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102. FLUDARABINE-BASED LOW-INTENSITY CONDITIONING FOR FANCONI ANEMIA IS ASSOCIATED WITH GOOD OUTCOMES IN APLASTIC ANEMIA BUT NOT IN MDS - A SINGLE-CENTER EXPERIENCE

Author

George, Biju, primary, Chattopadhyay, Sohini, additional, Lionel, Sharon, additional, Selvarajan, Sushil, additional, Devasia, Anup, additional, Korula, Anu, additional, Kulkarni, Uday, additional, Aboobacker, Fouzia, additional, Sindhuvi, Eunice, additional, Lakshmi, Kavitha, additional, Srivastava, Alok, additional, Abraham, Aby, additional, and Mathews, Vikram, additional

Published
2023
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104. Total marrow lymphoid irradiation and cyclophosphamide is associated with low toxicity and good outcomes in patients undergoing hematopoietic stem cell transplantation for acute lymphoblastic leukemia and chronic myeloid leukemia in lymphoid blast crises – A phase I study

Author

George, Biju, primary, Balakrishnan, Rajesh, additional, S, Patricia, additional, Lionel, Sharon, additional, Selvarajan, Sushil, additional, Devasia, Anup J., additional, Korula, Anu, additional, Lakshmi, Kavitha M., additional, Aboobacker, Fouzia N., additional, Kulkarni, Uday, additional, Godson, Henry Finlay, additional, Raj, Jose Solomon, additional, Abraham, Aby, additional, Backianathan, Selvamani, additional, and Mathews, Vikram, additional

Published
2023
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112. Treosulfan Exposure Predicts Thalassemia‐Free Survival in Patients with Beta Thalassemia Major Undergoing Allogeneic Hematopoietic Cell Transplantation.

Author

Pai, Aswin Anand, Mohanan, Ezhilpavai, Panetta, John C., Kulkarni, Uday P., Illangeswaran, Raveen Stephen Stallon, Balakrishnan, Balaji, Jayaraman, Agila, Edison, Eunice S., Lakshmi, Kavitha M., Devasia, Anup J., Fouzia, Nambiathayil Aboobacker, Korula, Anu, Abraham, Aby, George, Biju, Srivastava, Alok, Mathews, Vikram, Standing, Joseph F., and Balasubramanian, Poonkuzhali

Subjects
HEMATOPOIETIC stem cell transplantation, BETA-Thalassemia, LIQUID chromatography-mass spectrometry, OVERALL survival, GRAFT rejection
Abstract

A toxicity‐reduced conditioning regimen with treosulfan, fludarabine, and thiotepa in patients with high‐risk β‐thalassemia major has significantly improved hematopoietic stem cell transplantation (HCT) outcomes. However, complications resulting from regimen‐related toxicities (RRTs), mixed chimerism, and graft rejection remain a challenge. We evaluated the dose–exposure‐response relationship of treosulfan and its active metabolite S, S‐EBDM, in a uniform cohort of patients with β‐thalassemia major to identify whether therapeutic drug monitoring (TDM) and dose adjustment of treosulfan is feasible. Plasma treosulfan/S, S‐EBDM levels were measured in 77 patients using a validated liquid chromatography with tandem mass spectrometry method, and the pharmacokinetic parameters were estimated using nlmixr2. The influence of treosulfan and S, S‐EBDM exposure, and GSTA1/NQO1 polymorphisms on graft rejection, RRTs, chimerism status, and 1‐year overall survival (OS), and thalassemia‐free survival (TFS) were assessed. We observed that treosulfan exposure was lower in patients with graft rejection than those without (1,655 vs. 2,037 mg•h/L, P = 0.07). Pharmacodynamic modeling analysis to identify therapeutic cutoff revealed that treosulfan exposure ≥1,660 mg•hour/L was significantly associated with better 1‐year TFS (97% vs. 81%, P = 0.02) and a trend to better 1‐year OS (90% vs. 69%, P = 0.07). Further, multivariate analysis adjusting for known pre‐HCT risk factors also revealed treosulfan exposure <1,660 mg•h/L (hazard ratio (HR) = 3.23; 95% confidence interval (CI) = 1.12–9.34; P = 0.03) and GSTA1*B variant genotype (HR = 3.75; 95% CI = 1.04–13.47; P = 0.04) to be independent predictors for inferior 1‐year TFS. We conclude that lower treosulfan exposure increases the risk of graft rejection and early transplant‐related mortality affecting TFS. As no RRTs were observed with increasing treosulfan exposure, TDM‐based dose adjustment could be feasible and beneficial. [ABSTRACT FROM AUTHOR]

Published
2024
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115. Laplacian Likelihood-Based Generalized Additive Model for RNA-Seq Analysis of Oral Squamous Cell Carcinoma

Author

Vinai George Biju and Prashanth C. M.

