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5. The Outcome of Pediatric Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia: Experience from a Referral Center in South India

Author

Antonisamy, Nikita, primary, Boddu, Deepthi, additional, John, Rikki, additional, Korrapolu, Richa Sharon Angel, additional, Balasubramanian, Poonkuzhali, additional, Arunachalam, Arun Kumar, additional, Joseph, Leenu Lizbeth, additional, Srinivasan, Hema Nalapullu, additional, Mathew, Leni Grace, additional, and Totadri, Sidharth, additional

Published
2023
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6. What happens to children with acute lymphoblastic leukemia in low- and middle-income countries after relapse? A single-center experience from India

Author

Korrapolu, Richa Sharon Angel, primary, Boddu, Deepthi, additional, John, Rikki, additional, Antonisamy, Nikita, additional, Geevar, Tulasi, additional, Arunachalam, Arun Kumar, additional, Joseph, Leenu Lizbeth, additional, Srinivasan, Hema Nalapullu, additional, Mathew, Leni Grace, additional, and Totadri, Sidharth, additional

Published
2023
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7. Long-term outcomes and prognostic factors affecting survival after pulmonary metastasectomy in solid tumors of childhood: A single center experience

Author

Gaikwad, Vivek, John, Rikki, Karuppusami, Reka, Jacob, Tarun K., Mathew, Leni, and Kurian, Jujju

Subjects
Tumors -- Prognosis -- Complications and side effects, Health
Abstract

Byline: Vivek. Gaikwad, Rikki. John, Reka. Karuppusami, Tarun. K. Jacob, Leni. Mathew, Jujju. Kurian Introduction: This study assessed the long-term survival and the prognostic variables affecting survival following pulmonary metastasectomy [...]

Published
2022

13. What happens to children with acute lymphoblastic leukemia in low- and middle-income countries after relapse? A single-center experience from India

Author

Korrapolu, Richa Sharon Angel, Boddu, Deepthi, John, Rikki, Antonisamy, Nikita, Geevar, Tulasi, Arunachalam, Arun Kumar, Joseph, Leenu Lizbeth, Srinivasan, Hema Nalapullu, Mathew, Leni Grace, and Totadri, Sidharth

Abstract

Managing a child with acute lymphoblastic leukemia (ALL) after relapse is arduous in low- and middle-income countries. A file review of children aged ≤15 years diagnosed with relapsed ALL from 2010 to 2019 was performed. Classification of relapse followed the Berlin-Frankfurt-Münster (BFM) scheme. The majority of patients were treated with a modified ALL-REZ-BFM protocol. Of 764 children treated for ALL in the study period, 163 (21.3%) relapsed. The median age at relapse was 101 months (range: 8–297). The immunophenotype was B-ALL and T-ALL in 140 (86%) and 23 (14%) patients. The site of relapse was extramedullary, combined, and medullary in 46 (28%), 45 (28%), and 72 (44%) patients. Very early, early, and late relapses were observed in 57 (35%), 66 (40%), and 40 (25%) patients. The proportions of extramedullary and medullary sites were greater among patients with early and late relapses, respectively (p = 0.039). Eighty-four (52%) patients were treated with palliative intent. The 2-year event-free survival (EFS) of patients treated with curative intent was 36.3 ± 6.3%. The 2-year EFS for very early/early and late relapses were 18.2 ± 6.2% and 67.6 ± 10.4% (p < 0.001). The 2-year EFS did not differ between extramedullary, combined, and medullary relapses. Treatment-related mortality occurred in 14 (20%) patients. More than 50% of the patients with relapse were treated with the intent of palliation. Extramedullary relapses were more likely to be early and did not have a better outcome than medullary relapses. Children with late relapse had a fair chance of survival with chemotherapy.

Published
2023
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21. The Nutritional Trajectory of Children with Acute Lymphoblastic Leukemia: A 10-Year Follow up Study from a Referral Center in South India.

