| 1 |
Suggested Algorithms for Allogenic BMT |
1961-11-17 |
Male |
Yes |
672 | To be |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Laboratory |
Avijit Guha, Sarjana Dutt |
Dr (Col) Mahendra Narain Mishra |
Pathkind Diagnostics Pvt. Ltd, National Reference |
Gurugram |
7838101202 |
mahendra.narain@pathkindlabs.com |
Oral |
Title: Suggested Algorithms for Allogenic BMT
Authors: Mahendra Narain Mishra, Avijit K Guha, Sarjana Dutt
Introduction: No consensus guidelines are available for workup of less than fully matched allogenic BMT. There is an urgent requirement to specify guidelines for HLA typing and antibody work up in patients and potential donors for allogenic BMT. In first world countries two different samples are typed and all first degree relatives where available in order to avoid any errors and establish all four haplotypes. Most centres perform 11 locus typing including HLA-ABCDRB1DRB3/4/5DQA1 /DQB1DPA1DPB1. Either sample may be typed for fewer alleles, after which the results are correlated.
Methods: We reviewed the samples processed at our centre for allogenic BMT including HLA typing and antibody work up. A total of eighty samples were received once, only for 6 locus (HLA-ABCDRB1DQB1DPB1) typing by Next generation sequencing (NGS). The parents samples were not sent even if available. Antibody work up varied from CDC crossmatch CDCXM through Luminex (LXM) and Flow crossmatch (FCXM).
Results: As parents' samples were not available , in most cases it was not possible to define the haplotypes. In one case of possible recombination it was confirmed only after typing of all available five siblings. CDXM , LXM and FCXM were negative for all the cases except one. SAB analysis of one patient showed no antibodies against the donor, yet both FCXM and CDCXM were positive . Another patient was positive on Luminex Crossmatch with negative SAB and in another case it was false positive LXM as SAB showed both HLA -Class I and II DSA.
Conclusions: Histocompatibility and Immunogenetics guidelines are required for allogenic BMT recipients and need to include 11 loci typing and antibody work up by Single antigen bead assay with previous reflex pooled bead assay
Key words: SAB assay, Guidelines |
| 2 |
Role of Immunohistochemical markers (CD3, CD4, CD8, TIA-1) in assessing severity of GVHD in biopsies of transplant patients: An interplay of immunity and disease. |
1987-10-27 |
Female |
Yes |
L-1620 | H-LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Laboratory |
Jyotsna Madan, Devajit Nath, Priyanka Singh, Megha Sawhney, Akanksha Bhatia, Nita Radhakrishnan*, Silky Jain*, Anuj Sharma* Department of Pathology and Department of Pediatric Hematology-Oncology *, Postgraduate Institute of Child Health, Noida |
Neema Tiwari |
Post Graduate Institute of Child Health |
Noida |
09140435771 |
nehaneemat@yahoo.co.in |
Poster |
Title: Role of Immunohistochemical markers (CD3, CD4, CD8, TIA-1) in assessing severity of GVHD in biopsies of transplant patients: An interplay of immunity and disease. Authors: Jyotsna Madan, Neema Tiwari, Devajit Nath, Priyanka Singh, Megha Sawhney, Akanksha Bhatia, Nita Radhakrishnan*, Silky Jain*, Anuj Sharma* Introduction:The crucial role of CD4+ and CD8+ T cells in controlling immune responses during immune disease and cancer development has been well established. CD3+CD4-CD8- double-negative T cells are a rare subset of peripheral T cells. Graft versus host disease (GVHD) is an immune-mediated adverse effect of transplants. We discuss here the immunohistochemical and histopathological findings of 5 pediatric cases whose gut and liver biopsies were sent to us, suspecting GVHD. We aim to correlate the histopathological grading (Myersons and Lerner Sale) with the expression of IHC markers CD3, CD4, CD8, and TIA-1 in all these cases. Methods:Case 1: A 10-year-old male presented with persistent diarrhea after undergoing a bone marrow transplant for aplastic anemia. A biopsy(duodenal) was sent to the department of pathology to confirm GVHD vs CMV colitis. Case 2: A 7-year-old male diagnosed as a case of Hyper IgM syndrome underwent colonic biopsy to rule out GVHD vs CMV Colitis. Case 3: A 16-year-old male diagnosed as a case of Aplastic anemia post-transplant underwent liver biopsy to rule out or confirm a suspected GVHD. Case 4: An 8-year-old male suspected of post-transplant (pre-B-ALL) underwent a colonic biopsy to confirm GVHD. Case 5: A 11-year-old male diagnosed as a case of Ph-positive ALL post-transplant Day 81, clinically suspected case of Acute GVHD, underwent (antrum, duodenum) biopsy to confirm a suspected GVHD. IHC done for CMV, CD3, CD4, CD8, and TIA1. Results: Higher expression of lymphocytes with CD3, TIA-1 in cases where the higher Conclusion-Type of immune cells affects severity of GVHD. Key-immune,cells,GVHD |
| 3 |
Impact of cytology and cell block in diagnosing malignant ascitic and pleural effusion in a case of gastric Diffuse Large B-Cell Lymphoma: A rare case report |
1981-04-17 |
Male |
Yes |
L-1778 | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Jeevantika Rana(PG Resident), Ankit Dhaka(PG Resident) |
Kanwaljeet Singh |
Command Hospital Eastern Command (CHEC) Kolkata |
KOLKATA |
09205833486 |
kanwaljeet2009@gmail.com |
Poster |
Title: Impact of cytology and cell block in diagnosing malignant ascitic and pleural effusion in a case of gastric Diffuse Large B-Cell Lymphoma: A rare case report
Authors: Kanwaljeet Singh, Jeevantika Rana, Ankit Dhaka
Introduction: Body fluids involvement such as malignant pleural effusion by the lymphomas is not very common with overall prevalence of 8-18%. Further there is unclear prognosis and prevalence of malignant effusion in lymphoma patients due to various grouping / sub grouping of lymphomas in study population. The aim to present this case report is to highlight the importance of cytology and cell block in such cases.
Methods: We are presenting a rare case report of 50 years old patient who primarily presented with gastric symptoms, further diagnosed as a case of DLBCL (Diffuse large B cell lymphoma) gastric region and later developed ascites and pleural effusion
Results: Ascitic fluid cytology and pleural fluid cytology along with cell block histopathological evaluation and immunohistochemistry showed involvement by DLBCL positive for CD20, CD10 and high Ki67 labelling index.
Conclusions: Timely cytology and cell block evaluation can be cornerstone in prompting the apt diagnosis of lymphomatous effusions in DLBCL so as to improve prognosis in these patients by aggressive treatment protocol.
Key words: DLBCL, lymphomatous effusion, immunohistochemistry, cell block, cytology |
| 4 |
Deceptive Diagnosis: Extramedullary hepatic involvement of Multiple Myeloma with Elevated AFP Mimicking Hepatocellular Carcinoma |
1999-12-31 |
Male |
No |
- | pay_Q |
Malignant |
Plasma cell disorders |
Clinical |
Satyendra Khichar, All India Institute of Medical Sciences, Jodhpur; Gopal Krishana Bohra, All India Institute of Medical Sciences, Jodhpur; Abhishek Purohit, All India Institute of Medical Sciences, Jodhpur; Naman Lodha, All India Institute of Medical Sc |
Rajat Goyal |
All India Institute of Medical Sciences, Jodhpur |
Jodhpur |
+919461031497 |
rajatgoyald31@gmail.com |
Poster |
Title: Deceptive Diagnosis: Extramedullary hepatic involvement of Multiple Myeloma with Elevated AFP Mimicking Hepatocellular Carcinoma
Authors: Rajat Goyal, Satyendra Khichar, Gopal krishana bohra, Abhishek Purohit, Naman Lodha
Introduction: Multiple myeloma is a plasma cell neoplasm comprising approximately 10% of hematologic malignancies. Extramedullary plasmacytomas occur in 7–18% of cases, with hepatic involvement being exceedingly rare. We report a case of MM initially misdiagnosed as hepatocellular carcinoma due to elevated alpha-fetoprotein (AFP) levels and suspicious liver lesions.
Methods: A 67-year-old male presented with generalized body ache and weakness. Investigations revealed anemia (Hb 6.7 g/dL), hypercalcemia (11.98 mg/dL), azotemia and markedly elevated total protein (13.25 g/dL) with hypoalbuminemia. Abdominal ultrasound and MRI revealed multiple liver lesions with hemorrhagic features. AFP levels were raised to 590.8 ng/mL, raising suspicion of hepatocellular carcinoma. A liver biopsy was performed. For High suspicion of Multiple myeloma, SPEP was sent. Bone marrow biopsy was also done.
Results: Serum protein electrophoresis showed an M-spike (6.89 g/dL). Bone marrow biopsy demonstrated 22% plasma cells. The kappa/lambda ratio was significantly elevated at 406.7. Liver biopsy revealed lymphoplasmacytic infiltration without atypia or malignant hepatocytes, ruling out hepatocellular carcinoma and suggesting hepatic plasmacytomas. The patient was started on the VRd regimen (bortezomib, lenalidomide, dexamethasone). After four cycles, MRI showed a significant reduction in lesion size and hemorrhagic features, indicating a favorable response.
Conclusions: This case illustrates an uncommon presentation of Multiple Myeloma with hepatic involvement, mimicking hepatocellular carcinoma both clinically and radiologically. Elevated AFP further confounded the diagnosis. Comprehensive evaluation including immunofixation, marrow studies, and liver biopsy was pivotal in reaching the correct diagnosis. Timely initiation of therapy resulted in clinical improvement. Clinicians should consider Multiple Myeloma in the differential of atypical liver lesions with abnormal protein profiles.
Key words: Multiple myeloma, hepatic plasmacytoma, alpha-fetoprotein, extramedullary involvement, VRd therapy, hepatocellular carcinoma. |
| 5 |
Myths and Beliefs about Hemostasis Testing in Daily Clinical Practice: Let's Unlearn and Relearn! |
1978-09-03 |
Male |
Yes |
L-2267 | pay_Q |
Benign |
Hemeostasis |
Clinical |
|
DR AJAY GANDHI |
BLK-Max Superspeciality Hospitals |
New Delhi |
9826870517 |
drgandhiajay@yahoo.co.in |
Oral |
Introduction:
Hemostasis testing is the cornerstone, not just for bleeding or clotting tendency evaluation but also in perioperative and critical care decision-making. However, clinical practice is often influenced by longstanding myths and misconceptions, leading to suboptimal use of diagnostic tools and therapeutic interventions. This study explores prevalent beliefs surrounding hemostasis testing and evaluates their impact on clinical decision-making.
Methods:
A cross-sectional survey was conducted among clinicians across multiple specialties in all strata and levels of healthcare institutions. The questionnaire assessed perceptions, perspectives, and practices related to conventional coagulation tests (CCTs) and viscoelastic testing (e.g., ROTEM/TEG). Responses were analyzed to identify common misconceptions and their correlation with clinical behaviors.
Results:
Among 315 respondents, 72% believed that normal PT/aPTT reliably excludes coagulopathy, while 54% overestimated the predictive value of platelet count alone in bleeding risk assessment. CT was still being utilized as part of testing (18%) and BT was still being used in a non-standardized manner (81%). Around 36% had beyond routine (PT/aPTT,/Fibrinogen/D-Dimer) testing included in the scope of hemostasis testing. Only 18% routinely used viscoelastic testing, despite 81% acknowledging its superior diagnostic value. Clinical management of Thrombophilia around the diagnostic work-up was conspicuously under-recognised (27%) and A significant proportion (63%) reported transfusing plasma or platelets based on abnormal CCTs without clinical bleeding, reflecting a reliance on outdated thresholds. Misconceptions were more prevalent among non-hematology practitioners.
Conclusions:
The study highlights a persistent gap between evidence-based hemostasis management and clinical practice, driven by myths surrounding conventional tests. Overreliance on PT/aPTT and underutilization of viscoelastic assays contribute to inappropriate transfusion practices and delayed interventions. Educational initiatives and institutional protocols promoting protocolized, goal-directed, guided management are essential to dispel myths and improve patient outcomes.
Key words:
Hemostasis, hemophilia, thrombophilia, viscoelastic testing, coagulation myths, clinical practice, patient blood management, transfusion, PT/aPTT, bleeding risk. |
| 6 |
1st Single case in literature of Novel Treatment of a case of PNH ( Paroxysmal Nocturnal Heamoglobinuria) by oral wheat grass therapy |
1966-05-09 |
Female |
No |
- | H_LKO |
Benign |
Miscellaneous |
Laboratory |
Dr Jyotsana Punj |
Dr Babita Sodhi |
Max Super Speciality hospital |
New Delhi |
9940699490 |
babitasodhi196@gmail.com |
Oral |
Title: Novel Treatment of a Case of PNH (Paroxysmal Nocturnal Haematuria)( Single case in literature) by Oral Wheat Grass Therapy
Authors: Dr. Babita Sodhi (Corresponding Author), ( babitasodhi196@gmail.com) (Senior consultant, Department of Pathology, Max Super Speciality Hospital, New Delhi), Dr. Jyotsna Punj (Contributory Author) (Professor, AIIMS, Department of Anaesthesia, New Delhi)
Introduction: William Osler's famous quote, "Always notice unusual, publish it, place it on permanent record," has motivated the publication of this case report. This report presents the first documented case globally of successful treatment of PNH with oral wheat grass therapy. The patient, now 59 years old, pursued postgraduate education at the age of 40 yrs after successfully passing the entrance exam.
Methods: A 28-year-old educated woman was diagnosed with Paroxysmal Nocturnal Haemoglobinuria at the age of 28. She initiated wheat grass juice therapy on her own three years after diagnosis and has continued the therapy since then. The patient received nine blood transfusions (seven whole blood and two packed cells) in her life time and has not undergone any bone marrow transplantation or monoclonal antibody therapy.
Results: The patient is currently 59 years old, leading a fruitful life. Her latest report shows remission of the gene by flow cytometry.
Conclusion: Dr. Dean Ornish's An American doctor’s remarks that a special type of diet, if taken honestly and religiously, gets incorporated into the DNA of an individual, thus changing the DNA of the recipient. This phenomenon has likely occurred in our case.
Keywords: PNH (Paroxysmal Nocturnal Haemoglobinuria), FCM (Flow Cytometry), PGI CHD (Postgraduate Institute of Medical Education and Research, Chandigarh), AIIMS (All India Institute of Medical Sciences), Pt (Patient), BM (Bone Marrow), BMT (Bone Marrow Transplantation), DVT (Deep Vein Thrombosis), MAB (Monoclonal Antibody), EVM (Eye, Verbal, Motor) |
| 7 |
Essential Thrombocythemia among Patients with Myeloproliferative Neoplasms |
1986-08-30 |
Female |
Yes |
L-1887 | H_LKO |
Benign |
Platelet disorders |
Laboratory |
Dr. Renuka Verma, Dr. Rajnish Kalra, Dr. Veena Gupta, Dr. Sumiti Gupta, Dr. Sunita Singh, Department of Pathology, Pt. B. D. Sharma PGIMS, UHS, Rohtak (Haryana) |
Dr. Renuka Verma |
Pt. B. D. Sharma PGIMS, UHS, Rohtak (Haryana) |
Rohtak |
08295953200 |
renuka138pathology@gmail.com |
Poster |
Title: Essential Thrombocythemia among Patients with Myeloproliferative Neoplasms Authors: Dr. Renuka Verma, Dr. Rajnish Kalra, Dr. Veena Gupta, Dr. Sumiti Gupta, Dr. Sunita Singh Introduction: Essential thrombocythemia is an uncommon clonal myeloproliferative neoplasm characterized by sustained thrombocytosis and marked megakaryocytic hyperplasia. The aim of this study was to find out the prevalence of essential thrombocythemia among myeloproliferative neoplasms (MPNs), to analyze their clinical and hematological parameters, genetic mutations and to do risk stratification. Methods: This prospective observational study was conducted in the Department of Clinical Pathology, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana. All the patients with a diagnosis of essential thrombocythemia and willing to give consent in 3-year duration were included in the study while the patients with incomplete investigations were excluded. Results: Among 110 patients with myeloproliferative neoplasms, the prevalence of essential thrombocythemia was found to be 24 (21.81%). The mean age of patients was 52.20±12.46 years with age range of 32 to 78 years and male to female ratio of 1:1.4. In symptomatic patients, major complaints were generalised weakness (66.67%), headache (45.83%) and pain in abdomen (33.33%). The mean hemoglobin level was 11.10±2.70 g/dl, total leukocyte count was 13158.20±92185.40 cells/mm and platelet count was 845000±372000 cells/mm. Risk stratification was done and majority of the patients, 13 cases (54.17%) were in intermediate risk group, followed by 8 cases (33.33%) in high-risk group and 3 cases (12.50%) in low-risk group. Conclusions: Essential thrombocythemia is uncommon in this region of North-India. Patients were usually symptomatic on presentation indicating delay in seeking medical attention. Platelet counts were high and bone marrow was hypercellular with megakaryocytic proliferation in cases with homozygous JAK2 mutation and these patients also presented with more severe complications. Majority of patients were in high and intermediate risk category indicating aggressive disease course. Keywords: essential thrombocythemia; myeloproliferative neoplasms; hematology |
| 8 |
Genomic landscape of Beta-thalassemia in Indian population- A single centre experience |
1995-07-10 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Clinical |
Ankur Ahuja, Bhasker Mukherjee, Venkatesan Somasundaram, Rajan Kumar, Shreya Solanki, Anurodh Gupta* |
Subhashree Pradhan |
Armed Forces Medical College(AFMC) |
Pune, 411040 |
7978759411 |
subhashreepradhan79@gmail.com |
Poster |
Title: Genomic landscape of Beta-thalassemia in Indian population- A single centre experience
Authors: Subhashree Pradhan, Ankur Ahuja, Bhasker Mukherjee, Venkatesan Somasundaram, Rajan Kumar, Shreya Solanki, Anurodh Gupta*
Introduction: β-Thalassemia is one of the most common hemoglobinopathies belonging to a class of genetic auto-recessive disorders with prevalence of 3-4% in Indian population. It occurs due to mutation in β-globin gene of chromosome 11. The aim of this study was to identify the genomic variants in the β-chain gene causing β-thalassemia in Indian population.
Methods: This study was carried out at Armed Forces Medical College from August-2023 to June-2025. A total of 238 capillary zone electrophoresis confirmed beta-thalassemia cases of both sexes varying in age from 11 months-72 years, were included in this study. Peripheral blood samples were processed for sanger sequencing and data analysis was done using Chromas software. Franklin online tool was used to access the pathogenicity and population frequency of the rare variants.
Results: Out of 238 samples, 63(26.47%) were detected to have homozygous mutations, 153 (64.7%) with heterozygous and 21(8.83%) samples with compound heterozygous variants. 15 different pathogenic genomic variants were found in this study population, out of which 7 variants are very rare in Indian population i.e. HBB:c.79G>T (0.42%), HBB:c.119delA (0.42%), (HBB):c.166delA (0.84%), HBB:c.92+1G>T (0.84%), HBB:c.46delT (0.42%), HBB:c.364G>C (0.42%), HBB:c.92+1G>A (0.42%) with population frequency <0.04%. The most common mutation found was HBB:c.92+5G>C accounted for 67.64% of the study population, followed by HBB:c.79G>A (7.98%), HBB:c.47G>A (7.56%), HBB:c.92G>C(5.46%), HBB:c.126_129delCTTT (5.46%), HBB:c.27_28insG(5.04%), HBB:c.51delC(1.68%), HBB:c.92G>A (1.26%).
Conclusions: Sanger sequencing helped us to identify the common genomic variants along with very rare variants in the Indian population, which is very important for clinical management, prenatal diagnosis and genetic counselling. We identified 8 common mutations along with 7 very rare variants in our study population.
Key words: β-Thalassemia, Sanger sequencing, genomic variants, mutation |
| 9 |
Study Of Clinical And Laboratory Profile Of Vitamin B 12 Deficiency In Tertiary Health Care Centre |
1986-07-01 |
Female |
Yes |
- | pay_Q |
Benign |
|
Clinical |
Swasti Sinha1,Shailendra Prasad Verma1,Anil kumar Tripathi2 P.Raghuveer1,Gaurav Dutta1,Arita Saha1,Rajkumar Maurya1,Akshay1,Neha Shukla3 1Clinical Hematology and BMT, KGMU, Lucknow, U.P 2Hind Institute of Medical sciences ,Barabanki,U.P 3Department of St |
Alpika Shukla |
K.G.M.U |
LUCKNOW |
9453277731 |
alpika872@gmail.com |
Oral |
Title: Study Of Clinical And Laboratory Profile Of Vitamin B 12 Deficiency In Tertiary Health Care Centre
Authors: Alpika Shukla1,Swasti Sinha1,Shailendra Prasad Verma1,Anil kumar Tripathi2,P.Raghuveer1,Gaurav Dutta1,Arita Saha1,Rajkumar Maurya1,Akshay1,Neha Shukla3
1Clinical Hematology and BMT, KGMU, Lucknow, U.P
2Hind Institute of Medical sciences ,Barabanki,U.P
3Department of Statistics,University of Lucknow ,U.P
Introduction: Vitamin B12 deficiency is common in India, especially among young adults, often presenting with vague symptoms that delay diagnosis. Early detection through clinical evaluation and lab tests is crucial to prevent serious complications. This study assesses clinical presentations,hematological profile and investigates key laboratory markers aiding accurate diagnosis of B12 deficiency.
Methods: A cross-sectional study was conducted on 100 patients attending the Clinical Hematology OPD at tertiary health care centre. Patients with serum B12 levels <300 pg/mL were enrolled. Clinical symptoms, hematological profiles, and laboratory markers including methylmalonic acid (MMA), homocysteine (HC), and holotranscobalamin (HoloTC) were assessed.
Results: The majority of patients (61%) were aged 20–40 years, and 69% were male. Anemia was the most common hematological manifestation (58%), followed by bicytopenia (29%) and pancytopenia (13%). Mean Corpuscular volume in severe vitamin B12 deficiency was 111.81 ± 5.09 fL Neurological symptoms were present in 40% of patients, while 62% exhibited neuropsychiatric manifestations, 20 percent patients had gastrointestinal symptoms. Vegetarian diet (34%) followed by alcohol intake (18%) was the most common cause of vitamin B12 deficiency. Holotranscobalmin showed a positive correlation with B12 and was effective in identifying early or subclinical deficiency.
Conclusions: Vitamin B12 deficiency presents with diverse clinical and hematological features, even in younger individuals. Incorporating markers like HoloTC and Methyl Malonic Acid, along with clinical assessment, enhances diagnostic accuracy. A stratified, symptom-based diagnostic approach is recommended to improve early detection and treatment outcomes.
Key words: vitamin B12,homocysteine,methylmalonic acid ,holotranscobalmin
|
| 10 |
Performance Evaluation of a Novel Hemoglobin Analyzer Against a Reference Standard
|
1995-06-26 |
Male |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
Dr. Mudit Sabharwal, Anurag Meena , Pratik Lodha, Shubham Munde |
Nikunj Malpani |
Neodocs Healthcare Pvt Ltd. |
Mumbai |
9833694081 |
nikunj@neodocs.in |
Poster |
Title:Performance Evaluation of a Novel Hemoglobin Analyzer Against a Reference Standard
Authors: Dr. Mudit Sabharwal, Nikunj Malpani, Anurag Meena, Pratik Lodha , Shubham Munde
Introduction:Accurate hemoglobin (Hb) measurement is crucial for diagnosing and managing anemia, particularly in resource-limited settings with limited access to laboratory infrastructure. Point-of-care Hb analyzers offer immediate results, enabling timely clinical decision-making. The present study aims to evaluate the clinical performance and analytical accuracy of a novel mobile phone-based Neodocs (ND) Hb analyzer compared with the HemoCue Hb 301 system in tier-4 populations.
Methods: A cross-sectional study was conducted with 530 participants from a tier-4 city (males, n = 259, females, n = 271), including both children and adults. Capillary blood samples were simultaneously analyzed using ND and HemoCue devices under standardized protocols. Statistical evaluations included Pearson correlation analysis, Bland-Altman plots, bias estimation, and clinical concordance assessment. Subgroup analyses by age and gender were performed to assess systematic variations.
Results:Mean Hb levels measured by Neodocs and HemoCue were 12.04 g/dL and 12.03 g/dL, respectively, indicating a negligible bias of +0.065 g/dL (in favor of Neodocs). A strong linear correlation was observed (r = 0.846, p <0.001). Bland-Altman analysis showed 95% limits of agreement ranging from −2.11 to +2.24 g/dL, with a standard deviation of 1.11 g/dL for the differences.
Conclusions: ND demonstrated a high degree of agreement and strong correlation with the reference device, supporting its use as a reliable tool for point-of-care Hb testing. Neodocs shows promise for widespread anemia screening due to its mobile interface and consistent performance across demographics.
Key words: Haemoglobin, Anaemia, Point-of-care, Neodocs, HemoCue. |
| 11 |
Low Dose Inotuzumab As Single Agent Salvage Regimen In Relapsed/Refractory Adult Acute Lymphoblastic Leukemia |
1979-03-28 |
Male |
Yes |
1220 | pay_Q |
Malignant |
Leukemia & lymphoma |
Clinical |
|
Pawan Kumar Singh |
Yatharth Superspeciality Hospital |
Noida |
9717532903 |
pawan2809@gmail.com |
Oral |
Title: Low Dose Inotuzumab As Single Agent Salvage Regimen In Relapsed/Refractory Adult Acute Lymphoblastic Leukemia Authors: Isha Gambhir, Sachin Jain, Ravi Shankar, Pawan Kumar Singh Introduction: Relapsed/Refractory Acute Lymphoblastic Leukemia has remission rates of 40-50% with conventional chemotherapy regimens. Inotuzumab is having better outcomes with dose of 1.8 mg/m2, however reduced dose may also have similar responses. Aim: To study the efficacy of lower fixed dose single agent Inotuzumab in RR-ALL in terms of remission (CR) and Minimal Residual Disease (MRD) rates. Methods: In this retrospective study of 26 patients were enrolled and the primary outcome was CR and MRD negativity. Results: A total of 26 patients were enrolled, the median age of 32 years (range 19 – 59 yrs) out of which 58% were males. Fifty percent received no, 35% received 1 line and 7.5% recieved >2 lines of salvage therapy each. The Inotuzumab dose administered was 1 mg/m2, 1.2 mg/m2 and 1.8 mg/m2 in 13, 8 and 5 patients, respectively. Baseline characteristics were comparable in 3 groups. The CR, CRi, PR & NR were 69%, 8%, 0% & 3% in 1 mg/m2 arm; 25%, 37%, 25% & 12% in 1.2 mg/m2 and 20%, 60%, 0% & 20% in 1.8 mg/m2, respectively. Similarly the patients who achieved Overall Response (CR plus CRi), the MRD negativity rates were 77%, 100% and 60% in 1 mg, 1.2 mg and 1.8 mg group, respectively. These results show the overall response rates were 77%, 62% & 80% in 1 mg/m2, 1.2 mg/m2 & 1.8 mg/m2, respectively but CRi rates were more in higher dose groups of 1.2 mg/m2 and 1.8 mg/m2 dose probably attributed to high dose. Conclusion: Reduced dose Inotuzumab is cost effective and equally efficacious with higher doses associated with CRi. Key words: Relapsed/Refractory Acute Lymphoblastic Leukemia, Inotuzumab, Minimal Residual Disease |
| 12 |
Effect of hypothermia on prothrombin time (PT) and activated partial thromboplastin time (APTT) testing. |
1997-11-16 |
Female |
No |
- | H_LKO |
Benign |
Hemeostasis |
Laboratory |
Dr. Naveen Kakkar & Dr. Anuj Sharma (Department of Pathology in Maharishi Markandeshwar Medical College and Hospital) |
Mrs. Jyoti Devi |
Maharishi Markandeshwar Medical College and Hospit |
Solan, Himachal Pradesh, India. |
+917015284291 |
jyotidavi52@gmail.com |
Poster |
Title- Effect of hypothermia on prothrombin time (PT) and activated partial thromboplastin time (APTT) testing
Authors- Mrs. Jyoti Devi, Dr. Naveen Kakkar and Dr. Anuj Sharma.
Introduction: Coagulation testing in the laboratory is carried out at 37˚C. However, in-vitro testing may not capture the potential in-vivo functionality of coagulation factors in hypothermic patients. This study explored the effect of hypothermia on PT and APTT.
Methods: This cross-sectional analytical study was done in teaching hospital over an 18 months period. Fifty adult patients were randomly selected from the samples received for PT or APTT. PT and APTT were done by the manual tilt tube method. For PT, Uniplastin 5 (ISI-1.1) and for APTT, Liquicelin-E [Tulip diagnostics] was used. PT and APTT estimation was done at hypothermic temperatures [31˚C, 33˚C and 35˚C] and also at 37˚C. The variation in PT and APTT results among the three hypothermic temperatures and also with the normal temperature was analysed by ANOVA.
Results: The mean age of the 50 patients was 43.0 ± 15.7 years with slight male preponderance (M:F=1.3:1). Mean PT at 31˚C, 33˚C, 35˚C and 37˚C was 16.9 ± 5.3 seconds, 16 ± 4.9 seconds, 15.1 ± 3.9 seconds and 15.2 ± 5.0 seconds respectively. The difference was not statistically significant (p=0.2114). Mean APTT at 31˚C, 33˚C, 35˚C and 37˚C was 37.0 ± 11.8 seconds, 33.5 ± 10.7 seconds, 31.7 ± 10.3 seconds and 30.3 ± 11.5 seconds respectively. The difference was statistically significant (p=<0.0001).
Conclusion: PT did not show significant difference at hypothermic temperatures. APTT showed significant difference at hypothermic temperatures. A deranged APTT in extreme hypothermia may be missed since laboratory testing is routinely done at 37˚C. |
| 13 |
Unveiling the Role of Mitochondria in Venous Thromboembolism
|
1979-09-24 |
Female |
Yes |
- | pay_R |
Benign |
|
Laboratory |
Nilanjana Ghosh, Rashi Khare, Babita Kumari, Swati Srivastava: DIPAS, DRDO |
Iti Garg |
Defence Institute of Physiology and Allied Science |
DELHI |
09555740592 |
itigarg.dipas@gov.in |
Oral |
Title: Unveiling the Role of Mitochondria in Venous Thromboembolism Authors: Iti Garg*, Nilanjana Ghosh, Rashi Khare, Babita Kumari, Swati Srivastava Introduction: Thrombosis, the pathological formation of blood clots within blood vessels, is a major contributor to cardiovascular morbidity and mortality worldwide. Apart from the association of nuclear factor, growing recognition of mitochondrial gene mutations in various cardiovascular diseases has emphasized the importance of mitochondrial gene polymorphisms that connect altered protein functions to disease phenotypes. Methods: Whole Exome Sequencing (WES) was performed. Study participants were categories in (i) Sea Level Thrombosis patients (n=15), High Altitude Thrombosis Patients (n=6) and healthy controls (n=19). Eight variants are associated with four mitochondrially encoded genes-MT-ND3, MT-ND4, MT-CYB and MTCO3 on the basis of p-value<0.05. These eight variants have been registered with eight new accession IDs under ClinVar section of NCBI database. Polyphen-1, Polyphen-2 etc analysis were carried out to find out the nature of the non-synonymous mutation. VarMap was used to observe and study the structural change. Results: Three variants (rs28357684, rs2248727 and rs2853497) of MT-ND3, MT-CO3 and MT-ND4 genes were found to be synonymous in nature, while the variant rs3135031 (MT-CYB) was found to be non-synonymous in HA-VTE against healthy control group. Under SL-VTE against healthy control category, three variants (rs2853513, rs3087742 and rs2853518) were upstream variants in nature, rs3135031 (MT-CYB) was non-synonymous and rs2853495 (MT-ND4) was synonymous in nature. The transmembrane topology depicts that variant rs28357684 (G99G) falls in the outer membrane of the protein, rs2248727 (L112L), rs2853497 (W416W) falls in the inner region of the protein and rs2853495 (G320G) was found to be lying in the α-helix region of the protein. Conclusions: Mitochondrial variants identified in the present study had not been previously linked to Venous Thromboembolism (VTE), offering novel insights into the genetic underpinnings of this condition.
