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  • 1
    Online Resource
    Online Resource
    Rituximab and dose-adjusted EPOCH (R-EPOCH) for treatment of aggressive B-cell non-Hodgkin lymphomas: A developing country perspective.
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 15_suppl ( 2013-05-20), p. e19503-e19503
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. e19503-e19503
    Abstract: e19503 Background: Biological heterogeneity of diffuse large B-cell lymphomas (DLBL) is reflected in variable outcomes with R-CHOP. Clinicopathological features like high IPI, underlying acquired immunodeficiency, non-germinal center phenotype, primary mediastinal B-cell histology and Bcl-2 positivity correlate with adverse biology. Effect of adverse biological attributes is also reflected in outcomes B-cell lymphoma intermediate between diffuse large cell B-cell and Burkitt’s lymphomas (BCLU) and Burkitt’s lymphoma in elderly and HIV-positive individuals with low CD4 counts. Given the promising efficacy of R- EPOCH in poor-risk DLBL we used it in therapy of aggressive B-cell NHL. Methods: From May 2010 to December 2012 patients with de-novo aggressive B-cell lymphomas with adverse clinicopathological features (DLBL with multiple extranodal sites, high IPI, primary mediastinal B-cell lymphoma, BCLU, Burkitt’s lymphoma in elderly or in HIV-positive individuals) were treated with R-EPOCH. Demography,stage, bulk of disease, IPI, CD4 counts, grade 3/4 toxicities and death were recorded. Responses were evaluated at mid and end of therapy. Overall and progression-free survivals were calculated. Immunohistochemistry was used to classify the germinal center and non-germinal center phenotype. Results: 33 patients (males-21, female-12) were treated with median of 6 cycles (range 3-6) of R-EPOCH. Histologicalsubtypes distribution was- DLBL-16, BL-8, BCLU-5, and PMBL-4. Sixty percent of DLBL were non-germinal center type and bcl-2 positive. Median age was 33 years (range 15-73 years). More than 2/3 of patients had stage 3/4 bulky disease with high IPI. Twelve patients were HIV positive with median CD4 count of 173/µL (range 43-359/µL). Complete responses were seen in 66.7% at interim evaluation and in 90% at the end of therapy. At a median follow up of 8 months, 1- year overall survival and progression- free survival were 72.5% and 90% respectively. Two patients died due to therapyand grade 3/4 toxicities were seen in 10% patients. Conclusions: R-EPOCH regimen is efficacious in patients with poor-risk aggressive B-cell NHL however longer follow-up is needed.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2013.31.15_suppl.e19503
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
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  • 2
    Online Resource
    Online Resource
    Incidence of engraftment fever post autologous transplant for lymphomas and analysis of risk factors.
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 15_suppl ( 2013-05-20), p. 7043-7043
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. 7043-7043
    Abstract: 7043 Background: Engraftment fever (EF) is a phenomenon observed in some patients undergoing autologous transplant (ASCT). We analyzed our data to evaluate the incidence and risk factors associated with EF. Methods: Seventy-nine patients underwent ASCT (53-Hodgkin’s and 26- Non Hodgkin’s) from August 2007 – January 2013. All except 5 received LACE (Lomustine, Ara-C, Cyclophosphamide and Etoposide) conditioning regimen. EF was defined as onset of fever with rising white cell count for which no infectious cause was ascertained. Patients of EF and non-EF groups were compared for the following variables to determine risk factors. These included histology, number of lines of chemotherapy regimens pre-transplant, complete remission (CR) at transplant, peripheral blood CD 34 count on day 1 of collection (PBCD34-D1), CD 34 cell dose collected and infused and number of days of stem cell collection. Results: The median age at transplant was 23.5 years with 57 males and 22 females. Time to neutrophil and platelet engraftment was 10 and 13 days respectively. EF was seen in 35 patients (44 %) at a median of 9 days. Short course of methylprednisolone (n=28) or hydrocortisone (n=3) was given to which all responded. On univariate analysis, PBCD34-D1 〉 50/uL (P = 0.037), CD 34 cell dose infused 〉 5.9x10 6 /kg (P=0.012),CD34 cell dose collected 〉 7.2 x 10 6 /kg (P=0.032) , those receiving ≤ 2 lines of chemotherapy regimens before transplant (P=0.04), those who had ≤ 2 days of stem cell collection (P=0.002) and patients in CR at transplant (P = 0.015) were associated with risk of developing EF. On multivariate analysis, patients in CR at transplant and those who had ≤ 2 days of collection had higher risk of EF. Conclusions: The incidence of EF is high. Patients with lesser days of stem collection and those in CR at transplant have significant risk of developing EF.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2013.31.15_suppl.7043
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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  • 3
    Online Resource
    Online Resource
    Hodgkin Lymphoma involving Thyroid: Case Report and Comprehensive Review
    Jaypee Brothers Medical Publishing ; 2017
    In:  International Journal of Head and Neck Surgery Vol. 8, No. 4 ( 2017-12), p. 131-139
    Details
    In: International Journal of Head and Neck Surgery, Jaypee Brothers Medical Publishing, Vol. 8, No. 4 ( 2017-12), p. 131-139
    Type of Medium: Online Resource
    ISSN: 0975-7899 , 0976-0539
    URL: Article
    DOI: 10.5005/jp-journals-10001-1322
    Language: English
    Publisher: Jaypee Brothers Medical Publishing
    Publication Date: 2017
    detail.hit.zdb_id: 2625884-5
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  • 4
    Online Resource
    Online Resource
    Outcomes of autologous stem cell transplant (ASCT) in multiple myeloma from a tertiary cancer center in India.
