Neelum Mansoor, S. Maqsood, Syeda Ambreen Zehra, Imad Bakri
Abstract The Philadelphia chromosome is seen in 5% of pediatric and 25 to 50% of adult cases of acute lymphoblastic leukemia (ALL). It is linked to aggressive illness with a dismal prognosis. Additional chromosomal abnormalities are not prevalent with translocation 9;22; nevertheless, isochromosome derivative [ider(22)] with this translocation is rarely recorded in the literature. This is the third instance of ider(22) in pediatric B-cell acute lymphoblastic leukemia (B-ALL). Bone marrow chromosome analysis by G-banding showed 46,XX,t(9;22)(q34;q11.2)[6]/46,XX,ider(22)(q10)t(9;22)(q34;q11.2)[14]. Fluorescence in situ hybridization (FISH) analysis for BCR::ABL1 fusion showed 40% of interphase cells with two and 35% with three fusion signals that were in concordance with the karyotype. The patient was categorized as National Cancer Institute (NCI) high-risk (HR) and started with HR chemotherapy according to Children's Oncology Group (COG) protocol. Postinduction remission assessment by flow cytometry showed 2.6% measurable residual disease. The case highlights significance of cytogenetic analysis despite availability of advanced techniques like FISH. The prognostic significance of concurrent ider22(q10) with t(9;22) is yet to be explored.
{"title":"B-Lymphoblastic Leukemia Presenting with an Isoderivative Philadelphia Chromosome—A Rare Case Report and Review of Literature","authors":"Neelum Mansoor, S. Maqsood, Syeda Ambreen Zehra, Imad Bakri","doi":"10.1055/s-0043-1770094","DOIUrl":"https://doi.org/10.1055/s-0043-1770094","url":null,"abstract":"Abstract The Philadelphia chromosome is seen in 5% of pediatric and 25 to 50% of adult cases of acute lymphoblastic leukemia (ALL). It is linked to aggressive illness with a dismal prognosis. Additional chromosomal abnormalities are not prevalent with translocation 9;22; nevertheless, isochromosome derivative [ider(22)] with this translocation is rarely recorded in the literature. This is the third instance of ider(22) in pediatric B-cell acute lymphoblastic leukemia (B-ALL). Bone marrow chromosome analysis by G-banding showed 46,XX,t(9;22)(q34;q11.2)[6]/46,XX,ider(22)(q10)t(9;22)(q34;q11.2)[14]. Fluorescence in situ hybridization (FISH) analysis for BCR::ABL1 fusion showed 40% of interphase cells with two and 35% with three fusion signals that were in concordance with the karyotype. The patient was categorized as National Cancer Institute (NCI) high-risk (HR) and started with HR chemotherapy according to Children's Oncology Group (COG) protocol. Postinduction remission assessment by flow cytometry showed 2.6% measurable residual disease. The case highlights significance of cytogenetic analysis despite availability of advanced techniques like FISH. The prognostic significance of concurrent ider22(q10) with t(9;22) is yet to be explored.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45543555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Apart from their usual morphology (eccentrically placed round to ovoid nuclei with cart-wheel-like chromatin, perinuclear halo and deep basophilic cytoplasm), very rarely plasma cells show varied appearances—signet-ring, pleomorphic, blastic, vacuolated, spindle cell, and clear cell.1 Here, we present a case of plasmacytoma involving the right pleural cavity with unusual morphology and masquerading as a nonhematolymphoid neoplasm. A 75-year-oldwomanpresentedwith complaints of weakness, shoulder, and back pain with breathlessness. Magnetic resonance imaging (MRI) of the thoracic spine (►Fig. 1A) showed a heterogeneous lesion measuring 11.3 2.5 3.9 cm in the right pleural cavity with involvement of the adjacent ribs, costovertebral joints, and infiltration of the right neural foramina in the T3 toT4 and T4 toT5 regions. The lesion showed low fluorodeoxyglucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT) scan with standardized uptake value (SUV) max of 3.3. Needle core biopsy of the lesion under ultrasound guidance was done. Histopathological examination revealed fibrocollagenous tissue and skeletal muscle bundles with neoplastic cells arranged in cords and sheets (►Fig. 1B). The
{"title":"Plasma Cell Neoplasm with Clear Cell Morphology—A Diagnostic Dilemma","authors":"Sudipta Naskar, Rekha V. Kumar","doi":"10.1055/s-0043-1770786","DOIUrl":"https://doi.org/10.1055/s-0043-1770786","url":null,"abstract":"Apart from their usual morphology (eccentrically placed round to ovoid nuclei with cart-wheel-like chromatin, perinuclear halo and deep basophilic cytoplasm), very rarely plasma cells show varied appearances—signet-ring, pleomorphic, blastic, vacuolated, spindle cell, and clear cell.1 Here, we present a case of plasmacytoma involving the right pleural cavity with unusual morphology and masquerading as a nonhematolymphoid neoplasm. A 75-year-oldwomanpresentedwith complaints of weakness, shoulder, and back pain with breathlessness. Magnetic resonance imaging (MRI) of the thoracic spine (►Fig. 1A) showed a heterogeneous lesion measuring 11.3 2.5 3.9 cm in the right pleural cavity with involvement of the adjacent ribs, costovertebral joints, and infiltration of the right neural foramina in the T3 toT4 and T4 toT5 regions. The lesion showed low fluorodeoxyglucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT) scan with standardized uptake value (SUV) max of 3.3. Needle core biopsy of the lesion under ultrasound guidance was done. Histopathological examination revealed fibrocollagenous tissue and skeletal muscle bundles with neoplastic cells arranged in cords and sheets (►Fig. 1B). The","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49115264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neha Pathak, Anu R. I., Padmaj S. Kulkarni, Amol Patel
