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Sarin A, Agarwal A, Dodagoudar C, Baghmar S, Qureshi S, Raj A, Kailey N, Hasthavaram N, Kumar R, Potsangbam L, Bansal R, Bhardwaj S, Rajpurohit S, Vaibhav V, Handoo A, Dadu T, Mittal A, Gupta N, Aggarwal S. 285P Reticulocyte hemoglobin equivalent as an early predictor of iron deficiency anemia in cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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2
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Kumar A, Baghmar S, Mehta P, Tiwari P, Kumar L, Bakhshi S, Agarwal A, Gupta I, Trikha A, Bhatnagar S, Gogia A, Malik PS, Sahoo RK, Rastogi S, Pramanik R, Batra A, Pushpam D, Sharma CK, Sharma V, Kataria B, Goyal K, Samaga S, Bothra SJ, Sharma A. Characteristics & outcomes of cancer patients with COVID-19: A multicentre retrospective study from India. Indian J Med Res 2022; 155:546-553. [PMID: 36348601 PMCID: PMC9807197 DOI: 10.4103/ijmr.ijmr_1703_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background & objectives High mortality has been observed in the cancer population affected with COVID-19 during this pandemic. We undertook this study to determine the characteristics and outcomes of cancer patients with COVID-19 and assessed the factors predicting outcome. Methods Patients of all age groups with a proven history of malignancy and a recent diagnosis of SARS-CoV-2 infection based on nasal/nasopharyngeal reverse transcriptase (RT)-PCR tests were included. Demographic, clinical and laboratory variables were compared between survivors and non-survivors groups, with respect to observed mortality. Results Between May 11 and August 10, 2020, 134 patients were included from the three centres and observed mortality was 17.1 per cent. The median age was 53 yr (interquartile range 39-61 yr) and thirty four patients (25%) were asymptomatic. Solid tumours accounted for 69.1 per cent and breast cancer was the most common tumour type (20%). One hundred and five patients (70.5%) had received chemotherapy within the past four weeks and 25 patients (19.3%) had neutropenia at presentation. On multivariate analysis, age [odds ratio (OR) 7.99 (95% confidence interval [CI] 1.18-54.00); P=0.033], haemoglobin [OR 6.28 (95% CI 1.07-37.04); P=0.042] neutrophil-lymphocyte ratio [OR 12.02 (95% CI 2.08-69.51); P=0.005] and baseline serum albumin [OR 18.52 (95% CI 2.80-122.27); P=0.002], were associated with higher mortality. Recent chemotherapy, haematological tumours type and baseline neutropenia did not affect the outcome. Interpretation & conclusions Higher mortality in moderate and severe infections was associated with baseline organ dysfunction and elderly age. Significant proportion of patients were asymptomatic and might remain undetected.
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Affiliation(s)
- Akash Kumar
- Department of Medical Oncology, National Cancer Institute, New Delhi, India,For correspondence: Dr Akash Kumar, Department of Medical Oncology, National Cancer Institute, All India Institute of Medical Sciences, New Delhi 110 029, India e-mail:
| | - Saphalta Baghmar
- Department of Medical Oncology, BL Kapur Hospital, New Delhi, India
| | - Prashant Mehta
- Department of Medical Oncology/Hematology/BMT, Asian Institute of Medical Sciences, Gurugram, Haryana, India
| | - Priya Tiwari
- Department of Medical Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - Lalit Kumar
- Department of Medical Oncology, New Delhi, India
| | | | - Amit Agarwal
- Department of Medical Oncology, New Delhi, India
| | - Ishaan Gupta
- Department of Medical Oncology/Hematology/BMT, Asian Institute of Medical Sciences, Gurugram, Haryana, India
| | - Anjan Trikha
- Department of Anaesthesiology, Pain Medicine & Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anaesthesia & Palliative Medicine, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, New Delhi, India
| | - Ajay Gogia
- Department of Medical Oncology, New Delhi, India
| | | | | | | | | | - Atul Batra
- Department of Medical Oncology, New Delhi, India
| | - Deepam Pushpam
- Department of Onco-Anaesthesia & Palliative Medicine, Dr B.R. Ambedkar Institute Rotary Cancer Hospital, New Delhi, India
| | - Chitresh K Sharma
- Department of Surgical Oncology, National Cancer Institute, New Delhi, India
| | - Vinod Sharma
- Department of Medical Oncology, National Cancer Institute, New Delhi, India
| | - Babita Kataria
- Department of Medical Oncology, National Cancer Institute, New Delhi, India
| | - Kapil Goyal
- Department of Medical Oncology, New Delhi, India