Key Words: Thrombosis |
| 14 |
Genetic Predictors of Venous Thromboembolism Risk in Indian Population |
1981-09-23 |
Female |
No |
- | pay_R |
Benign |
Hemeostasis |
Laboratory |
Babita Kumari (DIPAS, DRDO), Sunanda Arya (DIPAS, DRDO), Iti Garg (DIPAS, DRDO), Prince (DIPAS, DRDO), Rajneesh Kumar Joshi (O/o DGAFMS), Rajiv Kumar (Army R&R hospital, Delhi) , Dharmendra Kumar (HAMRC, Leh) |
Dr. Swati Srivastava |
Defence Institute of Physiology and Allied Science |
Delhi |
09911135437 |
sri_swati@rediffmail.com |
Oral |
Title: Genetic Predictors of Venous Thromboembolism Risk in Indian Population
Authors: Authors: Swati Srivastava*, Babita Kumari, Sunanda Arya, Iti Garg, Prince, Rajneesh Kumar Joshi, Rajiv Kumar, Dharmendra Kumar
Background: Venous-thrombo-embolism (VTE) is a life threatening medical condition caused by both genetic and environmental risk factors. VTE is a result of abnormal alterations in blood flow, resulting in high morbidity and mortality rate.
Methodology: Present study analyze 10 common SNP mutations in 5 coagulation factor genes, previously linked to VTE including rs4524 and rs6025 in Factor 5, rs6046 and rs561241 in Factor 7, rs4149755 and rs6048 in Factor 9, rs3211755 in Factor 10 and rs5982, rs6003 and rs5985 in Factor 13. Study participants included Indian Army personnel and were divided into two groups, (i) VTE patients, n=~89 and (ii) healthy controls (n=~116). Briefly, DNA was extracted from peripheral blood. SNPs were determined using RT-PCR based TaqMan SNP genotyping assays for allelic discrimination. Genotypic and allelic frequencies were determined and compared.
Results: Eight out of 10 SNPs studied showed statistically significant association with VTE. Variants which showed statistically significant change (Fischer’s exact and χ2 p-value <0.05 and Odd’s ratio (OR)>2.0 with 95% CI) in allelic and genotypic frequency amongst VTE included rs4524 in Factor 5 gene, rs6046 and rs561241 in Factor 7 gene, rs4149755 and rs6048 in Factor 9 gene and rs6003 and rs5985 in Factor 13 gene. A risk stratification matrix was created based on allelic frequency and effect size (OR), wherein rs6046 in Factor 7 gene was graded as common-variant with large effect and rs6003 in Factor 13 gene was graded as rare-variant with large effect.
Conclusion: Present study identified eight specific variants in 5 coagulation factor genes to be associated with pathology of VTE. This panel may be used for assessing individual’s risk towards VTE.
|
| 15 |
Fixed Low dose Nivolumab with chemotherapy as an effective salvage for Refractory pediatric Hodgkin Lymphoma |
1991-02-17 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Soma De |
Arnab Chakraborty |
Saroj Gupta Cancer center and research institute, |
Kolkata |
8587847539 |
dr.arnab@outlook.com |
Poster |
Title: Fixed Low dose Nivolumab with chemotherapy as an effective salvage for Refractory pediatric Hodgkin Lymphoma
Introduction: Classical Hodgkin Lymphoma (cHL) is the most common Lymphoma in children and has very good event free and overall survival. Approximately 10% of cHL are refractory. Immune checkpoint inhibitors have shown promising results in children above 12 years, but data in younger children is lacking.
Case Description: We present a case of a 7 years old boy, with cervical nodal mass 8cm x 10 cm x 7cm with anasarca, pancytopenia, hepatosplenomegaly and fever. Histopathology showed Classical Hodgkin Lymphoma. PET CT showed disease both above and below diaphragm, liver, spleen and bone marrow involvement. He was started on ABVD chemotherapy. After 3 cycles of Chemotherapy there was a recurrent swelling at cervical region. PET and Histopathology confirmed local recurrence. Second line chemotherapy with Bendamustine, Gemcitabine and Vinorelbine followed by autologous transplant was planned. After 3 cycles of chemotherapy, the child had severe abdominal pain and fever. PET was done which showed a stage 4 recurrence with liver and bone marrow involvement. Child was started on salvage Nivolumab 40 mg (1.8mg/kg) with Ifosfamide, Carboplatin and Etoposide. After 2 cycles of chemo-immunotherapy, the child achieved complete remission on PET. Clinically child developed vitiligo spots. He was taken up for autologous transplant, but stem cell mobilization was not achieved. A total of 4 doses of Nivolumab (40mg each) was given and allogenic transplant was planned but patient dropped out due to socio-economic reasons. One year after last therapy, we have telephonically enquired that the child is well, but they are unwilling to continue treatment.
Conclusion: Low and fixed dose of Nivolumab with chemotherapy can act as an effective salvage regimen in young children with refractory Hodgkin Lymphoma.
Keywords: Checkpoint inhibitors, refractory Hodgkin lymphoma, children, Nivolumab |
| 16 |
HYPERTRIGLYCERIDEMIA IN PEDIATRIC ONCOLOGY: A CASE SERIES |
1991-02-17 |
Male |
No |
- | pay_R |
Benign |
Infection & supportive care |
Clinical |
Dr. Soma De |
Arnab Chakraborty |
Saroj Gupta cancer center and research institute |
Kolkata |
8587847539 |
dr.arnab@outlook.com |
Poster |
Title: HYPERTRIGLYCERIDEMIA IN PEDIATRIC ONCOLOGY: A CASE SERIES
INTRODUCTION: Hypertriglyceridemia in children with cancer can be multifactorial. Most of the cases reported in literature are drug induced. Suppression of Lipoprotein lipase may lead to hypertriglyceridemia. They may be associated with life threatening complications. Here we present a series of three cases of hypertriglyceridemia, due to diverse etiologies, and their management.
Case 1: Five year old boy with T cell Acute Lymphoblastic Leukemia, received induction as per BFM 2002 protocol, and on day 31 of induction, developed headache, lethargy. While sampling he had milky serum. Serum protein was 17 gm/dl with serum triglyceride (TG) of 7945 mg/dl. Treatment was with Insulin and glucose continuous infusion. Insulin infusion was titrated on blood glucose levels. Post normalization, child was put on Saroglitazaar for 3 months without any complications.
Case 2: A two year old boy with nasopharyngeal mass, bicytopenia and hepatosplenomegaly, was diagnosed with Anaplastic large cell lymphoma, ALK positive, with bone marrow involvement, was also found to have milky serum incidentally on sampling. TG was 789 mg/dl. After adequate hydration, prephase chemotherapy as per ALCL 99 protocol was started. Serum triglyceride levels rapidly normalized after initiation of therapy.
Case 3: 10 year old girl, suffering from osteosarcoma of distal end of femur and received Cispaltin and Doxorubicin. She developed Klebsiella sepsis, leading to a hyperinflammatory syndrome, with fever, jaundice (19.7mg/dl) and hypertriglyceridemia (720 mg/dl). Bone marrow did not show any hemophagocytosis. The child was treated with antibiotics as per sensitivity pattern and Dexamethasone at a dose of 6 mg/m2. Within 48 hours of starting steroids, bilirubin and TG started to normalize. She was also put on Saroglitazaar for 3 months.
Conclusion: Hypertriglyceridemia can be multifactorial. Identifying and treatment of the cause, including initiation of chemotherapy may be beneficial.
Keywords: Hypertriglyceridemia, pediatrics, chemotherapy |
| 17 |
Emerging Disseminated Fungal Infections in Hematological Disorders: Clinical Spectrum, Diagnostic Challenges, and Outcomes from a Tertiary Care Center |
1995-08-28 |
Male |
No |
- | pay_R |
Benign |
Infection & supportive care |
Clinical |
DR.HARSHAL MAMLEKAR , DR.RAJESH KASHYAP , DR. SANJEEV YADAV , DR.MONA VIJAYRAN , DR.SAYAN SINHA ROY , DR.RUCHI GUPTA , DR.KHALIQUR RAHMAN, DR.DINESH CHANDRA , DR.MANISH SINGH , DR.POORVI KAPOOR |
DR.V.BHARATH VIKREM |
SANJAY GANDHI POSTGRADUATE INSTITUTE |
LUCKNOW |
7373059597 |
vbharathvikrem@gmail.com |
Oral |
Title: Emerging Disseminated Fungal Infections in Hematological Disorders: Clinical Spectrum, Diagnostic Challenges, and Outcomes from a Tertiary Care Center
Introduction: Disseminated fungal infections (DFIs) are severe complications in patients with hematological disorders, particularly during periods of intense immunosuppression. Data from low- and middle-income countries remain scarce.
Methods: We retrospectively analyzed 10 patients with hematological disorders diagnosed with DFIs at a tertiary hematology-oncology center between November 2022 and April 2024. DFIs were defined as fungal involvement of ≥2 non-contiguous organs or presence of metastatic lesions, confirmed through clinical, radiological, microbiological, and/or histopathological criteria.
Results: Median age was 24 years (range 4–74); 90% were male. Underlying disorders included acute leukemias (n=5), aplastic anemia (n=2), Langerhans cell histiocytosis (n=1), Waldenström’s macroglobulinemia (n=1), and post-transplant β-thalassemia (n=1). Pulmonary involvement was most common (80%), followed by paranasal sinuses (50%), skin/soft tissue (40%), CNS (30%), bone marrow (20%), adrenal (10%), and hepatosplenic (10%). Pathogens identified were Aspergillus flavus (n=2), Mucorales spp. (n=3), Histoplasma capsulatum (n=2), Fusarium spp. (n=1), Candida auris (n=1), and Candida spp. (n=1). Liposomal amphotericin B was the primary agent in 9/10 cases, with escalation to azoles or echinocandins based on resistance or treatment failure. Surgical debridement was performed in 50% of patients. Mortality was 40%, with mucormycosis and CNS involvement associated with poorer outcomes.
Conclusions: DFIs in hematological patients present with diverse clinical manifestations and carry high mortality, particularly in cases of mucormycosis and CNS dissemination. Early tissue diagnosis, MIC-guided antifungal therapy, and timely surgical intervention are critical for improving survival. This series highlights the emerging role of resistant and uncommon fungal pathogens, underscoring the need for rapid diagnostics, antifungal stewardship, and multidisciplinary care approaches in resource-limited settings.
Key words: Disseminated fungal infections, hematological malignancies, mucormycosis, Aspergillus flavus, Histoplasma capsulatum, Candida auris, antifungal therapy |
| 18 |
Transfusion Dilemma faced by Daratumumab in a Multiple Myeloma patient: A case report |
1988-04-23 |
Female |
No |
- | H_LKO |
Malignant |
Plasma cell disorders |
Laboratory |
Amit Biswas, H Rama, Nandita Hazra |
Hempreet Kaur |
Command Hospital, Central Command |
Lucknow |
7298019651 |
pinnu23@gmail.com |
Poster |
Transfusion Dilemma faced by Daratumumab in a Multiple Myeloma patient: A case report
Hempreet Kaur*, Amit Biswas*, H Rama*, Nandita Hazra* *Department of Lab Sciences & Molecular Diagnostics, #Blood Centre, Command Hospital (Central Command), Lucknow
Background: Daratumumab (DARA), a human anti-CD38 monoclonal antibody, has significantly improved outcomes in relapsed and refractory multiple myeloma (RRMM). However, its use introduces challenges in transfusion medicine by causing panreactivity in serologic testing due to CD38 expression on red blood cells (RBCs), often leading to apparent incompatibility in crossmatching.
Case Report: We reported a case of 59-year-old male with a history of multiple myeloma diagnosed in 2016 and treated initially with a triplet induction regimen followed by autologous stem cell transplant. After relapse in 2023, he was started on a regimen including DARA at our hospital. During follow-up, the patient developed symptomatic anemia requiring transfusion support. Crossmatching performed by column agglutination technique revealed panagglutination, and indirect antiglobulin testing was strongly positive, though direct antiglobulin test and autocontrol were negative.
Intervention: Suspecting DARA interference, we employed a locally feasible and cost-effective method using 2-mercaptoethanol (2-ME) to treat donor PRBCs. This sulfhydryl reagent cleaves CD38 from RBC surfaces, mitigating DARA-related interference without significantly affecting most blood group antigens, except Kell antigens. Therefore, Kell-negative, ABO-compatible units were selected, treated with 2-ME, and crossmatched with patient’s blood sample. Post-treatment, compatibility was achieved and patient was successfully transfused without adverse events.
Conclusion: This case highlights a simple, reproducible, and resource-sparing method to resolve DARA-induced transfusion incompatibility using 2-ME-treated RBCs. With the increasing use of DARA in RRMM, transfusion services must adopt proactive strategies such as pretreatment antibody screening and establish standardized protocols to ensure timely and safe transfusion support. Our experience at this hospital, reinforces the clinical utility and feasibility of 2-ME in routine practice for managing such comple |
| 19 |
IMMUNOLOGIC REVERSAL OF CASTLEMAN DISEASE ASSOCIATED CARDIOMYOPATHY WITH RITUXIMAB: A NOVEL CASE REPORT |
1997-09-18 |
Female |
No |
- | 12345 |
Benign |
Miscellaneous |
Clinical |
Shinto Francis Thekkudan MBBS, MD, DM Hematology |
Greeshma George |
Baby Memorial Hospital Calicut |
Calicut |
+91 9746912485 |
greeshmageorge2021@gmail.com |
Poster |
Title: IMMUNOLOGIC REVERSAL OF CASTLEMAN DISEASE ASSOCIATED CARDIOMYOPATHY WITH RITUXIMAB: A NOVEL CASE REPORT
Introduction: HHV 8, HIV negative idiopathic Multicentric Castleman Disease is a lymphoproliferative disorder characterised by generalised lymphadenopathy. Case Report: This 56-year-old female presented with intermittent low grade fever, abdominal distension along with transfusion dependant anemia for 2 months. On admission she had gross ascitis with generalised bulky lymphadenopathy. Right axillary lymphnode biopsy showed follicles with atrophic germinal centres with Follicular Dendritic cell hyperplasia and hyalinisation with lollipop blood vessels, onion skinning of the mantle zones, and some show twinning of the germinal centres. There was paracortical widening with vascular proliferation and dense infiltrates of mature plasma cells. Immunofixation electrophoresis showed normal pattern with hypergammaglobulinemia. ANA profile showed anti SSA antibody positive. Bone marrow study was normal. HHV 8, HIV, and EBV quantitative PCR were negative. Baseline echocardiogram was normal with ejection fraction (EF) of 69%. On the 20th day of hospital stay, she developed sudden onset breathing difficulty. HRCT Thorax showed features suggestive of acute pulmonary oedema. She required non invasive ventilation , diuretics, morphine, emergency hemodialysis and therapeutic paracentesis. Low dose intravenous hydrocortisone 100 mg 8 hourly was added to the treatment regimen. Echocardiogram showed regional wall motion abnormality and mild LV systolic dysfunction (EF: 46%). Coronary angiogram revealed no flow limiting epicardial coronary disease. Her steroids were tapered to oral prednisolone 1 mg/kg/day. She received IV Rituximab 375mg/m2 weekly for 4 doses along with oral prednisolone after discussing the available treatment options including IL 6 R inhibitor Tocilizumab. After a month steroids were tapered and stopped in 8 weeks. Her ascites and lymphadenopathy completely subsided. Re-evaluation Echo showed fair LV function. (EF: 58%).
Conclusion: This novel case report is intended to consider an autoimmune hypothesis for Castleman disease associated reversible cardiomyopathy |
| 20 |
Unicentric Castleman Disease, Plasma Cell Variant: A Rare Mimicker Presenting as a Mediastinal Mass in a Middle-Aged Male |
1988-11-18 |
Female |
No |
- | H_LKO |
Benign |
Miscellaneous |
Laboratory |
Yashwinder Kumar, Kiran Chowdlu Kalappa, Deepak Mulajker, Nidhi Rathi, Manoj Gopal Madakshira |
Suchandra Banik |
Command Hospital (Eastern Command) |
Kolkata |
9654412333 |
dr.suchandrabanik@gmail.com |
Poster |
Unicentric Castleman Disease, Plasma Cell Variant: A Rare Mimicker Presenting as a Mediastinal Mass in a Middle-Aged Male
Authors: Suchandra Banik, Yashwinder Kumar, Kiran Chowdlu Kalappa, Deepak Mulajker, Nidhi Rathi, Manoj Gopal Madakshira
Introduction
Castleman disease (CD) is a rare lymphoproliferative disorder, typically presenting in either unicentric or multicentric forms. The plasma cell variant, though less frequent, can clinically and radiologically mimic neoplastic processes, especially when arising in the mediastinum. Thorough histopathological, immunohistochemical, and molecular evaluations are essential for diagnosis.
Case Report
A 42-year-old male was incidentally found to have anterior mediastinal mass. Excision biopsy of the mass (9 x 7.5 x 4 cm) revealed conglomerate lymph nodes encased in a thick fibrous capsule and partially preserved architecture, with notable interfollicular plasma cell infiltrates and follicles ranging from hyperplastic to regressed morphology. There was no evidence of atypia, necrosis, or granuloma. Immunophenotyping revealed a preserved follicular dendritic cell meshwork (CD21, CD23), an increase in plasma cells (CD138, MUM1, IgG), and strong vascular proliferation (CD34). Less than 1% of plasma cells were IgG4-positive. Special stains confirmed stromal fibrosis, and EBER in-situ hybridization was negative. The final diagnosis was unicentric CD, plasma cell variant.
Discussion
The case illustrates a classic unicentric plasma cell variant of CD presenting as an anterior mediastinal mass. The detailed immunohistochemical and molecular assessment distinguished it from reactive and neoplastic conditions. CD should be considered in the differential diagnosis of well-encapsulated mediastinal masses, particularly when histology shows polytypic plasma cell proliferation and partially preserved lymph node architecture. Accurate subtyping is crucial for management, as unicentric forms have a favourable prognosis with surgical excision, while multicentric or atypical presentations may require systemic therapy. Exclusion of reactive plasmacytosis and autoimmune conditions through clinical and laboratory correlation remains essential.
Key words: Castleman disease; plasma cell variant; mediastinal mass; unicentric, histopathology
|
| 21 |
Role of Trace Elements in patients with uexplained cytopenias and impact of their correction on cytopenias |
1995-05-04 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
Dr Mukul Aggarwal, Dr Jasmita Das, Depaartment of Hematology AIIMS NEW DELHI |
Dr Kartikey Saini |
AIIMS NEW DELHI |
NEW DELHI |
9799789859 |
Kartikeysaini0405@gmail.com |
Oral |
Title:
Prevalence of Heavy Metal Abnormalities in Unexplained Cytopenias and Low-Risk Myelodysplastic Syndromes: Preliminary Results from a Tertiary Center in North India
Introduction
Heavy metal toxicity and essential metal deficiencies are recognized, but often neglected, contributors to cytopenias and marrow dyspoiesis. Systematic screening for these abnormalities is uncommon in patients with unexplained cytopenias or low-risk myelodysplastic syndromes (MDS).
Methods:
Patients were enrolled upon presentation with cytopenias after confirmed exclusion of common causes, including nutritional deficiencies and systemic disorders. Low-risk MDS diagnosis required characteristic morphologic and laboratory features. Blood concentrations of copper, zinc, lead, cadmium, arsenic, mercury, selenium, vanadium, and cobalt were quantified by inductively coupled plasma mass spectrometry (ICPMS). Appropriate chelation or supplementation was offered for abnormal findings, and patients were followed monthly for hematologic improvement.
Results:
In the ongoing study, of the 79 patients screened, 56 (79%) exhibited at least one treatable metal abnormality. Eight patients have completed more than one month of follow-up and after intervention; four showed hematological response (three complete, one partial remission) with 3 patients receiving copper supplementation and one patient receiving lead chelation.
Conclusions:
Heavy metal abnormalities are highly prevalent in this cohort and can represent a reversible cause of cytopenia or bone marrow dysfunction in a subset of patients. Identifying and correcting these abnormalities through targeted interventions may lead to significant hematologic improvement.
Routine screening for heavy metal exposure should be considered in all patients with unexplained cytopenias before confirming a diagnosis of low-risk myelodysplastic syndrome (MDS). This approach helps avoid misdiagnosis and prevents patients from receiving unnecessary chemotherapy.
Keywords:
Unexplained cytopenia, myelodysplastic syndrome, heavy metals, ICPMS, chelation, supplementation, reversible cytopenia |
| 22 |
Rare of Case of Acquired Hemophilia A with ?Acquired Hemophilia B.
Unusual Lab Findings in case of Acquired Bleeding Disorder |
1995-05-04 |
Male |
No |
- | H_LKO |
Benign |
Hemeostasis |
Clinical |
Dr Mukul Aggarwal, Dr Jasmita Das, Depaartment of Hematology AIIMS NEW DELHI |
Dr Kartikey Saini |
AIIMS NEW DELHI |
NEW DELHI |
9799789859 |
Kartikeysaini0405@gmail.com |
Poster |
Title:
*Acquired Hemophilia A with Record High-Titer Factor VIII Inhibitor (2212 BU/mL) and Factor IX Deficiency*
Introduction:
We report an exceptional case of acquired hemophilia A (AHA) featuring the highest documented factor VIII inhibitor titer (2212 BU/mL) with concomitant factor IX deficiency, challenging current understanding of autoantibody specificity.
Methods:
A 65-year-old hypertensive, diabetic male presented with fatigue and spontaneous hematomas. Evaluation included coagulation studies, factor assays, and inhibitor quantification by Bethesda assay.
Results:
Key findings:
APTT 90 sec (uncorrected)
Factor VIII and IX <1%
Inhibitor titer 2212 BU/mL
Successful hemostasis with rFVIIa
Immunosuppression initiated
Conclusions:
This case demonstrates:
Very high inhibitor titer in AHA
Novel association with factor IX deficiency
Atypical bleeding phenotype
Key words: acquired hemophilia A, factor VIII inhibitor, high titer, factor IX deficiency, Bethesda assay |
| 23 |
DEAP-HUS : Atypical HUS with Antifactor H antibodies and Homozygous CFHR3/CHFR1 deletion |
1993-11-12 |
Male |
Yes |
L-461 | pay_R |
Benign |
Hemeostasis |
Clinical |
Kannan Subramanian , Prachi Hudlikar, Abhinit Deshmukh, Trupti Deshkar, Shashikant Apte, Yash Motwani, Mirang Patel |
Rajat Misal |
Sahyadri Superpeciality Hospital |
Pune |
8850980330 |
rajat.misal@gmail.com |
Poster |
Title: DEAP-HUS – Atypical Hemolytic Uremic Syndrome with Anti-Factor H Antibodies and Homozygous CFHR3/CFHR1 Deletion
Introduction:
Atypical Hemolytic Uremic Syndrome (aHUS) is a rare, life-threatening thrombotic microangiopathy characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal impairment. Unlike typical HUS, it is unrelated to Shiga toxin and is caused by genetic or acquired dysregulation of the alternative complement pathway. DEAP-HUS (Deficiency of CFHR Plasma Proteins and Autoantibody Positive) is a distinct subtype involving both anti-Factor H antibodies and homozygous CFHR3/CFHR1 deletion.
Case Presentation:
A 13-year-old boy, born of a non-consanguineous marriage, presented with facial puffiness, scleral icterus, and oliguria for 4–5 days. There was no history of diarrhea or recent infection. Examination and investigations revealed anemia (Hb 8.7 g/dL), severe thrombocytopenia (40,000/cumm), schistocytes (4–5/OIF), markedly elevated LDH (3109 IU/L), elevated creatinine (11.5 mg/dL), and indirect hyperbilirubinemia. He was initiated on plasmapheresis and hemodialysis. ADAMTS13 activity was normal, while anti-Factor H antibodies were markedly elevated (12,000 AU/mL). Multiplex ligation-dependent probe amplification (MLPA) confirmed homozygous CFHR3/CFHR1 deletion. The patient received Eculizumab (600 mg weekly ×2, then 900 mg weekly ×2) with significant clinical and biochemical improvement and is under regular follow-up.
Discussion:
DEAP-HUS combines acquired and genetic complement pathway abnormalities, often showing suboptimal response to plasmapheresis or immunosuppressants but excellent outcomes with Eculizumab (anti-C5 monoclonal antibody). Early identification of CFHR3/CFHR1 deletion in anti-Factor H antibody-positive aHUS is essential to guide targeted therapy.
Conclusion:
DEAP-HUS is a rare aHUS variant with a worse prognosis if untreated. Prompt recognition and initiation of Eculizumab can lead to favorable outcomes.
Keywords: atypical hemolytic uremic syndrome, DEAP-HUS, anti-Factor H antibody, CFHR3/CFHR1 deletion, Eculizumab, thrombotic microangiopathy. |
| 24 |
Post Allogenic Bone Marrow Transplant Pure Red Cell Aplasia: a non-fatal complication where no intervention is the best intervention. |
1979-03-28 |
Male |
Yes |
1220 | H_LKO |
Benign |
Anemia |
Clinical |
Isha Gambhir, Ravi Shankar |
Pawan Kumar Singh |
Yatharth Superspeciality Hospital |
NOIDA |
9717532903 |
pawan2809@gmail.com |
Oral |
Title: Post Allogenic Bone Marrow Transplant Pure Red Cell Aplasia: a non-fatal complication where no intervention is the best intervention.
Introduction: Allogenic bone marrow transplant can be done with ABO incompatibility, but at the risk of developing Pure Red Cell Aplasia especially. Many treatment options are there, but we wanted to study whether no intervention can be applied for this non-fatal complication.
Methods: One hundred ninety two consecutive patients, who underwent allogenic BMT were enrolled in this study from October 2021 till March 2025.
Results: 192 patients enrolled with a median age 22 years (range 0.5 - 64 years) and 133 (69%) were males. 64 (33%) had ABO incompatibility and of these 36 (56%) major, 23 (36%) minor and 5 (8%) had bidirectional type. Eight patients developed PRCA and all had ABO incompatibility (6 had major), but 1 patient also had Parvovirus infection and it improved with IVIg and supportive therapy. Out of these 7 patients who developed Post BMT PRCA, 3 had Haploidentical, 3 had Matched Sibling Donor and 1 had Matched Unrelated Donor transplant. Non-Myeloablative, Reduced Intensity and Myeloablative conditioning were used in 2, 2 and 3 patients, respectively. Median CD34 dose was 7.17 (range 2.82 – 13.84), median time to neutrophil engraftment was 9 days (range 6 – 12 days) and platelet engraftment was 12 days (range 9 – 18 days). The median day of onset of PRCA was 42 days post BMT (range 24 - 71). The median number of RBC transfusions were 32 (range 15 - 50) and the median time to resolve PRCA spontaneously was 362 days (range 240 - 500).
Conclusions: Post BMT PRCA can very well be managed with just blood transfusions and without targeting therapy at isohemagglutinins, and it resolves spontaneously.
Key words: Post PRCA, BMT, ABO incompatibility |
| 25 |
Pathway-Level Dissection of Pediatric ALL: Rare ABL-Class Fusions, Kinase Signalling Convergence, and New Precision Targets |
1977-05-30 |
Male |
No |
- | Pendi |
Malignant |
Leukemia & lymphoma |
Laboratory |
Shrinidhi Nathany, Rahul Bhargava, Nikhil Kumar, Anusha Swaminathan, Vikas Dua, Sohini Chakraborty, Arun Danewa, Sarsat K Nath |
Swati Bhayana |
Fortis Memorial Research Institute |
Gurugram |
9582026730 |
drswatipho@gmail.com |
Oral |
Title:Pathway-Level Dissection of Pediatric ALL: Rare ABL-Class Fusions, Kinase Signalling Convergence, and New Precision Targets
Introduction:Pediatric acute lymphoblastic leukemia (ALL) is a genetically heterogeneous disease where recurrent fusions and mutations perturb core pathways: transcriptional regulation, lymphoid differentiation, and pro-growth kinase signalling. While high-frequency lesions are well-characterized, rare fusions—particularly ABL-class rearrangements like NUP214::ABL1—remain under-reported in mixed-lineage cohorts, despite clear therapeutic implications.
Methods:Fifty-six consecutive pediatric ALL patients (B-ALL, n=44; T-ALL, n=12) underwent integrative DNA+RNA NGS, with orthogonal validation (FISH/RT-PCR). Variants, fusions, and copy-number alterations were classified per WHO 2022/ICC and assigned to oncogenic pathways (ABL-class kinase, JAK/STAT, RAS/MAPK, PI3K/AKT, epigenetic/transcriptional regulation).
Results:B-ALL subtypes included hyperdiploidy (25%), ETV6::RUNX1 (20.5%), DUX4-rearranged (9.1%), CRLF2-rearranged (13.6%), and ZNF384-rearranged (4.5%). CRLF2 lesions frequently co-occurred with JAK2 or STAT5B mutations, amplifying JAK/STAT signalling. RAS/MAPK activation via NRAS/KRAS (18.2%) appeared alongside transcription factor fusions, suggesting proliferative synergy. IKZF1 deletions (22.7%) enriched for high-risk phenotypes.
T-ALL harbored NOTCH1 mutations (58.3%), FBXW7 (25%), and PTEN loss (16.7%), implicating PI3K pathway activation. ABL-class fusions were enriched in T-lineage: BCR::ABL1 (n=3), NUP214::ABL1 (n=2), and SET::NUP214 (n=1). NUP214::ABL1 cases exhibited high WBC counts, cortical/mature T-phenotype, and HOXA cluster overexpression—consistent with epigenetically-mediated self-renewal. Rare entities included MEF2D::BCL9 and EP300::ZNF384, linking transcriptional deregulation to aberrant kinase signalling.