Abstract Introduction: Next-generation sequencing (NGS) has paved the way for precision oncology in oncology clinics today. With rapidly advancing therapeutics, it is becoming increasingly important to obtain information about the molecular milieu of a patient's tumor. However, reporting and interpreting of NGS is fraught with complexity and variability. To understand the questions surrounding NGS reporting in India, we conducted a survey. Objectives: The aim of this study was to assess the gaps in NGS reporting and interpretation in Indian medical oncology clinics. Materials and Methods : An anonymized 10-question survey-based study among Indian medical oncologists through Google forms was conducted between October 4 and 8, 2022. Results: The sample size was n = 58. Seventy-one percent felt there was heterogeneity in NGS reporting, 72% were unaware of NGS reporting guidelines, and 62% did not feel the need for a molecular scientist assist in NGS interpretation. Almost all (98%) felt there was a need for uniform NGS reporting as well as an Indian NGS repository and data-sharing system (93%). Conclusion: Our survey highlights the need for a uniform national guideline concerning NGS reporting.
{"title":"A Survey on Unmet Need for Uniform Next-Generation Sequencing Reporting in India","authors":"Neha Pathak, Anu R. I., Padmaj S. Kulkarni, Amol Patel","doi":"10.1055/s-0043-1770936","DOIUrl":"https://doi.org/10.1055/s-0043-1770936","url":null,"abstract":"Abstract Introduction: Next-generation sequencing (NGS) has paved the way for precision oncology in oncology clinics today. With rapidly advancing therapeutics, it is becoming increasingly important to obtain information about the molecular milieu of a patient's tumor. However, reporting and interpreting of NGS is fraught with complexity and variability. To understand the questions surrounding NGS reporting in India, we conducted a survey. Objectives: The aim of this study was to assess the gaps in NGS reporting and interpretation in Indian medical oncology clinics. Materials and Methods : An anonymized 10-question survey-based study among Indian medical oncologists through Google forms was conducted between October 4 and 8, 2022. Results: The sample size was n = 58. Seventy-one percent felt there was heterogeneity in NGS reporting, 72% were unaware of NGS reporting guidelines, and 62% did not feel the need for a molecular scientist assist in NGS interpretation. Almost all (98%) felt there was a need for uniform NGS reporting as well as an Indian NGS repository and data-sharing system (93%). Conclusion: Our survey highlights the need for a uniform national guideline concerning NGS reporting.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43226069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Keziah, M. Bindhiya, M. Jayaprakash, Rodrigues A Prudence
Abstract Introduction Myelosuppression is a commonly observed dose-limiting side effect of majority of chemotherapeutic drugs, characterized by a decrease in blood cell production. They cause neutropenia, thrombocytopenia, and anemia and can be life threatening in few susceptible individuals. Attempts to lessen chemotherapy-induced myelosuppression have been minimally effective. Managing myelosuppression has been a challenge to medical practitioners and pharmacist. Identifying their risk factors and the management strategies can help prevent the debilitating effects on chemotherapy patients. Objectives The aim of this study was to determine the risk factors for chemotherapy-induced myelosuppression and identify its management in a tertiary care hospital. We also observed the cycle it predominantly occurs and its prevalence rate in the region. Materials and Methods The study is a prospective observational cohort study conducted in a tertiary care hospital in Coimbatore, Tamil Nadu. The sample size was calculated using RAO software for a study duration of 4 months from 73 patients who were prescribed the inclusion criteria drugs paclitaxel, carboplatin, 5-fluorouracil, doxorubicin, and cyclophosphamide. The complete blood count was obtained and followed up to find myelosuppression occurrence on day 8 of first three cycles. The National Cancer Institute grading system was used to assess the severity of myelosuppression. It was done from May 2022 to August 2022. Chi-squared tests and percentages were adopted by