| | - Shreyas Samaga
- Department of Biochemical Engineering & Biotechnology, Institute of Technology, New Delhi, India
| | - Sneha J Bothra
- Department of Medical Oncology/Hematology/BMT, Asian Institute of Medical Sciences, Gurugram, Haryana, India
| | - Atul Sharma
- Department of Medical Oncology, New Delhi, India
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3
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Abraham G, Noronha V, Rajappa S, Agarwal A, Batra U, Somani N, Raja T, Patil S, Kaushal AM, Joshi A, Radhakrishnan V, Singh N, Babu G, Tewani R, Baghmar S, Dodagoudar C, Ananthakrishnan R, Haragadde Poppareddy S, Sharma V, Menon N, M Patil V, Joshi A, Gupta S, Prabhash K, Bajpai J. The clinical utility and safety of short-course immune checkpoint inhibitors in multiple tumours-A real-world multicentric study from India. Int J Cancer 2021; 150:1045-1052. [PMID: 34751432 DOI: 10.1002/ijc.33868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/14/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022]
Abstract
The real-world data on short course of immune checkpoint inhibitor (ICI) use are sparse and merit exploration. A multicentric observational study on the safety and efficacy of ICI in oncology patients between August 2014 and October 2020 involves 1011 patients across 13 centers in India. The median age was 59 (min 16-max 98) years with male preponderance (77.9%). The predominant cohort received short-course ICI therapy; the median number of cycles was 5 (95% confidence interval [CI] 1-27), and the median duration of therapy was 3 (95% CI 0.5-13) months. ICIs were used commonly in the second and third line setting in our study (66.4%, n = 671). Objective response rate (complete or partial response) was documented in 254 (25.1%) of the patients, 202 (20.0%) had stable disease, and 374 (37.0%) had progressive disease. The clinical benefit rate was present in 456 (45.1%). Among the patients whom ICI was stopped (n = 906), the most common reason for cessation of ICI was disease progression (616, 68.0%) followed by logistic reasons like financial constraints (234, 25.82%). With a median follow-up of 14.1 (95% CI 12.9-15.3) months, there were 616 events of progression and 443 events of death, and the median progression free survival and overall survival were 6.4 (95% CI 5.5-7.3) and 13.6 (95% CI 11.6-15.7) months, respectively, in the overall cohort. Among the immune-related adverse events, autoimmune pneumonitis (29, 3.8%) and thyroiditis (24, 2.4%) were common. Real-world multicentric Indian data predominantly with short-course ICI therapy have comparable efficacy/safety to international literature with standard ICI therapy.
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Affiliation(s)
- George Abraham
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Senthil Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Amit Agarwal
- Department of Medical Oncology, BLK Superspeciality Hospital, Delhi, India
| | - Ullas Batra
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Naresh Somani
- Department of Medical Oncology, HCG Cancer Centre, Jaipur, India
| | | | - Shekhar Patil
- Department of Medical Oncology, HCG Cancer Centre, Bengaluru, India
| | - Ashish M Kaushal
- Department of Medical Oncology, HCG Cancer Centre, Ahmedabad, India
| | - Ashish Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | | | - Navneet Singh
- Department of Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Govind Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India
| | - Rohan Tewani
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Saphalta Baghmar
- Department of Medical Oncology, BLK Superspeciality Hospital, Delhi, India
| | | | | | | | - Vibhor Sharma
- Department of Medical Oncology, Paras Hospitals, Gurgaon, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Vijay M Patil
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
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Agarwal A, Baghmar S, Qureshi S, Khurana A, Setia R, Khan MA, Barman P, Kapoor RK, Hasthavaram NR, Kumar R, Singh N, Sarin A, Handoo A. Persistent Antibody Responses to SARS-CoV-2 Infection in Cancer Patients: A Single-Center Retrospective Observational Study. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1733823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Introduction There is limited literature available regarding the prevalence and durability of immune response to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/coronavirus disease 2019 (COVID-19) in cancer patients.