    American Society of Clinical Oncology (ASCO) ; 2012
    In:  Journal of Clinical Oncology Vol. 30, No. 15_suppl ( 2012-05-20), p. e17003-e17003
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. e17003-e17003
    Abstract: e17003 Background: ASCT is part of standard treatment in multiple myeloma (MM).We report the results of such transplants and evaluate the role of prognostic factors if any in our patients. Methods: Sixty-one patients who underwent ASCT between June 1993 and March 2010 were included. Twenty four patients received VAD like regimen. Nineteen patients received novel agent based therapies. Ten patients underwent cyclophosphamide based mobilisation while only G-CSF based mobilisation done in 51 patients. Stem cells were harvested from peripheral blood in all patients. Melphalan was used at 200 mg/m 2 in 24 patients. Prognostic factors evaluated for overall (OS) and progression-free survival (PFS) were baseline hemoglobin and albumin, ISS stage, disease status at day 100 post transplant, use of maintenance treatment post transplant, response to first line chemotherapy, use of novel agents before transplant and time to transplant from diagnosis. Results: Median age was 46 years. Median baseline haemoglobin (Hb) and albumin were 9.7 g/dl and 3.9 g/dl respectively. At the time of transplant 36% were in complete remission (CR), 5% in very good partial response (VGPR) and 28% in partial remission (PR). Median time to engraftment of neutrophils and platelets was 12 and 17 days respectively. Grade III–IV oral mucositis was seen in 35%. Transplant related mortality was 8.0 %. The 5 year overall survival (OS) and progression free survival (PFS) were 73% and 33% respectively. OS was better for patients with pre-transplant Hb greater than 9.7 g/dl (P= .04) and those who achieved CR at day 100 post transplant (P= .03). Patients who received maintenance therapy showed trend towards better OS (P= .07). PFS was better for patients with baseline albumin greater than 3.9g/dl (P = .043), Hb greater than 9.7 g/dl (P = .027) and early stage disease by ISS staging system (P=.001). Conclusions: Our study confirms that ASCT in such patients is safe and effective. Baseline albumin and Hb, ISS stage, day 100 disease response and use of maintenance treatment are important prognostic factors affecting survival.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2012.30.15_suppl.e17003
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2012
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    Results of autologous transplants for children from a tertiary cancer center in India.