using the SPSS software. Result The result for primary objective is that among the total 73 patients employed, 30 patients were found to be myelosuppressive (41%) and the prevalence rate was 41%. Risk factors such as age, gender, and diagnosis showed statistically significant association (confidence interval: 95% and p -value <0.005). The drugs paclitaxel, carboplatin, 5-fluorouracil, cyclophosphamide, and adriamycin proved to be highly myelosuppressive with a p -value of 0.049. The results for secondary objectives were that cycle 1 was reported to be highly myelosuppressive with 27%. The treatment options that was highly used was granulocyte-colony stimulating factor (90%), followed by packed red blood cell transfusion (7%). Conclusion The incidence of chemotherapy-induced myelosuppression from this study showed that it was important to monitor the complete blood count levels in patients undergoing chemotherapy. Early assessment of risk for developing myelosuppression may prevent or reduce its severity.
{"title":"Prospective Observational Study on the Risk Factors of Chemotherapy-Induced Myelosuppression and Its Management in a Tertiary Care Hospital","authors":"D. Keziah, M. Bindhiya, M. Jayaprakash, Rodrigues A Prudence","doi":"10.1055/s-0043-1770905","DOIUrl":"https://doi.org/10.1055/s-0043-1770905","url":null,"abstract":"Abstract Introduction Myelosuppression is a commonly observed dose-limiting side effect of majority of chemotherapeutic drugs, characterized by a decrease in blood cell production. They cause neutropenia, thrombocytopenia, and anemia and can be life threatening in few susceptible individuals. Attempts to lessen chemotherapy-induced myelosuppression have been minimally effective. Managing myelosuppression has been a challenge to medical practitioners and pharmacist. Identifying their risk factors and the management strategies can help prevent the debilitating effects on chemotherapy patients. Objectives The aim of this study was to determine the risk factors for chemotherapy-induced myelosuppression and identify its management in a tertiary care hospital. We also observed the cycle it predominantly occurs and its prevalence rate in the region. Materials and Methods The study is a prospective observational cohort study conducted in a tertiary care hospital in Coimbatore, Tamil Nadu. The sample size was calculated using RAO software for a study duration of 4 months from 73 patients who were prescribed the inclusion criteria drugs paclitaxel, carboplatin, 5-fluorouracil, doxorubicin, and cyclophosphamide. The complete blood count was obtained and followed up to find myelosuppression occurrence on day 8 of first three cycles. The National Cancer Institute grading system was used to assess the severity of myelosuppression. It was done from May 2022 to August 2022. Chi-squared tests and percentages were adopted by using the SPSS software. Result The result for primary objective is that among the total 73 patients employed, 30 patients were found to be myelosuppressive (41%) and the prevalence rate was 41%. Risk factors such as age, gender, and diagnosis showed statistically significant association (confidence interval: 95% and p -value <0.005). The drugs paclitaxel, carboplatin, 5-fluorouracil, cyclophosphamide, and adriamycin proved to be highly myelosuppressive with a p -value of 0.049. The results for secondary objectives were that cycle 1 was reported to be highly myelosuppressive with 27%. The treatment options that was highly used was granulocyte-colony stimulating factor (90%), followed by packed red blood cell transfusion (7%). Conclusion The incidence of chemotherapy-induced myelosuppression from this study showed that it was important to monitor the complete blood count levels in patients undergoing chemotherapy. Early assessment of risk for developing myelosuppression may prevent or reduce its severity.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46802149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lakshmi Sandhya Singuluri, P. Ganesan, B. Srinivas, B. Dubashi, Y. Nisha
Abstract Superior sulcus tumors, also known as Pancoast tumors, present in a distinctive way with Horner's syndrome (ptosis, miosis, and anhidrosis), hand weakness brought on by the atrophy of the intrinsic hand muscles, and excruciating pain along the medial aspect of the arm. (1) Primary lung cancers constitute a majority of Pancoast tumors, but Pancoast syndrome can be multifactorial. (2) Here, we present a case of 62-year-old male who presented with right shoulder pain and weakness for 2 months. Clinically, he had a supraclavicular mass with atrophy of the intrinsic muscles of the hand and sensory-motor weakness. Computed tomography showed a mass lesion in the supraclavicular fossa with the erosion of the T1 vertebra and first rib, mimicking carcinoma right upper lobe. However, the biopsy from the mass was suggestive of metastasis from hepatocellular carcinoma (HCC). Our case report identifies HCC as a rare differential for Pancoast syndrome and highlights the unique metastatic presentation.