Objective The aim of this study was to analyze the seroconversion rate in cancer patients recovered from SARS-CoV-2 infection.
Materials and Methods We retrospectively analyzed antibody levels and seroconversion rates in serum samples from 135 cancer patients who had recovered from SARS-CoV-2 infection. Chemiluminescent immunoassay using Roche Cobas e801 analyzer (Roche Diagnostics, Rotkreuz, Switzerland) was performed to identify Pan Ig antibody against nucleocapsid antigen. Reports of first, third, and sixth month were analyzed. Seroconversion was also compared with health-care workers (HCW) of our institute who had recovered from COVID-19 infection.
Results Seroconversion rate in cancer patients was 81.2% at 1 month, 95% at 3 months, and 94.6% at 6 months post reverse transcriptase–polymerase chain reaction positivity. There was no difference in seroconversion rate among different age groups, gender, comorbidities, severity of COVID-19 symptoms, cancer disease status, and treatment with chemotherapy. Seroconversion rate in cancer patients is comparable to HCW (90.4 vs. 96%, p = 0.82) and is durable.
Conclusion Humoral response to COVID-19 infection in cancer patients is comparable to general population and sustained. Such responses suggest that cancer patients are likely to benefit from COVID-19 vaccination.
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Affiliation(s)
- Amit Agarwal
- Department of Medical Oncology, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Saphalta Baghmar
- Department of Medical Oncology, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Suhail Qureshi
- Department of Medical Oncology, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Aseem Khurana
- Department of Medical Oncology, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Rasika Setia
- Department of Transfusion Medicine, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Maroof Ahmad Khan
- Department of Bio-Statistics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, India
| | - Purabi Barman
- Department of Clinical Microbiology, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Raj Kumar Kapoor
- Department of Clinical Biochemistry, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | | | - Ramesh Kumar
- Department of Medical Oncology, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Navdeep Singh
- Department of Medical Oncology, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Aditya Sarin
- Department of Medical Oncology, Dr BL Kapur Super Specialty Hospital, New Delhi, India
| | - Anil Handoo
- Research & Continuing Education (AARCE), Dr BL Kapur Super Specialty Hospital, New Delhi, India
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Agarwal A, Baghmar S, Dodagoudar C, Qureshi S, Khurana A, Vaibhav V, Kumar G. PARP Inhibitor in Platinum-Resistant Ovarian Cancer: Single-Center Real-World Experience. JCO Glob Oncol 2021; 7:506-511. [PMID: 33852339 PMCID: PMC8162970 DOI: 10.1200/go.20.00269] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 01/07/2021] [Accepted: 03/03/2021] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Poly (ADP-ribose) polymerase inhibitors (PARPi) have proven efficacy in treatment of BReast CAncer (BRCA) gene mutation-positive platinum-sensitive ovarian cancers. There is paucity of data for their role in platinum-resistant ovarian cancer (PROC). We report here retrospective analysis of outcome of PARPi treatment in a group of patients including those of PROC. PATIENTS AND METHODS We analyzed all consecutive patients who received PARPi. The efficacy of PARPi monotherapy was assessed in patients with relapsed high-grade serous ovarian carcinoma with gBRCAm. The drug was procured through compassionate program. Drugs (olaparib and talazoparib) were provided in capsule form. RESULTS Between July 1, 2015, and June 30, 2019, 28 patients with ovarian cancer received PARPi. At the time of data censoring (September 30, 2019), four (14.3%) patients are still on treatment. Median age was 54.5 years (range, 39-75 years). Median number of previous lines of chemotherapy received was three (range, 1-6). Eleven platinum-sensitive patients received the drug as maintenance (five in complete response and six in partial response after chemotherapy), whereas 17 (60.7%) had platinum-resistant progressive disease while starting the drug. In PROC, objective response rate (complete response plus partial response) was 47%, median progression-free survival was 8.2 months (5.3-11.3), and overall survival was 14.9 months (11.2-18.5). No new side effects were observed. CONCLUSION This is the first study from India evaluating PARPi in platinum-resistant ovarian cancer. This study suggests that PARPi is a viable treatment option in patients with PROC with gBRCAm. This should be further evaluated in randomized clinical trial.