    American Society of Clinical Oncology (ASCO) ; 2012
    In:  Journal of Clinical Oncology Vol. 30, No. 15_suppl ( 2012-05-20), p. 9559-9559
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. 9559-9559
    Abstract: 9559 Background: Autologous transplantation is a curative option for children with various malignancies. We report the results of our center with the aim of evaluating toxicities and prognostic factors that may influence decision making to use our limited resources judiciously. Methods: Forty-six patients diagnosed below 18 years from 1 st April 1994- 28 th February 2011 were included in this retrospective study. Twenty-four patients had lymphoma, 12- neuroblastoma and 10-others ( 5- acute leukemia, 4- Ewing sarcoma and 1 - rhabdomyosarcoma). Twenty-eight patients received peripheral blood stem cells, 12 – marrow and 6-both. Prognostic factors evaluated for overall survival (OS) and progression-free survival (PFS) were remission status at transplant, baseline and pre-transplant serum albumin, time interval between diagnosis and transplant, type of malignancy and number of lines of chemotherapy pre transplant. Results: Median age at diagnosis and transplant were 9 and 12 years respectively. Median baseline and pre transplant serum albumin were 3.6 and 3.9 g/dl. Median number of lines of chemotherapy was 2. Median time from diagnosis to transplant was 1.1 years. Incidence of grade 3 and 4 oral mucositis and diarrhea were 46% and 25% respectively. At the time of transplant, 45% were in complete remission (CR), 41% in partial remission (PR) and 13% in refractory state. Total Parenteral Nutrition (TPN) was used in 63% patients with median duration of 11 days. No patient developed sinusoidal obstruction syndrome.Median days to neutrophil and platelet engraftment were 11 and 15 days respectively. Neutropenic sepsis leading to death was seen in 17%. Median follow up was 1.5 years. At 2 years, the probability of OS and PFS were 39% and 35% for all patients while OS and PFS for lymphoma, neuroblastoma and others were 45% and 32%, 17% and 0% and 50% and 40% respectively. CR at transplant was the most important determinant of better OS (59 % vs 28%; p = 0.000004) and PFS (53% vs 8%; p = 0.0000018). Conclusions: CR at transplant is the most important prognostic factor. Patients with neuroblastoma have dismal outcome which requires reevaluation of transplant strategies for this group.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2012.30.15_suppl.9559
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2012
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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  • 6
    Online Resource
    Online Resource
    Molecular technique for precise antibiotics administration in patients with cancer.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e18749-e18749
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e18749-e18749
    Abstract: e18749 Background: Infectious diseases are the second most common cause of mortality in oncology patients. Multiple hospital admissions and previous exposure to antibiotics are risk factors for infection with microorganisms having antibiotic resistance gene in these patients.Molecular technique helps in targeted antibiotic administration at the earliest. Methods: This was a retrospective observational study over a period of one year from November 2021 to October 2022 in Tata Memorial Hospital, Mumbai, on oncology patients with blood stream infection (BSI) whose blood sample underwent film array assay. The BioFire Blood culture Identification 2 Panel (BCID2) which identifies Imipenemases (IMP), Klebsiella pneumoniae carbapenemases (KPC), New Delhi metallo beta-lactamases (NDM), oxacillinase-48 like (OXA-48), Verona integron-encoded metallo beta-lactamase (VIM), CTX M and methicillin resistance gene like mec A/C was used. BSI was categorised according to the resistance gene and recommended antibiotics of choice as per the Infectious Disease Society of America (IDSA). CTX-M - Carbapenem & nbsp; OXA-48 like/ KPC - Ceftazidime-avibactam, Polymixin & nbsp; Metallo beta-lactamase (MBL) i.e VIM, IMP, NDM - Ceftazidime-avibactam plus aztreonam, polymyxin, Cefiderocol & nbsp; The impact of appropriate antibiotic administration on 30-day mortality was seen. Results: A total of 79 blood samples were submitted for film array assay during the study period. The mean age of the study population was 17± 4 years. 41(51.9%) patients had acute myeloid leukemia (AML), 29 (36.7%) had acute lymphocytic leukemia (ALL), 4 (5%) patients had lymphoma and 5 (6.3%) had other malignancies. 54(68.3%) BSI had microorganism with antibiotic resistance gene, 16 (20.3%) did not carry resistance gene and in 9 (11.4%), microorganism was not identified in film array assay, though conventional culture showed contaminants. Of the 54 BSI with microorganisms having antibiotic resistance gene, 37(68.5%) had MBL gene either alone or along with CTX-M or OXA-48 like genes, 12 (22.2%) had CTX-M and 5 (9.2%) had both CTX-M and OXA -48 like genes. Empirical antibiotic did not match the antibiotic resistance pattern in 40 (74.1%), antibiotic matched the resistance pattern in 14(22.9%). Antibiotic adjustment was done in 32 (86%) of MBL, 4 (80%) of OXA-48 like with CTX-M and 9 (75%) CTX-M. The 30-day mortality was significantly less (28% vs 80%, p = 0.042) in patients who received appropriate antibiotic versus those who continued inappropriate antibiotics in MBL BSI. Conclusions: Majority of the study population had BSI with antibiotic resistance gene and underwent a change in the antibiotic after the assay. There was lesser 30-day mortality in patients who received antibiotics appropriate for the identified resistance gene. Molecular technique is helpful for precise antibiotic administration in cancer patients who have a higher risk of infection with organisms having resistance gene.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.e18749
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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