{"title":"Case Report with a Review of Literature: Pancoast Syndrome—A Rare Presentation of Metastatic Hepatocellular Carcinoma","authors":"Lakshmi Sandhya Singuluri, P. Ganesan, B. Srinivas, B. Dubashi, Y. Nisha","doi":"10.1055/s-0043-1769492","DOIUrl":"https://doi.org/10.1055/s-0043-1769492","url":null,"abstract":"Abstract Superior sulcus tumors, also known as Pancoast tumors, present in a distinctive way with Horner's syndrome (ptosis, miosis, and anhidrosis), hand weakness brought on by the atrophy of the intrinsic hand muscles, and excruciating pain along the medial aspect of the arm. (1) Primary lung cancers constitute a majority of Pancoast tumors, but Pancoast syndrome can be multifactorial. (2) Here, we present a case of 62-year-old male who presented with right shoulder pain and weakness for 2 months. Clinically, he had a supraclavicular mass with atrophy of the intrinsic muscles of the hand and sensory-motor weakness. Computed tomography showed a mass lesion in the supraclavicular fossa with the erosion of the T1 vertebra and first rib, mimicking carcinoma right upper lobe. However, the biopsy from the mass was suggestive of metastasis from hepatocellular carcinoma (HCC). Our case report identifies HCC as a rare differential for Pancoast syndrome and highlights the unique metastatic presentation.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48263280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vasundhara Patil, Jeba Nazneen, P. Rai, Ujjwal Agarwal, A. Mahajan
Abstract Melanotic neuroectodermal tumors of infancy are rare pigmented neuroectodermal locally aggressive tumors that usually occur within 1 year of life. Head and neck areas are frequently involved with maxilla being the most common site. Expansile growth and high recurrence rate are characteristics of this cancer. Though rare, radiologists and clinicians must be aware and should consider this entity when diagnosing pediatric head and neck masses. Computed tomography can be used for diagnosing and looking at the extent of the disease and predicting the operative outcome. Surgery with wide resection margin is the mainstay of treatment for these masses. Surgery followed by adjuvant chemotherapy and radiation is reserved for aggressive malignant lesions. Since it has a high recurrence rate, follow-up is done with imaging and clinical examination. Early detection and treatment of recurrence have a favorable outcome for the patients.
{"title":"Melanotic Neuroectodermal Tumor of Infancy: A Case Report with Review of Literature","authors":"Vasundhara Patil, Jeba Nazneen, P. Rai, Ujjwal Agarwal, A. Mahajan","doi":"10.1055/s-0043-1768983","DOIUrl":"https://doi.org/10.1055/s-0043-1768983","url":null,"abstract":"Abstract Melanotic neuroectodermal tumors of infancy are rare pigmented neuroectodermal locally aggressive tumors that usually occur within 1 year of life. Head and neck areas are frequently involved with maxilla being the most common site. Expansile growth and high recurrence rate are characteristics of this cancer. Though rare, radiologists and clinicians must be aware and should consider this entity when diagnosing pediatric head and neck masses. Computed tomography can be used for diagnosing and looking at the extent of the disease and predicting the operative outcome. Surgery with wide resection margin is the mainstay of treatment for these masses. Surgery followed by adjuvant chemotherapy and radiation is reserved for aggressive malignant lesions. Since it has a high recurrence rate, follow-up is done with imaging and clinical examination. Early detection and treatment of recurrence have a favorable outcome for the patients.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57981092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purvish M. Parikh, Dinesh M. Shah, Urvish G. Parikh, A. Venniyoor, G. Babu, Apurva Garg, H. Malhotra
Abstract This review provides an overview about the OpenAI system's natural language chat bot called ChatGPT. It focuses on the preliminary assessment of its unique features, advantages, limitations, role in manuscript writing, value in oncology, and future implications.