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Affiliation(s)
- Amit Agarwal
- Department of Medical Oncology, Dr BL Kapur Memorial Hospital, New Delhi, India
| | - Saphalta Baghmar
- Department of Medical Oncology, Dr BL Kapur Memorial Hospital, New Delhi, India
| | | | - Suhail Qureshi
- Department of Medical Oncology, Dr BL Kapur Memorial Hospital, New Delhi, India
| | - Aseem Khurana
- Department of Medical Oncology, Dr BL Kapur Memorial Hospital, New Delhi, India
| | | | - Guresh Kumar
- Department of Statistics, Institute of Liver and Biliary Sciences, New Delhi, India
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6
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Hasthavaram NR, Dadu T, Duggal R, Qureshi S, Baghmar S, Agarwal A, Khurana A, Sarin A, Singh N, Kumar R. Diagnosing Primary Malignancy in Leptomeningeal Carcinomatosis by Using CSF Cytology and Immunohistochemistry: A Case Report. Indian J Med Paediatr Oncol 2020. [DOI: 10.4103/ijmpo.ijmpo_267_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractWe present a rare case of recurrent carcinoma of gallbladder with leptomeningeal carcinomatosis. Cerebrospinal fluid (CSF) cytology showed atypical cells, which were suspicious for malignancy on initial reporting. Diagnosis of malignancy and primary from hepatobiliary source was confirmed by doing immunohistochemistry on CSF cell block.
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Affiliation(s)
| | - Tina Dadu
- Department of Pathology, Dr BLK Hospital, New Delhi, India
| | - Rajan Duggal
- Department of Pathology, Dr BLK Hospital, New Delhi, India
| | - Suhail Qureshi
- Department of Medical Oncology, Dr BLK Hospital, New Delhi, India
| | - Saphalta Baghmar
- Department of Medical Oncology, Dr BLK Hospital, New Delhi, India
| | - Amit Agarwal
- Department of Medical Oncology, Dr BLK Hospital, New Delhi, India
| | - Aseem Khurana
- Department of Medical Oncology, Dr BLK Hospital, New Delhi, India
| | - Aditya Sarin
- Department of Medical Oncology, Dr BLK Hospital, New Delhi, India
| | - Navdeep Singh
- Department of Medical Oncology, Dr BLK Hospital, New Delhi, India
| | - Ramesh Kumar
- Department of Medical Oncology, Dr BLK Hospital, New Delhi, India
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7
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Agrawal C, Doval D, Agarwal A, Goyal P, Baghmar S, Talwar V, Batra U, Goyal S, Sinha R, Archana S, Jain P. Real world evidence of palbociclib use in metastatic hormone positive HER negative metastatic breast cancer in Indian population. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30812-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Baghmar S, Agarwal A, Gauda C, Qureshi S, Malik P, Vaibhav V. PARP inhibitor in platinum resistant ovarian cancer: Single center real world experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz426.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Pamecha V, Sadashiv Patil N, Kumar S, Rajendran V, Gupta S, Vasantrao Sasturkar S, Kumar Sinha P, Arora A, Agarwal N, Baghmar S. Upfront pancreaticoduodenectomy in severely jaundiced patients: is it safe? J Hepatobiliary Pancreat Sci 2019; 26:524-533. [DOI: 10.1002/jhbp.671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Viniyendra Pamecha
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Nilesh Sadashiv Patil
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Senthil Kumar
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Vivek Rajendran
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Sahil Gupta
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Shridhar Vasantrao Sasturkar
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Piyush Kumar Sinha
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Asit Arora
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Nikhil Agarwal
- Department of Liver Transplant and Hepato Pancreato Biliary Surgery Institute of Liver and Biliary Sciences D‐1, Acharya Shree Tulsi Marg, Vasant Kunj New Delhi 110070India
| | - Saphalta Baghmar
- Department of Medical Oncology Institute of Liver and Biliary Sciences New Delhi India
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10