Conclusions:Approximately one in five pediatric ALL patients carried kinase-activating lesions—ABL-class fusions, CRLF2/JAK mutations, PI3K axis alterations—amenable to targeted inhibitors. The presence of rare ABL-class fusions in both T- and B-lineages underscores the necessity of RNA-based fusion profiling in all pediatric ALL. Biologically, these data support a “dual-axis” model where lineage-defining transcriptional events co-operate with kinase signalling to drive leukemogenesis. Therapeutically, integrating pathway-directed agents into frontline regimens holds promise for expanding cure rates and preventing relapse in biologically high-risk subsets.
Key words: peidatric ALL, kinase fusions, NGS |
| 26 |
Integrative Genomic Profiling of 666 Indian Hematologic Malignancies Reveals Regional Drivers, Molecular Subtypes, and Environmental Signatures |
1998-12-22 |
Male |
No |
- | Pendi |
Malignant |
Leukemia & lymphoma |
Laboratory |
Shrinidhi Nathany, Rahul Bhargava, Nikhil Kumar, Anusha Swaminathan, Vikas Dua, Sohini Chakraborty, Arun Danewa, Sarsat K Nath |
Swarsat K Nath |
Fortis Memorial Research Institute |
Gurugram |
8779395898 |
swarsatkn@gmail.com |
Oral |
Title:Integrative Genomic Profiling of 666 Indian Hematologic Malignancies Reveals Regional Drivers, Molecular Subtypes, and Environmental Signatures
Introduction:Genomic data from low- and middle-income countries (LMICs) are limited, despite their disproportionate hematologic cancer burden. We performed a comprehensive genomic epidemiology of 666 patients with hematologic malignancies across India to identify regional mutation patterns, molecular clusters, and mutational processes.
Methods:Patients underwent NGS with a 75-gene myeloid/lymphoid panel. Regional subgroups (North, South, East, West) were compared for gene-level odds ratios. K-means clustering (k=4, silhouette score 0.74) identified molecular subtypes. COSMIC mutational signatures were reduced to 6-base substitution patterns and compared against the OHSU leukemia cohort.
Results:Among 666 patients (median age 42 years; 62% male), 481 (72.2%) had at least one pathogenic variant. Four molecular clusters emerged: Cluster 0 (n=241): AML-enriched (NPM1, FLT3-ITD, DNMT3A), predominant in East/North India (CBFB::MYH11, KIT). Cluster 1 (n=97): BCR::ABL1-driven (45%), enriched in North/South India (OR 3.87, p=0.001). Cluster 2 (n=228): MDS/MPN with ASXL1, TET2, JAK2, enriched in West/South India (PML::RARA, PTPN11). Cluster 3 (n=98): Cytopenias/rare neoplasms, mutationally quiet, mildly enriched in East India (low TET2, OR 0.29, p=0.041). Mutational signature analysis showed high concordance with the OHSU cohort (94.2% within ±2 SD), but five signatures were significantly enriched: SBS17a (28.3%, z=2.90), SBS17b (11.9%, z=2.38), SBS12 (30.7%, z=2.49), SBS26 (31.3%, z=2.48), SBS21 (33.1%, z=2.20)—linked to oxidative stress, pollution, and mismatch repair deficiency, particularly in Cluster 2. Conclusions:This is the first pan-India genomic study of hematologic malignancies, revealing biologically and geographically distinct clusters and novel environmental mutational signatures. These findings support region-adapted precision hematology and justify a national molecular registry for LMIC settings. |
| 27 |
NGS Versus dPCR for MRD Detection in AML: A Complementary Strategy for Resource-Limited Settings |
1988-10-15 |
Male |
No |
- | Pendi |
Malignant |
Leukemia & lymphoma |
Laboratory |
Rahul Bhargava, Shrinidhi Nathany, Nikhil M Kumar, Anusha Swaminathan, Swarsat KN, Harshu Shrivastava, Rachit Garwal , ANandita Pal, - Fortis Memorial Research Institue, Gurugram |
Haristuti Verma |
Fortis Memorial Research Institute |
Gurugram |
97112 61911 |
haristutvrm007@gmail.com |
Poster |
Title:NGS Versus dPCR for MRD Detection in AML: A Complementary Strategy for Resource-Limited Settings Introduction:Molecular measurable residual disease (MRD) detection is a critical component of post-remission monitoring in acute myeloid leukemia (AML). Digital PCR (dPCR) offers ultra-high sensitivity for defined hotspots at a lower cost but is limited to targeted mutations. Next-generation sequencing (NGS)–based MRD provides broader mutation coverage, detecting both canonical and noncanonical variants, but at higher cost and with lower sensitivity at very low variant allele fractions (VAFs). In resource-constrained countries like India, defining the optimal use of both modalities is essential for precision monitoring. Methods:Thirty AML patients in morphological remission underwent parallel MRD assessment using the QuantStudio™ Absolute Q Digital PCR System and the Oncomine™ Myeloid MRD Assay on the Ion S5™ System (Thermo Fisher Scientific). dPCR assays targeted NPM1 type A, IDH1 R132, and NRAS G12 codons. The NGS assay covered the full coding regions of target genes. Concordance and discordance were analyzed, including mutation spectrum and assay sensitivity as contributing factors. Results:For NPM1 (n=30), 23 (77%) were concordant; seven were NGS-positive/dPCR-negative due to non–type A insertions (types B/D), and two were dPCR-positive/NGS-negative at VAF <0.05%. For IDH1 (n=26), 21 (81%) were concordant; five NGS-positive/dPCR-negative for non-R132 mutations, and one dPCR-positive/NGS-negative at VAF 0.04%. For NRAS (n=12), nine (75%) were concordant; three NGS-positive/dPCR-negative for non-G12 variants, and one dPCR-positive/NGS-negative at VAF 0.03%. Overall, NGS detected 15 MRD-positive cases missed by dPCR due to off-target mutations, while dPCR identified four ultra-low-level positives below NGS sensitivity. Conclusions:NGS-based MRD offers comprehensive mutation surveillance and is essential for baseline mutation discovery. dPCR provides a rapid, sensitive, and cost-effective solution for longitudinal MRD tracking when baseline mutations are known, enabling frequent monitoring without prohibitive costs. A tiered approach—NGS for initial genotyping followed by dPCR for follow-up—maximizes both clinical utility and cost-efficiency |
| 28 |
Genomics-Guided Comparison of Busulfan and Treosulfan Conditioning in Allogeneic HSCT: Insights from an Indian Real-World Cohort |
1986-11-19 |
Female |
No |
- | Pendi |
Malignant |
Leukemia & lymphoma |
Clinical |
Rahul Bhargava, Vikas Dua, Shrinidhi Nathany, Anusha Swaminathan, Neha Panda, Nikhil Kumar, Rachit Agarwal, Hrithik Bagga |
Anandita Pal |
Fortis Memorial Research Institute |
Gurugram |
8811083876 |
aninditapal.dr@gmail.com |
Oral |
Title:Genomics-Guided Comparison of Busulfan and Treosulfan Conditioning in Allogeneic HSCT: Insights from an Indian Real-World Cohort
Introduction:Busulfan (BU) and Treosulfan (Treo) are widely used in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Treo has a favorable toxicity profile and encouraging outcomes in select populations, but its efficacy across genomic subgroups is unclear. With ELN 2022 classification incorporating mutations such as NPM1, FLT3, CEBPA, TP53, ASXL1, RUNX1, IDH1/2, DNMT3A, and KIT, next-generation sequencing (NGS) now enables risk-adapted conditioning analysis.
Methods:We retrospectively studied 100 consecutive allo-HSCT recipients (2018–2025, Fortis Memorial Research Institute, India) who received BU (n=58) or Treo (n=42) with myeloablative or reduced-intensity conditioning. Genomic profiling (50–75 gene myeloid NGS panel) assigned ELN 2022 categories: favorable (NPM1 without FLT3-ITD high AR, bZIP CEBPA, core-binding factor AML), intermediate (IDH1/2, DNMT3A, NRAS/KRAS), and adverse (TP53 multi-hit, RUNX1, ASXL1, FLT3-ITD high AR, complex karyotype). MRD was assessed by flow cytometry and molecular assays.
Results:Mutations included NPM1 (n=15), CEBPA (n=4), CBF AML (n=6; 2 relapsed, both with KIT exon 7 mutations), IDH1/2 (n=9), DNMT3A (n=11), NRAS/KRAS (n=7), TP53 (n=6), ASXL1 (n=9), RUNX1 (n=8), FLT3-ITD high AR (n=5), and complex karyotype (n=7). Over median follow-up of 809 days, relapse occurred in 7 and 25 died. In favorable-risk patients, Treo vs BU yielded HR 0.26 (p=0.108); in adverse-risk, HR 0.55 (p=0.23). Among high/adverse-risk patients, matched sibling donors showed survival advantage (HR 0.41; p=0.07). MRD positivity pre-HSCT increased relapse risk 9-fold (p=0.021); MRD+ with TP53, RUNX1, or FLT3-ITD high AR predicted median OS <12 months.
Conclusions:Treo showed a non-significant trend toward improved OS, especially in favorable/intermediate-risk genotypes. Adverse lesions, notably TP53 multi-hit and FLT3-ITD high AR, conferred poor prognosis regardless of conditioning. MRD status remained the strongest predictor of relapse. These findings support mutation-specific conditioning strategies and post-HSCT targeted maintenance to improve outcomes.
Key words:Conditioning, precision, genomics, treosulfan |
| 29 |
AI–Clinician Concordance in AML Genomic Classification and Therapy Selection: First Multi-Mutational Study from India |
2002-01-01 |
Female |
No |
- | Pendi |
Malignant |
Leukemia & lymphoma |
Clinical |
Rahul Bhargava, Shrinidhi Nathany, Nikhil kumar, Vikas Dua, Dinesh Bhurani, Anusha Swaminathan, Moin, Swarsat K Nath |
Ishita Singh |
Fortis Memorial Research Institute |
Gurugram |
8094673479 |
ishitasingh6647@gmail.com |
Oral |
Title:AI–Clinician Concordance in AML Genomic Classification and Therapy Selection: First Multi-Mutational Study from India Introduction: Acute Myeloid Leukemia (AML) management now relies on integrated cytogenetic–molecular classification to guide risk stratification and therapy. Large Language Models (LLMs) can theoretically interpret complex genomic data and emulate guideline-based decision-making, but their performance against expert, context-rich clinical judgment remains unexplored in Indian AML cohorts. Methods: We analyzed 99 de-identified AML cases (median age 49; range 18–72; 58% male) with complete cytogenetic and targeted NGS profiling. Expert hematologists assigned AML subtype, ELN 2022 risk, and NCCN 2022–based treatment. Identical genomic profiles, without clinical metadata, were processed by three independent LLMs prompted to determine subtype, risk, and treatment. Concordance was assessed via raw agreement and Jaccard similarity scores, with subgroup analysis by mutation class and cytogenetic group Results: Mutations included NPM1 (n=18), FLT3-ITD/TKD (n=14), TP53 (n=11), IDH1/2 (n=9), ASXL1 (n=8), RUNX1 (n=7), and CBF (n=11). Adverse cytogenetics occurred in 28%, complex karyotype in 12%. Subtype concordance was highest for NPM1 (96%), CBF (91%), and FLT3 (88%), and lower for TP53/complex karyotype (73%) and RUNX1 (69%) (median Jaccard 0.84). Risk category agreement was 75% (favorable), 68% (intermediate), and 71% (adverse) (median Jaccard 0.68), with discordances in NPM1+FLT3 and TP53+ASXL1. Treatment concordance was 58% (median Jaccard 0.56), with largest gaps in fitness-based decisions. For fit patients <60 with adverse-risk mutations (n=21), agreement was 81%, vs 42% in unfit patients (n=14). LLMs under-recommended FLT3 inhibitors (64% alignment) and over-recommended intensive induction for TP53-mutated AML, omitting palliative/clinical trial options in 41%. Conclusions:In this first Indian AML multi-mutational AI–clinician concordance study, LLMs excelled in subtype classification and moderately aligned on risk but underperformed in mutation-targeted and fitness-adapted therapy selection. Embedding patient-level context/ molecular therapy triggers into LLM design could transform them into reliable decision-support tools for precision AML care in Asia |
| 30 |
An Open-Access, AI-Driven Framework for Rapid and Affordable Variant Annotation and Clinical Reporting in NGS |
1998-12-22 |
Male |
No |
- | Pendi |
Malignant |
Leukemia & lymphoma |
Laboratory |
Shrinidhi Nathany, Rahul Bhargava, Vikas Dua, Moin, Haristuti, Siddharth Sagar, Harhsu, Srishty SHarma, Hrithik Bagga, Nikhil Kumar, Anusha Swaminathan, Dinesh Bhurani |
Swarsat K Nath |
Fortis Memorial Research Institute |
Gurugram |
8779395898 |
swarsatkn@gmail.com |
Oral |
Title:An Open-Access, AI-Driven Framework for Rapid and Affordable Variant Annotation and Clinical Reporting in NGS Introduction:In low- and middle-income settings, manual next-generation sequencing (NGS) variant interpretation by molecular pathologists is time-intensive and difficult to scale. Commercial software solutions offer automation but remain costly and infrastructure-heavy. To address this gap, we developed a free, Python-based platform that automates variant annotation using public knowledgebases, prioritizes clinically relevant variants for manual review, and integrates large language models (LLMs) with retrieval-augmented generation (RAG) to produce structured, clinician-ready reports. Methods:We evaluated 31,102 real-world variants—13,899 single-nucleotide variants (SNVs), 1,370 multi-nucleotide variants (MNVs), 5,424 indels, and 10,409 gene fusions. The platform normalizes multiallelic variants to HGVS-like notation, then queries MyVariant and ClinVar, enriched with SIFT, CADD, m-CAP, COSMIC, and CIViC annotations. Additional literature evidence is gathered through targeted web-scraping. LLM-assisted reporting integrates OncoKB, Jackson Labs, and ClinVar-derived insights into standardized sections covering gene biology, mutation epidemiology, pathogenicity assessment, therapeutic relevance, and final diagnostic summary. Results:Annotation and report generation time per case was reduced by 68% compared with manual workflows (mean 12–24 hours vs. 11–26 minutes). Concordance with expert annotation was 93.2% for SNVs, 82.6% for indels, 70.2% for MNVs, and 54.1% for fusions, with fusion discordance primarily reflecting incomplete public database entries. Manual transcription errors occurred in 4.3% of conventional workflows, versus 7.9% misclassification rates in AI-assisted runs. LLM-generated reports required only minor edits in 79% of cases (median edit time <3 minutes), and in 12% were approved without any modifications. Conclusions:This AI-augmented, open-access tool provides a low-cost, high-efficiency alternative to commercial variant interpretation platforms. By combining automated annotation, variant prioritization, and structured evidence-based reporting, it significantly reduces turnaround time and human error, making precision NGS interpretation more accessible in resource-limited healthcare systems. Ongoing development will expand knowledgebase coverage and improve fusion interpretation accuracy
Key words:Variant Annotation |
| 31 |
ThalSaarthi: A Privacy-Secure, Retrieval-Augmented AI System for Automated Hemoglobinopathy Diagnosis in India |
2004-10-11 |
Male |
No |
- | Pendi |
Benign |
Anemia |
Laboratory |
Rahul Bhargava Vikas Dua Swarsat Nath Shirnidhi Nathany Nikhil Kumar Anusha Swaminathan |
Moin Makda |
Fortis Memorial Research Institute |
Gurugram |
9015166070 |
moinmakda1@gmail.com |
Oral |
Title:ThalSaarthi: A Privacy-Secure, Retrieval-Augmented AI System for Automated Hemoglobinopathy Diagnosis in India
Introduction:India carries the world’s highest hemoglobinopathy burden, with over 42 million carriers and 10,000–15,000 new thalassemia major births annually. In many tier-2 and tier-3 cities, expert interpretation of CBC and HPLC profiles remains scarce, causing delays, misdiagnoses, and missed opportunities for prevention. Conventional diagnosis requires nuanced analysis, often unavailable outside specialized centers.Objective:
To design and validate ThalSaarthi, an AI-enabled, offline, retrieval-augmented framework that delivers accurate, scalable hemoglobinopathy interpretation tailored to the Indian healthcare context.
Methods:The system integrates a two-stage approach:
Rule-based engine using established thresholds (e.g., HbA2 >3.5% for β-thalassemia trait, HbF >10% for sickle cell disorders).
Retrieval-Augmented Generation (RAG) module built on locally hosted large language models enhanced with a curated knowledge base (>3,000 peer-reviewed references and 1,250 annotated edge cases validated by hematologists).
Validation involved 10,000 anonymized CBC + HPLC reports from 27 centers across 11 states. Gold-standard diagnoses were derived via double-blinded expert consensus.
Results:Overall accuracy was 95.5% (sensitivity 97.2%, specificity 94.1%, PPV 93.8%, NPV 97.5%). Subtype-specific accuracy: β-thalassemia trait 96.8% (n=4,320), HbE trait 94.6% (n=1,240), sickle cell trait 95.2% (n=2,070), and complex/borderline cases 91.3% (n=1,185). The RAG module resolved 87.5% of edge cases misclassified or inconclusive via rules alone, especially distinguishing β-thalassemia trait from iron deficiency anemia in borderline HbA2 (3.3–3.6%) and detecting HbD/HbS variants with atypical retention times.
Processing time per case was <4 seconds with zero data leakage risk due to fully offline deployment, ensuring compliance with India’s Digital Personal Data Protection Act (2023).
Conclusions: ThalSaarthi is the first offline, retrieval-augmented AI system for automated hemoglobinopathy screening in India. It delivers high diagnostic precision, resolves challenging cases without specialist input, and enables equitable, privacy-preserving screening—supporting nationwide genetic counseling and prevention strategies.
Key words: Thalassemia, AI, HPLC, Reporting |
| 32 |
Inflammatory Transcriptomic Signature Predicts Poor Outcomes in Indian Acute Myeloid Leukemia: Insights from Immune Profiling with the Oncomine Assay |
1987-12-24 |
Male |
No |
- | Pendi |
Malignant |
Leukemia & lymphoma |
Laboratory |
Shrinidhi Nathany Rahul Bhargava Vikas Dua Haristuti Verm Hrshu SHrivastava, Bhupendra Singh Vikas Dua, Dinesh Bhurani, Nikhil Kumar Anusha Swaminathan |
Siddharth Sagar |
Fortis Healthcare |
Gurugram |
9008814520 |
sagarsiddharth@gmail.com |
Oral |
Title:Inflammatory Transcriptomic Signature Predicts Poor Outcomes in Indian Acute Myeloid Leukemia: Insights from Immune Profiling with the Oncomine Assay
Introduction:Inflammatory gene expression signatures have recently emerged as independent prognostic markers in acute myeloid leukemia (AML), particularly among patients of African ancestry. However, data from Indian populations—a demographically and genomically distinct cohort—are lacking. We hypothesized that Indian AML patients demonstrate a high prevalence of inflammation-associated transcriptomic profiles, with potential impact on clinical outcomes.
Methods:We analyzed 32 newly diagnosed adult AML cases of Indian origin using the Oncomine™ Immune Response Research Assay (Thermo Fisher Scientific), a 395-gene RNA panel. Sequencing was performed on the Ion S5 Plus platform with Ion Chef automation. Normalized gene expression data were used to calculate an inflammation score (iScore) adapted from Lasry et al. (Nature Cancer, 2023). Patients were stratified into “High” and “Low” inflammation groups using k-means clustering and reference medians. Clinical outcomes including complete remission (CR) and 1-year overall survival (OS) were analyzed and adjusted for ELN 2022 risk and age.
Results:Unsupervised clustering segregated patients into equal High and Low inflammatory clusters. Core binding factor (CBF) and myelodysplasia-related AMLs showed the highest median iScores, while NPM1-mutated AML had the lowest. Geographic variation was evident, with higher iScores in southern Indian patients. High-iScore patients had lower CR rates (68% vs. 90%) and inferior 1-year OS (50% vs. 85%; log-rank P<0.01). Multivariable Cox regression confirmed iScore as an independent prognostic factor
Conclusions:Indian AML patients show a predominance of high inflammatory transcriptomic profiles associated with adverse outcomes—even among ELN-favorable subtypes. These findings support the incorporation of immune gene expression profiling in AML risk models and suggest that iScore-guided immunomodulation strategies (e.g., corticosteroids or anti-cytokine agents) merit evaluation in high-risk patients.
Key words:Inflammation, AML, Transcriptome |
| 33 |
From PCR to Precision: Transforming AML Diagnostics in an LMIC Through Rapid In-House NGS |
1994-05-12 |
Male |
No |
- | Pendi |
Malignant |
Leukemia & lymphoma |
Laboratory |
Shrinidhi Nathany Rahul Bhargava Vikas Dua Siddharth Sagar Nikhil Kumar ANusha Swaminathan Swarsat Haristuti Harshu Bhuipendra Moin |
Rachit D Agarwal |
Fortis Memorial Research Institute |
Gurugram |
94277 98356 |
dickey120594@gmail.com |
Oral |
Title: From PCR to Precision: Transforming AML Diagnostics in an LMIC Through Rapid In-House NGS
Introduction:Precision oncology in acute myeloid leukemia (AML) hinges on rapid and comprehensive molecular profiling. However, in many low- and middle-income countries (LMICs), including India, molecular diagnostics have historically relied on single-gene PCR assays due to cost, infrastructure, and turnaround time limitations. We report the successful clinical implementation of a fully automated, sample-to-report NGS workflow for myeloid neoplasms at a tertiary care center in India.
Methods:From June 2024 to July 2025, we prospectively analyzed 600 bone marrow samples using the Oncomine™ Myeloid GX v2 panel on the Ion Torrent™ Genexus™ system. DNA and RNA were co-extracted, and samples underwent single-day library prep, templating, sequencing, and automated analysis. QC metrics, turnaround times (TAT), variant classification (per AMP/ASCO/CAP guidelines), and failure rates were monitored. Data were compared with published AML genomic datasets including TCGA and prior Indian cohorts.
Results:Of 600 samples, 360 were AML, 180 MPN, and 60 MDS or MDS/MPN. The assay demonstrated a success rate of 99.7%, with only two sample failures and zero bioinformatic QC failures. Mean TAT was 54 hours (range 49–72), enabling real-time treatment decisions. Compared to Western cohorts, Indian AML cases showed higher frequencies of TP53, ASXL1, and CHIP-associated mutations such as DNMT3A and TET2. Rare fusions like NUP214::ABL1 and PICALM::MLLT10 were detected, with implications for targeted therapy. This implementation eliminated the need for redundant single-gene PCR testing, reducing costs and time to diagnosis
Conclusions:We demonstrate the feasibility, robustness, and clinical utility of rapid NGS-based myeloid profiling in a real-world Indian hospital setting. Our findings lay the foundation for democratizing precision hematology in LMICs and establishing genomics-first protocols for AML care.
Key words:rapid NGS India AML |
| 34 |
Acquired Factor V Inhibitors - Whether to Treat or Be Masterly Inactive? |
1996-10-15 |
Male |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
Chandrachud Potdar1, Mona Vijayaran1, Dinesh Chandra1, Ruchi Gupta1, V. Bharath Vikrem1, Sakshi Tripathi1, Aishwarya Muralidharan1, Manish Kumar Singh1, Khaliqur Rahman1, Sanjeev Yadav1, Sayan Sinha Roy1, Rajesh Kashyap1 1Department of Clinical Hematolog |
Chandrachud Potdar |
Sanjay Gandhi Institute of Medical Sciences, Luckn |
Lucknow |
7506745279 |
chandrachudnpotdar@gmail.com |
Poster |
Title
Acquired Factor V Inhibitor-Whether to Treat or Be Masterly Inactive?
Authors/Affiliations
Chandrachud Potdar1, Mona Vijayaran1, Dinesh Chandra1, Ruchi Gupta1, V. Bharath Vikrem1, Sakshi Tripathi1, Aishwarya Muralidharan1, Manish Kumar Singh1, Khaliqur Rahman1, Sanjeev Yadav1, Sayan Sinha Roy1, Rajesh Kashyap1
1Department of Clinical Hematology, Sanjay Gandhi Institute of Medical Sciences, Lucknow, India.
Introduction
Acquired Factor-V (FV) inhibitors are rare autoantibodies neutralizing FV with an incidence of ~0.09/million person-years. They are often triggered by drugs, infections, malignancy, autoimmunity, or idiopathic. Clinically, asymptomatic coagulopathy to life-threatening bleeding. Management varies from supportive care to immunosuppression.
Methods
We report 2 patients with deranged coagulation parameters who ultimately diagnosed to have acquired factor inhibitors.
Results
Case-1
A 69-year-old hypertensive female developed hematuria 25 days after ceftriaxone for diarrhea. Labs: PT 56.2s, APTT >140s, FV activity 0.1% with inhibitor 22.4BU, no mixing correction; mild reduction in II, VIII, X. ANA 2+, IgG-κ MGUS. Managed with Ethamsylate, and platelet transfusions; immunosuppression deferred (frailty, ECOG 3). Hematuria resolved by 4 months, coagulation normalized spontaneously.
Case-2
56-year-old woman, with dilated cardiomyopathy, was incidentally found to have prolonged PT (41.9s) and APTT (128s) during workup for pacemaker implantation. Mixing study showed no correction; factor assays revealed FV activity 2% with inhibitor titre 258 BU, and transient lupus-like effects on multiple factors. No bleeding history. Workup for secondary causes was negative. She received oral methylprednisolone without improvement, followed by four weekly rituximab doses, leading to complete normalization of coagulation profile and uneventful pacemaker insertion.
Conclusion
These cases illustrate distinct management strategies—masterly inactivity in a frail patient with bleeding versus active eradication in a procedural candidate. High-titer inhibitors do not always predict bleeding severity. Acquired FV inhibitors demand individualized therapy; supportive monitoring may suffice in elderly, while use immunosuppression, when intervention is planned.
Keywords
Factor V inhibitor; Ceftriaxone; MGUS; Hematuria; Intervention; Immuno-suppression.
|
| 35 |
Plerixafor and G-CSF-Primed High-Dose Cytarabine–Idarubicin Salvage With or Without Venetoclax as a Bridge to Allogeneic Hematopoietic Cell Transplantation in Relapsed/Refractory Acute Leukemia: Single-Center Experience |
1996-10-15 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Chandrachud Potdar1, Sayan Sinha Roy1, Sakshi Tripathi1, Prisha Nankana1, V. Bharath Vikrem1, Manish Kumar Singh1, Dinesh Chandra1, Khaliqur Rahman1, Mona Vijayaran1, Sanjeev Yadav1, Ruchi Gupta1, Rajesh Kashyap1 1Department of Clinical Hematology, Sanja |
Chandrachud Potdar |
Sanjay Gandhi Institute of Medical Sciences, Luckn |
Lucknow |
7506745279 |
chandrachudnpotdar@gmail.com |
Oral |
Title
Plerixafor and G-CSF-Primed High-Dose Cytarabine–Idarubicin Salvage With or Without Venetoclax as a Bridge to Allogeneic Hematopoietic Cell Transplantation in Relapsed/Refractory Acute Leukemia: Single-Center Experience
Authors and affiliations
Chandrachud Potdar1, Sayan Sinha Roy1, Sakshi Tripathi1, Prisha Nankana1, V. Bharath Vikrem1, Manish Kumar Singh1, Dinesh Chandra1, Khaliqur Rahman1, Mona Vijayaran1, Sanjeev Yadav1, Ruchi Gupta1, Rajesh Kashyap1
1Department of Clinical Hematology, Sanjay Gandhi Institute of Medical Sciences, Lucknow, India.
Introduction
Relapsed/refractory acute leukemias have dismal salvage outcomes due to chemo-resistant leukemic stem cells (LSCs) in marrow niches. Plerixafor mobilizes LSCs by disrupting CXCR4–CXCL12 interactions, while G-CSF drives quiescent blasts into cycle, enhancing cytarabine efficacy. Data on combined use are limited.
Patients and Methods
Eight consecutive patients (median age 27.5 y; range 6–60) with R/R acute leukemia were treated between Oct-2024 and Jun-2025: AML (n=4), AMKL (n=1), pediatric MDS (n=1), T-MPAL (n=1), ETP-ALL (n=1). Six had high-risk molecular/cytogenetic lesions (TP53, KMT2A, ASXL1, GATA2). Median baseline TLC before plerixafor was 4,075/µL. All received plerixafor 240 µg/kg SC 10 hours before 1st dose of cytarabine, G-CSF starting from D1 till count recovery, high-dose cytarabine(1.5–3 g/m²/day, D1–5) + idarubicin(6–12 mg/m²/day, D3–5). Four received venetoclax 100 mg/day×5d. Complete remission(CR) = Morphological recovery(MR) with ANC ≥1000/µL and platelets ≥100,000/µL; CRi = MR with incomplete recovery.
Results
All achieved MR(CR n=4; CRi n=4). MRD negativity: 5/8(62.5%). All developed Grade-4 febrile neutropenia; fungal pneumonia in 2. No mucositis or induction deaths occurred. Median day of ANC recovery: 29 d (24–51); platelets: 34 d (26–65). Three (37.5%) proceeded to allo-HCT; 2 remain in remission (4 and 8 months), 1 died from early HCT complications.
Conclusion
This dual mobilization approach achieved universal remission, high MRD negativity, and enabled HCT bridging without any induction mortality in a high-risk cohort.
Keywords
Leukemia, plerixafor, G-CSF, cytarabine, idarubicin, venetoclax, MRD, salvage, transplantation.
|
| 36 |
BONE MARROW HISTOPATHOLOGY IN VITAMIN D DEFICIENT CHILDREN: INSIGHTS FROM A TERTIARY CARE EXPERIENCE |
1987-09-04 |
Female |
Yes |
L-2297 | pay_R |
Benign |
Miscellaneous |
Laboratory |
Dr. Jyotsna Madan, Dr. Savitri Singh, Dr. Neema Tiwari, Dr. Megha Sahwney, Dr. Devajit Nath, Dr. Akansha Bhatia, *Dr. DK Singh, ** Dr. Nita Radhakrishnan Department of Pathology, Department of *Pediatrics and Department of **Pediatric Hematooncology |
Priyanka Singh |
PGICH, Noida |
NOIDA |
8887784916 |
dr.singh1907@gmail.com |
Poster |
Title: BONE MARROW HISTOPATHOLOGY IN VITAMIN D DEFICIENT CHILDREN: INSIGHTS FROM A TERTIARY CARE EXPERIENCE
Introduction: Nutritional rickets remains common among children in developing countries. Vitamin D deficiency can lead to impaired bone metabolism and altered bone marrow architecture. Bone marrow biopsies in such patients frequently demonstrate features of myelofibrosis, marked by fibrotic scarring and disrupted marrow cellularity. The aim of the study is to evaluate histopathological features in bone marrow biopsies of pediatric patients with confirmed vitamin D deficiency.
Methods:A retrospective study was conducted at PGICH, Noida over 10 months (August 2024–May 2025), including 10 pediatric patients with biochemical evidence of vitamin D deficiency. Clinical and histopathological parameters analysed included hemoglobin, total leukocyte count and platelet count, dry tap, marrow cellularity, stromal congestion, edema, necrosis, and fibrosis. Fibrosis grading was performed using reticulin stain.