{"title":"ChatGPT—Preliminary Overview with Implications for Medicine and Oncology","authors":"Purvish M. Parikh, Dinesh M. Shah, Urvish G. Parikh, A. Venniyoor, G. Babu, Apurva Garg, H. Malhotra","doi":"10.1055/s-0043-1768985","DOIUrl":"https://doi.org/10.1055/s-0043-1768985","url":null,"abstract":"Abstract This review provides an overview about the OpenAI system's natural language chat bot called ChatGPT. It focuses on the preliminary assessment of its unique features, advantages, limitations, role in manuscript writing, value in oncology, and future implications.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"377 - 383"},"PeriodicalIF":0.2,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45658064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Goyal, A. Jajodia, V. Koyyala, A. Bansal, U. Batra, S. Pasricha, S. Puri, Arvind K. Chaturvedi
Abstract Background Diffusion-weighted magnetic resonance imaging (DW-MRI) sequences report the cellularity in tissues and 18-fluorodeoxyglucose (18-FDG) positron emission tomography–computed tomography (PET-CT) provides information on glucose metabolism in cells, associated to tumor aggressiveness. The aim of this study was to assess the correlation between quantitative diffusion-weighted magnetic resonance parameters and maximum standardized uptake value (SUVmax) using 18-FDG PET-CT in lung cancer and metastatic lymph nodes. Methods Histologically proven 29 patients of lung cancers were subjected to 18-FDG PET-CT and DW-MRI (parameters: repetition time/time to echo [TR/TE] = 4,000/76 ms; b -values = 0, 400, and 800 s/mm 2 ) between June 2018 and June 2019. SUVmax was calculated on the PET-CT images representing region of interest (ROI) in the tumor. The apparent diffusion coefficient (ADC) values were quantified by placing an ROI over the tumor at a high b -value of 800 mm 2 /s. Statistical analyses for correlation between SUVmax and ADC were done using Pearson's correlation coefficient ( r ). Results Significant negative correlation was observed between analyses of ADC and SUVmax for primary lesions of all nonsmall-cell lung cancers (NSCLCs; p < 0.05) and its histological subtype adenocarcinoma ( p < 0.05) but not squamous cell carcinomas ( p = 0.35). Significant negative correlation was also observed for metastatic lymph nodes of adenocarcinoma ( p < 0.05) but not for metastatic lymph nodes of all NSCLCs ( p = 0.05) or squamous cell carcinomas ( p = 0.55). Conclusions Diffusion-weighted imaging (DWI) with ADC may represent a new prognostic marker due to a significant negative correlation between ADC determined by DWI and SUVmax by PET-CT in NSCLCs. Furthermore, DWI-MRI of the thorax can be added to routine 18-FDG PET-CT for staging and response assessment in lung cancer in prospects.
{"title":"Correlation of Quantitative Diffusion-Weighted MR Parameters and SUVmax from 18-FDG PET-CT in Lung Cancer: A Prospective Observational Study","authors":"J. Goyal, A. Jajodia, V. Koyyala, A. Bansal, U. Batra, S. Pasricha, S. Puri, Arvind K. Chaturvedi","doi":"10.1055/s-0042-1754392","DOIUrl":"https://doi.org/10.1055/s-0042-1754392","url":null,"abstract":"Abstract Background Diffusion-weighted magnetic resonance imaging (DW-MRI) sequences report the cellularity in tissues and 18-fluorodeoxyglucose (18-FDG) positron emission tomography–computed tomography (PET-CT) provides information on glucose metabolism in cells, associated to tumor aggressiveness. The aim of this study was to assess the correlation between quantitative diffusion-weighted magnetic resonance parameters and maximum standardized uptake value (SUVmax) using 18-FDG PET-CT in lung cancer and metastatic lymph nodes. Methods Histologically proven 29 patients of lung cancers were subjected to 18-FDG PET-CT and DW-MRI (parameters: repetition time/time to echo [TR/TE] = 4,000/76 ms; b -values = 0, 400, and 800 s/mm 2 ) between June 2018 and June 2019. SUVmax was calculated on the PET-CT images representing region of interest (ROI) in the tumor. The apparent diffusion coefficient (ADC) values were quantified by placing an ROI over the tumor at a high b -value of 800 mm 2 /s. Statistical analyses for correlation between SUVmax and ADC were done using Pearson's correlation coefficient ( r ). Results Significant negative correlation was observed between analyses of ADC and SUVmax for primary lesions of all nonsmall-cell lung cancers (NSCLCs; p < 0.05) and its histological subtype adenocarcinoma ( p < 0.05) but not squamous cell carcinomas ( p = 0.35). Significant negative correlation was also observed for metastatic lymph nodes of adenocarcinoma ( p < 0.05) but not for metastatic lymph nodes of all NSCLCs ( p = 0.05) or squamous cell carcinomas ( p = 0.55). Conclusions Diffusion-weighted imaging (DWI) with ADC may represent a new prognostic marker due to a significant negative correlation between ADC determined by DWI and SUVmax by PET-CT in NSCLCs. Furthermore, DWI-MRI of the thorax can be added to routine 18-FDG PET-CT for staging and response assessment in lung cancer in prospects.