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Baghmar S, Shasthry SM, Singla R, Patidar Y, Bihari CB, Sarin SK. Solitary Duodenal Metastasis from Renal Cell Carcinoma with Metachronous Pancreatic Neuroendocrine Tumor: Review of Literature with a Case Discussion. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_214_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractRenal cell cancinoma (RCC) is a unique malignancy with features of late recurrences, metastasis to any organ, and frequent association with second malignancy. It most commonly metastasizes to the lungs, bones, liver, renal fossa, and brain although metastases can occur anywhere. RCC metastatic to the duodenum is especially rare, with only few cases reported in the literature. Herein, we review literature of all the reported cases of solitary duodenal metastasis from RCC and cases of neuroendocrine tumor (NET) as synchronous/metachronous malignancy with RCC. Along with this, we have described a unique case of an 84-year-old man who had recurrence of RCC as solitary duodenal metastasis after 37 years of radical nephrectomy and metachronous pancreatic NET.
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Affiliation(s)
- Saphalta Baghmar
- Departments of Medical Oncology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - S M Shasthry
- Departments of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajesh Singla
- Departments of Medical Oncology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Yashwant Patidar
- Departments of Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Chhagan B Bihari
- Departments of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - S K Sarin
- Departments of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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11
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Patekar M, Adhikari N, Biswas A, Raina V, Kumar L, Mohanti BK, Gogia A, Sharma A, Batra A, Bakhshi S, Garg A, Thulkar S, Sharma MC, Vishnubhatla S, Baghmar S, Sahoo RK. Primary CNS Lymphoma in India: A 17-Year Experience From the All India Institute of Medical Sciences. J Glob Oncol 2019; 5:1-9. [PMID: 30811305 PMCID: PMC6426510 DOI: 10.1200/jgo.18.00124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The information about the outcome of primary CNS lymphoma (PCNSL) in India is scarce, because there is no population-based or large hospital-based data. MATERIALS AND METHODS This is a retrospective study that spanned 17 years (2001 to 2017) to study the outcome of PCNSL at the All India Institute of Medical Sciences (AIIMS), which is a tertiary care center in Northern India. RESULTS Only one of 99 patients was positive for HIV serology. Diffuse large B-cell lymphoma was the most common histology (97.7%). The median patient age was 50 years (range, 13 to 70 years), and the ratio of men to women was 1.9. The median duration of symptoms before diagnosis was 3.5 months (range, 0.5 to 48 months), and 58.5% had a performance status (PS) of 3 or more. Multiple intracranial lesions were present in 81.8% of patients. Surgical resection was performed in 45%, and approximately 22% of patients were ineligible for treatment. Most patients (n = 73) were treated with high-dose methotrexate (HDMTX)–based regimens (ie, methotrexate, vincristine, and procarbazine with or without rituximab). Pharmacokinetic monitoring of methotrexate was not available at our center. HDMTX-related mortality was 3.9%. The median follow-up duration, event-free survival (EFS), and overall survival (OS) were 34 months, 20.4 months, and 31.7 months, respectively. Addition of rituximab (n = 27) to MVP resulted in a higher objective response rate (88.9% v 73.9% without rituximab; P = .12), complete remission (81.5% v 56.5%; P = .03), 2-year EFS (57.3% v 40.4%; P = .02), and 2-year OS (61.6% v 53.4%; P = .056). CONCLUSION This is the largest study of PCNSL from India. The patients were immunocompetent and young but presented with a high-burden disease that precluded treatment in approximately 22%. The treatment with HDMTX appears safe without pharmacokinetic monitoring. The outcome is comparable to those observed in the West, and rituximab use showed additional benefit. There are notable barriers with respect to management of PCNSL in the real world, and efforts are required to improve the outcome more.
