.
Histoplasmosis*
;
Humans
2.An unusual etiology of plummer-Vinson syndrome.
Ankur JAIN ; Parimal AGRAWAL ; Pankaj MALHOTRA ; Ritambhra NADA ; Subhash VARMA
Blood Research 2018;53(1):79-81
No abstract available.
Plummer-Vinson Syndrome*
3.Plasma cell leukemia in North India: retrospective analysis of a distinct clinicohematological entity from a tertiary care center and review of literature.
Karthik BOMMANNAN ; Man Updesh Singh SACHDEVA ; Pankaj MALHOTRA ; Narender KUMAR ; Prashant SHARMA ; Shano NASEEM ; Jasmina AHLUWALIA ; Reena DAS ; Neelam VARMA ; Gaurav PRAKASH ; Alka KHADWAL ; Radhika SRINIVASAN ; Subhash VARMA
Blood Research 2016;51(1):23-30
BACKGROUND: Plasma cell leukemia (PCL) is a rare and aggressive plasma cell neoplasm. In PCL, clonal plasma cells comprise ≥20% of the peripheral blood (PB) leukocytes and/or the absolute clonal PB plasma cell count is ≥2×10(9)/L. Primary PCL (PPCL) originates de novo, whereas, secondary PCL (SPCL) evolves from pre-existing multiple myeloma. METHODS: Clinicohematological features, immunophenotypic profile, and survival of PCL patients were analyzed retrospectively. RESULTS: Between January 2007 and December 2014, ten PPCL and four SPCL patients were investigated (8 PPCLs and 3 SPCLs had complete clinical data). All were North Indians, sharing common geography and ethnicity. Our cohort showed less frequent renal failure, more frequent hepatomegaly, and non-secretory type disease. In contrast to western literature, flow cytometric immunophenotyping of our cohort revealed altered expression of CD138 (67%), CD56 (33%), and CD20 (0%). With novel therapeutic agents, these PPCL patients had a median overall survival of 15 months. CONCLUSION: We highlight that our PPCL patients from North India had distinct clinicohematological and immunophenotypic profiles. The significance of our findings must be tested in a larger patient cohort and must be supported by molecular and cytogenetic investigations to unmask possible significant effects on pathogenesis.
Cohort Studies
;
Cytogenetics
;
Geography
;
Hepatomegaly
;
Humans
;
Immunophenotyping
;
India*
;
Leukemia, Plasma Cell*
;
Leukocytes
;
Multiple Myeloma
;
Neoplasms, Plasma Cell
;
Plasma Cells*
;
Plasma*
;
Renal Insufficiency
;
Retrospective Studies*
;
Tertiary Care Centers*
;
Tertiary Healthcare*
4.A young man with acute respiratory distress syndrome: eosinophilia is not always “benign”.
Ankur JAIN ; Pankaj MALHOTRA ; Vikas SURI ; Ritesh AGARWAL ; Amanjit BAL ; Subhash VARMA
Blood Research 2017;52(4):329-332
No abstract available.
Eosinophilia*
;
Respiratory Distress Syndrome, Adult*
5.Late Onset Agranulocytosis with Clozapine Associated with HLA DR4 Responding to Treatment with Granulocyte Colony-stimulating Factor: A Case Report and Review of Literature.
Aakanksha SINGH ; Sandeep GROVER ; Pankaj MALHOTRA ; Subhash C VARMA
Clinical Psychopharmacology and Neuroscience 2016;14(2):212-217
Agranulocytosis as a side effect of clozapine has been reported to be associated with initial phases of treatment, i.e., first six months. Agranulocytosis with clozapine during the initial phases of treatment has been linked to genetic vulnerability in the form of variations in the human leukocyte-antigen haplotypes. However, there is limited literature on late onset agranulocytosis with clozapine and this has very rarely been linked to human leukocyte-antigen haplotypes vulnerability. In this report we review the existing data on late onset agranulocytosis with clozapine and describe the case of a young man, who developed agranulocytosis with clozapine after 35 months of treatment and was found to have genetic vulnerability in form of being positive for HLA DR4. This case highlights underlying autoimmune immune mechanism in clozapine-induced agranulocytosis and the need for frequent blood count monitoring on clozapine even after the initial 6 months of starting treatment especially in patients with genetic vulnerability to develop this condition.
Agranulocytosis*
;
Clozapine*
;
Granulocyte Colony-Stimulating Factor*
;
Granulocytes*
;
Haplotypes
;
Humans
;
Neutropenia
6.A weeping ulcer that vanished with a ‘SMILE’.
Ankur JAIN ; Gaurav PRAKASH ; Amanjit BAL ; Pankaj MALHOTRA ; Subhash VARMA
Blood Research 2018;53(1):8-8
No abstract available.
Ulcer*
7.Primary pyomyositis in North India: a clinical, microbiological, and outcome study.