Subjects
Human-Computer Interaction, Artificial Intelligence, Software
Abstract

The study's objective is to identify the non-linear relationship of differentially expressed genes that vary in terms of the tumour and normal tissue and correct for any variations among the RNA-Seq experiment focused on Oral squamous cell carcinoma samples from patients. A Laplacian Likelihood version of the Generalized Additive Model is proposed and compared with the regular GAM models in terms of the non-linear fitting. The Non-Linear machine learning approach of Laplacian Likelihood-based GAM could complement RNA-Seq Analysis mainly to interpret, validate, and prioritize the patient samples data of differentially expressed genes. The analysis eases the standard parametric presumption and helps discover complexity in the association between the dependent and the independent variable and parameter smoothing that might otherwise be neglected. Concurvity, standard error, deviance, and other statistical verification have been carried out to confirm Laplacian Likelihood-based GAM efficiency.

Published
2022

119. Patterns of Renal Dysfunction and Profile of Kidney Biopsies in Hematopoietic Stem Cell Transplant Recipients

Author

John, Elenjickal Elias, primary, Roy, Sanjeet, additional, Devasia, Anup J., additional, Karuppusami, Reka, additional, Jose, Nisha, additional, Mani, Selvin Sundar Raj, additional, Eapen, Jeethu Joseph, additional, Yusuf, Sabina, additional, Thomas, Athul, additional, Valson, Anna T., additional, David, Vinoi George, additional, Mathews, Vikram, additional, George, Biju, additional, Varughese, Santosh, additional, and Alexander, Suceena, additional

Published
2023
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120. Comprehensive laboratory diagnosis of Fanconi anaemia: comparison of cellular and molecular analysis

Author

Joshi, Gaurav, primary, Arthur, Nancy Beryl Janet, additional, Geetha, Thenral S, additional, Datari, Phaneendra Venkateswara Rao, additional, Modak, Kirti, additional, Roy, Debanjan, additional, Chaudhury, Anurag Dutta, additional, Sundaraganesan, Prasanth, additional, Priyanka, Sweety, additional, NA, Fouzia, additional, Ramprasad, Vedam, additional, Abraham, Aby, additional, Srivastava, Vivi M, additional, Srivastava, Alok, additional, Kulkarni, Uday Prakash, additional, George, Biju, additional, and Velayudhan, Shaji R, additional

Published
2023
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122. Early Immune Reconstitution Following Treosulfan-Based Reduced Toxicity Conditioning in Patients Undergoing Allogeneic Transplantation

Author

Pai, Aswin Anand, primary, Arunachalam, Arun Kumar, additional, Nayanthara, K B, additional, Karumathil, Sujith, additional, Agila, J, additional, Aashritha, S, additional, Stallon Illangeswaran, Raveen Stephen, additional, Abraham, Aby, additional, George, Biju, additional, Kulkarni, Uday, additional, Mathews, Vikram, additional, and Balasubramanian, Poonkuzhali, additional

Published
2023
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123. High Melphalan Systemic Exposure Is Associated with Poor Event-Free Survival after Autologous Stem Cell Transplantation (ASCT) in Patients with Multiple Myeloma

Author

Pai, Aswin Anand, primary, Kulkarni, Uday, additional, Devasia, Anup J, additional, Panetta, John Carl, additional, Lakshmi, Kavitha, additional, Korula, Anu, additional, NA, Fouzia, additional, Lionel, Sharon, additional, Selvarajan, Sushil, additional, Abraham, Aby, additional, Srivastava, Alok, additional, Mathews, Vikram, additional, George, Biju, additional, and Balasubramanian, Poonkuzhali, additional

Published
2023
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124. Glutathione S-Transferase Gene Promoter Polymorphism (GSTA1*B) Influences Haematopoietic Cell Transplantation (HCT) Outcome in Patients with β-Thalassemia Receiving Treosulfan/Fludarabine/Thiotepa Regimen

Author

Pai, Aswin Anand, primary, Nayanthara, K B, additional, Kulkarni, Uday, additional, Lakshmi, Kavitha, additional, Stallon Illangeswaran, Raveen Stephen, additional, Mohanan, Ezhilpavai, additional, Agila, J, additional, Korula, Anu, additional, NA, Fouzia, additional, Devasia, Anup J, additional, Lionel, Sharon, additional, Selvarajan, Sushil, additional, Sindhuvi, Eunice, additional, Abraham, Aby, additional, Srivastava, Alok, additional, George, Biju, additional, Mathews, Vikram, additional, and Balasubramanian, Poonkuzhali, additional

Published
2023
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125. Comparing Outcomes with Bone Marrow or Peripheral Blood Stem Cells as Graft Source for Matched Sibling Transplants in Severe Aplastic Anemia across Different Economic Regions