Results: Patient ages ranged from 18 months to 19 years (mean: 9.3 years). Anemia was the most common presentation; most patients had pancytopenia. Hypocellular marrow was seen in 50% of cases. Fibrosis was the predominant histopathological finding, observed in 80% of cases—primarily paratrabecular. Stromal edema, congestion, and increased monocyte/macrophage activity were noted in 50%, and necrosis in 40% of cases. One patient was later diagnosed with Ghosal hematodiaphyseal dysplasia based on molecular studies.
Conclusions: Vitamin D deficiency may underlie reversible secondary myelofibrosis in children. Greater clinical awareness can help avoid unnecessary investigations. Early identification and appropriate vitamin D therapy can reverse marrow changes and improve outcomes.
Key words: : Vitamin D deficiency, myelofibrosis, nutritional rickets, pediatric patients, bone marrowbiopsy, pancytopenia |
| 37 |
DKMS Access to Transplantation (ATT) Program: Giving Hope for a Healthy Future |
1978-01-19 |
Female |
No |
- | H_LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
K Jothi, Sanjana Dontula, Nitin Agarwal, Patrick Paul, Regina Landwehr |
Reshma Kumari MV |
DKMS Foundation India |
Bengaluru |
+919019963482 |
reshma.kumari@dkms-india.org |
Poster |
Title: DKMS Access to Transplantation (ATT) Program: Giving Hope for a Healthy Future Introduction: Healthcare in India remains challenged by affordability, accessibility and availability. Several NGOs seek to address these challenges and help the patients find relief and improve the relevant clinical outcome. DKMS’s Access to Transplantation (ATT) program is designed to bring value to patients with blood cancer and blood disorders by removing barriers to access hematopoietic stem cell transplantation (HSCT) in resource-limited settings, particularly low- and middle-income countries (LMICs). Methods: In India, the DKMS Thalassemia Program India and the DKMS Patient Funding Program India seek to facilitate access to transplantation for patients in need, by • Providing free high-resolution HLA typing for thalassemia patients, their siblings and parents. • Raising awareness on HSCT and free searches for unrelated donors when no family match is found. • Guidance on treatment options and financial aid, with support for underprivileged patients through the Patient Funding Program to help transplant costs. Results: Impact of Access to Transplant (ATT) program in India from 2021-2025 (Q2): • DKMS Thalassemia program India in collaboration with 16 partner organizations, provided 29,553 free HLA typings, leading to 1972 perfect family matches. 650 patients received an HSCT till June 2025. • DKMS Patient Funding Program India received 588 (Till June 2025) applications from 42 transplant centers. Funding was confirmed for 504 patients (86%), who required a transplantation as a potential cure. Among these, 196 patients were diagnosed with blood cancer and 308 with blood disorders. Conclusions: In India, DKMS ATT programs have enabled • Access to life-saving transplants by providing free high-resolution HLA typing for thalassemia patients and their family members. • Supporting HSCT treatment costs for blood cancer and other blood disorders. • The patients in India to reduce their socioeconomic barriers, through this program. |
| 38 |
THE MORPHOLOGICAL TRAP: A CASE REPORT OF MEGALOBLASTIC ANEMIA MASKING ACUTE LEUKEMIA |
1986-11-03 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Akanksha Bhatia, Dr. Jyotsna Madan, Dr. Neema Tiwari, Dr. Devajit Nath, Dr. Priyanka Singh Affiliation: Department of Pathology, Post Graduate Institute of Child Health, Noida. |
Dr. Megha Sawhney |
Post Graduate Institute of Child Health, Noida |
Noida |
7206191047 |
drmegharalli@gmail.com |
Poster |
Title:THE MORPHOLOGICAL TRAP: A CASE REPORT OF MEGALOBLASTIC ANEMIA MASKING ACUTE LEUKEMIA
Introduction: The incidence of acute lymphoblastic leukemia is 4.3 per 100,000 in the pediatric age group. The most common initial presentation includes fatigue or fever with or without organomegaly, which may at times mimic nutritional anemia especially megaloblastic anemia. A complete blood count may reveal pancytopenia in both scenarios. The presence of blasts in the peripheral smear or bone marrow confirms the diagnosis of acute leukemia. Therefore, in cases with low blast counts in peripheral smear and morphological features similar to megaloblasts in bone marrow aspirate/biopsy, immunohistochemistry (IHC) and flow cytometry become important for diagnosis. We present a case diagnosed as megaloblastic anemia that presented as frank acute leukemia within two months.
Case Report:A 12-year-old boy initially presented with fever and fatigue for 15 days without any organomegaly. Complete blood count (pancytopenia), peripheral smear, and bone marrow examination showed megaloblastic erythroid hyperplasia, and the patient was started on vitamin B12 and folic acid supplements. Despite initial clinical improvement, the patient developed hepatosplenomegaly 2 months later. Repeat investigations revealed 80% blasts with total leukocyte count of 60,000/cmm, and disgnosed as acute lymphoblastic leukemia (ALL) on peripheral smear and flow cytometry. Retrospective evaluation of Tdt IHC on initial marrow biopsy showed 8-10% blasts in interstitial areas.
Discussion: This case underscores the diagnostic difficulties in distinguishing megaloblastic anemia from early leukemias and highlights the need for careful follow-up in atypical cases. There are case reports published showing cases with megaloblastic anemia, pernicious anemia, or autoimmune hemolytic anemia coexisting in cases of acute leukemia. The incidence of megaloblastic anemia and leukemia is rare. Cases presenting with low blast percentage, ancillary workup with simple and easily available technique like IHC should be done to differentiate megaloblasts from leukemic blasts.
Keywords: Acute leukemia, Megaloblastic |
| 39 |
Hyper-reactive malarial splenomegaly syndrome -A case series posing a diagnostic enigma. |
1989-05-09 |
Female |
No |
- | H_LK |
Benign |
Infection & supportive care |
Clinical |
Utkarsh Bansal, Professor and head department of pediatrics, Hind Institute of medical sciences, A.K Tripathi, Professor, Department of Medicine, Hind Institute of Medical sciences.f. |
Nivedita Prabhakar Yerramilli |
Hind Institute of Medical Sciences |
Lucknow |
08867142889 |
niveditaprabhakar@gmail.com |
Oral |
Title: Hyper-reactive malarial splenomegaly syndrome -A case series posing a diagnostic enigma.
Introduction: Malaria is an endemic disease in our country and important cause for massive splenomegaly, known as hyper-reactive malarial splenomegaly syndrome (HMSS). This enigmatic condition can be diagnosed by criteria proposed by Bates and Bedu-Addo. However, in practice the diagnosis of HMSS is made primarily by excluding other clinical causes. Hereby we present clinico -pathological features of 9 cases empirically diagnosed as HMSS.
Case series: A total of 9 patients were studied out of which 8 were female. The mean age of our patients was 16.3 years. Splenomegaly was incidentally detected during clinic-pathological evaluation for pancytopenia in 7 and anemia in 2 patients. The average size of spleen was noted to be 13.11cm (below left costal margin). Important causes of pancytopenia with splenomegaly such as infections, hemato-lymphoid malignancies, auto-immune diseases and portal hypertension were excluded. In patients with isolated anemia, nutritional and haemolytic causes were ruled out. Bone marrow aspiration and biopsy was done in 7 patients which showed normal cellularity with tri-lineage haematopoiesis. Serum IgM levels could be done in 7 patients and the mean value was 436.61mg/dL (50-300mg/dL) After diagnosis area specific anti-malarial therapy followed by weekly chloroquine was advised. All patients were followed-up out of which 2 have completed a total 6 months of therapy. Both these patients have demonstrated a substantial decrease in spleen size (40%).
Conclusion: Although, HMSS remains one of the most common causes of massive splenomegaly there is limited available literature. The diagnosis of this condition remains clinical and these patients should be offered antimalarial treatment rather than subjecting them to splenectomy at the outset. Larger multi-centric studies with longer follow-up periods are needed in-order to establish local guidelines that are relevant to Indian settings.
Keywords: HMSS, serum IgM, pancytopenia |
| 40 |
Is Lupus anticoagulant testing , relevant in patients with autoimmune hemolytic anemia ? |
1968-08-07 |
Female |
Yes |
- | 111 |
Benign |
Miscellaneous |
Laboratory |
: N Thomas, Jakhi Amit, Anurag Pandey,Anil Divekar, Dr.D.Kriplani DR V.P Antia |
Enna Maria Lourenco |
Breach Candy Hospital Trust, Mumbai, India |
Mumbai |
+91 9820389317 |
ennalou@rediffmail.com |
Poster |
Is Lupus anticoagulant testing , relevant in patients with autoimmune haemolytic anaemia ? Presenting author: Enna Maria Lourenco. Co-author : Nirmal Thomas, Jakhi Amit, Anurag Pandey, Dr.D.Kriplani DR V.P Antia . Institute : Breach Candy Hospital Trust, Mumbai, India Email:ennalou@rediffmail.com. Introduction Lupus anticoagulant [also known as Lupus antibody or LA OR LAC or Lupus inhibitors] is an immunoglobin that binds to phospholipids and proteins associated with the cell membrane. LA is a silent antibody that harms our own body instead of protecting it. Lupus anticoagulant is one of three malfunctioning antibodies [Lupus anticoagulant [LA] , anticardiolipin [ACA] and beta 2 Glycoprotein1 called antiphospholipid antibodies. LAC increase risk of blood clots [thrombosis] in veins or arteries and also can lead certain pregnancy complications such as recurrent miscarriage or factor II deficiency associated with LAC may be at risk for bleeding.LA also occur in patients taking certain medicines like phenothiazine’s ,phenytoin, hydralazine, quinine and antibiotic amoxicillin. Also in conditions such as inflammatory bowel disease [Cohn’s disease & ulcerative colitis infection and certain kinds of tumour. Autoimmune hemolytic anaemia [AIHA] is an autoimmune disease where there is a fall in red blood cells because of antibody-mediated red blood cell destruction. . There are two categories of AIHA i.e. warm and cold. In children with AIHA, some can be life-threating and immediate medical care is required..
AIM: Patients having autoimmune hemolytic anemia especially suspected Venous Thromboembolism [VTE] and also patients with increased aPTT were tested for Lupus antibody [LA] to rule out underlying diseases in confirming or refuting the diagnosis which help to investigate unexplained clotting events and patients with increased aPTT .
Material and Method: Study was done a tertiary hospital, Mumbai, India. Blood sample tested for LA with blood test such as dilute Russell’s viper venom time [ DRVVT ] and activated
Inclusion criteria: Patients having AIHA with less Haemoglobin ,peripheral smear showing spherocytes [in warm AIHA ],auto agglutination[ in cold AIHA ],positive direct anticoagulant testing [DAT ] OR direct coombs test , suspected VTE disease and patients with increased aPTT
Rejection Criteria: Sample grossly haemolysed or underfilled or overfilled or patient on blood thinners
134 samples analyzed with Male female ratio: 2:1
RESULTS
Control [Normal] [n=15] 11.20 %, DRVVT confirm ratio <1.20 LA Negative
Patients with autoimmune hemolytic anaemia with underlying VTE [ n=15] 11.20 % DRVVT confirm ratio > 1.20 LA Positive & Mixing studies and confirmatory test confirmed the presence
Patients with LA+ACP with AIHA [n=4 ] 3.0 % DRVVT confirm ratio >1.20 1.20 LA Positive & Mixing studies and confirmatory test confirmed the presence
ACA WITH AIHA [n=3 ] 2.24 DRVVT confirm ratio <1.20 LA Negative but ACA Positive
VTE without AIHA [ n=6 ] 4.48 % DRVVT confirm ratio <1.20 LA Positive LA Positive & Mixing studies and confirmatory test confirmed the presence
ACA without AIHA [n=5 ] 3.70 % DRVVT confirm ratio <1.20 LA Negative but ACA Positive
Patients with other underlying history [n=77 ] 57.46 % DRVVT confirm ratio <1.20 LA Negative
Patients on anticoagulant [n=09 ]6.72 % DRVVT confirm ratio <1.20 LA False Positive patients on blood thinners.
Conclusion: Presence of Lupus anticoagulant in autoimmune haemolytic anaemia [AIHA] in patients is significant, as it indicate a higher risk of developing VTE which is a potentially serious complication
Detection of Lupus anticoagulant in patient with AIHA helps in appropriate preventative measures. And also role of prophylactic anticoagulation. AIHA Patients with severe low anaemia <7.0 g/dl are at high risk of VTE.
Key message: Lupus anticoagulant testing helps in identifying patients at increased risk of venous thromboembolism [VTE] a major complication of Autoimmune haemolytic anaemia [AIHA
Key words: Lupus anticoagulant, aPTT, VTE, AIHA |
| 41 |
Title: Relapsed Hodgkin’s lymphoma navigating treatment strategies and outcome |
1994-04-27 |
Female |
No |
- | 56011 |
Malignant |
Leukemia & lymphoma |
Clinical |
bharat vikram |
AISHWARYA MURALIDHARAN |
SGPGI |
lucknow |
09711428845 |
aishooma@gmail.com |
Oral |
Title: Relapsed Hodgkin’s lymphoma navigating treatment strategies and outcome Introduction:Hodgkins’s lymphoma has excellent outcomes with Indian data showing 5 year OS of 80% which mirrors that of western literature . Amongst the patients who relapse treatment options vary from chemotherapy, immunotherapy ultimately consolidation with transplant (if eligible). Data on relapsed Hodgkin’s with contemporary therapy modalities is scarce. Here we analyse the patient and disease profile and treatment outcomes of relapsed/refractory Hodgkins’s lymphoma in a tertiary care centre.
Methods: Study design: single centre retrospective study All confirmed cases of relapse Hodgkin’s lymphoma were taken from 2020 to 2024. Data on baseline characteristics, stage and timing of relapse, details of previous therapy received, and salvage outcomes were collected.
Results:A total of 36 patients of relapsed Hodgkin’s lymphoma was collected between 2020 to 2024, median age 25.5, range (7-55). 6 out of 36 were paediatric Hodgkins (age <18), all except one were classified high risk disease as per NCCN risk stratification. Majority of the adult relapsed Hodgkins (age≥18 )patients were advanced disease as per NCCN classification with only 13.3% being early unfavourable and 6% being early favourable. Majority of the adult and paediatric Hodgkins received interim PET guided ABVD therapy as front line . Predominantly relapse stage was 3 or 4. 82% of those who received immunotherapy-based salvage achieved complete response, compared to 52% seen in those who received platin based therapy.
Conclusions: Response rates of relapsed Hodgkin’s lymphoma has improved considerably with the advent of immunotherapy; the most common stage of relapse is stage 4. Chemoimmunotherapy have better response rates than chemotherapy alone. Salvage options should be tailored to each patient based on tolerability, early or late relapse, relapse stage, plan for autologous hematopoietic stem cell transplant and most importantly affordability. Further trials are needed to optimise treatment in relapsed Hodgkin’s lymphoma. |
| 42 |
Exploring the Role of Procalcitonin and Proadrenomedullin in Pediatric Acute Leukemia: Biomarkers for Infection and Beyond |
1983-12-30 |
Male |
No |
- | 0001 |
Malignant |
Leukemia & lymphoma |
Clinical |
Jagdish Prasad Meena, Harshita Makkar, Sujata Bhattacharya, Aditya Kumar Gupta, Ashutosh Halder, Ruksana Sidhique P.R., Rachna Seth |
DR JAGDISH PRASAD MEENA |
All India Institute of Medical Sciences, New Delhi |
New Delhi |
08890139358 |
drjpmeena@yahoo.com |
Oral |
Title: Exploring the Role of Procalcitonin and Proadrenomedullin in Pediatric Acute Leukemia: Biomarkers for Infection and Beyond
Introduction: Procalcitonin (PCT) and Proadrenomedullin (ProADM) remain underexplored in immunocompromised children. This study aimed to evaluate PCT and ProADM levels at the time of leukemia diagnosis and compare them during episodes of febrile neutropenia (FN).
Methods: Children aged ≤18 years with newly diagnosed acute leukemia [acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML)] were prospectively enrolled. Serum samples for PCT and ProADM were obtained at baseline (prior to initiation of chemotherapy) and subsequently at the presentation of FN.
Results: This study recruited 80 children with acute leukemia. The cohort's median age was 5 years (IQR: 3; 7 years). The acute ALL accounted for 67.5%, and AML for 32.5%. At leukemia diagnosis (n=80), the median PCT was 0.19 ng/ml (0.07; 0.54), and the median ProADM was 0.04 nmol/L (0.01; 0.07). Out of 80 patients with acute leukemia, we analyzed blood samples from 32 patients who developed FN subsequently and compared them with baseline samples. The median PCT (P = 0.03) and ProADM (P < 0.001) were significantly higher at the time of FN compared to the diagnosis of acute leukemia. Splenomegaly was the only determinant associated with elevated PCT at the time of leukemia diagnosis (P = 0.010). In ALL, PCT levels remained unchanged between diagnosis and FN, suggesting a baseline inflammatory influence, while ProADM rose significantly during FN, indicating infection specificity. In contrast, both PCT and ProADM increased during FN in AML.
Conclusions: PCT and ProADM levels significantly increased during FN, supporting their role as infection-related biomarkers. ProADM demonstrated greater infection specificity, particularly in ALL, highlighting its potential utility in guiding the management of febrile episodes.
Key words: Leukemia, procalcitonin, proadrenomedullin; febrile neutropenia; children |
| 43 |
Fatal Candidemia Detected on Peripheral Smear in a Post-Chemotherapy Colon Cancer Patient with Pancytopenia |
1970-11-03 |
Male |
Yes |
L-2150 | pay_Q |
Benign |
Infection & supportive care |
Laboratory |
Dr.Aswathy M Pillai, Dr Aswathy Chandramohan |
Dr.Vivek George |
Sree Gokulam Medical College and Research Foundati |
Venjaramoodu, Trivandrum |
9567518025 |
georgevivek@hotmail.com |
Poster |
Title:Fatal Candidemia Detected on Peripheral Smear in a Post-Chemotherapy Colon Cancer Patient with Pancytopenia
Introduction:Candidemia is a severe fungal infection usually diagnosed by blood cultures. Rarely, Candida spp. can be visualized on peripheral blood smears, often reflecting a high fungal load and poor prognosis. We report a rare case of Candida tropicalis detected in a smear of a patient with pancytopenia following chemotherapy for metastatic colon cancer.
Methods:Investigations included urine and blood cultures, routine haematology, and peripheral smear stained with Leishman and Giemsa.
Results:CBC showed pancytopenia. On day four, the peripheral smear demonstrated occasional budding yeasts intra and extra cellularly. Later, blood culture for fungus confirmed the presence of Candida tropicalis. Despite prompt antifungal therapy, the patient succumbed to infection on day eleven of admission
Conclusions:Detection of Candida tropicalis on peripheral smear is a rare but critical finding, suggesting disseminated infection and poor prognosis. Peripheral smear review may occasionally reveal candidemia earlier than blood culture, emphasizing its diagnostic value in high-risk patients. A high index of suspicion improves rate of detection, which is vital for early intervention, although outcomes remain poor in immunocompromised hosts.
Key words:Candidemia, Candida tropicalis, peripheral smear diagnosis, pancytopenia. |
| 44 |
Evaluation of High Fluorescence Lymphocyte Count Percentage for Early and Reliable Diagnosis of Dengue in Background of Acute Febrile Illness |
1988-09-16 |
Male |
No |
- | H_LKO |
Benign |
Infection & supportive care |
Laboratory |
Paras Kharbanda, Gaurav Kumar, Snehanshu Shukla, Arshita Srivastava, Sagar Srivastava, Ananya Pandey, Satyajeet Verma |
Mayank Kumar |
Rajarshi Dashrath Autonomous State Medical College |
Ayodhya |
9739867063 |
mayankkumar1618@gmail.com |
Oral |
Title: Evaluation of High Fluorescence Lymphocyte Count Percentage for Early and Reliable Diagnosis of Dengue in Background of Acute Febrile Illness
Introduction: The dengue virus (DENV) infection, a mosquito-borne viral infection, poses a significant global health threat. This serious viral disease has a prominent presence in India, being a matter of substantial healthcare concern.
Patients with DENV often exhibit overlapping clinical features with other causes of acute febrile illnesses (AFI). Early, reliable diagnosis is imperative as prompt institution of appropriate medical care decreases morbidity and mortality.
High fluorescence lymphocyte count percentage (HFLC%), a research parameter obtained from haematology analyzers, exhibits significant correlation with reactive lymphocytes (RL) in peripheral blood. RLs play an important role in immune responses, and their visual identification supports the diagnosis of viral infection, including DENV.
Methods: 350 cases of fever that were subjected to evaluation for DENV were included in the study, after ruling out systemic haematological and autoimmune disorders. Peripheral blood samples were tested for HFLC% and DENV. HFLC% for DENV-positive cases (NS1Ag-positive, IgM-positive, dual-positive) were compared with cases of fever that tested negative for DENV.
Results: The mean HFLC% (5.63%) was significantly higher (p<0.001) in DENV-positive cases compared to negative controls (0.37%). The receiver operator curve analysis indicated a HFLC% cutoff at 5.9% for NS1Ag-positive cases (sensitivity 80.2%, specificity 98.1%), 3.5% for IgM-positive cases (sensitivity 82.3%, specificity 98.3%), and 2.3% for dual positive cases (sensitivity 85.7%, specificity 97.5%).
Conclusions: The ever-increasing burden of DENV infection and high chances of life-threatening complications necessitate a robust and active approach for early diagnosis. HFLC% can play an important role in this regard, as the initial blood sample sent for haematological analysis can point towards a probable diagnosis of DENV, leading to improved patient outcome.
Key words: acute febrile illness, dengue, high fluorescence lymphocyte count |
| 45 |
Machine Learning-Based Comparative Evaluation of Diagnostic Indices for Differentiating Iron Deficiency Anemia and Thalassemia. |
1978-04-10 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
1) Dr. Savitri M. Nerune, Professor 2) Dr Sayandeep Das, Postgraduate |
Dr. Savitri M. Nerune |
BLDE (DU), Shri B.M. Patil Medical College, Hospit |
Vijayapura |
9008179806 |
savitri.nerune@bldedu.ac.in |
Oral |
Title: Machine Learning-Based Comparative Evaluation of Diagnostic Indices for Differentiating Iron Deficiency Anaemia and Thalassemia.
Author: Savitri M. Nerune, Sayandeep Das
Introduction
Iron Deficiency Anemia (IDA) and β-Thalassemia are the commonest causes of microcytic hypochromic anemia and required distinctly different therapies. In India, more than half of the women and young children are iron deficient and about 42 million people carry the β-Thalassemia trait. Accurate differentiation between IDA and Thalassemia is crucial for effective treatment. Recent advancements in Machine Learning (ML) models in haematology has shown immense potential in improving diagnostic differentiation. So the study was done to evaluate and compare the diagnostic utility of traditional haematological indices in differentiating IDA from β-Thalassemia using machine learning technique.
Methodology
A hospital-based, cross-sectional pilot study was conducted at the Central Laboratory of tertiary care hospital. A total of 80 blood samples (40 IDA and 40 Thalassemia) were analysed using six diagnostic indices: Mentzer, Shrivastava, Shine and Lal, RDW, Green and King, and England and Fraser. Machine learning models including Logistic Regression, K-Nearest Neighbor (K-NN), Support Vector Machine (SVM), Decision Tree and Random Forest were applied using the KNIME Analytics platform with ethical approval.
Results
Random Forest demonstrated the highest accuracy, particularly with the Mentzer (95.8%) and Shrivastava (91.7%) indices. The K-NN model also performed well, especially with the England and Fraser index, achieving 92.9% accuracy. Machine learning rescued weaker index like Green-King which rose from 62.5% to 79.2% after Random Forest ensemble with largest relative gain of 26%.
Conclusion
The integration of machine learning with traditional diagnostic indices enhances the accuracy of distinguishing IDA from Thalassemia. This study underscores the potential of ML to revolutionize diagnostic workflows, particularly in resource-limited settings, and contributes to the early detection and tailored treatment of these prevalent anemias.
Keywords: Microcytic Hypochromic Anemia, Machine Learning.
|
| 46 |
miR-451A Emerges as a Key Driver of Chronic Myeloid Leukemia Progression via High-Throughput miRNA Profiling |
1995-01-15 |
Female |
No |
- | S2953 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Nitu Nigam, Dr. S.P. Verma, Dr. Rashmi Kushwaha, Dr. Swasti Sinha (All co-authors are affiliated with King George's Medical University, Lucknow) |
Surbhi Gupta |
King George's Medical University, Lucknow |
Lucknow |
9838301603 |
jhs.surbhi25@gmail.com |
Poster |
Title: miR-451A Emerges as a Key Driver of Chronic Myeloid Leukemia Progression via High-Throughput miRNA Profiling
Introduction: The study analyzed the differential expression of microRNAs (miRNAs) in approximately 450-500 miRs between CML patients and healthy controls, revealing distinct patterns of upregulation and downregulation.
Methodology: The study collected 2.5 ml of whole blood from 77 adult patients with newly diagnosed CML before TKI treatment and 77 healthy individuals. miRNA was purified using the PAXgene blood RNA isolation kit following the manufacturer’s protocol. An advanced miRNA sequencing was performed on a few samples to study the role of microRNAs in driving EMT and metastasis in CML. Further validation for the highly upregulated miR451A was done via qRT-PCR.
Result: Among all 450-500 identified miRs, the highest expression was observed for hsa-miR-451A (18.5356), followed by hsa-miR-363-3P (11.4551) and hsa-miR-4732-5P (11.1225). The analysis of downregulated miRNAs reveals distinct differential expression patterns, with all values falling below a six-sigma lower threshold of -6.836 and an upper threshold of -5.683. The most significant downregulation was observed in hsa-miR-224-5P (-8.997), followed by hsa-miR-21-3P (-8.632) and hsa-miR-615-3P (-8.354). miR-451A was significantly elevated in CML cases (p = 0.001), showing 76.6% sensitivity and 53.2% specificity. ROC analysis showed moderate predictive ability (AUROC = 0.655) with a cut-off dCt >1.165. Logistic regression confirmed dCt as an independent predictor, with each unit increase raising disease odds by 16.5% (OR = 1.165, p = 0.001).
Conclusion: Targeting specific miRNAs could improve treatment outcomes in CML patients and provide new diagnostic methods and selective treatment processes. This research aims to enhance our understanding of CML biology and offer potential biomarkers for prognosis and treatment response.
Keywords: Chronic myeloid leukemia, epithelial to mesenchymal transition, microRNA sequencing, quantitative RT-PCR, differential expression.
|
| 47 |
Study of T Regulatory Cells, Cytotoxic T‑lymphocyte‑associated Antigen 4, and Transforming Growth Factor‑β1 in Patients with Chronic Myeloid Leukemia on Dasatinib Therapy |
1989-12-15 |
Female |
Yes |
L-1964 | 52370 |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Rashmi Kushwaha, Shailendra Prasad Verma, Wahid Ali, King George's Medical University, Lucknow |
Akanksha Singh |
Sanjay Gandhi Post-Graduate Institute of Medical S |
Lucknow |
9559815220 |
assiduous2007@gmail.com |
Poster |
Title: Study of T Regulatory Cells, Cytotoxic T‑lymphocyte‑associated Antigen 4, and Transforming Growth Factor‑β1 in Patients with Chronic Myeloid Leukemia on Dasatinib Therapy
Introduction: Tyrosine kinase inhibitors improve chronic myeloid leukemia (CML) outcomes. Dasatinib inhibits breakpoint cluster region‑Abelson 1 proto‑oncogene tyrosine kinase better than imatinib in CML. T‑regulatory cells prevent autoimmune diseases and aberrant immune responses by reducing oncoprotein antigen reactivity. They also reduce self‑antigen‑induced immune responses to maintain peripheral tolerance. In this study, T‑regulatory cells in the peripheral blood of chronic myeloid leukemia‑chronic phase patients were measured, together with serum levels of cytotoxic T‑lymphocyte‑associated antigen‑4 (CTLA‑4) and transforming growth factor (TGF)‑β1 at diagnosis and 3 months post-dasatinib therapy.
Methods: The Pathology and Clinical Haematology Departments at King George’s Medical University, Lucknow, India, conducted this prospective analytical study. Forty CML patients and 10 healthy controls were analysed. Flow cytometry was done for the determination of T‑regulatory cell percentage in peripheral blood mononuclear cells of newly diagnosed CML patients before and after 3 months of dasatinib treatment; ELISA was used to measure serum levels of CTLA‑4 and TGF‑β1.
Results: T‑regulatory cells, CTLA‑4, and TGF‑β1 significantly decreased in CML patients after 3 months of dasatinib therapy compared to the initial diagnosis. No significant change in T‑regulatory cell, CTLA‑4, or TGF‑β1 percentages was seen between responders and poor responders. However, responders had a lower rate of T‑regulatory cells than suboptimal responders.
Conclusions: This study concluded that dasatinib treatment improved response in CML patients with decreased Treg cells. Dasatinib reduces Treg-mediated immunological suppression by decreasing CTLA-4 and TGF‑β1 levels.
