Publications by authors named "Gujral Sumeet"

Chronic myeloid leukaemia (CML) is caused by balanced translocation t(9::22)(q34;q11) resulting in formation of pathogenic BCR-ABL fusion gene. Tyrosine kinase inhibitors (TKI) have revolutionised the treatment of CML. Ongoing treatment with TKI leads to side effects and has financial impact.

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  • Multicolor flow cytometry (MFC) is an important tool for detecting minimal bone marrow (BM) involvement in non-Hodgkin lymphomas (NHL) that are often missed by trephine biopsies or imaging.
  • In a study of 1,084 BM samples from patients with B-NHL, MFC identified 172 samples that appeared morphologically negative but had detectable lymphoma cells, demonstrating the technique's effectiveness.
  • CD305 emerged as a critical marker in flow cytometry for identifying minimal BM involvement, with many cases showing only low-level presence of lymphoma cells that conventional techniques could overlook.
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Background: Spindle cell lipomas (SL) and pleomorphic lipomas (PL) are rare variants of lipomas, occurring predominantly in the head and neck region. Laryngeal SL/PL is very uncommon and causes obstructive symptoms needing immediate intervention. These tumors are often challenging in radiology due to the admixture of elements and the presence of adipose tissue may help in diagnosis.

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Circulating tumor plasma cells (CTPCs) provide a noninvasive alternative for measuring tumor burden in newly diagnosed multiple myeloma (NDMM). Moreover, measurable residual disease (MRD) assessment in peripheral blood (PBMRD) can provide an ideal alternative to bone marrow MRD, which is limited by its painful nature and technical challenges. However, the clinical significance of PBMRD in NDMM still remains uncertain.

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  • High-grade B-cell non-Hodgkin lymphomas (NHLs) are more prevalent in patients with HIV, and this study reflects on the treatment outcomes of such patients treated with a specific chemotherapy regimen called DA-EPOCH(+/-R) from 2011 to 2015.
  • The analysis included 40 patients with various types of B-cell NHL, and a notable 82.5% had a 5-year overall survival rate, indicating the regimen's effectiveness.
  • While most patients experienced significant side effects, such as febrile neutropenia and mucositis, the treatment remains a viable option even for those with serious health challenges related to HIV.
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  • An 8-year-old girl diagnosed with classical Hodgkin lymphoma exhibited symptoms like fever, cervical swelling, and ptosis, with imaging revealing extensive disease spread, including intracranial masses.
  • After receiving a specific chemotherapy regime followed by radiotherapy, the patient has been disease-free for 44 months, but the rarity of CNS involvement in Hodgkin lymphoma means more research is needed to establish effective treatment guidelines.
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Objectives: Measurable residual disease (MRD) is the most relevant predictor of disease-free survival in B-cell acute lymphoblastic leukemia (B-ALL). We aimed to establish a highly sensitive flow cytometry (MFC)-based B-ALL-MRD (BMRD) assay for patients receiving anti-CD19 immunotherapy with an alternate gating approach and to document the prevalence and immunophenotype of recurrently occurring low-level mimics and confounding populations.

Methods: We standardized a 15-color highly-sensitive BMRD assay with an alternate CD19-free gating approach.

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The staging, prognostication, and treatment of ENKTL has evolved over the years with better understanding of the disease biology. There is significant heterogeneity in the treatment followed across the world. Literature from India have been few with small number of patients.

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  • Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is a rare type of lymphoma making up over 95% of CNS lymphomas, and its classification into cell-of-origin (COO) subtypes is debated compared to systemic versions of the disease.* -
  • The study evaluated 143 cases using immunohistochemistry and classified them into COO subtypes with both Hans and Choi algorithms, revealing a high discordance rate but 91.8% overall agreement between the two methods.* -
  • Results showed that 84.9% of cases were non-germinal center B-cell (GCB) subtype and 90.7% were activated B-cell (ABC) subtype,
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Background And Aims: Thrombotic events (TEs) have been extensively studied in adult cancer patients, but data in children are limited. We prospectively analyzed pediatric cancer-associated thrombosis (PCAT) in children with malignancies.

Methods: Children below 15 years of age with confirmed malignancies, treated at a large tertiary cancer center in India from July 2015 to March 2020 developing any TE were eligible.

