Publications by authors named "Vaskar Saha"
Article Synopsis
- During the maintenance treatment phase for acute lymphoblastic leukemia (ALL), personalized dosing of oral antimetabolite drugs is essential, but challenging, leading to a higher relapse risk if not done correctly.
- An open-source R-based analytical toolkit, including the allMT R package and the VIATAMIN application, has been developed to assist in evaluating and improving drug titration during treatment.
- The toolkit provides visual analyses of drug dosing patterns, assesses prescriber compliance, and intends to integrate into a clinical support system for real-time adjustments, with future updates planned to include more factors affecting drug titration.
Article Synopsis
- Acute lymphoblastic leukemia (ALL) treatment for children includes a 2-year outpatient maintenance therapy (MT), which transitioned from entirely outpatient to a hybrid e-clinic/outpatient model over 8 years.
- The study analyzed data from 478 children on MT, finding that the hybrid model reduced outpatient visits by about two-thirds while maintaining treatment effectiveness and increasing dose intensity.
- Families reported significant satisfaction with the hybrid service, which also cut maintenance treatment costs by roughly 50%, demonstrating it as an effective and less burdensome approach for patients.
Background: Research is essential for the advancement of science, technology and development. Research requires funding and resource allocation. And funding requires the ability to write research grant application.
View Article and Find Full Text PDFCure rates in pediatric acute lymphoblastic leukemia (ALL) currently approach 90% in the developed world. Treatment involves 6-8 mo of intensive multi-drug chemotherapy followed by 24 mo of maintenance treatment (ALL-MT). The cornerstone of ALL-MT is the daily administration of oral 6-mercaptopurine (6MP), a purine analogue.
View Article and Find Full Text PDFPurpose: In the absence of a standardized tool to assess the quality of pediatric hematology/oncology training programs, the Education Program Assessment Tool (EPAT) was conceptualized as a user-friendly and adaptable tool to evaluate and identify areas of opportunity, pinpoint needed modifications, and monitor progress for training programs around the world.
Methods: The development of EPAT consisted of three main phases: operationalization, consensus, and piloting. After each phase, the tool was iteratively modified based on feedback to improve its relevance, usability, and clarity.
Background: The outcome of children with Philadelphia chromosome-positive (Ph-positive) acute lymphoblastic leukaemia significantly improved with the combination of imatinib and intensive chemotherapy. We aimed to investigate the efficacy of dasatinib, a second-generation ABL-class inhibitor, with intensive chemotherapy in children with newly diagnosed Ph-positive acute lymphoblastic leukaemia.
Methods: CA180-372/COG AALL1122 was a joint Children's Oncology Group (COG) and European intergroup study of post-induction treatment of Ph-positive acute lymphoblastic leukaemia (EsPhALL) open-label, single-arm, phase 2 study.
Outcomes for children with acute lymphoblastic leukemia (ALL) have improved worldwide to >85%. For those who relapse, outcomes have remained static at ~50% making relapsed acute lymphoblastic leukemia one of the leading causes of death in childhood cancers. Those relapsing within 18 mo in the bone marrow have a particularly dismal outcome.
View Article and Find Full Text PDFBackground: To evaluate the treatment cost and cost effectiveness of a risk-stratified therapy to treat pediatric acute lymphoblastic leukemia (ALL) in India.
Methods: The cost of total treatment duration was calculated for a retrospective cohort of ALL children treated at a tertiary care facility. Children were risk stratified into standard (SR), intermediate (IR) and high (HR) for B-cell precursor ALL, and T-ALL.
Purpose: Formal training in clinical research methodologies is limited in limited-resource countries. Through collaboration among high- and middle-resource settings and in response to an identified need verbalized by regional pediatric oncology practitioners, Pediatric Oncology East & Mediterranean Group and St Jude Global developed a workshop focused on capacity building in research skills. Here, we describe its structure, implementation, and early results.
View Article and Find Full Text PDFBackground: The north and north-eastern regions of India have among the highest incidence of gallbladder cancer (GBC) in the world. We report the clinicopathological charateristics and outcome of GBC patients in India.