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"414 - 421"},"PeriodicalIF":0.2,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45328191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract In the elderly, polypharmacy is a common problem, and drug interactions and adverse drug reactions (ADR) have been linked to considerable harm in several population-based studies. However, when compared with other medical disciplines, studies with elderly cancer patients are lacking in oncology and India in particular. Additionally, intake of multiple drugs and, at times, potentially inappropriate medications (PIMs) are also common in older cancer patients. Physiologically, the body's metabolic functions are reduced in the elderly, resulting in altered medication pharmacokinetics and pharmacodynamic characteristics. There is also a high risk of aging-related disorders, and an increase in pharmaceutical use. Because cancer can affect the physiological milieu, patients are more likely to experience negative drug responses, drug–disease interactions, and drug–drug interactions, thereby making the elderly more vulnerable to the ill effects. Considering this, there is a need for greater knowledge and measures that try to lessen exposure to and the risks connected to drug combinations that might be detrimental. As the geriatric population grows, the need to address medical issues among aging cancer patients becomes more pressing, particularly in India. As far as the authors are aware, there is no review that addresses the drug–drug interactions and adverse drug responses brought on by polypharmacy in older cancer patients. It is expected that this endeavor will help the fraternity and the patients, and will serve as a valuable academic material for the health care students.
{"title":"Adverse Drug Reaction Reporting in Geriatric Oncology in India: An Understudied Topic that Needs Attention","authors":"S. Kuriachan, P. Palatty, T. George, M. Baliga","doi":"10.1055/s-0043-1768569","DOIUrl":"https://doi.org/10.1055/s-0043-1768569","url":null,"abstract":"Abstract In the elderly, polypharmacy is a common problem, and drug interactions and adverse drug reactions (ADR) have been linked to considerable harm in several population-based studies. However, when compared with other medical disciplines, studies with elderly cancer patients are lacking in oncology and India in particular. Additionally, intake of multiple drugs and, at times, potentially inappropriate medications (PIMs) are also common in older cancer patients. Physiologically, the body's metabolic functions are reduced in the elderly, resulting in altered medication pharmacokinetics and pharmacodynamic characteristics. There is also a high risk of aging-related disorders, and an increase in pharmaceutical use. Because cancer can affect the physiological milieu, patients are more likely to experience negative drug responses, drug–disease interactions, and drug–drug interactions, thereby making the elderly more vulnerable to the ill effects. Considering this, there is a need for greater knowledge and measures that try to lessen exposure to and the risks connected to drug combinations that might be detrimental. As the geriatric population grows, the need to address medical issues among aging cancer patients becomes more pressing, particularly in India. As far as the authors are aware, there is no review that addresses the drug–drug interactions and adverse drug responses brought on by polypharmacy in older cancer patients. It is expected that this endeavor will help the fraternity and the patients, and will serve as a valuable academic material for the health care students.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"44 1","pages":"384 - 390"},"PeriodicalIF":0.2,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48945981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aroonima Misra, B. Rishi, S. Bajaj, S. Saluja, Ashutosh Kumar Singh
In resource-constraint settings, genetic testing is rarely available for patients. We report the association of SETBP1, a major oncogene of interest in myeloid malignancies, with juvenile myelomonocytic leukemia (JMML) and with GATA 1 mutation. The modulating role of SETBP1 in Rat sarcoma virus (RAS)-driven myeloid malignancies, especiallyJMML, is unknown. In vivo and in vitro studies point to the role of SETBP1 in aggressive leukemogenesis. 1 SETBP1 mutation is not considered the primary event. 2 The association of SETBP1 with RAS and PTPN11, protein tyrosine phosphatase nonreceptor type 11 (PTPN11) confers both self-renewal and oncogenic transformation. The outcome of SETBP1 with confounding mutations like PTPN11 and interlinked path-ways of Mitogen-activated
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