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Background: Many novel therapies are being evaluated for the treatment of Multiple myeloma (MM). The cell-surface protein B-cell maturation antigen (BCMA, CD269) has recently emerged as a promising target for CAR-T cell and monoclonal-antibody therapies in MM. However, the knowledge of the BCMA expression-pattern in myeloma patients from the Indian subcontinent is still not available.

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Management of acquired immunodeficiency syndrome (AIDS)-related diffuse large B-cell (DLBCL) and plasmablastic lymphomas (PBL) poses significant challenges. The evidence supports use of dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin) with or without rituximab as first-line therapy. The need for central venous access, growth factors and significant toxicities limits its use in resource-constrained settings.

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Background: Treatment of Diffuse Large B-Cell Lymphoma (DLBCL) in the elderly aims to achieve disease remission while minimizing treatment-related toxicities. The use of anthracycline in the elderly is associated with increased risk of cardiotoxicity and myelosuppression. Non-anthracycline-based regimens have commonly been used in patients with cardiac contraindications or anticipated severe toxicities to anthracyclines.

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The upcoming 5th edition of the World Health Organization (WHO) Classification of Haematolymphoid Tumours is part of an effort to hierarchically catalogue human cancers arising in various organ systems within a single relational database. This paper summarizes the new WHO classification scheme for myeloid and histiocytic/dendritic neoplasms and provides an overview of the principles and rationale underpinning changes from the prior edition. The definition and diagnosis of disease types continues to be based on multiple clinicopathologic parameters, but with refinement of diagnostic criteria and emphasis on therapeutically and/or prognostically actionable biomarkers.

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  • The overview discusses the upcoming 5th edition of the WHO Classification of Haematolymphoid Tumours, specifically focusing on lymphoid neoplasms, while myeloid and histiocytic neoplasms will be covered separately.
  • Key changes from the previous 4th edition include a hierarchical reorganization of entities, modifications in their nomenclature, and revisions to diagnostic criteria and subtypes.
  • The new edition will also see the deletion of certain entities, the introduction of new ones, and the inclusion of tumour-like lesions and germline predisposition syndromes related to lymphoid neoplasms.
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Background: This manuscript describes the genetic features of SARS-CoV-2 mutations, prevalent phylogenetic lineages, and the disease severity amongst COVID-19-vaccinated individuals in a tertiary cancer hospital during the second wave of the pandemic in Mumbai, India.

Methods: This observational study included 159 COVID-19 patients during the second wave of the pandemic from 17 March to 1 June 2021 at a tertiary cancer care centre in Mumbai. The cohort comprised of healthcare workers, staff relatives, cancer patients, and patient relatives.

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Background: Diagnosis of MALT lymphoma in the oral cavity is challenging. There is a great overlap in the histopathologic, immuno-histochemical and molecular features of MALT lymphoma with reactive lymphoid proliferations. The literature shows a very few case reports of primary MALT lymphoma of oral cavity.

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Background: T-cell/NK-cell non-Hodgkin's lymphoma (T/NK-NHL) is an uncommon heterogeneous group of diseases. The current classification of T/NK-NHL is mainly based on histopathology and immunohistochemistry. In practice, however, the lack of unique histopathological patterns, overlapping cytomorphology, immunophenotypic complexity, inadequate panels, and diverse clinical presentations pose a great challenge.

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Background: Multicolor flow cytometry-based DNA-ploidy (MFC-ploidy) analysis is a simple, sensitive, and popular method for ploidy analysis in B-cell acute lymphoblastic leukemia (B-ALL). However, the utility of MFC-ploidy in the detection of B-ALL with endoreduplication or masked hypodiploidy has not been reported. Herein, we studied the patterns of MFC-ploidy assessment and its utility to detect B-ALL with hypodiploidy and endoreduplication.

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Pediatric B-cell lymphoblastic lymphoma (LBL) is a rare entity, and appropriate treatment for pediatric B-cell LBL is not well defined. While intensive ALL type regimens achieve long term survival of 90% across Western co-operative group trials, published data from Asian studies on long term outcomes are scarce. We retrospectively analyzed the data of pediatric B-cell LBL patients treated between January 2010 and December 2017 on a uniform protocol (modified BFM 90).

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Clinicopathologic profile and outcome of 15 children (15 years or above) with diffuse large B-cell lymphoma treated with MCP-842 protocol are reported. Eleven of 15 presented with advanced (stage-III/IV) disease. Post-2 cycles of chemotherapy, complete metabolic and morphologic response was documented in 10 (66%) and rest 5 (33%) with partial response achieved complete metabolic remission by end of treatment.

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