Author

Kumar, Rajat, Kimura, Fumihiko, Ahn, Kwang Woo, Hu, Zhen-Huan, Kuwatsuka, Yachiyo, Klein, John P., Pasquini, Marcelo, Miyamura, Koichi, Kato, Koji, Yoshimi, Ayami, Inamoto, Yoshihiro, Ichinohe, Tatsuo, Wood, William Allen, Jr., Wirk, Baldeep, Seftel, Matthew, Rowlings, Philip, Marks, David I., Schultz, Kirk R., Gupta, Vikas, Dedeken, Laurence, George, Biju, Cahn, Jean-Yves, Szer, Jeff, Lee, Jong Wook, Ho, Aloysius Y.L., Fasth, Anders, Hahn, Theresa, Khera, Nandita, Dalal, Jignesh, Bonfim, Carmem, Aljurf, Mahmoud, Atsuta, Yoshiko, and Saber, Wael

Published
2016
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126. Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies

Author

Pasquini, Marcelo C., Zhang, Mei-Jie, Medeiros, Bruno C., Armand, Philippe, Hu, Zhen-Huan, Nishihori, Taiga, Aljurf, Mahmoud D., Akpek, Görgün, Cahn, Jean-Yves, Cairo, Mitchell S., Cerny, Jan, Copelan, Edward A., Deol, Abhinav, Freytes, César O., Gale, Robert Peter, Ganguly, Siddhartha, George, Biju, Gupta, Vikas, Hale, Gregory A., Kamble, Rammurti T., Klumpp, Thomas R., Lazarus, Hillard M., Luger, Selina M., Liesveld, Jane L., Litzow, Mark R., Marks, David I., Martino, Rodrigo, Norkin, Maxim, Olsson, Richard F., Oran, Betul, Pawarode, Attaphol, Pulsipher, Michael A., Ramanathan, Muthalagu, Reshef, Ran, Saad, Ayman A., Saber, Wael, Savani, Bipin N., Schouten, Harry C., Ringdén, Olle, Tallman, Martin S., Uy, Geoffrey L., Wood, William A., Jr., Wirk, Baldeep, Pérez, Waleska S., Batiwalla, Minoo, and Weisdorf, Daniel J.

Published
2016
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127. Outcome of allogeneic stem cell transplant for Fanconi anemia in India.

Author

Yadav, Satya Prakash, Raj, Revathi, Uppuluri, Ramya, Choudhary, Dharma, Doval, Divya, Dua, Vikas, Bhat, Sunil, Kharya, Gaurav, Patil, Rajesh, Bansal, Shweta, M, Deendayalan, Mehdi, Intezar, Mathews, Vikram, Abraham, Aby, and George, Biju

Subjects
FANCONI'S anemia, STEM cell transplantation, HEMATOPOIETIC stem cell transplantation, BONE marrow transplantation
Abstract

This letter to the editor discusses the outcome of allogeneic stem cell transplant (HSCT) for Fanconi Anemia (FA) in India. FA is a rare genetic disease that can lead to bone marrow failure, myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), and head and neck malignancies. The study analyzed data from 190 patients who underwent HSCT for FA in India from 1999 to 2019. The results showed that the overall survival rate was 64%, and the event-free survival rate was 62.5%. The study also found that matched related donor transplants had the highest survival rate, and chronic graft-versus-host disease (GVHD) was associated with a higher risk of second malignancy. The authors suggest considering T-cell depletion and the use of bone marrow grafts to reduce the risk of chronic GVHD and associated malignancies. [Extracted from the article]

Published
2024
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132. Combination Versus Monotherapy for Carbapenem-Resistant AcinetobacterSpecies Serious Infections: A Prospective IPTW Adjusted Cohort Study

Author

Manesh, Abi, George, Mithun Mohan, Palanikumar, Prasannakumar, Nagaraj, V., Bhanuprasad, Kundakarla, Krishnan, Ramya, Nivetha, G., Lal, Binesh, Triveni, K. Rajitha, Gautam, Priyanka, George, Biju, Kulkarni, Uday, Mathews, Vikram, Subramani, K., Rao, Shoma, Chacko, Binila, Zachariah, Anand, Sathyendra, Sowmya, Hansdak, Samuel George, Abraham, Ooriapadickal Cherian, Iyadurai, Ramya, Karthik, Rajiv, Peter, John Victor, Mo, Yin, Veeraraghavan, Balaji, Varghese, George M., and Paterson, David Leslie