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Affiliation(s)
- Mukesh Patekar
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Narayan Adhikari
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Ahitagni Biswas
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Raina
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Kumar
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Bidhu Kalyan Mohanti
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Gogia
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Atul Sharma
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Atul Batra
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Garg
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Thulkar
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Meher Chand Sharma
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Sreenivas Vishnubhatla
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Saphalta Baghmar
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
| | - Ranjit Kumar Sahoo
- 1 Dr B.R.A. Institute Rotary Cancer Hospital, New Delhi, India.,2 All India Institute of Medical Sciences, New Delhi, India
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Baghmar S, Panda D, Bihari C, Thapar S. Late Recurrence of Malignant Choroidal Melanoma Mimicking
Hepatocellular Carcinoma. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_12_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractLate recurrence (after more than 10 years) of choroidal melanoma, though infrequent, has been documented well in Western countries. In India, however, this disease being uncommon, there is no data regarding its late recurrence. Here, we report a case of late metastatic manifestation of choroidal melanoma in the form of liver metastases in a 45-year-old man who presented with abdominal pain; metastases to liver occurred 10 years after enucleation of the right eye.
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Panda D, Aggarwal M, Yadav V, Agrawal N, Arora A, Baghmar S, Kumar G. Gemcitabine and cisplatin based combination chemotherapy in patients of locally advanced and metastatic gall bladder cancer: An observational study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx660.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sahai P, Baghmar S, Nath D, Arora S, Bhasker S, Gogia A, Sikka K, Kumar R, Chander S. Extrapulmonary Small Cell Carcinoma - a Case Series of Oropharyngeal and Esophageal Primary Sites Treated with Chemo-Radiotherapy. Asian Pac J Cancer Prev 2016; 16:7025-9. [PMID: 26514485 DOI: 10.7314/apjcp.2015.16.16.7025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The optimal sequence and extent of multimodality therapy remains to be defined for extrapulmonary small cell carcinoma because of its rarity. The purpose of our study was to assess the response to neoadjuvant chemotherapy followed by chemoradiation/radiation in patients with extrapulmonary small cell carcinoma. MATERIALS AND METHODS Four consecutively diagnosed patients were included in this study. The primary tumor site was oropharynx in three patients and esophagus in one. The patients with the limited disease were treated with chemotherapy followed by concurrent chemoradiation (n=2) or radiotherapy (n=1). The patient with the extensive disease with the primary site in vallecula was treated with chemotherapy and palliative radiotherapy to the metastatic site. RESULTS The median follow-up was 22.5 months (range, 8-24 months). Three patients with the limited disease (base of tongue, n=2; esophagus, n=1) were in complete remission. The patient with the extensive disease died of loco-regional tumor progression at 8 months from the time of diagnosis. CONCLUSIONS The combination of chemotherapy and radiotherapy is the preferred therapeutic approach for patients with extrapulmonary small cell carcinoma. Induction chemotherapy followed by concurrent chemoradiation or radiation provides a good loco-regional control in patients with limited disease.
