Publications by authors named "Nagavalli Somasundaram"

The importance of extra-nodal disease has been well recognized in follicular lymphoma, and is incorporated into various prognostic tools. However, the optimal treatment strategy for this subgroup remains unclear. In this multicenter retrospective study, we analyzed 143 patients who received either R-CHOP or Bendamustine-Rituximab (BR), with a median follow-up of 69.

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  • Mentoring is essential for professional identity formation (PIF), as it fosters personalized relationships and integrates program values, though its mechanisms remain unclear.
  • A systematic scoping review examined existing literature on mentoring support from 2000 to mid-2023, using rigorous methodology to analyze themes and categories.
  • Key findings highlight four domains vital to effective mentoring support: definitions and roles, personalisation, shepherding, and PIF, showcasing the importance of adapting mentoring approaches to meet individual mentee needs.
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Background: The most common aggressive lymphoma in adults is diffuse large B-cell lymphoma (DLBCL). Consolidative radiotherapy (RT) is often administered to DLBCL patients but guidelines remain unclear, which could lead to unnecessary RT. We aimed to evaluate the value of end-of-treatment PET-CT scans, interpreted using the Deauville score (DV), to guide the utilization of consolidative RT, which may help spare low-risk DLBCL patients from unnecessary RT.

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  • Medical education focuses on developing Professional Identity Formation (PIF) in students, emphasizing reflective practice amid challenges like resource constraints.
  • Group non-written reflections (GNWR) involve facilitator-led discussions to foster shared reflection, potentially improving PIF in medical training.
  • A systematic scoping review identified 98 relevant studies, highlighting four key areas: the value of GNWR, its structure, models of reflective practice, and elements of communities that aid socialization.
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Background: Journeying with patients throughout their cancer trajectory and caring for them at the end of life can lead to emotional and moral distress in oncologists, negatively impacting their personal and professional identities. A better understanding of how transitions in care goals affect oncologists can shed light on the challenges faced and the support required. This study explored the impact of care transitions on oncologists' professional identity formation (PIF).

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  • - The study explores how mentorship in medical education has transitioned from a one-on-one relationship to include group and peer mentoring, highlighting its evolving and context-specific nature.
  • - A systematic review of literature from 2000 to 2023 identified 216 articles that illustrate mentoring as a complex adaptive system (CAS), with key characteristics such as community dynamics and long-term support.
  • - The conclusion stresses the need to rethink how mentorship is designed and supported in medical training, emphasizing the importance of understanding mentorship as a CAS for enhancing mentor training and support.
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Background: Reviewing experiences and recognizing the impact of personal and professional views and emotions upon conduct shapes a physician's professional and personal development, molding their professional identity formation (PIF). Poor appreciation on the role of reflection, shortages in trained tutors and inadequate 'protected time' for reflections in packed medical curricula has hindered its integration into medical education. Group reflection could be a viable alternative to individual reflections; however, this nascent practice requires further study.

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Background: Reports of emotional, existential and moral distress amongst medical students witnessing death and suffering of patients during their clinical postings have raised awareness on the need for better psycho-emotional support during medical school. Furthermore, the stress experienced by medical students stemming from the rigours of their academic curriculum underlines the need for greater awareness on mental health issues and better self-care practices across medical training. With such programmes lacking in most medical schools, we propose a systematic scoping review (SSR) to map and address our research question, "what is known about self-care education interventions amongst medical students?".

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  • The use of CNS prophylaxis for patients with diffuse large B-cell lymphoma (DLBCL) is debated due to the rarity of CNS relapses, which are often fatal in this generally treatable condition.
  • The existing literature is primarily retrospective and shows mixed results on how effective CNS prophylaxis is, raising questions about its overall utility.
  • This review examines clinical guidelines, identifies high-risk patients, analyzes changes in CNS relapse patterns, and discusses the need for better diagnostics and new treatments, highlighting the reliance on retrospective data for guidance in an area lacking large-scale studies.
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Objective: To examine the association between the performance of mapping biopsies and surgical outcomes postexcision of extramammary Paget's disease (EMPD).

Background: Primary EMPD is a rare entity associated with poorly defined surgical margins and difficult-to-access sites of lesions. Surgical resection with clear margins remains the preferred management method.

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In our Asian multicenter retrospective study, we investigated the clinical prognostic factors affecting the outcomes of AITL patients and identified a novel prognostic index relevant in the Asian context. In our 174-patient cohort, the median PFS and OS was 1.8 years and 5.