Methods: Electronic medical records of patients diagnosed with GBC at Tata Medical Center, Kolkata between 2017 and 2019 were analyzed.
In successive UK clinical trials (UKALL 2003, UKALL 2011) for paediatric acute lymphoblastic leukaemia (ALL), polyethylene glycol-conjugated E. coli L-asparaginase (PEG-EcASNase) 1000 iu/m was administered intramuscularly with risk-stratified treatment. In induction, patients received two PEG-EcASNase doses, 14 days apart.
View Article and Find Full Text PDFBackground: In the west, survival following treatment of childhood acute lymphoblastic leukaemia (ALL) approaches 90%. Outcomes in India do not exceed 70%. To address this disparity, the Indian Collaborative Childhood Leukaemia group (ICiCLe) developed in 2013 a contemporary treatment protocol for uniform risk-stratified management of first presentation ALL based on cytogenetics and minimal residual disease levels (MRD).
View Article and Find Full Text PDFRisk factors and outcomes in children with high-risk B-cell precursor and T-cell relapsed acute lymphoblastic leukaemia: combined analysis of ALLR3 and ALL-REZ BFM 2002 clinical trials.
Eur J Cancer
July 2021
Article Synopsis
- The study analyzed the outcomes of 393 children with high-risk relapsed acute lymphoblastic leukaemia (ALL) from two clinical trials, focusing on the impact of minimal residual disease (MRD) and genetic factors on survival.
- Results indicated that the event-free survival rates for B-cell precursor (BCP) and T-cell ALL were similar, but better MRD responses led to significantly improved disease-free and overall survival rates.
- The conclusion suggests that new therapeutic strategies are necessary to enhance remission rates and maintain long-term survival after stem cell transplantation in high-risk ALL patients.
Background: The biotherapeutic asparaginase is a cornerstone of therapy in acute lymphoblastic leukaemia (ALL). With limited access to the original native Escherichia coli-derived asparaginase (EcASNase), a variety of EcASNase biogenerics are used in low-middle-income countries (LMICs). The variable quality of these biogenerics potentially influences clinical outcomes.
View Article and Find Full Text PDFImportance: Blinatumomab is a CD3/CD19-directed bispecific T-cell engager molecule with efficacy in children with relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL).
Objective: To evaluate event-free survival in children with high-risk first-relapse B-ALL after a third consolidation course with blinatumomab vs consolidation chemotherapy before allogeneic hematopoietic stem cell transplant.
Design, Setting, And Participants: In this randomized phase 3 clinical trial, patients were enrolled November 2015 to July 2019 (data cutoff, July 17, 2019).
Background: L-asparaginase is a key component of treatment for patients with acute lymphoblastic leukaemia (ALL) in the UK. Commonly used forms of asparaginase are native E. coli-derived asparaginase (native asparaginase) and pegaspargase in first-line combination therapy, and native Erwinia chrysanthemi-derived asparaginase (Erwinia asparaginase) as second-line treatment.
View Article and Find Full Text PDFArticle Synopsis
- The UKALL 2011 trial evaluated the effects of different dosing regimens of dexamethasone in treating acute lymphoblastic leukaemia, focusing on a short (10 mg/m/d for 14 days) versus a standard (6 mg/m/d for 28 days) approach to see which would be more effective and have fewer toxicities.
- Blood samples from 174 children were analyzed to study how dexamethasone levels varied, finding significant differences in drug exposure amongst patients and a higher cumulative exposure with the longer dosing regimen.
- The findings suggest that the duration of dexamethasone therapy and the overall drug exposure may have a greater impact on treatment response than the actual dose taken, with no
Article Synopsis
- A study in India assessed bortezomib (BZB) and reduced doses of cytarabine in treating children with relapsed acute lymphoblastic leukemia (rALL), involving 55 participants.
- Out of those treated, 88% achieved second remission and a significant number showed low minimal residual disease after induction therapy.
- The results showed promising one-year survival rates, with 74.7% event-free survival and 79.6% overall survival in the group receiving treatment.