Key words: Chronic myeloid leukemia, dasatinib, T-regulatory cells, flowcytometry, cytotoxic T‑lymphocyte‑associated antigen‑4, transforming growth factor-β1 |
| 48 |
Pediatric PRCA Beyond DBA: Expanding the Differential |
1995-08-28 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
DR.MONA VIJAYRAN,DR.RAJESH KASHYAP , DR. SANJEEV YADAV , DR.SAYAN SINHA ROY , DR.RUCHI GUPTA , DR.KHALIQUR RAHMAN, DR.DINESH CHANDRA , DR.MANISH SINGH |
DR.V.BHARATH VIKREM |
SANJAY GANDHI POSTGRADUATE INSTITUTE |
LUCKNOW |
7373059597 |
vbharathvikrem@gmail.com |
Oral |
Title: Pediatric PRCA Beyond DBA: Expanding the Differential Introduction: Pure red cell aplasia (PRCA) in children manifests as profound anemia due to erythroid hypoplasia, traditionally linked to Diamond-Blackfan Anemia (DBA). However, emerging non-DBA etiologies, including autoinflammatory, genetic immunodeficiency, infectious, and syndromic causes, are increasingly identified, posing diagnostic and therapeutic challenges. This study explores the diverse origins of transfusion-dependent pediatric PRCA, highlighting novel pathways beyond ribosomal defects to inform precision medicine. Methods: A retrospective review of 18 pediatric PRCA cases (less than 18 years ; 12 males, 6 females) from a tertiary hematology center (2022–2025) was conducted. DBA cases (n=3) were excluded. Evaluations included whole exome sequencing (WES), viral serologies, immunoglobulin profiling, and bone marrow studies. Treatments encompassed steroids (1–2 mg/kg), cyclosporine (5 mg/kg), sirolimus (2–2.5 mg/m²), tofacitinib, and supportive transfusions. Responses were classified as complete (CR: Hb >10 g/dL, transfusion-independent), partial (PR), or none, with follow-up until August 2025. Results: Among 15 non-DBA cases, etiologies comprised Inborn errors of immunity (40%: ADA2 deficiency [n=2], BLNK-agammaglobulinemia [n=1], JAK3-SCID [n=1], STAT3 gain-of-function with HLH [n=1]); infectious (13%: parvovirus [n=1], CMV [n=1]); syndromic (13%: NPHP3 renal-hepatic-pancreatic dysplasia [n=1], SLC4A1 membranopathy with acidosis [n=1]); congenital dyserythropoietic anemia type IIIA(VUS) (7%: n=1); suspected neuroblastoma (7%: n=1); and idiopathic (20%: negative WES [n=3]). Transfusions averaged 6 units/case. First-line steroids/cyclosporine yielded CR in 47% (n=7), but 27% (n=4) relapsed on tapering. Second-line sirolimus or tofacitinib achieved CR in 75% of refractory cases (n=3/4). Two fatalities occurred (respiratory failure, unspecified). Latest Hb ranged 8.2–12.5 g/dL in survivors. Conclusions: Among inborn errors of immunity (IEI), only DADA2 has been linked to PRCA in the literature. With wider access to affordable NGS and increasing recognition of other IEIs (e.g., SCID, STAT3, BLNK). Immunosuppressants and targeted JAK/STAT inhibitors have shown excellent responses
Keywords: Pediatric PRCA, non-DBA etiologies, inbornerror of immunity |
| 49 |
Novel PDGFRA mutation in a young female with eosinophilia: A nearly missed diagnosis, highlighting the importance of raw data analysis of the whole exome |
1984-11-18 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Mona Vijayaran( Asst Professor), SGPGIMS, Deptt of Clinical Hematology. Dr.Rudrarpan Chatterjee (Asst Prof) Deptt of Clinical Immunology |
Dr Sakshi Tripathi |
SGPGIMS |
Lucknow |
7607503735 |
dr.sakshitripathi@gmail.com |
Poster |
Title- Novel PDGFRA mutation in a young female with eosinophilia: A nearly missed diagnosis, highlighting the importance of raw data analysis of the whole exome
Author-Sakshi Tripathi
Introduction- Myeloid and lymphoid neoplasms with eosinophilia and PDGFRA rearrangements are recognized as a distinct entity. There are studies (Elling et al 2011, Blood; Zhao et al 2019, Cancer Biology and therapy) where PDGFRA point mutations were detected in patient with negative FIP1L1-PDGFRA rearrangement. We present a case with a novel PDGFRA mutation responsive to Imatinib.
Case--A 19 year old female presented to OPD with undiagnosed eosinophilia (TLC 41200/µL, AEC 30076/µL) referred from gastroenterology, having complaints of low-grade fever, jaundice and pruritis. Her case was complicated by recurrent hepatitis, purpuric skin lesions, multiple cerebral infarcts and gastrointestinal bleeding. Her working diagnosis in gastroenterology was hypereosinophilic syndrome with autoimmune hepatitis. She was prescribed steroid without sustained relief. Peripheral blood examination showed 40% eosinophils, 8% basophils without atypical T lymphocytes. Bone marrow showed mild hypercellularity with eosinophilia. Skin biopsy showed vasculitis with increased eosinophils. FISH for FLIP1L1-PDGFRA rearrangement and other TK gene fusions was negative. Suspecting an autoimmune cause she was referred to immunology. Whole exon sequencing (WES) was sent and FOXN1 was reported but did not match with her phenotype so the immunologist reanalyzed the raw data of the whole genome which identified PDGFRA compound heterogenous mutation at positions 236, 275 and 311. This variant has not been reported before in gnomAD and clinvar. She was prescribed Imatinib 100 mg OD.
Result-Hepatitis is improving and AEC has normalized(TLC 11000/µL, AEC 550/µL).
Conclusion- In patients with negative FIP1L1-PDGFRA rearrangement and other TK gene fusions, point mutations in PDGFRA should be looked for as these are targetable and responsive to Imatinib. WES by NGS with raw data analysis should be done.
Key words: Eosinophilia, PDGFRA, Imatinib |
| 50 |
Rare complication of Splenic Rupture in a PBSC Donor after G-CSF |
1979-03-28 |
Male |
Yes |
1220 | H_LKO |
Benign |
Transfusion medicine |
Clinical |
Isha Gambhir, Ravi Shankar, Harprit Singh, Sachin Jain |
Pawan Kumar Singh |
Yatharth Superspeciality Hospital |
NOIDA |
9717532903 |
pawan2809@gmail.com |
Poster |
Introduction: For Bone marrow transplant, stem cells are collected from peripheral blood through apheresis machine after mobilization by 5 days of G-CSF. Here, we report a case of splenic rupture in a PBSC donor.
Case: Mr A, 36 yrs male Haplo donor was given G-CSF (at dose 10 microgm/kg/day as single dose) for 5 days. On 5th day he had moderately severe pain in back which was controlled with IV Paracetamol. Harvest was started at 8 am and the procedure was complete by 2 pm. After 2 hrs he again started having severe pain in left hypochondrium not controlled with Paracetamol and Tramadol, so was started on Morphine infusion and then after pain control he was taken up for CECT abdomen. CECT showed acute subcapsular splenic hemorrhage with perisplenic extension upto the left subdiaphragmatic region and hemoperitoneum with hepatosplenomegaly. He was immediately taken up for surgery and exploratory laparotomy with bleeding evacuation and splenic capsule repair was done with drain put in-situ. As the capsular tear was small so splenectomy was not done. He was monitored for next 7 days and the bleeding in the drain was gradually stopped over next 4-5 days and the repeat CECT did not show any major collection or hematoma.
Discussion: The usual complications are bone pain and weakness, however rarely the complications can be fatal like Avascular Necrosis of hip, splenic infarcts, splenic rupture, Myocardial infarction or stroke. Prompt detection of these complications is very important in preventing fatality after these complications.
Conclusion: Splenic rupture in BMT donor should be anticipated and early detection is the key to management of this potentially fatal complication.
Keywords: G-CSF, Splenic Rupture, splenectomy
|
| 51 |
Factor XIII Val34Leu polymorphism in Indian Myocardial Infarction Patients vs Caucasians |
1980-07-10 |
Male |
Yes |
L-1684 | pay_R |
Benign |
Hemeostasis |
Laboratory |
Amit Sharma, Hareram Pandey, Jasmita Dass, Richa Chauhan, Ganesh Kumar, Mukul Aggarwal, Rishi Dhawan, Tulika Seth, Manoranjan Mahapatra, AIIMS, New Delhi |
Ravi Ranjan |
All India Institute of Medical Sciences |
New Delhi |
9871713554 |
raviranjanaiims@gmail.com |
Poster |
Title: Factor XIII Val34Leu polymorphism in Indian Myocardial Infarction Patients vs Caucasians
Introduction: There are contradictory reports on the role of factor XIII gene (FXIII) Val34Leu polymorphism in the pathogenesis of myocardial infarction (MI). We aimed at finding out the actual role of Val34Leu in Indian MI patients with the assumption that it is associated with thrombosis.
Methods: We recruited 155 consecutive patients with MI confirmed by coronary angiography as well as a group of equal number of age and sex matched controls. Factor XIII Val34Leu polymorphism was determined through Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) analysis.
Results: We did not find the Leu/Leu genotype in patients and only 2 (1.3%) of the controls had this genotype. The Val/Leu heterozygotes were present in 2 (1.3%) MI patients and 9 (5.8%) controls. The Leu allele frequency in MI patients was 0.6% whereas it was 4.2% in controls. The heterozygote Val/Leu genotype was associated with a significantly decreased risk of MI (P =0.006; adjusted odds ratio [OR] = 1.62; 95%confidence interval [CI] = 1.14-2.2). Furthermore, our study displayed that the frequency of the Leu34allele in Indian population was lower than that in Caucasian populations (4.2 vs 20.4%-28.3%).
Conclusions: Our preliminary data indicate that the FXIII-A Leu34 allele may contribute to a protective effect against the development of MI which is in concordance with the other Asian countries literature. There is a low prevalence of the Leu34 allele in Indian MI patients compared to Caucasians.
Key words: Polymorphism, Factor XIII, Myocardial, genotype, Heterozygotes, Indian, Caucasian |
| 52 |
Aspirin as Targeted Therapy in Ghosal Haematodiaphyseal Dysplasia: Clinical Outcomes in TBXAS1-Mutated Patients |
1996-09-30 |
Male |
No |
- | H_LKO |
Benign |
Marrow failure |
Clinical |
|
Dr Sabir Shaikh |
Christian Medical College , Vellore |
Vellore |
8999170944 |
sabir.shaikh@cmcvellore.ac.in |
Oral |
Title: Aspirin as Targeted Therapy in Ghosal Haematodiaphyseal Dysplasia: Clinical Outcomes in TBXAS1-Mutated Patients.
Introduction: Ghosal Haematodiaphyseal Dysplasia (GHDD) is a rare genetic disorder caused by TBXAS1 mutations, leading to prostaglandin metabolism imbalance. It typically presents with pancytopenia and recurrent joint pain. We describe the clinical course of five GHDD patients diagnosed at our centre.
Methods and Results : Five patients (3 females, 2 males; aged 19–42 years) presented with fatigue, anaemia, joint pain, and transfusion dependence. Haemoglobin levels ranged from 4.5–8.3 g/dL, with normal to low white blood cell and platelet counts. Splenomegaly was observed in two patients, with progressive enlargement in one. Bone marrow biopsies revealed hypocellularity in four patients and mild hypercellularity in one, all showing reticulin fibrosis. Radiologic findings included cortical thickening, widened long bones, and skeletal sclerosis. Mutation panels for JAK2, CALR, and MPL were negative. Next-generation sequencing confirmed TBXAS1 mutations in all patients; one had additional ASXL1 and IDH1 mutations.
Patient 1 responded well to Aspirin after having no response to Danazol. Patients 2 and 4 initially responded to Thalidomide, Prednisolone, and Aspirin (75 mg) but relapsed upon discontinuation. At relapse, patient 2 was treated with Danazol and patient 4 with Thalidomide, Prednisolone, and Desidustat—neither responded. Patient 2 achieved recovery after restarting Aspirin 150 mg, while patient 4 remained transfusion dependent, awaiting NSAID therapy. Patient 3 failed ATG and remained unresponsive to Cyclosporine, Danazol, and Eltrombopag. Following molecular confirmation of TBXAS1, she was started on Aspirin 150 mg, resulting in haematologic recovery. Patient 5 was lost to follow-up.
Conclusions: These cases underscore the importance of suspecting TBXAS1-associated marrow failure syndromes in patients with unexplained cytopenia’s, marrow fibrosis, and bony dysplasia. Early recognition is crucial, as targeted anti-inflammatory therapy with aspirin may lead to hematologic recovery and obviate the need for stem cell transplantation. |
| 53 |
MORPHO-HAEMATOLOGICAL PATTERNS AND DIAGNOSTIC CORRELATIONS IN ANEMIA: A CROSS-SECTIONAL STUDY FROM EASTERN UTTAR PRADESH |
1992-12-21 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
|
Sqn Ldr (Dr) Toyaja Jadhav |
7 Airforce Hospital, Kanpur |
Kanpur |
8081137487 |
toyajadhav.21@gmail.com |
Poster |
Title: MORPHO-HAEMATOLOGICAL PATTERNS AND DIAGNOSTIC CORRELATIONS IN ANEMIA: A CROSS-SECTIONAL STUDY FROM EASTERN UTTAR PRADESH
Background: Anemia remains a significant public health issue in India, especially the rural Northern India; yet the morphological data is often under-utilized in guiding initial diagnosis. This study evaluates RBC morphology along with red cell indices, the WBC pattern, eosinophil counts and platelet trends to identify the diagnostic patterns in Anemia, especially in the absence of advanced biochemical tests.
Aims and Objectives:
1. To classify anemia according to hemoglobin levels and RBC indices
2. To assess the significance of WBC counts, eosinophilia and platelet counts in Anemic patients
3. To assess the prevalence of anemia in population reporting to a secondary care hospital in eastern UP.
Methodology: Prospective cross-sectional study was conducted on 94 patients reporting with various complaints to a secondary care hospital in eastern UP, and who underwent a screening blood examination for the same. Parameters assessed included age, sex, Hb, RBC indices, TLC, eosinophil count and platelet count. Associations were evaluated using various statistical tests.
Results: Mean age in this study was 44 years with females being more commonly affected. Most patients had microcytic hypochromic anemia and moderately severe anemia. It was also observed that the severity of anemia had a statistical correlation with age and the incidence of sepsis. Eosinophilia was also observed in a subset of patients, but it was not associated with presence of parasites on PBS.
Conclusion: Routine peripheral smear, combined with basic CBC indices provides a critical diagnostic insights in anemia cases. They may serve as early indicators of infection, nutritional deficiency as well as other hematological disease, even in the absence of advanced lab investigations.
Keywords: Anemia, RBC indices, Sepsis, RBC morphology |
| 54 |
Wilsons disease presenting with pancytopenia-- An unusual presentation of rare disease. |
1986-01-12 |
Female |
Yes |
L-1397/OCT/14 | H_LKO |
Benign |
Anemia |
Laboratory |
|
Dr. Richa Pawar |
Pt. B. D. Sharma, PGIMS |
Rohtak |
7206321412 |
richapawar12@gmail.com |
Poster |
Title: Wilson's Disease presenting with Pancytopenia --An uncommon presentation of rare disease.
Introduction: Wilsons disease (hepato-lenticular degeneration) is an autosomal recessive defect in cellular transport of copper with prevalence of approximately 1 in 30,000 live births. Tissue deposition can occur in various organs, leading to hepatic, neurologic, ocular, hematologic and renal impairment. its diagnosis is based on typical clinical features such as Kayser-Fleischer (KF) rings, neurological symptoms, and low serum ceruloplasmin levels.
Methods: A 16 year old female presented with features of persistent anemia and repeated infections. She also had weakness, tremors in limbs. Complete hemogram showed anemia (Hb -9.6g/dl), leucopenia (TLC-750/ul of blood), and thrombocytopenia(APC-32000/uL of blood). Her MCV-89.4fl, MCH-27.2pg, MCHC- 30.4g/dl, RDW- 16.9%. Peripheral smear was reported as pancytopenia. MRI Brain showed deposits (metallic) in basal ganglia. Her s. copper , s. ceruloplasmin was low and 24 hr urine copper was raised. LFT were moderately deranged and RFT were normal. On further work up, slit lamp examination of eyes reveal KF rings. Based on these findings , diagnosis of Wilsons disease was made. as patient belong to low socio-economic status, she denied for liver biopsy and molecular testing. patient was put on zinc acetate and there was improvement in symptoms as well as blood counts on follow up after 3 weeks.
Results: Wilsons disease is an autosomal recessive disorder due to mutation in ATP7B gene located on chromosome 13. Pancytopenia is an unusual initial presentation , hemolysis has been reported in some patients resulting in erythroid hyperplasia in bone marrow.
Conclusions: This unusual presentation may misguide the clinician and delay the treatment, worsening the condition. In addition, the hematologic parameters of patients on chelation and zinc therapy should be monitored regularly, as copper deficiency can cause anemia not responding to routine therapy.
Key words: Wilson Disease, pancytopenia, copper. |
| 55 |
Improving the Immunophenotypic Discrimination of Chronic Lymphocytic Leukemia and Mantle Cell Lymphoma: Role of CD148, CD180 and CD200 |
1996-05-11 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Ravikiran N Pawar1, Poorva Gurjar1, Pooja Prasad2 , Twinkle Khanka1, Gunit Nongthombam1, Sankalp Sancheti1, Puneet Somal1, Aishwarya Sharma1, Nilay Nishith1, Rahul Raj1 1. Department of Oncopathology, Homi Bhabha Cancer Hospital and Research centre, New C |
MANSI MEHROTRA |
HOMI BHABHA CANCER HOSPITAL AND RESEARCH CENTRE |
NEW CHANDIGARH, PUNJAB |
9012736024 |
mansimehrotra290@gmail.com |
Oral |
Title: Improving the Immunophenotypic Discrimination of Chronic Lymphocytic Leukemia and Mantle Cell Lymphoma: Role of CD148, CD180 and CD200
Introduction
Chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) are CD5-positive B-cell chronic lymphoproliferative disorders (CLPD) with overlapping morphology and immunophenotype but markedly different treatment strategies. Traditional flow cytometry may be inconclusive in atypical cases. Additional markers such as CD148, CD180, and CD200, especially when analyzed by mean fluorescence intensity (MFI), can refine diagnosis.
Methods
All CLPD cases diagnosed between January 2024 and January 2025 by immunophenotyping, cytogenetics, and molecular studies were retrospectively retrieved. Peripheral blood and bone marrow samples collected in EDTA were processed within 24 hours using a bulk-lyse-wash protocol and analyzed on BD FACSLyric (BD Biosciences; 3 lasers, 12-color) with 12–15 antibody panels. Expression was scored as positive (dim, dim–moderate, moderate), subset, or negative. MFI values were recorded for CD148, CD180, and CD200.
Results
Of 105 CLPD cases, 59 (56.2%) were CLL and 14 (13.3%) MCL. Mean age was 64.0 years in CLL and 62.4 years in MCL, with male predominance in both (71%). CLL showed higher mean WBC counts (87.7×10^9/L) than MCL (37.7×10^9/L), while MCL had higher LDH (401.5 U/L vs. 234.9 U/L). CD200 was expressed in all CLL tested (mean MFI 2186, range 550–3911) but only 2/14 MCL (mean MFI 316, range 38–673). CD148 was strongly expressed in MCL (14/14 positive; mean MFI 4551, range 1417–12177) but lower in CLL (28/59 positive; mean MFI 1335, range 220–3460). CD180 expression overlapped in both groups.
Conclusion
This retrospective study highlights the difficulty of distinguishing CLL from MCL on morphology alone. Given their different treatment pathways, reciprocal CD148 and CD200 expression, particularly MFI analysis, provides strong diagnostic value and should be integrated into flow cytometry panels for CD5-positive B-cell CLPD.
Keywords
CLL; MCL; CD148; CD200; Flow cytometry; MFI |
| 56 |
An age paradox - Multiple Myeloma in the young; Insights from a tertiary centre of Punjab |
1996-08-12 |
Female |
No |
- | pay_R |
Malignant |
Plasma cell disorders |
Laboratory |
Pragya Sharma, Vikram Narang, Bhavna Garg, Suvir Singh; Dayanand Medical College and Hospital, Ludhiana, Punjab |
Priyanka Seth |
Dayanand Medical College and Hospital |
Ludhiana |
08968582845 |
pseth0@gmail.com |
Poster |
Title: An age paradox - Multiple Myeloma in the young; Insights from a tertiary center of Punjab
Introduction: Though usually linked to older adults, Multiple Myeloma (MM) can also occur in younger individuals, where it often remains neglected. Younger patients make up a substantial proportion with 10% of all cases involving individuals under 50. The current study probes hematological characteristics of young individuals (of age ≤50 years) with MM.
Methods: This 5 year retrospective study (July 2020 to June 2025) was carried out in a tertiary center of Punjab. Patients with lytic bone lesions, anemia, etc were included. Bone marrow (BM) examination, Serum Protein Electrophoresis (SPE), etc were analyzed. MM was diagnosed using the Salmon-Durie criteria.
Results: A total of 197 patients were diagnosed with MM, of which 19 (9.6%) were aged ≤ 50 years. The mean age was 44.5 years (range, 32-50). Male to female ratio was 1.4:1. Bone aches, fever, edema and limb weakness were common clinical signs. 17 (89.5%) cases had anemia, while 7 (36.8%) had hypercalcemia and serum creatinine levels of >2.0 mg/dL. 4 (21.1%) patients had osteolytic lesions. 11 (57.9%) patients had ≥60% plasma cells in their BM. The most common pattern observed on BM biopsies was diffuse infiltration by plasma cells (42.1% cases). On SPE, M band was present in 13 patients (68.4%), most commonly located in the γ-region. Majority cases were of IgG type (57.9%).
Conclusions: Our study spots MM cases with a younger onset and range of signs. Low clinical suspicion delays diagnosis in younger patients. However, early detection, personalized treatment, and follow-up can improve the outcomes.
Key words: Paradox, Multiple Myeloma, plasma cells |
| 57 |
Early T-cell Precursor Acute Lymphoblastic Leukemia: A Case Series from a
Tertiary Centre in Punjab |
1997-02-26 |
Female |
No |
- | T2508 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Priyanka Seth, Vikram Narang, Bhavna Garg, Suvir Singh; Dayanand Medical College and Hospital, Ludhiana, Punjab |
Pragya Sharma |
Dayanand Medical College and Hospital |
Ludhiana |
9781547476 |
pragyaatri1997@gmail.com |
Poster |
Title: Early T-cell Precursor Acute Lymphoblastic Leukemia: A Case Series from a Tertiary Centre in Punjab
Introduction: Early T-cell precursor lymphoblastic leukaemia is an uncommon neoplasm
found in both children and adults. It is a neoplasm composed of cells which are committed to
the T-cell lineage but with a unique immunophenotype indicating early T-cell differentiation.
Methods: All cases meeting the immunophenotypic criteria for ETP-ALL were included in
this retrospective study conducted at Department of Pathology, Dayanand Medical College
and Hospital, Ludhiana. Then these were correlated with clinical presentation, hemogram
findings and treatment details.
Results: Over a span of nine years, 11 cases of Early T-cell Precursor Lymphoblastic
Leukemia were recorded. Of these, seven patients were male and four were female. Two
patients presented with hepatosplenomegaly and mediastinal lymphadenopathy, while the
remaining patients presented with generalized weakness, fever, headache, and hemoptysis.
Further investigations revealed that 7 (63.6%) patients were pancytopenic, whereas 4 (36.3%)
had leucocytosis with total leukocyte counts ranging from 12,800/mm³ to 31,200/mm³.
Peripheral blood smears showed blasts in all cases, with blast percentages ranging from 2%
to 90%. Bone marrow aspiration and biopsy were performed in 4 (36.3%) patients. Flow
cytometric analysis was done in all patients showing positivity for CD34, CD117, CD13,
CD7, cytoplasmic CD3 and CD38. Immunohistochemistry was performed in 3 cases, yielding
similar results. On follow-up, one patient is currently on treatment, two have died and the
others have been lost to follow-up.
Conclusions: Early T-cell precursor lymphoblastic leukemia is a distinct and aggressive
subtype of T-ALL with characteristic immunophenotypic features and poor prognosis. Early
identification and stratification are crucial for improving clinical outcomes.
Key words: Early T cell precursor lymphoblastic leukemia, Immunophenotype |
| 58 |
When Schistocytes Mislead: IgA Nephropathy Presenting as a Hematological Mimic of aHUS. |
1998-11-28 |
Male |
No |
- | H_LKO |
Benign |
Miscellaneous |
Clinical |
|
Balaga Karthik |
Motilal Nehru Medical College |
Prayagraj |
8919387241 |
balagakarthik1@gmail.com |
Oral |
When Schistocytes Mislead: IgA Nephropathy Presenting as a Hematological Mimic of aHUS
Balaga karthik (Presenting Author), Arvind Gupta, Archana Ojha, Poonam Gupta.
Background:
Schistocytes on peripheral smear are often considered a hallmark of thrombotic microangiopathy (TMA) such as atypical hemolytic uremic syndrome (aHUS). However, their presence in acute kidney injury (AKI) is not pathognomonic and may lead to diagnostic errors. This case underscores the importance of kidney biopsy in differentiating hematological mimics of aHUS.
Case Presentation:
A 21-year-old male presented with persistent vomiting and anorexia for 14 days, followed by sudden anuria. He required multiple sessions of hemodialysis for rapidly worsening renal failure. Laboratory evaluation showed normocytic normochromic anemia with few schistocytes, raising strong suspicion of aHUS. Urine microscopy revealed microscopic hematuria (6–8 RBCs/hpf).
Investigations:
Renal biopsy demonstrated mild mesangial matrix expansion and cellularity without crescents, endocapillary hypercellularity, tuft necrosis, or sclerosis. Oxford MEST-C score was M0E0S0T0C0. Immunofluorescence revealed mesangial granular IgA (2+) and C3 (1+) with negative IgG and C1q. No biopsy features of TMA were identified. Moderately severe acute tubular injury (ATI) was also noted. The findings confirmed IgA nephropathy with ATI as the cause of renal dysfunction.
Discussion:
The presence of schistocytes initially diverted the clinical suspicion towards aHUS. However, biopsy evidence established IgA nephropathy, highlighting that schistocytes may occur as a secondary finding in AKI without underlying TMA. Recognizing this pitfall is critical to prevent unnecessary use of complement-directed therapies.
Conclusion:
This case illustrates that schistocytes, though a valuable hematological clue, are not disease-specific. In young patients with AKI and hematuria, timely renal biopsy remains the cornerstone to distinguish IgA nephropathy from aHUS, ensuring accurate diagnosis and appropriate management.
Keywords:
Schistocytes, IgA nephropathy, aHUS, thrombotic microangiopathy, acute kidney injury.
|
| 59 |
Romiplostim for Platelet Recovery in Post-Transplant Patients: A Single-Centre Experience |
1995-05-09 |
Male |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dr Sanjukta, Dr Veronica, Dr Sushma, Dr Michael, Dr Ruthvik, Dr Archana, Dr Nisarga, Dr Chaitanya, Dr Cecil Ross, Dr Seetharam Anandram |
Dr Kaushik N |
St John's Medical College Hospital, Bangalore, Kar |
Bangalore |
8197637502 |
nagendra.kaushik95@gmail.com |
Oral |
Title: Romiplostim for Platelet Recovery in Post-Transplant Patients: A Single-Centre Experience
Introduction: To assess the efficacy of romiplostim in reducing the duration of thrombocytopenia in patients undergoing hematopoietic stem cell transplantation (HSCT).
Methods: We studied 29 patients who underwent peripheral blood stem cell transplantation at our centre between March 2023 and May 2025. Nineteen underwent autologous and ten allogeneic transplants; 23 were for malignant and 6 for benign diseases. Conditioning regimens included myeloablative (n=13) and reduced intensity (n=16). Romiplostim (2–3 mcg/kg) was administered between day +5 and +10 post-transplant. The primary endpoint was platelet engraftment, defined as the first of two consecutive unsupported platelet counts >20,000/µL.
Results: The cohort included 15 males and 14 females. Romiplostim was administered on day +5 (n=4), day +7 (n=18), or day +10 (n=6). The median time to platelet engraftment was day +12 (range, 9–28). No clinically significant bleeding events were observed.
Conclusions: Romiplostim appears safe and may accelerate platelet engraftment in HSCT recipients, thereby reducing transfusion requirements and associated morbidity. Considering the clinical and financial burden of delayed platelet recovery, pre-emptive use of romiplostim—similar to G-CSF for neutrophil recovery—warrants validation in larger randomized studies
Key words: |
| 60 |
Hemolysis Following Anti-Thymocyte Globulin Therapy in Aplastic Anemia: A Single-Center Experience |
1995-05-09 |
Male |
No |
- | pay_R |
Benign |
Marrow failure |
Clinical |
Dr Sanjukta, Dr Veronica, Dr Sushma, Dr Michael, Dr Ruthvik, Dr Archana, Dr Nisarga, Dr Chaitanya, Dr Cecil Ross, Dr Seetharam Anandram |
Dr Kaushik N |
St Johns Medical College Hospital |
Bengaluru |
8197637502 |
nagendra.kaushik95@gmail.com |
Poster |
Title: Hemolysis Following Anti-Thymocyte Globulin Therapy in Aplastic Anemia: A Single-Center Experience
Introduction: To evaluate hemolysis post anti-thymocyte globulin (ATG) therapy in patients with aplastic anemia.
Methods: We studied 11 consecutive patients with aplastic anemia who received horse ATG (40 mg/kg over 4 days) between January 2023 and March 2025. Severity of aplastic anemia was classified using Camitta criteria: 9 had severe and 2 very severe disease; 2 of the severe cases had significant PNH clones. Hemolysis was assessed by indirect hyperbilirubinemia, direct Coombs test positivity, and elevated serum LDH. The onset, resolution, and severity (CTCAE grading) of hemolysis were recorded, along with packed red cell (PRBC) transfusion requirements
Results: Eight of 11 patients developed laboratory evidence of hemolysis. Four had direct Coombs positivity, seven had indirect hyperbilirubinemia, and four had mixed hyperbilirubinemia. Reticulocytosis was observed only in the two patients with PNH clones, while the rest showed reticulocytopenia consistent with marrow failure. Hemolysis began on day 0 post-ATG and resolved by a median of day +9. The mean serum LDH was 225 U/L, and CTCAE grade 1 was most frequent. Patients required a mean of 3 PRBC transfusions following ATG.
Conclusions: Hemolysis is a frequent but mostly mild complication of ATG therapy in aplastic anemia. Various mechanisms have been implicated, including cross-reactivity with RBC antigens, Complement-mediated intravascular hemolysis, and Fc-mediated extravascular hemolysis
Key words: |
| 61 |
Does Immature Reticulocyte Fraction and Immature Platelet Fraction Recovery Predict Bone Marrow Recovery Following Post Chemotherapy or Hematopoietic Stem Cell Transplant in Patients Diagnosed with Hematological Malignancies? An Observational Study |
1991-07-14 |
Male |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dr. Jyoti Kotwal, Dr. Naman Bansal, Dr. Shruti, Dr. Priyamvadha, Dr. Deepak, Dr. Nitin Gupta. |
Dr. Navneet Mishra |
Sir Ganga Ram Hospital, New Delhi |
New Delhi |
8840907946 |
drnavneet.m@gmail.com |
Oral |
Title: Does Immature Reticulocyte Fraction and Immature Platelet Fraction Recovery Predict Bone Marrow Recovery Following Post Chemotherapy or Hematopoietic Stem Cell Transplant in Patients Diagnosed with Hematological Malignancies? An Observational Study
Introduction: Accurate early detection of bone marrow recovery is vital in managing patients after hematopoietic stem cell transplantation (HSCT) or chemotherapy. Neutrophil (ANC) and platelet recovery are traditional markers, but emerging evidence suggests Immature Reticulocyte Fraction (IRF) and Immature Platelet Fraction (IPF), measurable by automated hematology analyzers, may indicate recovery earlier
Methods: In this 18-month prospective study at a tertiary care center, patient of hematological malignancies in myelosuppresion were monitored from post-treatment (Day 0) until marrow recovery. Bone marrow recovery was defined as first of the three consecutive days of ANC >0.5 × 10^9/L and platelet count >20 × 10^9/L. IRF >12% and IPF >6% following post treatment nadir were considered recovery thresholds.