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Diffuse large B-cell lymphoma (DLBCL) represents the commonest subtype of non-Hodgkin lymphoma and encompasses a group of diverse disease entities, each harboring unique molecular and clinico-pathological features. The understanding of the molecular landscape of DLBCL has improved significantly over the past decade, highlighting unique genomic subtypes with implications on targeted therapy. At the same time, several new treatment modalities have been recently approved both in the frontline and relapsed settings, ending a dearth of negative clinical trials that plagued the past decade.

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Hodgkin's lymphoma carries an excellent prognosis with modern chemotherapy, but a significant proportion of patients remain refractory to or relapse after first-line treatment. Immunological changes post-treatment, such as chemotherapy-induced neutropenia (CIN) or lymphopenia, have shown prognostic significance in multiple tumor types. Our study aims to investigate the prognostic value of immunologic changes in Hodgkin's lymphoma by examining the post-treatment lymphocyte count (pALC), neutrophil count (pANC) and the neutrophil-lymphocyte ratio (pNLR).

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  • Combination therapy is currently the standard treatment for relapsed/refractory non-Hodgkin's lymphoma (RR-NHL), but response rates are often low, especially in patients resistant to chemotherapy.
  • Researchers evaluated a new method called quadratic phenotypic optimization platform (QPOP), which can predict effective drug combinations using limited tumor samples from RR-NHL patients.
  • In a study involving 71 patients, QPOP-guided treatments showed improved outcomes and fewer cases of disease progression compared to traditional chemotherapy, providing a strong basis for future clinical trials on this approach.
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Background: Contemporary data of peripheral T-cell lymphoma (PTCL) and natural-killer/T-cell lymphoma (NKTL) patients treated with ifosfamide, carboplatin and etoposide (ICE) are limited.

Aims: We performed a retrospective analysis to estimate outcomes of ICE-treated PTCL and NKTL patients at three tertiary cancer centres in Singapore.

Methods And Results: Patients were identified through lymphoma databases from National Cancer Centre Singapore (NCCS), National University Hospital, Singapore (NUHS), and Singapore General Hospital (SGH).

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Background: Ratios of differential blood counts (hematological indices, HIs) had been identified as prognostic variables in various cancers. In primary central nervous system lymphomas (PCNSLs), higher baseline neutrophil-lymphocyte ratio (NLR) in particular was found to portend a worse overall survival. However, it was often observed that differential counts shift drastically following steroid administration.

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Liquid biopsy circulating tumor DNA (ctDNA)-based approaches may represent a non-invasive means for molecular interrogation of gastrointestinal stromal tumors (GISTs). We deployed a customized 29-gene Archer LiquidPlex™ targeted panel on 64 plasma samples from 46 patients. The majority were known to harbor mutations ( = 41, 89.

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We analyzed the prognostic factors for treatment outcomes amongst 34 patients with adult Burkitt lymphoma (BL) who received rituximab with standard first-line chemotherapy. Seven patients had human immunodeficiency virus (HIV)-associated BL. Overall, we observed a complete remission (CR) rate of 91.

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Introduction: Desmoid tumor is a locally-invasive neoplasm that causes significant morbidity. There is recent interest in cryotherapy for treatment of extra-abdominal desmoid tumors. This systematic review assesses evidence on safety and efficacy of cryotherapy in the treatment of extra-abdominal desmoid tumors.

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Diffuse large B-cell lymphoma is treated with anti-CD 20 and multi-drug chemotherapy for cure. Positron emission tomography (PET) scans are performed at end of treatment (EOT) to assess response. EOT Deauville scores (DS) are equivocal for treatment response in some situations, requiring physicians to determine the need for further investigations or treatment.

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Background: Mantle cell lymphoma (MCL) is widely considered an incurable malignancy even with current therapies and relapsed/refractory (R/R) disease to primary treatment remains common. With improved treatment guidelines and the advent of novel agents, patients are increasingly being treated with more lines of regimens. However, outcomes after each line of treatment remain poorly characterized, especially in the Asian population.

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Background: Empathy is pivotal to effective clinical care. Yet, the art of nurturing and assessing empathy in medical schools is rarely consistent and poorly studied. To inform future design of programs aimed at nurturing empathy in medical students and doctors, a review is proposed.

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Background: Significant progress has been made in the treatment outcomes of mantle cell lymphoma (MCL) since the introduction of cytarabine and rituximab in modern regimens. However, older patients may not readily tolerate these agents nor derive benefit. We investigated the impact of age on treatment patterns and clinical outcomes of MCL patients in an Asian population.

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Study Objective: To evaluate a surveillance protocol in managing the risk of hepatitis B virus (HBV) reactivation among lymphoma patients with resolved HBV infection receiving rituximab.

Design: Prospective, single-arm study.

Setting: National Cancer Centre, Singapore.

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