Abstract

Introduction: International guidelines recommend definitive combination antibiotic therapy for the management of serious infections involving carbapenem-resistant Acinetobacter(CRAB) species. The commonly available combination options include high-dose sulbactam, polymyxins, tetracyclines, and cefiderocol. Scanty prospective data exist to support this approach. Methods: Patients with CRAB bacteraemia, ventilator-associated pneumonia (VAP), or both were categorized based on whether they received combination therapy or monotherapy. The 30-day mortality was compared between the two groups. Inverse probability treatment weighting (IPTW) was done using propensity score (PS) for a balanced comparison between groups. Results: Between January 2021 and May 2023, of the 161 patients with CRAB bacteraemia (n= 55, 34.2%), VAP (n= 46, 28.6%), or both (n= 60, 37.3%) who received appropriate intravenous antibiotic therapy, 70% (112/161) received monotherapy, and the rest received combination therapy. The overall 30-day mortality was 62% (99/161) and not different (p= 0.76) between the combination therapy (31/49, 63.3%) and monotherapy (68/112, 60.7%) groups. The propensity score matching using IPTW did not show a statistical difference (p= 0.47) in 30-day mortality for receiving combination therapy with an adjusted odds ratio (OR) Pof 1.29 (0.64, 2.58). Conclusion: Combination therapy for CRAB infections needs further study in a randomised controlled trial, as this observational study showed no difference in 30-day mortality between monotherapy and combination therapy.

Published
2024
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138. Haploidentical Natural Killer Cell Therapy as an Adjunct to Stem Cell Transplantation for Treatment of Refractory Acute Myeloid Leukemia

Author

Kulkarni, Uday, primary, Arunachalam, Arun Kumar, additional, Palani, Hamenth Kumar, additional, Nair, Reeshma Radhakrishnan, additional, Balasundaram, Nithya, additional, Venkatraman, Arvind, additional, Korula, Anu, additional, Selvarajan, Sushil, additional, Lionel, Sharon, additional, Balasubramanian, Poonkuzhali, additional, Maddali, Madhavi, additional, Abraham, Aby, additional, George, Biju, additional, and Mathews, Vikram, additional

Published
2023
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140. Hematopoietic stem cell transplantation in hemophagocytic lymphohistiocytosis: A single centre experience

Author

Luckose, Minu, primary, Sindhuvi, Eunice, additional, Kumar, Arun, additional, Korula, Anu, additional, Selvarajan, Sushil, additional, Kulkarni, Uday, additional, Lionel, Sharon, additional, Devasya, Anup J., additional, Mathews, Vikram, additional, George, Biju, additional, Srivastava, Alok, additional, Abraham, Aby, additional, and A, Fouzia N., additional

Published
2023
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146. Real-World Outcomes for Acute Promyelocytic Leukemia: Need to Address Induction Mortality

Author

Sengar, Manju, primary, Jain, Hasmukh, additional, Kulkarni, Uday Prakash, additional, Goli, Vasu Babu, additional, Korula, Anu, additional, Samuel, Prasanna, additional, Selvarajan, Sushil, additional, Nayak, Lingaraj, additional, Abraham, Aby, additional, Prakash, Om, additional, N., Fouzia, additional, Kumaran, Saranya, additional, Thorat, Jayashree, additional, Bagal, Bhausaheb, additional, Balasubramanian, Poonkuzhali, additional, Shetty, Dhanlaxmi, additional, Patkar, Nikhil, additional, George, Biju, additional, and Mathews, Vikram, additional

Published
2022
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147. Population Pharmacokinetics of Mycophenolic Acid in Haploidentical Transplant Recipients Receiving Post-Transplant Cyclophosphamide Based GvHD Prophylaxis

Author

PAI, Aswin Anand, primary, Kulkarni, Uday, additional, Mathew, Binu Susan, additional, KB, Nayanthara, additional, Panetta, John C, additional, Karumathil, Sujith, additional, Abraham, Aby, additional, Mathews, Vikram, additional, George, Biju, additional, and Balasubramanian, Poonkuzhali, additional

Published
2022
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148. A Model-Informed Precision Busulfan Dosing in Pediatric Patients Undergoing Hematopoietic Cell Transplantation- Real-World Data

Author

Balasubramanian, Poonkuzhali, primary, PAI, Aswin Anand, additional, Nagarajan, Rajesh, additional, Hughes, Stephanie, additional, Edison, Eunice Sindhuvi, additional, Kulkarni, Uday Prakash, additional, Abraham, Aby, additional, Srivastava, Alok, additional, Mathews, Vikram, additional, and George, Biju, additional

Published
2022
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149. Decentralized manufacturing of anti CD19 CAR-T cells using CliniMACS Prodigy®: real-world experience and cost analysis in India

Author

Palani, Hamenth Kumar, primary, Arunachalam, Arun Kumar, additional, Yasar, Mohammed, additional, Venkatraman, Arvind, additional, Kulkarni, Uday, additional, Lionel, Sharon Anbumalar, additional, Selvarajan, Sushil, additional, Korula, Anu, additional, Abraham, Aby, additional, George, Biju, additional, Adair, Jennifer E., additional, Orentas, Rimas, additional, Dropulic, Boro, additional, and Mathews, Vikram, additional

Published
2022
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