Results: Total 40 patients were included in study. IRF recovery significantly preceded neutrophil recovery across all groups: allogeneic HSCT (2.46 ± 1.39 days, p<0.001), autologous HSCT (2.89 ± 1.53 days, p<0.001), and chemotherapy (1.28 ± 1.38 days, p=0.049). Similarly, IPF recovery occurred earlier than platelet recovery: allogeneic (3.08 ± 1.16 days, p<0.001), autologous (2.78 ± 1.17 days, p<0.001), and chemotherapy (2.25 ± 1.16 days, p=0.049). Pooled analysis showed IRF >12% preceded ANC recovery by 2.45 ± 1.54 days and IPF >6% preceded platelet recovery by 2.76 ± 1.17 days (both p<0.001). Only 2 patients (5%) failed to achieve IRF/IPF recovery; in 95%, both parameters predicted marrow recovery
Conclusions: IRF and IPF are robust, early predictors of bone marrow recovery, preceding conventional ANC and platelet count recovery by 2–3 days. Readily available through modern CBC analyzers, they offer a cost-effective, accessible method for monitoring marrow activity in both HSCT and chemotherapy settings.
Key words: IRF, IPF, HSCT |
| 62 |
From Neck Clot to Colon Clues |
1988-12-28 |
Female |
Yes |
L-1842 | H_LKO |
Benign |
Hemeostasis |
Clinical |
DR VRINDA KULKARNI |
DR. KALYANI PATIL |
TNMC & BYL NAIR HOSPITAL |
MUMBAI |
6381634255 |
kalyanibapat2812@gmail.com |
Poster |
Title: From Neck Clot to Colon Clues
Introduction: Internal Jugular vein thrombosis (IJVT) is a rare clinical entity typically secondary to central venous catheterization , local infection, trauma, malignancy or hypercoagulable state. Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome caused by germline mutation in APC gene and characterized by multiple adenomatous colorectal polyps with inevitable progression to colorectal cancer. We present this case to highlight an unusual sentinel presentation of FAP as isolated IJVT.
Methods: 24 year old female , known case of Type 1 diabetes mellitus, presented with fever and right side neck pain and swelling. CT scan of neck revealed complete lumen occluding thrombus of right internal jugular vein (IJV). Thrombophilia work up done was negative. Patient was started on therapeutic dose of Low molecular weight heparin (LMWH) followed by rivaroxaban. After 7 days of starting rivaroxaban patient developed bleeding per rectum, in view of which anticoagulation was withheld. Colonoscopy done revealed multiple polyps throughout larfe intestine while upper GI scopy showed gastric polyps. Biopsy of colonic polyp showed tubulovillous adenoma with low grade dysplasia. Patient was restarted on therapeutic dose of (LMWH) overlapped with warfarin, dose adjusted to achieve therapeutic INR. Patient was later posted for elective laproscopic proctocolectomy.
Results: This case highlights an unusual presentation where IJVT was sentinel event which later led to diagnosis of FAP. IJVT as first presentation of hereditary colorectal cancer syndromes is extremely unusual. Thus venous thrombosis at unusual sites should warrant thorough workup for all possible causes as it can be often first sign of an underlying malignancy.
Conclusions: This case underscores the importance of thorough evaluation of underlying systemic causes especially in cases of atypical or unprovoked site thrombosis as early recognition is crucial for its long term management of anticoagulation.
Keywords : Thrombosis, polyposis, unprovoked |
| 63 |
Cytarabine-Induced Red Ear Syndrome: A Rare Adverse Event |
1996-04-01 |
Male |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
D ROY J PALATTY ,Consultant in Hematology |
DR JOSEPH JOSE |
RAJAGIRI HOSPITAL , ALUVA,ERNAKULAM, KERALA |
ALUVA |
9846029858 |
josephjose2210@gmail.com |
Poster |
Title: Cytarabine-Induced Red Ear Syndrome: A Rare Adverse Event , Authors - Dr Joseph Jose , Dr Roy J Palatty
Introduction: Red Ear Syndrome (RES) is a rarely reported neurovascular condition marked by paroxysmal erythema of the external ear, with scant mention in the context of cytarabine chemotherapy. Cytarabine, widely used in the treatment of hematological malignancies such as acute myeloid leukemia (AML), is known for various dermatologic toxicities, but RES is exceptionally uncommon. Early recognition is essential to differentiate from infectious processes and to guide appropriate management.
Methods: A 57-year-old female with newly diagnosed AML received FLAG plus Cytarabine chemotherapy. During treatment, she developed bilateral parotid swelling and erythematous pinnae. Comprehensive clinical assessment, laboratory investigation, and imaging (including ultrasonography of the parotid glands) were performed to exclude infection and other differential diagnoses.
Results: Clinical evaluation and imaging ruled out parotitis and otitis externa. The absence of infectious etiology or pain led to consideration of cytarabine-induced RES. Supportive care included oral and topical steroids, resulting in significant resolution of symptoms. This case reinforces that the presentation of RES can mimic infection but is benign and manageable with symptomatic therapy.
Conclusions: Cytarabine-induced Red Ear Syndrome is a unique, rare, and likely under-recognized dermatologic toxicity. Increased awareness among clinicians can prevent unnecessary investigations or alteration of chemotherapy. Supportive measures—primarily corticosteroids—are generally sufficient for symptom resolution. Ruling out infectious causes remains crucial before attributing ear erythema to cytarabine in immunocompromised patients.
Key words: Red Ear Syndrome, Cytarabine, Acute Myeloid Leukemia, Chemotherapy Toxicity, Case Report, Dermatologic Adverse Event, Ear Erythema, FLAG regimen |
| 64 |
Post BMT graft rejection, rescue in a case of Triple Viral Positive Thalassemia. |
1979-03-28 |
Male |
Yes |
1220 | H_LKO |
Benign |
Miscellaneous |
Clinical |
Isha Gambhir, Ravi Shankar, Harprit Singh |
Pawan Kumar Singh |
Yatharth Superspeciality Hospital |
NOIDA |
9717532903 |
pawan2809@gmail.com |
Poster |
TITLE: Post BMT graft rejection, rescue in a case of Triple Viral Positive Thalassemia.
Introduction: With the current advancement in the anti-viral therapy, nowadays BMT can be done in these viral infection positive patients, just like normal persons. With this case report, we emphasize on successful transplant in triple virus positive thalassemia and then stem cell boost as rescue for Poor Graft Function.
Case: Mast A, 3 yrs boy, a case of thalassemia Hepatitis B, C and HIV positive when planned for Matched Sibling Donor BMT. HBV DNA was negative, HCV RNA was 47660 copies/ml, HIV RNA was 951327 copies/ml and Absolute CD4 count was 372/microL. He was started on Sofosbuvir plus Valapatasavir for HCV and Abacavir/Lamivudine plus Lopinavir/Ritonavir combination for HIV. After 6 months HCV-RNA became negative. After 1 year of CAART, his HIV copy number became 5342 copies/ml and CD4 count became 372/microL. MSD allogenic BMT with TTF plus ATG conditioning was done on 22-03-23 with 3.2 million/kg. Neutrophilic and platelet engraftment was achieved on day +26 and day +40, respectively. By day +75 he started developing pancytopenia and split donor chimerism showed 100% T cell and 23.44% myeloid. Cyclosporine stopped and stem cell boost with positively selected CD34 cells (11 million/kg) were given on day +109 without any prior conditioning or immunosuppression. Myeloid chimerism improved to 99% after 1 month and it is still persisting at full split donor chimerism. Cyclosporine was restarted 45 days after boost and continued till 9 months. His HBV-DNA, HCV-RNA & HIV-RNA are all negative and the absolute CD4 count is 706/microL and continuing CAART.
Conclusion: Allogenic BMT can be done very safely in viral marker positive patients with newer anti-virals and CAART. Stem cell boost is a good option for poor graft function.
Keywords: HIV, CAART, BMT, Stem cell boost |
| 65 |
IMMUNOGLOBULIN G4-ASSOCIATED ROSAI DORFMAN DISEASE |
1989-12-15 |
Female |
Yes |
L-1964 | 52370 |
Benign |
Miscellaneous |
Clinical |
Aarti & Sanjay Gandhi Post Graduate Institute of Medical Sciences |
Akanksha Singh |
Sanjay Gandhi Post Graduate Institute of Medical S |
Lucknow |
9559815220 |
assiduous2007@gmail.com |
Poster |
Title: IMMUNOGLOBULIN G4-ASSOCIATED ROSAI DORFMAN DISEASE Introduction: Rosai-Dorfman disease (RDD), a sinus histiocytosis with massive lymphadenopathy, represents an idiopathic proliferation of peculiar, histiocyte-like cells of unknown aetiology. Most patients with RDD present with multiple lymphadenopathies, although RDD also involves a variety of extra-nodal sites. Methods: Case Presentation: A 64-year-old woman presented to head & neck surgery clinic with a complaint of swelling on left side of her neck since 2021, which was insidious in onset and gradually progressive. On examination, multiple firm, mobile swellings were present involving bilateral level II, III, V, with swelling in the left level II of 5 x 6 cm, infiltrating skin. MRI head and CECT neck were done. Acute phase reactants comprising of IgM 59 mg/dL (range 60-280), IgG 3150 mg.dL (range 800-1800) and IgG4 314 mg/dl (range 10-140) showed increased levels of IgG and IgG4. FNA showed inflammatory pathology. Swelling was excised and sent for histopathological examination. Results: Culture was negative for acid fast bacilli after 8 weeks of incubation. Mycobacterium complex was not detected by GeneXpert Assay. On microscopy, sections showed epidermis was lined by mild hyperplastic stratified squamous epithelium. Dermis shows fibrosis, sheets of foamy histiocytes and neutrophilic infiltration. Underlying lymph node shows partially preserved architecture with marked expansion of sinuses by sheets of foamy histiocytes having vesicular chromatin and abundant vesicular nuclei. Intervening areas show mixed inflammatory infiltrates comprising of lymphocytes, plasma cells, polymorphs and occasional eosinophils. On IHC, histiocytes showed positivity for CD68 and S100 and negative for CD1a. Conclusions: We observed a unique case of RDD with marked increase of IgG4-positive plasma cells in a patient with a history of graves’ disease. We believe it is of paramount importance to increase the awareness of IgG4-associated RDD for pathologists.
Keywords: Rosai-Dorfman disease, sinus histiocytosis, histopathology, immunohistochemistry, graves’ disease. |
| 66 |
Post-transplant cyclophosphamide (PTCY) based GVHD Prophylaxis in Matched Hematopoietic Stem Cell Transplant: A Retrospective Study |
1991-07-14 |
Male |
No |
- | H_LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Meena Verma, Saikat Mondal, Naveen Vairamoorthy, Naman Bansal, Navneet Mishra, Priyamvadha, Shruti Sinha, Deepika Gupta, Nitin Gupta |
Dr. Navneet Mishra |
Sir Ganga Ram Hospital, New Delhi |
New Delhi |
8840907946 |
drnavneet.m@gmail.com |
Oral |
Title: Post-transplant cyclophosphamide (PTCY) based GVHD Prophylaxis in Matched Hematopoietic Stem Cell Transplant: A Retrospective Study
Introduction: Post-transplant cyclophosphamide (PTCy) has become standard in haploidentical transplants, but its application in matched sibling and unrelated donor (MSD/MUD) settings remains limited-especially in real world Indian Contexts.
Methods: In a retrospective analysis (January 2022-Januray 2025), 12 MSD/MUD HSCT recipient at a tertiary Indian center received PTCy-based GVHD prophylaxis alongside cyclosporine or tacrolimus. We evaluated engraftment, GVHD incidence, CMV reactivation, relapse, survival, and complications using SPSSv25.
Results: Twelve patients (male: 9 and female: 3) were identified; median age 40 years. Underlying diagnoses included AML (n=7), ALL (n=1), CML-LBC (n=1), MM (n=1), LBCL (n=1), and SAA (n=1). Conditioning regimens included: myeloablative (Flu-Bu) (n=9), Flu-Mel (n=2) and one patient with SAA received Flu-Cy-TBI. All patients engrafted; median day of neutrophil and platelet engraftment was 15.5 days (12 – 18 days) and 14 days (11 – 20 days), respectively. CMV reactivation was observed in 50% of patients, which was managed with gancyclovir. Acute GVHD was noted in 3 (25%) of patients; (Skin (Grade-1), Gut (Grade-1), and Liver (Grade-1); all grade 1 – 2 and none with grade 3 - 4. Chronic GVHD occurred in 3 (25%) of patients, mostly mild in all. Relapse rate was 3 (25%), and non-relapse mortality (NRM) was 1 (8.3%). At a median follow-up of 24.8 months, 3 patients have died, including one due to non-relapse mortality (NRM, 8.3%) and two due to progressive disease (16.7%). The estimated 1- and 2-year progression-free survival (PFS) was 63.5% and 47.6%, respectively. The 2-year overall survival (OS) was 63.5%.
Conclusions: In matched donor HSCT, PTCy- based GVHD prophylaxis appears effective and safe-yielding low GVHD rates and transplant related mortality. While CMV reactivation is relatively higher, timely intervention maintains low associated mortality.
Key words: PTCy, GVHD, MSD |
| 67 |
Demystifying anaplastic large cell lymphoma: A clinicopathologic analysis from a tertiary cancer center of North India |
1993-11-28 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Zachariah Chowdhury, Ipsita Dhal, Anil Singh, Raghwesh Ranjan. Mahamana Pandit Madan Mohan Malviya Cancer Centre & Homi Bhabha Cancer Hospital (Tata Memorial Centre), Homi Bhabha National Institute, Varanasi, India. |
Isha Makker |
Mahamana Pandit Madan Mohan Malviya Cancer Centre |
Varanasi |
8447724687 |
isha.makker@gmail.com |
Oral |
Title: Demystifying anaplastic large cell lymphoma: A clinicopathologic analysis from a tertiary cancer center of North India
Introduction: Anaplastic large cell lymphomas (ALCLs) are high-grade T cell lymphomas characterized by large pleomorphic cells and expression of CD30, accounting for 2-8% of Non-Hodgkin lymphoma in adults and 10-15% in children. ALCL can be classified as ALK positive (ALK+) and ALK negative (ALK-) ALCL depending upon the expression of ALK protein by immunohistochemistry.
Methods: All cases diagnosed as ALCL on histomorphology and immunohistochemistry over a period of 6 years were explored.
Results: A total of 104 cases were identified, with an almost equal distribution of ALK+ (n=54) and ALK- (n=50) ALCL. Median age of presentation was 17years in ALK+ (2-64 years) while it was 46years (8-82 years) in ALK- group. While the most common presenting complaint was lymphadenopathy, 43% patients presented with B symptoms. Extranodal involvement was perceived in 75% cases, with the most common sites being soft tissue and bone, followed by skin, lung, stomach, intestine, etc. ALCL presented with diverse histomorphology, because of which immunohistochemistry was mandatory for accurate diagnosis. LCA was immunoreactive in 89% cases, while a potential pitfall was the negativity of CD3 in nearly 40%. On a median follow up period of 32 months, 31% patients experienced disease progression and 40% patients succumbed to disease, 47% ALK+ and 53% ALK-. The 3-year progression-free survival rate of the cohort was 50.2±5.8% (ALK+ 57.3±7.5% and ALK- 43.8±8.4%). The 3-year overall survival rate of the cohort was 61.9±5.4% (ALK+ 65.1±7%, ALK- 59.3±7.9%).
Conclusions: Meticulous histopathologic assessment is crucial in precise detection of ALCL, since it has a varied histomorphology with numerous close differentials including Hodgkin lymphoma, Diffuse Large B cell Lymphoma, Peripheral T cell lymphoma, as well as metastatic carcinomas, melanomas and sarcomas.
Key words: ALCL, North India |
| 68 |
Synergistic Hemostatic Effect of Thrombin-Impregnated Chitosan–PVA Patch |
1982-11-03 |
Male |
No |
- | H_LKO |
Benign |
Miscellaneous |
Clinical |
Co- Authors: Helen Jalaja Shibu, Aparna BS, Lynda V Thomas, Anugya Bhatt; Affiliation: Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram |
Renjith P Nair |
Sree Chitra Tirunal Institute for Medical Sciences |
Thiruvananthapuram, Kerala |
09048116067 |
renjith@sctimst.ac.in |
Oral |
Title: Synergistic Hemostatic Effect of Thrombin-Impregnated Chitosan–PVA Patch
Authors: Helen Jalaja Shibu, Aparna BS, Lynda V Thomas, Anugya Bhatt and Renjith P Nair
Introduction: Topical hemostats are widely used to prevent bleeding during accidents, military emergencies, surgical procedures. However, existing hemostatic agents often have limitations related to ease of application, cost, biocompatibility, and overall efficacy. Thrombin is a natural hemostatic agent. In this study, we explored the synergistic hemostatic potential of thrombin combined with a cross-linked chitosan–poly(vinyl alcohol) (ChPVA) matrix.
Methods: ChPVA was synthesized as per a patented process. ChPVA sponges were fabricated via controlled lyophilization of synthesized ChPVA and cut into 3 × 3 cm patches. These were impregnated with varying concentrations of thrombin (100 IU to 200 IU). Hemolysis and coagulation effects were evaluated according to ISO 10993-4 standards. Hemostatic efficacy was assessed by performing blood clotting index assay. Commercially available chitosan sponges served as controls.
Results: Blood clotting assays demonstrated that thrombin-ChPVA patches induced clot formation within 30 seconds, outperforming the controls. The highest clotting efficiency efficacy was observed with 200 IU thrombin–ChPVA patches. Across all assays, thrombin–ChPVA patches exhibited significantly higher hemostatic performance than both ChPVA-only sponges and commercial chitosan-based patches. ChPVA patches also showed significantly higher in vitro clotting efficiency compared to commercial chitosan sponges. The synergistic interplay of chitosan-PVA, and thrombin enhanced platelet activation and aggregation, facilitating rapid clot formation. Hemolysis assays showed that thrombin–ChPVA patches were non-hemolytic.
Conclusion: Human thrombin–impregnated ChPVA patches demonstrated high efficacy in accelerating hemostasis. These patches will serve as an advanced hemostatic materials for clinical use in trauma care, surgical procedures, and emergency medicine.
Key words: Thrombin, Hemostats, blood clotting.
|
| 69 |
Real-World Experience from India with Varnimcabtagene Autoleucel: Advancing CAR-T Access and Outcomes |
1968-05-12 |
Male |
Yes |
ISHBT19-G/1035- | H_LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dinesh Bhurani 1, Sharat Damodar 2, Rohan Halder 1, Vikram Mathews 3, Aby Abraham 3, Narendra Agrawal 1, Nataraj KS 4, Sanket Shah 5, Neeraj Sidharthan 6, Gaurav Kharya 7, Kripa Bajaj 8, Uday Kulkarni 3, Pavan Kumar Boyella 9, Padmaja Lokireddy 10, Monish |
Dr. Dinesh Bhurani |
Rajiv Gandhi Cancer Institute and Research Centre |
Delhi |
9971500861 |
imagine@immuneel.com |
Oral |
Title: Real-World Experience from India with Varnimcabtagene Autoleucel: Advancing CAR-T Access and Outcomes
Introduction: Varnimcabtagene autoleucel (IMN-003A), an autologous second-generation CAR T-cell product with a 4-1BB co-stimulatory domain and murine A3B1 binder, was approved in India in Feb 2024 for B-cell Non-Hodgkin’s Lymphoma (B-NHL) above 18 years. This observational study presents real-world experience on access, safety, and efficacy from multiple Indian centres.
Methods: Patients ≥18 years with r/r B-NHL infused with varnim-cel (fractionated 10%/30%/60%) at 5x10⁶/kg CAR+ cells after Flu-Cy lymphodepletion between 02 Aug 2024 to 15 Jul 2025 were included. Ten centres were trained in clinical and toxicity management. Manufacturing and scheduling were centralized. No adjuvant/maintenance therapy was given. Outcomes included manufacturing success rate (MSR), brain-to-vein (registration to infusion), vein-to-vein (apheresis to infusion), response (per IWG), and AEs (CRS, ICANS, IEC-HS).
Results: 30 patients underwent leukapheresis (median age 58, range 21–79; 63% male; 100% Asian). Subtypes: DLBCL 67%, PMBCL 3%, THRLBCL 3%, Transformed Indolent 7%, FL 10%, MCL 10%; 83% had extranodal involvement, 37% bulky disease, 7% CNS involvement. Median prior treatments: 3 (range 1–5). One patient had prior auto-transplant. MSR was 96%. Median CAR-T manufacturing time: 26 days. Median brain-to-vein: 45 days; vein-to-vein: 34 days. 23 infused (1 death, 1 failed manufacturing, 5 awaiting). 17 (57%) had bridging therapy. Median distance travelled to access varnim-cel was 493 km.
D+28 ORR in 19 evaluable pts: 79% (CR 53%). D+90 ORR: 60% (6/10); 4 relapsed by D+90. AESIs: CRS 48% (G3+ 4%), ICANS 9% (G3+ 4%), ICAHT – neutropenia 48% (G3+ 26%), anemia 70% (G3+ 13%), thrombocytopenia 57% (G3+ 9%). Safety was comparable to IMAGINE trial.
Conclusion: RWE confirms safety, efficacy, and feasibility of varnim-cel via a centralized model ensuring equitable access across India and South Asia.
Key words: CAR-T Cell Therapy, B-NHL, B-ALL, B Cell Malignancies
|
| 70 |
Molecular and Clinical Spectrum of 29 Congenital Dyserythropoietic Anaemia Type II Patients in the Indian Population |
1968-06-26 |
Male |
Yes |
L-898 | pay_R |
Benign |
Marrow failure |
Laboratory |
|
Dr Prabhakar Kedar |
ICMR National Institute of Immunohematology Mumbai |
Mumbai |
09969007500 |
kedarps2002@yahoo.com |
Oral |
Title:
Molecular and Clinical Spectrum of 29 Congenital Dyserythropoietic Anaemia Type II Patients in the Indian Population
Introduction
Congenital dyserythropoietic anaemia type II (CDA II) is a rare autosomal recessive disorder caused by mutations in the SEC23B gene. It manifests with anaemia, jaundice, and splenomegaly, often complicated by iron overload and gallstones. This study aimed to characterize the clinical and molecular spectrum of CDA II in Indian patients and assess the effect of SEC23B variants on gene expression.
Methods
Twenty-nine clinically suspected CDA II patients underwent haematological, biochemical, and bone marrow evaluation. Molecular analysis was performed using targeted next-generation sequencing (t-NGS). Variant pathogenicity was assessed using bioinformatics tools. SEC23B mRNA expression was quantified by real-time PCR.
Results
All patients presented with moderate to severe anaemia, pallor, jaundice, indirect hyperbilirubinemia, and splenomegaly. Haematology revealed hypochromic microcytic anaemia with spherocytes, and bone marrow showed erythroid hyperplasia with >10% binucleated erythroblasts and karyorrhexis. t-NGS identified 13 SEC23B variants. The most frequent was c.1385A>G (p.Tyr462Cys), present in 19 homozygous patients. Two novel variants were identified: a splice-site variant (c.2148+1G>T) and a nonsense variant (p.Gln220Ter). Quantitative PCR showed reduced SEC23B mRNA expression across all patients, with a more pronounced reduction in compound heterozygotes harbouring missense and nonsense variants. Clinically, one patient underwent hematopoietic stem cell transplantation, three underwent splenectomy, and the remainder are managed with transfusion support.
Conclusions
This study delineates the clinical and molecular spectrum of 29 CDA II patients from India, reporting two novel SEC23B variants. Findings emphasise genotype–phenotype correlations and demonstrate that SEC23B mutations reduce mRNA levels, underscoring the utility of integrated molecular and clinical approaches for diagnosis and management.
Keywords: Congenital Dyserythropoietic Anaemia II, SEC23B gene, Dyserythropoiesis, t-NGS, SEC23B gene expression
|
| 71 |
Transplant Outcome in Diamond-Blackfan Anemia- A Single Centre Experience |
1985-03-07 |
Male |
Yes |
L-2219 | pay_R |
Benign |
Marrow failure |
Clinical |
Dr Sharon Lionel; Dr Anu Korula;Dr Sushil Selvarajan; Dr Uday Kulkarni; Dr Aby Abraham; Dr Vikram MathewsDr Biju George, Christian Medical College Vellore |
Dr Sujith.K |
Christian Medical College Vellore |
Vellore |
7012737118 |
sksujith89@gmail.com |
Oral |
Title: Transplant Outcome in Diamond-Blackfan Anemia- A Single Centre Experience
Introduction: Diamond-Blackfan Anemia (DBA) is a rare congenital bone marrow failure syndrome characterized by anemia, physical abnormalities, and predisposition to malignancies. Hematopoietic stem cell transplant (HSCT) remains the only curative treatment for DBA.
Methods: This retrospective study evaluated 20 patients diagnosed with DBA who underwent HSCT from 1st November 1997 to 31st March 2025. Data was collected from electronic medical records and analyzed using SPSS software
Results: During the study period 20 patients underwent HSCT for DBA. The median age was 5.5 (range: 0-14) years. Majority were males (60%). Most of the patients presented within 3 months of age (65%). Median ferritin at HSCT was 2072.5(range 348-7985) ng/ml. Majority (90%) had myeloablative conditioning (MAC) regimen.and serotherapy was given for 70% patients. Stem cell donor was matched related (MRD) in 40%, haploidentical in 40% and matched unrelated (MUD) in 20%. Stem cell source was peripheral blood stem cells (PBSC) in 80%. Engraftment was seen in 85% at a median of 15 (range 11-24) days for neutrophil engraftment and 16.5 (range 10-69) days for platelet engraftment. Acute GVHD was seen in 65% of patients with grade 3-4 seen in 18%.Chronic GVHD was seen in 65% of patients Overall survival of the entire cohort was 61.7% ±11.6%at a median follow up of 41 months There was no difference in overall survival between recipients of MRD and alternate donor (58.3±18.6% for MRD; 65.6±14% for alternate donor, p= 0.948).Five patients died during the follow up. The most common cause for mortality was TRM
Conclusions: HSCT offers a potential cure for DBA, with encouraging long-term survival in our cohort. However, TRM remain significant challenge, underscoring the need for optimized conditioning and supportive care strategies.
Key words: Diamond-Blackfan Anemia, Stem cell Transplant |
| 72 |
Myeloperoxidase immunophenotyping in Acute Leukemias and Chronic Myeloid Leukemia: Are we relying too much? |
1979-08-10 |
Female |
Yes |
L 1384 | 52400 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Subhajit Hajra, Dr Ankita Sen, Dr Abhishek Kumar, Dr Basab Bagchi |
Pronati Gupta |
Chittaranjan National Cancer Institute |
Chittaranjan National Cancer Institute, KOLKATA |
09674023750 |
drpronati@gmail.com |
Oral |
Title: Myeloperoxidase immunophenotyping in Acute Leukemias and Chronic Myeloid Leukemia: Are we relying too much?
Authors: Dr Pronati Gupta, Dr Subhait Hajra, Dr Ankita Sen, Dr Abhishek Kumar, Dr Basab Bagchi
Introduction : Cytoplasmic Myeloperoxidase (cMPO) staining has traditionally been used for the diagnosis of Acute Myeloid leukemia (AML). With the advent of immunophenotyping, the importance of cMPO staining was superceded by the presence of various myeloid antigens. However cMPO remains important and crucial when it comes to differentiating Mixed phenotype acute leukemias (MPAL) versus Early T cell precursor Lymphoblastic leukemia (ETP-ALL) and acute undifferentiated leukemia (AUL).
Methods: Retrospective study of one year duration was conducted on all cases of acute leukemia and Chronic Myeloid leukemia (CML) in all phases, which underwent immunophenotyping by a 13 colour flow cytometry, at Chittaranjan National Cancer institute, Kolkata. Immunophenotyping with special emphasis on cMPO and final diagnosis were noted in each case.
Results: A total of 150 cases of acute leukemia and CML underwent immunophenotyping during the period of study. Of these, 45 were B- lymphoblastic leukemia (B-ALL), 19 were T-Lymphoblastic leukemia (T-ALL), 5 were ETP ALL or near ETP ALL, 61 were AML, 6 were MPAL and 14 were cases of CML with variable number of blasts. cMPO expression was noted in all cases of AML except two cases. All cases of T ALL, ETP ALL, Near ETP ALL and B-ALL were negative except one case of B-ALL. Interestingly of the 11 cases of CML with increased myeloid blasts/ myeloid blast crises, 8 cases showed complete negative expression of cMPO in myeloblasts.
Conclusions: cMPO though cornerstone in the diagnosis of AML, should be interpret cautiously in cases of ETP ALL versus MPAL as well as in cases of CML in blast crises.
Keywords: Myeloperoxidase, Immunophenotyping, Acute leukemia, Chronic myeloid Leukemia |
| 73 |
Making every drop count: An audit of Blood Component Utilization in a Tertiary Care Blood Centre. |
1993-10-05 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Vatsala kishore, Uma Shankar gupta, Ajmal Singh bhayal, Neeraj singh, Saumya pandey. |
Tanvi Garg |
Heritage Institute of Medical Sciences |
Varanasi |
9315747148 |
dr.tanvigarg@outlook.com |
Oral |
Title:Making every drop count: An audit of Blood Component Utilization in a Tertiary Care Blood Centre.
Introduction:Blood transfusion is an indispensable part of modern medical practice, with applications in surgery, trauma, obstetrics, oncology, and critical care. However, inappropriate or excessive transfusion can not only deplete this scarce supply but also expose patients to complications such as transfusion reactions, alloimmunization, and immunomodulation. To ensure judicious use, transfusion practices must be periodically reviewed, with emphasis on component therapy over whole blood transfusion.
Methods:This is a prospective observational study conducted in Heritage institute of medical sciences blood center, Varanasi, over 12 months (July 2024–July 2025). All blood/component requisitions received by the institutional blood center during the study period included. Data regarding patient demographics, diagnosis, transfusion indication, type and number of units cross-matched and transfused, and adverse transfusion reactions if any collected. Statistical analysis performed using SPSS v25.0.
Results/Conclusions: By mapping patterns of transfusion practices and calculating utilization indices, this study will provide valuable insights into the rational use of blood and its components. The findings will help reduce unnecessary transfusions, minimize wastage, and promote safer evidence-based transfusion practices, ultimately enhancing patient care. Findings will also guide policy formulation and serve as a baseline for future audits in similar healthcare settings.