Author

Joseph, Leenu Lizbeth, Srinivasan, Hema Nalapullu, Robert, Magdalenal, Boddu, Deepthi, John, Rikki, Mathew, Leni Grace, and Totadri, Sidharth

Subjects
RESEARCH, OBESITY, NUTRITIONAL assessment, LYMPHOBLASTIC leukemia, LEANNESS, DESCRIPTIVE statistics, STATISTICAL correlation, BODY mass index, LONGITUDINAL method
Abstract

Survivors of childhood acute lymphoblastic leukemia (ALL) are vulnerable to late adverse events such as obesity and an associated metabolic syndrome. Children treated for ALL from 2002 to 2012 were included. BMI was calculated at diagnosis, end of treatment, and 5, 8, and 10-years from diagnosis. BMI-centiles were used to categorize the patients: underweight (<5th-percentile), normal (5th–85th percentile), overweight (85th–95th percentile), and obese (≥95th centile). The study included 179 children with ALL (median age: 59-months). The proportions of patients who were underweight, normal, overweight/obese, were 37%, 56% and 7%, respectively, at diagnosis; and 15%, 51% and 34%, respectively, at 5-years from diagnosis. The median (IQR) BMI Z-score at diagnosis was −1.12(−2.40, −0.26). The median (IQR) BMI z-score of the cohort was higher after 5 [0.22(−0.83,1.24), P < 0.001] and 10-years of diagnosis [0.30(−0.69,0.99), P < 0.001], respectively. The proportion of overweight/obese individuals was higher after 5 (34%, P < 0.001) and 10 (26%, P = 0.001) years. There was a significant correlation between the baseline BMI Z-score and that observed after 5-years (ρ = 0.49, P < 0.001), and 10-years (ρ = 0.55, P < 0.001). At 10-years of follow-up, >25% of children with ALL were overweight/obese. The BMI Z-score at the time of diagnosis continued to correlate with the Z-score after 10-years. [ABSTRACT FROM AUTHOR]

Published
2023
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33. Factors affecting survival in childhood Hodgkin lymphoma

Author

Boddu, Deepthi, primary, John, Rikki R., additional, Totadri, Sidharth, additional, Joseph, Leenu, additional, Ns, Hema, additional, Manipadam, Marie Therese., additional, Yadav, Bijesh, additional, Mathew, Leni G., additional, and Guttikonda, Apoorva, additional

Published
2020
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44. Histoplasma capsulatum Infection with Extensive Lytic Bone Lesions Mimicking LCH.

Author

Mathews, Divya Mariam, John, Rikki, Verghese, Valsan, Parmar, Harshad, Chaudhary, Narendra, Mishra, Sataroopa, and Mathew, Leni

Subjects
*HISTOPLASMA capsulatum, *BONE diseases in children, *LANGERHANS-cell histiocytosis, *NEUROBLASTOMA, *HYPERPARATHYROIDISM, *LEUKEMIA, *AMPHOTERICIN B, *ANTIFUNGAL agents, *HISTOPLASMOSIS diagnosis, *FUNGI classification, *ITRACONAZOLE, *FEVER, *FUNGI, *HISTOPLASMOSIS, *IMMUNE response, *IMMUNOCOMPETENT cells, *TREATMENT effectiveness, *THERAPEUTICS
Abstract

Multiple lytic bone lesions in a child can be a manifestation of various diseases like Langerhans cell histiocytosis, metastatic neuroblastoma, leukemia, hyperparathyroidism, multifocal osteomyelitis and histoplasmosis. Disseminated histoplasmosis caused by Histoplasma capsulatum var. duboisii is well known to present with multiple osteolytic lesions in immunocompromised adults and is mostly restricted to the African subcontinent. Histoplasmosis seen in American and Asian countries is caused by Histoplasma capsulatum var. capsulatum, which presents with pulmonary and systemic manifestations and rarely bone involvement. We report a case of histoplasmosis, caused by H. capsulatum var. capsulatum with extensive lytic bone lesions in a 13 year old immunocompetent boy who presented with prolonged fever, weight loss and multiple boggy swellings. He responded to amphotericin and is currently on Itraconazole. This case is unique for extensive osteolytic lesions with H. capsulatum var. capsulatum infection in an immunocompetent child. [ABSTRACT FROM AUTHOR]

Published
2016
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45. Liver metastasis in an adolescent treated for third ventricle germ cell tumor.

Author

John, Rikki R., Lionel, Arul Premanand, Sitaram, Venkatramani, and Mathew, Leni G.

Subjects
*LIVER metastasis, *DISEASES in teenagers, *GERM cell tumors, *CANCER chemotherapy, *HEPATECTOMY, *LYMPH nodes
Abstract

Systemic dissemination of intracranial germ cell tumors (GCTs) occur only in 3% of cases and the common sites are bone, lungs, and lymph nodes. Metastasis to the liver is rare. As far as we could find, only six cases of liver metastasis of intracranial GCTs have been reported so far. We report an adolescent girl who presented with hepatic relapse 2½ years after successful completion of treatment of intracranial GCT. She was treated with chemotherapy and right hepatectomy and is doing well 30 months after treatment for the metastatic disease. [ABSTRACT FROM AUTHOR]

Published
2014
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