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Affiliation(s)
- Puja Sahai
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India E-mail :
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Baghmar S, Bihari C, Agrawal N, Patidar Y. P-108 Role of adjuvant treatment in periampullary carcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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Baghmar S, Kumar L, Rani L, Mathur N, Sreenivas V, Malik PS, Tilak TVSVGK, Gupta R. Prognostic Relevance of T Regulatory Cells in Patients with Advanced-Stage Serous Carcinoma Ovary. Indian J Gynecol Oncolog 2016. [DOI: 10.1007/s40944-016-0050-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Panda D, Aggarwal M, Yadav V, Kumar S, Mukund A, Baghmar S. Broncho-biliary fistula secondary to biliary obstruction and lung abscess in a patient with pancreatic neuro-endocrine tumor. J Egypt Natl Canc Inst 2016; 28:117-21. [PMID: 26994644 DOI: 10.1016/j.jnci.2016.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 01/31/2016] [Accepted: 02/03/2016] [Indexed: 12/20/2022] Open
Abstract
We present a case report of broncho-biliary fistula that developed due to the blockage of biliary stent placed during the management of pancreatic neuroendocrine tumor (pNET); diagnosed on high clinical suspicion, percutaneous cholangiogram and contrast enhanced computed tomography (CECT); and successfully treated with percutaneous transhepatic biliary drainage (PTBD).
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Affiliation(s)
- Dipanjan Panda
- Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi 110070, India.
| | - Mayank Aggarwal
- Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi 110070, India.
| | - Vikas Yadav
- VMMC and Safdarjung Hospital, New Delhi 110029, India.
| | - Sachin Kumar
- Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi 110070, India.
| | - Amar Mukund
- Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi 110070, India.
| | - Saphalta Baghmar
- Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi 110070, India.
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Kakkar A, Baghmar S, Garg A, Suri V, Raina V, Sarkar C, Sharma MC. Recurrent rhabdoid meningioma with lymph node, pulmonary and bone metastases: a diagnostic and therapeutic challenge. Brain Tumor Pathol 2016; 33:228-33. [PMID: 26875176 DOI: 10.1007/s10014-016-0250-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/25/2016] [Indexed: 10/22/2022]
Abstract
Rhabdoid meningioma is a rare meningioma variant, classified as WHO grade III. Although this tumor is known for its aggressive behavior and poor prognosis, extracranial metastasis is rare. We report the rare case of a 31-year-old patient with rhabdoid meningioma which recurred several times despite gross total resection, radiation therapy, and gamma knife radiosurgery, and the last recurrence was associated with metastases to lungs, lymph node and bone. The patient showed no response to paclitaxel-carboplatin, or vincristine-cyclophosphamide-adriamycin chemotherapy, and succumbed to the disease. Metastases from rhabdoid meningioma prove to be a diagnostic challenge, and treatment for metastatic meningiomas is not optimized, thus necessitating documentation and interdisciplinary consensus on management protocols.
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Affiliation(s)
- Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Saphalta Baghmar
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ajay Garg
- Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Vinod Raina
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mehar Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Baghmar S, Kumar S, Gupta SD, Raina V. Follicular dendritic cell sarcoma with paraneoplatic pemphigus: Rare case and a brief review of literature. Indian J Med Paediatr Oncol 2014; 34:317-9. [PMID: 24604965 PMCID: PMC3932603 DOI: 10.4103/0971-5851.125255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Paraneoplastic pemphigus (PNP) is often a fatal autoimmune bullous disease characterized by severe stomatitis, polymorphous skin eruptions, and underlying neoplasms. We describe a patient with PNP associated with follicular dendritic cell sarcoma (FDCS), a rare neoplasm originating from follicular dendritic cells, which are non-lymphoid, non-phagocytic accessory cells of the lymphoid system and play an integral role in regulation of the germinal center reaction and present antigens to B-cells. The presence of rich vascularity around the tumor and few hyalanized vascular follicles found in histopathological examination gives the clue that the tumor might have developed from Castleman's disease (CD). As for the mechanisms by which CD induces PNP, it has been proposed that autoantibodies secreted from the Castleman's tumor play pivotal role. This hypothesis seems to be supported by the present case, in which CD may have triggered both the FDCS and the PNP.