Key words: Blood transfusion, blood component, C/T ratio, Transfusion index, patient safety. |
| 74 |
Platelets function tests in newly diagnosed multiple myeloma with and without renal disease |
1994-10-30 |
Female |
Yes |
L-2172 | 56068 |
Malignant |
Plasma cell disorders |
Clinical |
Dr. Arnab Chattopadhyay |
Dr. Sweety Kumari |
IHTM, Medical college kolkata |
Kolkata |
8789725060 |
ysweety71@gmail.com |
Oral |
Title: Platelet function tests in newly diagnosed multiple myeloma with or without renal dysfunction
Introduction:
Methods:
Results:
Conclusions:
Key words: |
| 75 |
Unresolved Anemia in Sitosterolemia Despite Ezetimibe Therapy: Evidence for Novel Treatment Pathways. |
1978-10-23 |
Male |
No |
- | H_LKO |
Benign |
Anemia |
Clinical |
Pradnya dehadrai, Prachi Kamble, Neha Samanpalliwar, Rashmi Dongerdiye, Manisha Madkaikar, Chandrakala Shanmukhaiah, Prabhakar Kedar. 1.ICMR-National Institute of Immunohaematology, 13th floor, New Multistoried Building, KEM Hospital, Parel, Mumbai 40001 |
DR PRASHANT PRAKASH WARANG |
ICMR-National Institute of Immunohaematology, 13th |
MUMBAI |
09892833782 |
prashantviraj23@gmail.com |
Oral |
Title:
Unresolved Anemia in Sitosterolemia Despite Ezetimibe Therapy: Evidence for Novel Treatment Pathways
Introduction: Sitosterolemia is a rare autosomal recessive lipid disorder caused by pathogenic variants in ABCG5 or ABCG8, leading to pathological accumulation of dietary plant sterols. Clinical manifestations include xanthomas, premature atherosclerosis, and hematological abnormalities such as hemolytic anemia, thrombocytopenia, and stomatocytosis. Diagnosis is often delayed due to overlap with other hematological and lipid disorders.
Methods: We investigated four patients with unexplained inherited hemolytic anemia and a history of repeated transfusions. Hematological workup included CBC, peripheral smear, reticulocyte count, EMA binding assay, RBC enzyme activity, and HPLC for hemoglobinopathies. Biochemical evaluation comprised liver, renal, and lipid profiles, while plasma sterol levels were quantified by GC-MS. Functional studies assessed intracellular calcium flux, red cell density profiling, and oxidative stress. Whole exome sequencing (WES) was performed to identify causative variants, supported by in-silico pathogenicity predictions.
Results: All patients exhibited mild to moderate anemia (Hb 8.0–12.3 g/dL), stomatocytosis, and thrombocytopenia. Routine enzymatic and membranopathy studies were normal. WES revealed homozygous nonsense variants in ABCG5/ABCG8, including a novel ABCG8 (p.Trp584*, c.1751G>A) mutation. Plasma sterols, particularly stigmasterol and β-sitosterol, were markedly elevated. Ezetimibe therapy (10 mg/day for 6 months) reduced sterol levels but did not normalize hemoglobin or reduce overhydrated red cells. Functional assays demonstrated before and after Ezetimibe therapy shows elevated intracellular Ca²⁺ influx, increased oxidative stress, and persistent stomatocytosis, consistent with irreversible red cell membrane damage.
Conclusion: Ezetimibe lowers plasma sterols but fails to correct hemolysis in sitosterolemia, underscoring the role of sterol-induced membrane remodeling, oxidative stress, and abnormal Ca²⁺ handling. Combination therapy with ezetimibe and Ca²⁺-modulating agents may represent a novel therapeutic approach to ameliorate persistent hemolysis in affected patients.
Keywords: Sitosterolemia, Hemolytic Anemia, Ezetimibe Resistance, Red Blood Cell Membrane Pathophysiology, Calcium Dysregulation |
| 76 |
Silent Carriers in the Crowd: Role of HPLC in Unmasking Undiagnosed Hemoglobinopathies in Outpatient Clinics |
1989-11-29 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Neha Sharma, Chintamani Pathak, Mukul Singh (VMMC and Safdarjung Hospital, New Delhi)) |
Neha Sharma |
VMMC and Safdarjung Hospital, New Delhi |
New Delhi |
8890556405 |
drneha.bkn@gmail.com |
Oral |
Title: Silent Carriers in the Crowd: Role of HPLC in Unmasking Undiagnosed Hemoglobinopathies in Outpatient Clinics
Introduction: Hemoglobinopathies represent one of most common inherited red cell disorders worldwide, with particularly high prevalence in India. Their clinical recognition is often obscured by overlap with nutritional anemia, especially in antenatal women, leading to underdiagnosis and delayed intervention. High-performance liquid chromatography (HPLC) has emerged as a sensitive tool for identifying abnormal hemoglobin variants. This study aimed to determine the prevalence and spectrum of previously undiagnosed hemoglobinopathies among outpatient attendees using HPLC screening.
Methods: A cross-sectional study was conducted from January 2022 to December 2024. A total of 7,440 EDTA blood samples from patients attending general medicine, pediatrics, and antenatal outpatient departments were analyzed. Patients with known hemoglobinopathy or history of blood transfusion within the past year were excluded. Complete blood count, peripheral smear, sickling tests, and HPLC chromatograms were evaluated systematically.
Results: Out of 7,440 samples (female predominance, 81.2%), 165(2.21%) showed abnormal hemoglobin fractions consistent with hemoglobinopathy. The most frequent variant was heterozygous β-thalassemia trait(1.37%), followed by heterozygous HbAE(0.32%), HbAS/sickle cell trait(0.18%), and HbAD Punjab(0.14%). Rare variants included HbSS(0.04%), hereditary persistence of fetal hemoglobin(0.05%), and isolated cases(0.01% each) of homozygous HbEE, heterozygous HbAC, compound HbE-β thalassemia, and δβ-thalassemia. Additionally, five patients(0.06%) exhibited unidentified abnormal peaks warranting molecular confirmation. Retention peaks in P03/P04 windows were associated with elevated HbA1c in diabetics and excluded from hemoglobinopathy classification.
Conclusions: HPLC proved to be a robust, rapid, and sensitive screening modality, capable of detecting both common and rare hemoglobinopathies in outpatient practice. Incorporating HPLC into routine antenatal and general health screening can enable timely diagnosis, facilitate genetic counseling, and support preventive strategies. Wider implementation holds promise for reducing the burden of transfusion-dependent disorders and improving long-term outcomes in at-risk populations.
Key words: Hemoglobinopathy, HPLC, Hemoglobin |
| 77 |
“The Postpartum Masquerade: Unmasking Thrombotic Thrombocytopenic Purpura with ADAMTS13 Deficiency” |
1988-03-24 |
Female |
Yes |
L-2258 | H_LKO |
Benign |
Miscellaneous |
Clinical |
DR ROSHAN DIKSHIT, DR ANKUSH SINGHAL |
DR HEMA GOYAL |
AAKASH HEALTHCARE SUPERSPECIALITY HOSPITAL, |
DELHI |
7379140789 |
hemagoyal88@gmail.com |
Oral |
Title:
“The Postpartum Masquerade: Unmasking Thrombotic Thrombocytopenic Purpura with ADAMTS13 Deficiency”
Introduction:
Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy characterized by the pentad of microangiopathic hemolytic anemia, thrombocytopenia, neurological dysfunction, renal impairment, and fever. Acquired TTP due to ADAMTS13 deficiency is particularly uncommon in the postpartum setting and often poses a diagnostic challenge because of its clinical overlap with other pregnancy-related complications such as HELLP syndrome and atypical hemolytic uremic syndrome (aHUS). Delay in diagnosis may result in rapid deterioration. Early suspicion, ADAMTS13 testing, and prompt institution of plasma exchange remain the cornerstone of management and survival.
Methods:
We report a case from a tertiary care centre in Delhi: a 27-year-old woman, one day postpartum following cesarean delivery, presented with sudden onset purpura, anuria, and profound thrombocytopenia. Peripheral blood smear revealed schistocytes with laboratory evidence of microangiopathic hemolysis. ADAMTS13 activity was markedly reduced, establishing the diagnosis of TTP. The patient was managed with urgent daily therapeutic plasma exchange and sustained low efficiency dialysis (SLED) for acute kidney injury.
Results:
The patient underwent consecutive sessions of plasma exchange and SLED for six days. Platelet counts improved steadily, hemolysis markers normalized, and urine output gradually resumed. The coordinated effort of the hematology, nephrology, critical care, and blood centre teams ensured complete clinical recovery. This case demonstrates the efficacy of aggressive early intervention in preventing maternal morbidity and mortality.
Conclusions:
Postpartum TTP is a “wolf in sheep’s clothing”—often masquerading as more common obstetric complications. ADAMTS13 testing provided diagnostic clarity in this patient. Plasma exchange combined with renal replacement therapy proved lifesaving. This case highlights the importance of heightened clinical suspicion, rapid diagnosis, and multidisciplinary management in achieving favorable outcomes in this rare but catastrophic entity.
Key words:
Postpartum TTP, ADAMTS13 deficiency, Thrombotic microangiopathy, Plasma exchange, SLED dialysis, AKI.
|
| 78 |
Evaluation of CD41/CD42 Dose as a Predictor of Platelet Engraftment in Leukemia Patients Undergoing Allogeneic Stem Cell Transplantation- A Single Centre prospective study |
1993-04-04 |
Female |
No |
- | H_LK0 |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dr. Tina dadu, Dr. Rasika Dhawan Setia, Dr. Sanjeev kumar Sharma |
Dr. Kshirabdhi Tanaya Panda |
Dr. B L Kapur Memorial Hospital, New Delhi |
New Delhi |
9040789442 |
kshirabdhitanayapanda3@gmail.com |
Oral |
Title:
Evaluation of CD41/CD42 Dose as a Predictor of Platelet Engraftment in Leukemia Patients Undergoing Allogeneic Stem Cell Transplantation- A Single Centre prospective study.
Introduction:
Platelet engraftment is a critical determinant of hematologic recovery following allogeneic stem cell transplantation. While CD34+ cell dose has been widely used to assess graft adequacy, it lacks specificity for megakaryocyte lineage responsible for platelet production. CD41 and CD42 are glycoprotein markers of megakaryocyte progenitors and may serve as better predictor of platelet recovery. However, data validating their clinical utility remains limited.
Our objective is to evaluate the relationship between infused CD41/CD42-positive stem cell dose and platelet engraftment time in two groups of matched sibling donor and haploidentical donor transplant settings.
Methods:
This study included 23 leukemia patients (MSD: n=12; Haplo: n=11) undergoing allo-SCT. CD41/CD42 positive doses were quantified from stem cell graft before infusion. Platelet engraftment was defined as first of three consecutive days with a platelet count ≥20×10⁹/L without transfusion. Statistical analysis was performed in SPSS v24.
Results:
A strong correlation exist between CD41/CD42 dose and platelet engraftment time. In MSD group median CD41/CD42 dose was 1.52 and median time of platelet engraftment was 10.5 days and a strong negative correlation with platelet engraftment time was observed (Pearson r= -0.949, p< 0.00001; Spearman r= -0.920, p= 0.00002). In Haplo group median CD41/CD42 dose was 2.20 and median time of platelet engraftment was 18.0 days and the correlation was significant (Pearson r= -0.640, p= 0.034; Spearman r= -0.798, p= 0.0032). No significant correlation was found between CD34+ cell dose and platelet engraftment in either group.
Conclusions:
CD41/CD42-positive cell dose shows a significant and stronger correlation with platelet engraftment than CD34+ dose, in both MSD and Haplo transplants.
Key words:
CD41/CD42, platelet engraftment, MSD, haploidentical transplant, CD34 |
| 79 |
The Indispensable Utility of Flow Cytometry in Acute Leukemia of Mixed or Ambiguous Lineage : From Diagnosis to Prognosis |
1991-05-17 |
Male |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Asish Rath1 Mayur Parihar1,2 Sushant S Vinarkar1,3 Deepak Kumar Mishra1,3 Jeevan Kumar4 Arijit Nag4 Reena Nair4 Shouriyo Ghosh4 Dibakar Podder4 Debranjani Chattopadhay4 Saswata Saha4 1-Department of laboratory hematology, 2 - Cytogenetics, 3 - Molecula |
Kunal Gaur |
Tata Medical Center, Kolkata |
Kolkata |
8178502829 |
kunal.gaur@tmckolkata.com |
Oral |
Title: The Indispensable Utility of Flow Cytometry in Acute Leukemia of Mixed or Ambiguous Lineage : From Diagnosis to Prognosis
Introduction: Acute Leukemia of Mixed or Ambiguous Lineage (ALAL) is a rare (<4% of acute leukemias) and aggressive hematologic malignancy with a poor prognosis. Accurate diagnosis is critical for directing appropriate, lineage-specific therapy. This study highlights the integral role of multiparameter flow cytometry (MFC) in the diagnosis and classification of ALAL, integrated with comprehensive molecular and cytogenetic analysis.
Methods: We retrospectively analyzed 2,314 consecutive acute leukemia cases by MFC (6- to 11-color panels). Cases were classified as ALAL according to the WHO Classification of Hematolymphoid Tumors, 5th Edition criteria. Identified ALAL cases underwent further characterization via karyotyping, FISH, and next-generation sequencing (NGS) to identify associated genetic aberrations. Treatment regimens and outcomes were reviewed.
Results: ALAL was diagnosed in 25/2314 cases (1.1%). Subtype distribution was: B/Myeloid (n=9), T/Myeloid (n=7), B/T (n=6), B/T/Myeloid (n=1), and undifferentiated (n=2). Genetic profiling identified KMT2A rearrangements and BCR::ABL1 fusions as the most prevalent abnormalities, each with an incidence of 30% (n = 3 each). Analysis of therapeutic interventions revealed a higher overall survival (OS) in patients who received an acute lymphoblastic leukemia (ALL)-like regimen (81.8% OS, p value = 0.011) compared to those who received an acute myeloid leukemia (AML)-like regimen (0% OS, p value = 0.011). Four patients underwent allogeneic hematopoietic stem cell transplantation (HSCT) and remain alive in remission.
Conclusion: Multiparameter flow cytometry is a cornerstone for the accurate diagnosis and classification of ALAL. When integrated with genetic studies, it facilitates risk stratification and guides the selection of optimal therapeutic strategies, which may favor an ALL-oriented approach. This comprehensive diagnostic pathway is essential for improving clinical outcomes in this high-risk leukemia subgroup.
Key words: Acute Leukemia of Ambiguous Lineage, Multiparameter Flow Cytometry. |
| 80 |
“ANALYSIS OF CD25, CD64, HLA-DR, NEUTROPHIL LYMPHOCYTE RATIO (NLR) AND NEUTROPHIL PLATELET RATIO(NPR) IN DIAGNOSIS OF SEPSIS” |
1993-07-27 |
Male |
No |
- | H_LK |
Benign |
Infection & supportive care |
Clinical |
Dr. Ankur Ahuja |
Akshat K Aggarwal |
Armed Forces Medical College |
Pune |
7798726282 |
akshataggarwal85@gmail.com |
Oral |
Introduction:
Sepsis is a major cause of ICU mortality, with delays in diagnosis contributing to poor outcomes. Traditional biomarkers such as CRP and procalcitonin lack optimal accuracy. Flow cytometry markers (CD64, CD25, HLA-DR) and novel haematological indices like neutrophil to platelet ratio (NPR) & neutrophil to lymphocyte ratio (NLR) may provide rapid, objective, and reliable alternatives for early diagnosis and prognostication.
Aims and Objectives:
To evaluate the diagnostic performance of serological, flow cytometry, and novel haematological markers in sepsis, and to compare their individual and combined utility.
Materials and Methods:
A prospective observational study was carried out on 32 patients with suspected sepsis. Blood samples were analysed for CRP and procalcitonin, novel indices (NPR, NLR) and flow cytometric markers: CD64 on neutrophils, HLA-DR on monocytes, and CD25 on lymphocytes. ROC curves and correlation with clinical severity were assessed.
Results:
CD64 showed the best diagnostic performance (sensitivity 96.9%, specificity 100%), significantly elevated in sepsis cases compared to controls. HLA-DR expression was markedly reduced in septic patients, correlating with disease severity and poor prognosis. CD25 levels were significantly raised in sepsis, with moderate sensitivity (84.4%) and specificity (100%), supporting its role as an early marker. NLR showed better accuracy than NPR
Conclusion:
Flow cytometry markers provide superior diagnostic and prognostic value in sepsis. CD64 is highly sensitive and specific for diagnosis, HLA-DR downregulation reflects immunosuppression and severity, while CD25 aids in early discrimination of infectious from non-infectious SIRS. A two-marker flow-cytometric panel (CD64 + HLA-DR), optionally complemented by CD25/NLR, appears clinically practical and highly accurate for early sepsis identification.
Keywords: Sepsis, CD64, CD25, HLA-DR, Neutrophil-lymphocyte ratio (NLR), Neutrophil-platelet ratio (NPR), Flow cytometry
|
| 81 |
Early Detection of hemoglobinopathies in paediatric population using HPLC: A Key to better Outcomes |
1986-07-31 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
Dr. Ruchi Agarwal(Professor), Dr. Parveen Kundu (Professor), Dr. Monika Gathwal (Professor), Dr. Sunaina Hooda (Associate Professor), Dr. Swaran Kaur Saluja (Professor), Dr. Shrishti (PG Resident) |
Dr. NITIKA CHAWLA (Associate Professor, Pathology) |
Bhagat Phool Singh Government Medical College for |
SONEPAT |
7027733338 |
nitika.chawla31@gmail.com |
Poster |
Title: Early Detection of hemoglobinopathies in paediatric population using HPLC: A Key to better Outcomes
Introduction: Hemoglobinopathies are a group of inherited disorders which constitute a major bulk of genetic disease in India. In India, prevalence of significant hemoglobinopathies is 1.2/1000 live births. High Performance Liquid Chromatography (HPLC) is a highly sensitive method for early detection and screening of paediatric population for various hemoglobinopathies so that appropriate counselling can be provided to couples and families who may be at risk of hematological consequences.
Objective- To evaluate spectrum of various hemoglobinopathies in paediatric population (upto 18 years) in rural tertiary care hospital of Haryana.
Material & Methods- This retrospective cross sectional study was conducted in Department of Pathology, Bhagat Phool Government Medical College for Women from September 2020 to August 2025.
Results- A total of 956 paediatric cases were received for HPLC, out of which hemoglobinopathy was detected in 80 cases (8.37%). Male: female ratio was 1.2:1. The most common hemoglobinopathy was beta thalassemia trait (45%) followed by beta thalassemia major (17.5%). Hb D – Punjab Heterozygous and Hb E heterozygous were seen in 11.25% and 10% cases respectively followed by double heterozygous Hb S/beta thalassemia and Hb E/ beta thalassemia in 5% and 2.5% cases respectively. One case each of Sickle cell heterozygous, sickle cell homozygous, HbJ Meerut, Hb Lepore and HPFH were also reported. Most common type of anemia observed was microcytic hypochromic anemia in 82.5% cases.
Conclusion- HPLC is a highly sensitive and specific tool for detection of various hemoglobinopathies. The high prevalence of hemoglobinopathies in Indian paediatric population necessitates early screening of all anemic patients in pediatric age group to facilitate timely genetic counselling, transfusion therapies and curative treatments like bone marrow transplantation.
Keywords- hemoglobinopathies, High performance liquid chromatography, paediatric, beta thalassemia trait, genetic counselling |
| 82 |
chameleon in hematology: a case series of castleman disease |
1997-01-17 |
Male |
No |
- | H_LKO |
Malignant |
Rare hematological malignancies |
Clinical |
Dr. Alok Ranjan |
Dr. Suvam Dash |
IGIMS, Patna |
patna |
9508725720 |
d.suvam219@gmail.com |
Oral |
Title: Chameleon in Haematology: Castleman Disease – A Case Series of 7 Cases
Introduction: Multicentric Castleman Disease (MCD) is a rare, non-clonal lymphoproliferative disorder characterized by systemic inflammation, lymphadenopathy which can be generalised or specific, various systemic symptoms, often mimicking other hematologic malignancies, Tuberculosis, autoimmune diseases. Its heterogeneous clinical presentation frequently delays diagnosis, making it a diagnostic and therapeutic challenge.
Methods: We present a retrospective data of 7 patients over the period of 4 years from 2021 till 2025 diagnosed with Castleman disease. The data was analysed in terms of presenting Clinical features, Gender predilection, Centricity Laboratory parameters HIV status, HHV-8 status, ESR value, Imaging findings, Histopathology, Treatment regimens, Compliance to treatment and outcomes, Overall survival were analysed.
Results: The median age at diagnosis was assessed along with a male-to-female ratio. Systemic symptoms such as fever, weight loss, and generalized lymphadenopathy were the most common presenting complaints. Laboratory findings included elevated CRP, ESR, Anaemia and increased IL-6 levels. HHV-8-associated Multicentric Castleman Disease was identified in only 1 case. Histopathology revealed a mixed hyaline-vascular and plasmacytic variant. Treatment included corticosteroids, and rituximab-based regimens. Overall response rate was good, with disease specific mortality in only 1 patient. The compliance to treatment was good and therapy was well tolerated.
Conclusions: Multicentric Castleman Disease remains a diagnostic “chameleon” in haematology due to its clinical and pathological overlap with other entities. Hence in patients with fever and generalised lymphadenopathy Castleman disease should be kept as a differential diagnosis as early detection and prompt treatment could save the patient’s life.
Key words: castleman disease, multicentric/unicentric, HHV-8 negative, POEM Syndrome |
| 83 |
Tale of a "Blast Spreader" |
2000-01-20 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Dr. Jasmine Kaur, Dr. Pragya Sharma, Dr Saloni Goyal, Dr Vikram Narang |
Dr. Kanishka Garg |
Dayanand Medical College and Hospital |
Ludhiana |
8054029920 |
kanishka87602@gmail.com |
Poster |
Title:Tale of a “blast spreader” from a Tertiary Centre in Punjab
Introduction:A peripheral blood smear prepared for routine complete blood count and morphological examination unexpectedly demonstrated 42% blasts, predominantly clustered near the head and body of the slide, with relative sparing of the tail—an atypical and concerning distribution pattern.
Methods:A peripheral blood smear was prepared with a patient’s drop of blood using a spreader into a thin smear and stained with Giemsa for routine CBC and morphological examination. This smear case was examined at Department of Pathology, DMCH Ludhiana.
A peripheral blood smear prepared for routine complete blood count and morphological examination unexpectedly demonstrated 42% blasts, predominantly clustered near the head and body of the slide, with relative sparing of the tail—an atypical and concerning distribution pattern. However, repeat smears from the same EDTA sample and a finger prick sample showed no blasts. Upon investigation, it was found that the immediately preceding smear belonged to a patient with 90% blasts of similar morphology. This led to the conclusion that the spreader slide had retained a small amount of blood from the prior blast sample, resulting in cross-contamination and a false positive blast count. This case highlights a significant diagnostic pitfall stemming from inadequate smear preparation technique. Literature emphasizes the need for clean, smooth, and undamaged spreader slides to avoid contamination artifacts.
Results:This case highlights the importance of technical diligence and quality control in smear preparation to ensure reliable diagnostic outcomes in hematopathology.
Conclusions:. This case highlights a significant diagnostic pitfall stemming from inadequate smear preparation technique. Literature emphasizes the need for clean, smooth, and undamaged spreader slides to avoid contamination artifacts. To prevent such errors, spreader slides must be thoroughly cleaned or replaced between samples.
Key words: spreader, blasts, cross contamination, false positive blast count |
| 84 |
Acquired Amegakaryocytic Thrombocytopenia in Two Adults: A Rare Dilemma with Ambiguous Pathology |
1986-05-20 |
Female |
No |
- | pay_R |
Benign |
Platelet disorders |
Clinical |
Dr Sanjeev, Dr Khaliqur Rahman, Dr Ruchi Gupta, Dr Manish Kumar Singh, Dr Dinesh Chandra, Dr Sayan S Roy, Dr Rajesh Kashyap, SGPGIMS, Lucknow |
Mona Vijayaran |
Sanjay Gandhi Post graduate Institute of Medical S |
Lucknow |
08707076379 |
monavijayran1@gmail.com |
Poster |
Title: Acquired Amegakaryocytic Thrombocytopenia in Two Adults: A Rare Dilemma with Ambiguous Pathology
Introduction: Acquired amegakaryocytic thrombocytopenia (AAT) is a rare disorder characterized by severe thrombocytopenia with preserved other hematopoietic lineages. The etiology is often elusive, unlike congenital amegakaryocytic thrombocytopenia which presents in childhood. We describe two adult patients with AAT with an ambiguous underlying pathology.
Cases:Case 1: A 59-year-old male presented with ecchymotic patches for 6 months without major bleeding. No prior history of any drug intake or bleeding. Examination revealed bleeding manifestations only. CBC showed Hb 11.2 g/dl, TLC 9800/mm³, and platelets 20,000/mm³. Bone marrow was cellular with absent megakaryocytes but normal myeloid and erythroid lineages. ANA and viral markers were negative. Whole exome sequencing detected a heterozygous TPM4 variant of uncertain significance. He was initially treated with romiplostim (5–10 mcg/kg) without response, then started on azathioprine (1 mg/kg) and is under follow-up.
Case 2: A 55-year-old female presented with gum bleeding and ecchymoses for 3 months. Examination showed mild pallor and bleeding manifestations. CBC revealed Hb 9.5 g/dl, normal TLC, and platelets 12,000/mm³. Bone marrow was cellular with reduced megakaryocytes. NGS for MDS was advised but deferred due to cost. Autoimmune work-up showed ANA 2+ (dsDNA negative). She reported pesticide exposure. She was started on azathioprine (1 mg/kg) and romiplostim (5 mcg/kg) and is on follow-up.
Conclusions:AAT is often misdiagnosed as chronic ITP unless bone marrow examination is performed. Literature suggests poor response to IVIg and corticosteroids, with variable outcomes on immunosuppressants such as cyclosporine and azathioprine. In our patients, the presence of a heterozygous TPM4 variant in Case 1 and toxin exposure in Case 2 highlights the need for further evaluation, underscoring the importance of collaborative efforts to delineate the pathophysiology of this rare entity.
Key words: Acquired amegakaryocytic thrombocytopenia, Adults, Rare, Immunosuppressants |
| 85 |
Beyond the Usual: A quartet of deceptive Plasma Cell Neoplasms |
1988-09-29 |
Female |
No |
- | pay_R |
Malignant |
Plasma cell disorders |
Laboratory |
Dr. Anirban Kundu, Associate Consultant |
Dr. Sulagna Giri |
Apollo Multispeciality Hospital, Kolkata |
Kolkata |
9867198777 |
giri.sulagna@gmail.com |
Oral |
Title: Beyond the Usual: A quartet of deceptive Plasma Cell Neoplasms
Introduction: Plasma cell neoplasm encompasses spectrum of disorders ranging from monoclonal gammopathy of undetermined significance to extramedullary plasmacytoma and multiple myeloma. The typical presentation includes CRAB features (hypercalcemia, renal dysfunction, and anemia and bone lytic lesions). However unusual manifestation may occur due to extramedullary spread, light chain disease or involvement of uncommon sites (such as pleura, skin or central nervous system).
Here we present a case series highlighting four patients with plasma cell neoplasm exhibiting unusual clinical presentation.
Methods: NA
Results: Case 1: An elderly female presented with cough, radiologically mimicking a lung mass. High suspicion of lung carcinoma was made. Further evaluation revealed previously undiagnosed, pulmonary amyloidoma with underlying multiple myeloma.
Case 2: A young male presenting with history of abdominal pain, diagnosed clinically and radiologically as acute pancreatitis. Additionally had hypercalcemia and upon hematological evaluation -prompted by detection of plasma cells in peripheral blood smear- led to the diagnosis of plasma cell leukemia, with secondary hypercalcemia likely contributing to pancreatitis.
Case 3 and 4: A middle-aged patient and an elderly male, both are known cases of multiple myeloma, presented with pericardial and pleural effusion respectively. On fluid analysis, plasma cells were seen. Clinical diagnosis of relapsed multiple myeloma with rare extramedullary involvement was made. While pleural cavity involvement is relatively more common in multiple myeloma, pericardial involvement remains a rare and potentially life-threatening manifestation.
Conclusions: These cases underscore the diverse and often deceptive nature of plasma cell neoplasms presentations. The absence of typical features can delay diagnosis. Hence, a high index of early suspicion, clinical vigilance and comprehensive diagnostic approach- including careful exclusion of common mimickers and differentials- are critical for timely identification and management.
Key words: Plasma Cell Neoplasm, Unusual presentation, diagnostic dilemma. |
| 86 |
STUDY OF SERUM ERYTHROFERRONE LEVELS IN CHILDREN WITH BETA THALASSEMIA |
1997-04-03 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Sunita Sharma , Mukesh Dhankar |
Gunjan Batra |
LADY HARDINGE MEDICAL COLLEGE |
NEW DELHI |
9650690494 |
batra.gunjan97@gmail.com |
Oral |
Title:
STUDY OF SERUM ERYTHROFERRONE LEVELS IN CHILDREN WITH BETA THALASSEMIA
Introduction:
Beta thalassemia is a monogenic blood disorder characterized by defective beta globin chain synthesis, leading to an imbalance between alpha and beta chains, ineffective erythropoiesis and severe anemia. The disease requires lifelong blood transfusion, resulting in iron overload and associated complications. Erythroferrone (ERFE), a hormone produced by erythroblasts in response to erythropoietin, plays a critical role in regulating iron homeostasis by suppressing hepcidin and enhancing iron availability. The study aims to evaluate erythroferrone levels in children with beta thalassemia and its correlation with iron status, transfusion dependency and hepcidin (marker of iron homeostasis).
Methods:
A cross sectional study was conducted, involving 60 paediatric thalassemia patients, comprising of 30 thalassemia major (Transfusion dependent thalassemia-TDT) and 30 thalassemia intermedia (Non transfusion dependent thalassemia-NTDT). Serum ERFE levels were measured using enzyme linked immunosorbent assay (ELISA) in these patients and compared with 30 healthy controls. Additionally, ERFE levels were correlated with serum ferritin (measured by chemiluminescent immunoassay) and serum hepcidin (by ELISA).
Results:
Results indicate significantly elevated levels of serum ERFE in Beta thalassemia patients (80.75 ± 47.29ng/ml) as compared to controls (8.81 ± 2.44ng/ml) with (p<0.001), with strong positive correlation between ERFE and ferritin (r= 0.842 and p=0.001) and strong inverse correlation between ERFE and hepcidin (r= -0.811and p= <0.001). Among the cases, ERFE levels were much higher in TDT than in NTDT (p=0.002).
Conclusions:
In beta thalassemia, in spite of iron overload, there is paradoxical decrease in hepcidin levels as the erythroid drive takes over store drive. ERFE can serve as a potential marker for assessing iron overload. Further, monoclonal antibodies targeting ERFE can be used to correct iron overload, thereby reducing morbidity and mortality in these patients, making ERFE a novel therapeutic target.
Keywords:
Beta thalassemia, Erythroferrone, Hepcidin, Ferritin |
| 87 |
Scattergram Patterns in Cup Like Blast-Acute Myeloid Leukemia in SYSMEX XN Series Automated Cell Counters |
1996-05-05 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Pronati Gupta, Specialist Grade 1, Laboratory Medicine; Sada Mounika, Post Graduate Student, Laboratory Medicine; Subhajit Hajra, Specialist Grade 2, Laboratory Medicine |
Debdeep Biswas |
Chittaranjan National Cancer Institute |
Kolkata |
8098842635 |
dbiswas5548@gmail.com |
Oral |
Title: Scattergram Patterns in Cup Like Blast-Acute Myeloid Leukemia in SYSMEX XN Series Automated Cell Counters
Introduction: Association of significant number of cup like blasts on peripheral smear with the presence of NPM1 gene mutation in AML has been well established in literature.