Susheel KUMAR ; Ashish BHALLA ; Rajveer SINGH ; Navneet SHARMA ; Aman SHARMA ; Vikas GAUTAM ; Surjit SINGH ; Subhash VARMA
The Korean Journal of Internal Medicine 2018;33(2):417-431
BACKGROUND/AIMS: Pyomyositis is an infective condition with primary involvement of the skeletal muscles. There is sparse recent literature on patients with pyomyositis. METHODS: This study was carried out at emergency services of a tertiary care center located in subtropical area of Indian subcontinent. RESULTS: Sixty-two patients of primary pyomyositis formed the study cohort. Mean age of occurrence was 29.9 ± 14.8 years. There were 54 men. Twelve patients had underlying medical diseases. Muscle pain was seen in all 62 patients. Forty-eight patients (77.4%) had the fever. Most common site of involvement was thigh muscles (n = 29, 46.8%). Forty-nine patients (79%) presented in the suppurative stage of illness. Patients with comorbidities were older (age: median 36 years [interquartile range (IQR), 25 to 47] vs. 24 years [IQR, 16 to 35], p = 0.024), had higher culture positivity with gram-negative organisms (8/9 [88.89%] vs. 6/29 [20.69%], p = 0.001). Importantly, higher number of these patients received inappropriate antibiotics initially. Patients with positive pus culture result had higher complication rate (32/38 [84.21%] vs. 10/18 [55.56%], p = 0.044). Six patients (9.7%) had in-hospital mortality. Lower first-day serum albumin, initial inappropriate antibiotic therapy, and advanced form of the disease at presentation were associated with increased in-hospital mortality. CONCLUSIONS: Primary pyomyositis is not an uncommon disease entity. Patients with comorbidities were more likely to receive initial inappropriate antibiotic therapy. Patients with positive pus culture report had the higher rate of complications. Lower first-day serum albumin, initial inappropriate antibiotic therapy and advanced form of the disease at presentation were associated with increased in-hospital mortality.
Anti-Bacterial Agents
;
Cohort Studies
;
Comorbidity
;
Emergencies
;
Fever
;
Hospital Mortality
;
Humans
;
India*
;
Male
;
Muscle, Skeletal
;
Muscles
;
Myalgia
;
Outcome Assessment (Health Care)*
;
Pyomyositis*
;
Serum Albumin
;
Suppuration
;
Tertiary Care Centers
;
Thigh
8.Bendamustine in combination with ifosfamide, etoposide, and vinorelbine (VIBE) is an effective salvage regimen for heavily pre-treated patients with relapsed or refractory Hodgkin lymphoma:a single-center experience
Gaurav PRAKASH ; Arihant JAIN ; Kamalkant SAHU ; Amanjit BAL ; Charanpreet SINGH ; Rajender BASHER ; Harmandeep SINGH ; Kundan MISHRA ; Aditya JANDIAL ; Deepesh LAD ; Alka KHADWAL ; Radhika SRINIVASAN ; Ashim DAS ; Neelam VARMA ; Subhash VARMA ; Pankaj MALHOTRA
Blood Research 2021;56(3):134-140
Background:
This study evaluated the outcomes of patients with refractory/relapsed Hodgkin lymphoma (RRHL) treated with a bendamustine-based regimen in combination with ifosfamide, etoposide, and vinorelbine (VIBE).
Methods:
Consecutive RRHL patients who were treated with the VIBE regimen were identified and studied for clinicopathologic characteristics, response to VIBE regimen, event-free survival (EFS), and feasibility of an autologous stem-cell transplant (autoSCT).
Results:
In total, 24 patients received the VIBE regimen, and a median of 3 cycles were administered. In this cohort, 80% of the patients had received ≥2 prior lines of therapy. The overall and complete response rates with VIBE were 79% and 42%, respectively. After a median follow-up (following VIBE regimen) of 14 months (range, 3‒76), the 3-year EFS and OS were 46% and 74%, respectively. Of the eligible patients, 92% underwent successful AutoSCT. The mean CD34+ cell count in the autograft was 5.5×106/kg (SD 2.07). Neutropenia was the commonest hematologic toxicity and it was observed in 42% of the patients. However, only 9% of the patients developed grade III/IV febrile neutropenia. Chemotherapy-induced nausea and vomiting were the second most common grade III/IV toxicities in our cohort of patients.
Conclusion
In this retrospective analysis, the combination regimen, VIBE, has shown good efficacy in heavily pre-treated patients with RRHL without compromising stem cell collection. These encouraging results provide a rationale for further development of this regimen.
9.Bendamustine in combination with ifosfamide, etoposide, and vinorelbine (VIBE) is an effective salvage regimen for heavily pre-treated patients with relapsed or refractory Hodgkin lymphoma:a single-center experience
Gaurav PRAKASH ; Arihant JAIN ; Kamalkant SAHU ; Amanjit BAL ; Charanpreet SINGH ; Rajender BASHER ; Harmandeep SINGH ; Kundan MISHRA ; Aditya JANDIAL ; Deepesh LAD ; Alka KHADWAL ; Radhika SRINIVASAN ; Ashim DAS ; Neelam VARMA ; Subhash VARMA ; Pankaj MALHOTRA
Blood Research 2021;56(3):134-140
Background:
This study evaluated the outcomes of patients with refractory/relapsed Hodgkin lymphoma (RRHL) treated with a bendamustine-based regimen in combination with ifosfamide, etoposide, and vinorelbine (VIBE).
Methods:
Consecutive RRHL patients who were treated with the VIBE regimen were identified and studied for clinicopathologic characteristics, response to VIBE regimen, event-free survival (EFS), and feasibility of an autologous stem-cell transplant (autoSCT).
Results:
In total, 24 patients received the VIBE regimen, and a median of 3 cycles were administered. In this cohort, 80% of the patients had received ≥2 prior lines of therapy. The overall and complete response rates with VIBE were 79% and 42%, respectively. After a median follow-up (following VIBE regimen) of 14 months (range, 3‒76), the 3-year EFS and OS were 46% and 74%, respectively. Of the eligible patients, 92% underwent successful AutoSCT. The mean CD34+ cell count in the autograft was 5.5×106/kg (SD 2.07). Neutropenia was the commonest hematologic toxicity and it was observed in 42% of the patients. However, only 9% of the patients developed grade III/IV febrile neutropenia. Chemotherapy-induced nausea and vomiting were the second most common grade III/IV toxicities in our cohort of patients.
Conclusion
In this retrospective analysis, the combination regimen, VIBE, has shown good efficacy in heavily pre-treated patients with RRHL without compromising stem cell collection. These encouraging results provide a rationale for further development of this regimen.