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Affiliation(s)
- Saphalta Baghmar
- Department of Medical Oncology, Dr. BRA IRCH, AIIMS, New Delhi, India
| | | | | | - Vinod Raina
- Department of Medical Oncology, Dr. BRA IRCH, AIIMS, New Delhi, India
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Abstract
Hand-foot syndrome, is a side effect of cytotoxic chemotherapy, causes erythema, dysthesias, swelling of palms and soles and sometimes blisters. Rarely, it may ulcerate. The most commonly used drug that frequently causes this reaction is 5-fluorouracil or its prodrug oral capecitabine. High dose cytarabine is known to cause HFS. Here we report a case of HFS caused by standard dose cytarabine.
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Affiliation(s)
- Atul Sharma
- Department of Medical Oncology, Dr. BRA IRCH, AIIMS, New Delhi, India
| | - Saphalta Baghmar
- Department of Medical Oncology, Dr. BRA IRCH, AIIMS, New Delhi, India
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Baghmar S, Mohanti BK, Sharma A, Kumar L, Prakash G, Kumar S, Gupta R, Kumar R, Raina V. Solitary plasmacytoma: 10 years’ experience at All India Institute of Medical Sciences, New Delhi. Leuk Lymphoma 2012; 54:1665-70. [DOI: 10.3109/10428194.2012.750725] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Baghmar S, Raina V, Sharma A, Kumar L. Plasmacytoma: 10 years experience at a tertiary care center in India. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e18573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18573 Background: To evaluate the clinical features, diagnoses, prognostic factors, progression to MM of the patients of solitary plasmacytoma (SP) treated at AIIMS in last 10 years(2001-2010). Methods: From 2001-2010, we identified 57 patients with SP. OS, EFS, progression to myeloma were calculated using the Kaplan-Meier method and log rank test. Results: Out of 57 patients; 48 patients were evaluable. The M:F ratio was 3.5:1 with the median age of 49 years. The primary site was osseous(SBP) in 49 patients, extramedullary(EMP) in 8; 5 lesions were located in the upper respiratory passages, ie nasal cavity and maxillary sinus and rest of the 3 were one each in bronchus, gluteal region and intracranial. 43.8% of the lesions involved the vertebral column. The thoracic spine was the single most commonly involved site (12/57 patients). Out of 25 patients with lesions in vertebral column, 12 presented with paraparesis. Monoclonal protein was present in 48% patients and Urine M- Band in additional 2 patients. Treatment consisted of RT [45 Gy (8-50 Gy)] alone in 27, excision in 2 and excision and RT(n=9) and combined modality(n=10). The median follow-up was 28 months(range 3-160 months). Local control was achieved in 41(85%) while progressive disease was seen in 4. Serum M protein became undetectable after treatment in 60% patients. 17(41%) patients progressed to MM after initial response. The median duration of progression to MM was 21 months. Even though there was a trend towards a better EFS and OS for EMP than SBP, in univariate analysis this was not statistically significant. Patients having vertebral lesion showed trend towards progression to MM (p=.057). 5 yr EFS & OS were 44.4% and 89 % respectively. Median EFS and OS were 38 and 122 months respectively. 5 yr survival rate in patients who developed MM and those who did not were 81% and 100% respectively. None of the baseline characteristics were predictive of survival. Conclusions: Out of 1129 patients of plasma cell dyscrasias registered between 2001-2010; 5% were of SP. Bone was the most common site. Attainment of local control is the predictor of significant EFS (p<0.0001) and OS (p<0.05). Progression to MM is the commonest pattern of failure. Vertebrae involvement was predictor for disease progression to MM.
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Affiliation(s)
- Saphalta Baghmar
- Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Raina
- Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Sharma
- Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Kumar
- All India Institute of Medical Sciences, New Delhi, India
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Abstract
We are describing a case of plasmodium vivax malaria in a child with complications including pancytopenia secondary to marrow involvement, jaundice and neurological features. The child improved with antimalarial treatment.DOI: 10.3126/jnps.v30i3.3922J Nep Paedtr Soc 2010;30(3):168-170
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