This study aims to further expedite the process and raise a suspicion of NPM1 mutated AML even before PS examination, by reviewing the scattergram pattern displayed by automated hematology analyzers.
Methods: This is a retrospective cohort study conducted in a tertiary care cancer hospital in eastern India. The scattergram patterns of 10 CLB-AML were reviewed and compared with the scattergram patterns of 10 other subtypes of AML.
Results: The 10 CLB-AML cases showed a similar pattern on scattergram, having low Side Flourescence Light (SFL) with distinct merging of lymphocyte and monocyte regions, and to some extent, even the granulocyte region. This was different from the scattergram patterns of the other AML subtypes, with the main difference being high SFL, and a steeper pattern, showing expansion of any one region, not all.
Conclusions: Scattergram patterns can be reliably used to suspect CLB-AML without waiting for the PS examination, saving valuable time and fast tracking the diagnostic process.
Key words: Acute Myeloid Leukemia, AML, Cup like blasts, Scattergram |
| 88 |
ANCA NEGATIVE GRANULOMATOUS VASCULITIS IN BONE MARROW: A RARE CASE REPORT |
1987-06-26 |
Female |
No |
- | H_LKO |
Benign |
Miscellaneous |
Laboratory |
Ketki Kelkar, Rumma Manchanda, Vipul Chakurkar, Valentine Lobo; KEM Hospital, PUNE |
Mayuri Swamy |
KEM Hospital and research centre |
PUNE |
7259353699 |
mayuriswamy13@gmail.com |
Oral |
Title: ANCA NEGATIVE GRANULOMATOUS VASCULITIS IN BONE MARROW: A RARE CASE REPORT
Introduction:
Granulomatous vasculitis describes a spectrum of disorders marked by granulomatous inflammation within blood vessel walls, leading to vessel destruction and potential multi-organ involvement. While commonly associated with antineutrophil cytoplasmic antibody (ANCA)-positive conditions like granulomatous polyangitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA), a subset presents with classic features but without ANCA positivity. These ANCA-negative cases may stem from infection, autoimmune, or idiopathic causes.
Case report:
We present a case of 36-year-old woman with autosomal dominant polycystic kidney disease, and rheumatoid arithritis on tofactinib, admitted in March 2025 with fever, chills, nausea, vomiting, and diarrhoea for five days. Examination revealed pedal edema and renomegaly. Laboratory investigations showed acute kidney injury (Creat 8.1 mg/dl), eosinophilia and severe metabolic acidosis. Blood and urine culture were negative and ,the patient did not respond to antibiotics. Persistent feverprompted a PET scan, which revealed hypermetabolic activity in lymphnodes and FDG uptake in the spleen and bone marrow, suggestive of a lymphoproliferative disorder. ANCA testing is negative. Bone marrow trephine biopsy demonstrated granulomatous reactions in the intima of blood vessels with increased eosinophils. A suspicion of ANCA negative granulomatous vasculitis was considered and a course of corticosteroid was given. The patient recovered with regression of lymph nodes on repeat scan.
Conclusion:
This case illustrates the diagnostic complexity of granulomatous vasculitis in the setting of ANCA negativity. The initial presentation mimicked pyelonephritis, but persistent symptoms and further investigations led to the diagnosis of granulomatous vasculitis. The absence of ANCA, in conjunction with systemic findings and underlying polycystic kidney disease, emphasizes the need for a broad differential diagnosis. Timely recognition is critical for effective management of such atypical cases.
Key words: Granulomatous vasculitis; ANCA negative; granulomas in bone marrow.
|
| 89 |
Acquired Glanzmann Thrombasthenia in Post-renal transplant patient: A rare case report |
1987-06-26 |
Female |
No |
- | H_LKO |
Benign |
Platelet disorders |
Laboratory |
Rumma Manchanda (KEM HOSPITAL,PUNE), Bipin P Kulkarni (NIIH, MUMBAI), Sandeep Morkhandikar, Urmi Seth (RUBY HALL CLINIC, PUNE) |
Mayuri Swamy |
KEM Hospital and research centre |
PUNE |
7259353699 |
mayuriswamy13@gmail.com |
Oral |
Title: Acquired Glanzmann Thrombasthenia in Post-renal transplant patient: A rare case report. Introduction: Glanzmann thrombasthenia (GT) is an inherited platelet disorder caused by mutation un the ITGA2B and ITGB3 genes encoding the IIb3 integrin. The patients present with mild to moderate bleeding as spontaneous bruising, bleeding from gum and nose, gastrointestinal hemorrhage and excessive menorrhagia. These patients have little or no IIb3. In acquired disease, a GT-like phenotype is seen when auto antibodies are formed against IIb3. The various conditions have been listed which leads to development of autoantibodies like immune thrombocytopenic purpura (ITP), Evans syndrome, SLE and APLA; secondary conditions are organ transplant (Kidney, liver, cardiac), leukemias, NHL, multiple myelomas, solid tumors and certain drugs.
Case Report: A 30-year-old male patient presented to hospital, known case of chronic kidney disease since February 2024 with live donor renal transplant done in October 2024 and no history of bleeding from childhood. The patient was admitted multiple times post-operatively for hematoma at surgical site. On laboratory investigations CBC was normal with normal platelet morphology & good clumping; PT and APTT were normal; Factor VIII activity was more than 200% with normal Factor 13 activity. Whole blood clotting and Clot retraction time was normal. On platelet aggregometry, platelets showed no aggregation with ADP, collagen and normal aggregation with ristocetin. Final report of Glanzmann thrombasthenia like features probably acquired was reported and IIb3 receptor level was 30% (Low).
Conclusion: The patient’s presentation with persistent bleeding despite normal coagulation parameters underlines the importance of advanced platelet function testing in such scenarios. Similar case of Post-renal transplant acquired GT was described by Tholouli et al. This case emphasizes the need for heightened clinical awareness of acquired platelet function disorders in post-transplant patients, as timely intervention can significantly improve patient outcomes.
Keywords: Platelet disorder, Glanzmann Thrombasthenia, post-transplant |
| 90 |
CLINICAL, HEMATOLOGICAL AND FLOW CYTOMETRIC ASSESSMENT OF PNH CLONES IN PATIENTS OF APLASTIC ANEMIA |
1997-03-31 |
Male |
No |
- | H_LKO |
Benign |
Marrow failure |
Laboratory |
DR. ANIRUNA DEY, DR. SHILPI MORE, DR. DIPTI SIDAM, DR. MUKTA PUJANI, DR. TATHAGATA CHATTERJEE |
Sahil Garg |
ESIC MCH |
Faridabad |
7467002795 |
drsahil1garg@gmail.com |
Poster |
Title: CLINICAL, HEMATOLOGICAL AND FLOW CYTOMETRIC ASSESSMENT OF PNH CLONES IN PATIENTS OF APLASTIC ANEMIA
Introduction: Aplastic Anemia (AA) is an immune mediated, primary hematopoietic disorder characterized by pancytopenia with significant morbidity and mortality. With the long survivals of AA patients, clonal evolution into Myelodysplastic Syndrome (MDS) and clinically evident Paroxysmal Nocturnal Hemoglobinuria (PNH) is frequently seen over a period of 5-10 years. PNH is characterised by triad of intravascular hemolysis, bone marrow failure and thrombotic events. We determined the size of WBC PNH clones in four patients of Aplastic anemia.
Methods: Complete blood cell count (CBC), peripheral smear (P/S), reticulocyte count (RC), and other ancillary investigations (such as vitamin B12 and folate levels) were done in all patients to rule out other causes of pancytopenia. Bone marrow aspirate and biopsies were performed along with relevant IHC markers. WBC (granulocytes and monocytes) PNH clone analysis was done by FCM on peripheral blood.
Results: Out of four patients of aplastic anemia, one patient was found to have PNH clones in neutrophils & monocytes (Neutrophil clones size-12.7% & monocyte clones size-31.7%) by FCM. This patient underwent bone marrow transplantation, while the other three patients tested negative for PNH clones in blood cells and were started on cyclosporine.
Conclusions: This case series highlights the importance of PNH clones in Aplastic anemia and follow up of PNH clones in these patients.
Key words: Aplastic anemia(AA), Paroxysmal nocturnal hemoglobinuria(PNH) |
| 91 |
THE MIXED BAG OF MYELOPROLIFERATIVE DISORDERS : A CASE SERIES |
1999-02-25 |
Male |
No |
- | T2508 |
Benign |
Miscellaneous |
Clinical |
Dr. D. Radhakrishnan M.D HOD General Medicine AMC Visakhapatnam |
Dr. Vedanth.S |
Andhra Medical College |
Visakhapatnam |
8547072604 |
7vedanth@gmail.com |
Oral |
Title: THE MIXED BAG OF MYELOPROLIFERATIVE DISORDERS : A CASE SERIES
Introduction: To describe the clinical profile, diagnostic workup and outcomes of patients diagnosed with Myeloproliferative Neoplasms at King George Hospital, Visakhapatnam.
Methods: This a cross-sectional observational study conducted on participants diagnosed with Myeloproliferative Neoplasms at King George Hospital Visakhapatnam between 01-07-2025 to 01-08-2025. Due to the limited availability of time period for the study, a sample size of 11 patients were taken for the same. Demographic data, presenting features, haematological and molecular findings, therapeutic interventions and follow up outcomes were reviewed and analyzed.
Results: The 11 participants that were enrolled in the study included 5 females and 6 males (with male: female ratio of 1.2:1) over an age group of 37 to 70years of which 55% had no comorbidities and 9%were smokers and alcoholics and 27% were hypertensives. 9% patients were found to be incidentally detected, while 73% had splenomegaly and 18%presented with thrombotic complications. 55%pateints were diagnosed with Polycythemia Vera and 36% were diagnosed with Essential Thrombocytosis. JAK2 Mutations were identified in 100% of the patients. Patients were managed with cytoreductive therapies, anticoagulation and regular phlebotomies as and when required. On regular follow up, all of the patients showed good prognosis and complications were controlled effectively.
Conclusions: This case series highlights the clinical heterogeneity of Myeloproliferative Neoplasms and underscores integrating molecular diagnostics for accurate classification. Early diagnosis, individualized therapy and close monitoring remain essential to improve outcomes. Our experience adds to the limited regional data and emphasizes the need for larger multicenter studies.
Key words: Myeloproliferative Neoplasms, Polycythemia Vera, Essential Thrombocytosis, cross sectional study, observational study |
| 92 |
Allogeneic Stem Cell Transplantation for Relapsed/Refractory Hodgkin Lymphoma: A Single-Centre Retrospective Study |
1993-06-03 |
Female |
Yes |
L-2245 | H-LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Uday Kulkarni DM1, Sushil Selvarajan DM1, Alen Antony Joy MBBS2, Sharon Lionel DM1, Sujith Karumuthil DM1, Kavitha Lakshmi MSc1, Fouzia N Aboobacker DM1, Anu Korula DM1, Aby Abraham DM1, Vikram Mathews DM1, Biju George DM1 1Christian Medical College and |
DR Yamuna Naik |
Christian Medical College,Vellore |
Vellore |
9769585927 |
yamunanaik267@gmail.com |
Oral |
Title: Allogeneic Stem Cell Transplantation for Relapsed/Refractory Hodgkin Lymphoma: A Single-Centre Retrospective Study
Introduction: While most Hodgkin lymphoma (HL) patients are cured with chemotherapy, 5-10% have refractory disease and 10-30% relapse. We evaluated AlloSCT and ASCT outcomes for relapsed/refractory Hodgkin lymphoma (RR-HL) at Christian Medical College, Vellore (2001-2025).
Methods: Relapsed-refractory disease was defined as primary refractory disease, remission <1 year, and chemo-refractoriness. Data were collected from medical records and databases.
Results: Twenty-eight patients (median age 27.6 years) underwent AlloSCT, and 162 (median age 28.6 years) underwent ASCT. For ASCT, 61.1% achieved complete response, 6.8% had stable/progressive disease, and 32% had partial response. Median CD34 cell dose was 6.04±3.2x10^6 cells/kg, with neutrophil and platelet recovery at 11 and 16 days. Thirteen patients had AlloSCT post-ASCT failure; fifteen had upfront AlloSCT. Donors were matched sibling/family (n=15), unrelated (n=1), and haploidentical (n=12). Conditioning included Flu/Mel ± TBI (n=17) and Flu/Cy/TBI (n=9). Acute GVHD occurred in 12 patients (42.8%), with grade III-IV in 25%, while chronic GVHD affected 10 patients. Deaths occurred from infections (n=6), GVHD (n=4), and relapse (n=1). Relapse rates were 10.7% for AlloSCT and 24.8% for ASCT. Five-year OS was 81.9% ± 3.5% with ASCT versus 57% ± 9.9% with AlloSCT (P=0.002), while EFS was similar (68.9% ± 4% vs 57% ± 9.9%, P=0.2). Flu/Cy/TBI showed better OS/EFS than Flu/Mel/TBI (88.8% vs 47%, P=0.027).
Conclusions: RR-HL is effectively treated by autoSCT; however, early identification of patients who may benefit from upfront Allo-SCT is essential, given the excellent outcomes with Flu/Cy/TBI conditioning.
Key words: Relapsed/Refractory Hodgkin Lymphoma, Allogenic stem cell transplant, Autologous stem cell transplant |
| 93 |
TITLE: CLINICAL, HEMATOLOGICAL AND FLOWCYTOMETRIC IMMUNOPHENOTYPICAL FINDINGS OF ATYPICAL CLL: OUR EXPERIENCE |
1997-10-09 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
DR. DIPTI SIDAM, DR. SHILPI MORE, DR. VARSHA CHAUHAN, DR MUKTA PUJANI, DR. TATHAGATA CHATTERJEE |
Dr. Mansi Kushwah |
ESIC Medical College and Hospital |
Faridabad |
8718815355 |
mansi.kushwah35@gmail.com |
Oral |
Title :CLINICAL, HEMATOLOGICAL AND FLOWCYTOMETRIC IMMUNOPHENOTYPICAL FINDINGS OF ATYPICAL CLL: OUR EXPERIENCE
Authors: DR. MANSI KUSHWAH, DR. DIPTI SIDAM, DR. SHILPI MORE, DR. VARSHA CHAUHAN, DR MUKTA PUJANI, DR. TATHAGATA CHATTERJEE
Introduction: Chronic lymphoproliferative disorders are a heterogeneous category of neoplastic disorders with variable morphological and immunophenotypic characteristics. It is defined as the clonal proliferation of mature B, T, and NK lymphoid cells in the peripheral blood and bone marrow. Atypical CLL can be distinguished from typical CLL morphologically and immunophenotypically. Morphologically atypical CLL have large, atypical forms, prolymphocytes or cleaved cells. Immunophenotypically, atypical CLL differs from typical CLL in variable or lack of expression of CD5 and CD23, positive CD79b and the patient does not meet the criteria for any other B cell lymphoid malignancy.
Methods: All the patients whose clinical features and CBC reports are suggestive of chronic lymphoproliferative disorders will be subjected for flow cytometric immunophenotyping.
Results: We diagnosed a total of 24 patients with Chronic lymphoproliferative disorder and after a detailed analysis of clinical, hematological and flow cytometric parameters 9 patients were diagnosed as Atypical CLL constituting about 37.5% of the total number of cases
Conclusion: Atypical CLL (aCLL) is characterized by morphologic, immunophenotypic, and cytogenetic differences compared to classic CLL. However, aCLL is not formally defined and is not included in the 2022 WHO list of hematological neoplasms resulting in diagnostic difficulty. Patients with aCLL display markers associated with poor prognosis, including trisomy 12, unmutated IGVH, and CD38 expression, in comparison with classic CLL. However, following the recent introduction of targeted drugs designed on the basis of biological mechanisms, a better definition of aCLL is needed to provide the optimal treatment for each group of patients.
Key words: Atypical CLL, diagnostic difficulty, poor prognosis |
| 94 |
Utility of flowcytometry in lymphoma diagnosis: Beyond biopsies |
1994-06-18 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
|
Aprajita |
Lady Hardinge Medical College |
New Delhi |
7250760879 |
appy3969@gmail.com |
Oral |
Title: - Utility of flowcytometry in lymphoma diagnosis: Beyond biopsies
AUTHORS- Aprajita, Vandana Puri, Shailaja Shukla, P. Lalita Jyotsna, Kiran Agarwal, Shilpi Agarwal, Smita Singh, Jenna Bhattacharya, Priti Rai
Introduction: Flowcytometry has emerged as powerful, non invasive diagnostic tool in, particularly for lymphomas. It allows rapid analysis of diverse samples including aspirates from lymph nodes, suspected masses, bone marrow, various body fluids. This technique not only enables quick and accurate identification of primary lymphoma subtypes but also detects spread into body fluids and leukemic infiltration, significantly expediting clinical decision making.
Methods: Samples from clinically suspected lymphoma cases that were received in hematology wing, lady hardinge medical college from August 2024 to August 2025 were analyzed. Aspirates from lymph nodes, bone marrow, suspected masses, different body fluids (pleural, pericardial, peripheral blood) were sujected to flowcytometric evaluation.
Results: 12 cases were included in this study. 5 of these were diagnosed as Burkitt's lymphoma of which 3 cases presented with cervical and axillary lymphadenopathy and 2 of them with retroperitoneal mass and small intestinal mass. one of the case was of cortical T cell lymphoma which presented as mediastinal mass and 2 cases of T cell lymphoblastic lymphoma and peripheral T cell lymphoma which presented as cervical and axillary lymphadenopathy. 3 other cases were reported as Diffuse large B cell, B cell lymphoblastic and mature B cell lymphoma that presented with cervical lymphadenopathy. Another case was of leukemic infiltration of Mantle cell lymphoma in peripheral blood.
Conclusions: Flowcytometry is rapid, reliable, minimally invasive diagnostic modality . Its ability to analyze wide variety of aspirates and body fluids makes it indispensable tool for early diagnosis, classification and detection of lymphomas.
Key words: Flowcytometry, lymphoma, body fluids, aspirate, lymph node, pleural, pericardial, Burkitt’s, Diffuse large, T cell, mantle cell, B cell, lymphoblastic, Cortical. |
| 95 |
Development of a clinical risk score to predict Carbapenem resistant gram negative bacteremia in patients with Febrile neutropenia |
1991-11-02 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Chandran K Nair, Dr Praveen K Shenoy, Dr Abhilash Menon, Dr Shoaib Nawaz , Dr Kiran N, Dr Venu S, Malabar Cancer Centre |
Dr Preethi Susan Philip |
Malabar Cancer Centre |
Kannur |
9501413941 |
preethiphils@gmail.com |
Oral |
Title: Development of a clinical risk score to predict Carbapenem resistant gram negative bacteremia in patients with Febrile neutropenia
Introduction: Scoring systems to predict MDR infections in Febrile neutropenia (FN) is scarce from India.
Methods: We aimed to develop a clinical scoring system to predict carbapenem resistant gram negative bacteremia (CRGNB), in patients of hematological disorders with FN. An ambispective study was conducted to develop a scoring system for CRGNB. Case files of patients admitted in haematology division with FN between January 2021 till November 2024, between the age of 15-65 yrs were studied. Baseline demographics, vital signs, examination findings, basic laboratory parameters and culture reports were studied.
Results: We included 75 patients with 140 Febrile Neutropenia (FN) episodes. After finding association of the variables, with CRGNB, those with significant p values were identified. Univariate and multivariate logistic regression was done. Temperature above 102F, oxygen saturation (Spo2) below 95 percentage and albumin below 3.5g/dl were found to be predictive of CRGNB. The CRGNB rate was 12.3%, 56% and 100% for those with single risk factor, two of the three and all the three risk factors respectively. The frequency of gram negative bacteremia (GNB) and carbapenem resistant gram negative bacteremia (CRGNB) in patients with Febrile neutropenia was found to be 39.3 percent and 20 percent respectively. Mortality rates due to Febrile Neutropenia was 10.7%, due to GNB was 25.45% and due to CRGNB was 50% respectively.
Conclusions: - Our CRGNB risk score would be useful for deciding early prophylactic antibiotics while awaiting culture and sensitivity reports which would further decline mortality in high-risk periods. A locally validated bedside tool for assessing risk of CRGNB will be useful for the treating physician especially in resource limited settings.
Key words: Febrile neutropenia , Carbapenem resistant gram negative bacteremia, Risk score |
| 96 |
Quality of Life assessment in children with Transfusion dependent Thalassemia: Gauging the disease burden |
1994-09-22 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
Dr.Ritika Khurana, Dr.Siddhi Khapre , Dr.Poorva Kanvinde, Dr. Minnie Bodhanwala, Dr.Sangeeta Mudaliar . Bai Jerbai Wadia Hospital for Children Parel , Mumbai |
Dr. Kiran Wankhede |
Bai Jerbai Wadia Hospital For Children , Parel, Mu |
Mumbai |
9923651378 |
wankhedekr2015@gmail.com |
Oral |
Title: Quality of Life assessment in children with Transfusion dependent Thalassemia: Gauging the disease burden
Introduction: In India, 10,000 to 12,000 children are born with beta-thalassemia major annually. This chronic condition and its demanding treatment regimen impose a significant burden, affecting the quality of life (QOL) of both the children and their caregivers. At our thalassemia day care centre, we used the PedsQL questionnaire to assess the QOL of children with transfusion-dependent thalassemia and their parents.
Methods: A prospective survey study was conducted at the Thalassemia Day Care Centre of B. J. Wadia Hospital for Children from July 2021 to January 2022. The Pediatric Quality of Life Inventory (PedsQL) Generic Core Scale 4.0 questionnaire was used to assess the QOL of children with beta-thalassemia major and their caregivers. The tool evaluates four domains: Physical, Emotional, Social, and School Functioning. Each item is rated on a 5-point Likert scale from 0 (never) to 4 (almost always). Scores are transformed on a 0–100 scale, with higher scores indicating better QOL.
Results: Among 81 child-parent pairs, the mean total PedsQL score was 74.67 for children and 75.30 for parents. The mean score was higher for male children (76.33) than for females (73.23). Parents of children aged 2-4 years reported higher scores across all domains compared to parents of older children. The lowest scores among the children themselves were observed in the 8-12 years age group. For children aged 5-12 years, the School Functioning domain was the most adversely affected, while for adolescents (13-18 years), the Emotional domain was the most affected.
Conclusions: Thalassemia major significantly impairs the QOL of affected children and their caregivers. Significant gaps persist in holistic patient management at many centers. Routine QOL assessments are essential to identify the most impacted domains. Targeted, timely interventions to address these specific issues can substantially improve their quality of life and potentially their long-term outcomes.
Key words: Quality of Life, Thalassemia major, PedsQL, Pediatrics, Caregiver burden |
| 97 |
Primary lymph node plasmacytoma: An interesting case presentation |
1971-12-17 |
Female |
Yes |
- | pay_Q |
Malignant |
Plasma cell disorders |
Laboratory |
Dr. Geetika, Dr. Simran, Dr. Sunita Singh |
Dr. Veena Gupta |
Pt. B.D.S PGIMS, Rohtak |
Rohtak |
9416162494 |
guptaveena201516@gmail.com |
Poster |
Title: Primary lymph node plasmacytoma: An interesting case presentation
Authors: Veena Gupta, Geetika, Simran, Sunita Singh.
Introduction:Plasmacytomas are localized proliferations of plasma cells that are morphologically and immunophenotypically similar to those found in MM, but without systemic or bone marrow involvement. Primary plasmacytomas account for approximately 1.6–4% of all plasma cell disorders. These tumors can present as solitary or multiple lesions, and may occur in various organs. Based on their location, plasmacytomas are divided into osseous plasmacytomas (arising from bone) and extramedullary plasmacytomas (EMP) originating in soft tissues.
Primary lymph node involvement is extremely uncommon, comprising only about 2% of EMP cases, most of which are limited to a single lymph node. Reports of multiple lymph nodes involvement are exceptionally rare and combination of a primary plasmacytoma in the lymph nodes and lytic bone lesions is rarer and must be distinguished from metastatic multiple myeloma.
Methods: Case report of 55-year-old male presenting with a gradually enlarging, painful swelling on the right side of neck with no constitutional symptoms. A PET-CT scan demonstrated multiple subcentimetric to enlarged lymph nodes and several lytic lesions with high FDG uptake in the axial skeleton. The neck mass was surgically excised and submitted for histopathological examination.
Results: Neck mass revealed lymph node revealing infiltration by plasma cells with light chain restriction. Further workup conducted excluded multiple myeloma (absence of bone marrow involvement and systemic symptoms). Taking into account the clinical, pathological, biochemical, and radiological findings, the patient was diagnosed with Multifocal plasmacytoma.
Conclusions: Primary lymph node plasmacytoma is rare and association with lytic bone lesions without bone marrow involvement is rarer. It requires careful management and follow-up to detect any progression to systemic multiple myeloma.
Key words: Plasmacytoma, Lymph node, Lytic bone lesions. |
| 98 |
CSF ELECTROPHORESIS - A GAME CHANGER IN MYELOMA |
1996-03-03 |
Female |
No |
- | pay_R |
Malignant |
Plasma cell disorders |
Laboratory |
Dr Sharat Damodar / Head of the department |
Dr Shanmitha Padmanaban |
NH hospital |
Bangalore |
7373330222 |
shanmithapadmanaban@gmail.com |
Poster |
TitleTITLE: CSF ELECTROPHORESIS -A GAME CHANGER IN MYELOMA?
AUTHOR: DR. SHANMITHA PADMANABAN (SENIOR RESIDENT)
CO-AUTHOR: DR SHARAT DAMODAR (HEAD OF THE DEPARTMENT) AND DR SHILPA PRABHU (SENIOR CONSULTANT), DEPARTMENT OF ADULT HEMATOLOGY AND BMT, NH HEALTH CITY, BANGALORE.
INTRODUCTION: This case series is about two Multiple myeloma patients who had presented to the hospital with neurological symptoms. One is a 64-year-old female who was k/c/o IgKappa gammopathy relapsed on Daratumumab maintenance after Autologous transplant with 3 cycles of Dara-VCD in July 2025( k-181 L-6.57 ,IgG-3.96, M spike absent ). Second was 77 year old male who was k/c/o IgG kappa gammopathy who had relapsed on Thalidomide maintenance after 6 cycles of VTD (K-4830, L-22, M spike absent, SIFE-IgGkappa).
CASE SERIES: 77-year-old male presented with acute urinary retention and altered sensorium. MRI brain was normal, and CSF analysis showed 2 cells with cytology being negative. Meningoencephalitis panel was negative (P- 69, G- 66). CSF Electrophoresis did not show M spike, but CSF FLC showed monoclonal free kappa chains in the CSF which was of the same molecular weight as in serum. He planned for Daratumumab based chemotherapy but had expired a week later due to worsening urosepsis with MODS.
64-year-old female had presented with Giddiness with bone pain on maintenance. As her MRI showed leptomeningeal enhancement, CSF was done. CSF showed free Kappa -515 mg/ml much more than Serum Kappa-19.5mg/ml suggestive of Intrathecal production. Meningoencephalitis panel was negative, and CSF analysis showed 4 cells with Cytology being negative. She expired a week later due to progressive symptoms.
RESULTS: This case series shows how CSF electrophoresis with FLC would bring about definitive diagnosis of CNS involvement in Multiple myeloma when Cytology is negative. This could alter the landscape of myeloma diagnosis significantly as it will help in chartering therapy and prognosticating patients
|
| 99 |
PANDORA'S BOX- A CASE REPORT |
1996-03-03 |
Female |
No |
- | H_LKO |
Benign |
Infection & supportive care |
Clinical |
Dr Shilpa Prabhu, Senior consultant |
Dr Shanmitha Padmanaban |
NH hospital |
Bangalore |
7373330222 |
shanmithapadmanaban@gmail.com |
Poster |
Title: Introduction: PANDORA’S BOX – A CASE REPORT AUTHOR ; DR. SHANMITHA PADMANABAN (SENIOR RESIDENT) AUTHOR: DR SHARAT DAMODAR (HEAD OF THE DEPARTMENT), DR SHILPA PRABHU (SENIOR CONSULTANT). DEPARTMENT OF ADULT HEMATOLOGY AND BMT, NH HEALTH CITY, BANGALORE. INTRODUCTION: Patient had presented with History of High-grade fever with chills – intermittent in nature present for a month relieved by antipyretics. There was no h/o any localizing symptoms like cough , loose stools, vomiting, headache, dyspnea or chest pain. On examination: • Well-nourished and built • Pallor+, No Icterus/ cyanosis/clubbing /pedal edema/lymphadenopathy • Per abdomen: • Spleen felt midway between Umbilicus and Left costal margin. INVESTIGATIONS: Hb/TC /PLT - 10.6/ 1600 ( N60 L14 M25 E1)/65000. ESR/CRP/LDH- 74/74/240 . RFT -Cr / UA /Na/K LFT – 0.8/ 8.0/ 130/3.8 . TB/DB/OT/PT: 1.40/0.00/44/37/121. PET CT Hypermetabolic mediastinal nodes. Right adrenal lesion with spleen enlargement and uptake. FDG uptake in axial and appendicular skeleton s/o lymphoproliferative disorder. BONE MARROW ASPIRATION AND BIOPSY DONE HYPERCELLULAR REACTIVE MARROW WITH NO ATYPICAL CELLS . BUT ADRENAL AND RIGHT AXILLARY LYMPH NODE BIOPSY DONE SHOWED : Round to oval budding yeast cells seen within histiocytes morphologically resembled Histoplasmosis with multinucleated giant cells. There were multiple such vague granulomas. Special stains – GMS and PAS were positive confirming Disseminated Histoplasmosis. IMMUNODEFECIENCY WORK UP: SERUM IMMUNOGLOBULIN ASSAY : IgA-3.47 / IgG-21.10 /IgM-1.64
ABSOLUTE LYMPHOCYTE : 302. CD3/CD4/CD8/CD19/CD16+56 : 198/93/92/71/31 .CD4/CD8 / RATIO : 1.0. HIV RNA PCR : NEGATIVE WESTERN BLOT FOR HIV-1 &2 : NEGATIVE .SERUM ACE LEVEL : 87. ANA PROFILE : NEGATIVE. CLINICAL EXOME : NEGATIVE. URINE HISTOPLASMA ANTIGEN : NEGATIVE .LEISMHANIA RK-39 ANTIBODY : NEGATIVE .BONE MARROW AFB CULTURE : NEGATIVE .TREATMENT : Liposomal Amphotericin B for 2 weeks followed by Tab Itraconaole for 1 YEAR PET CT IN 3 MONTHS : PARTIAL RESPONSE |
| 100 |
BLOOD DONOR DEFERRAL PATTERN AS AN IMPORTANT TOOL FOR BLOOD SAFETY - A SEVEN YEAR RETROSPECTIVE STUDY IN A TERTIARY CARE TEACHING HOSPITAL IN EASTERN UTTAR PRADESH, INDIA
|
1996-11-07 |
Female |
No |
- | pay_R |
Benign |
Transfusion medicine |
Clinical |
Dr. Saurabh Gupta, Dr. Aarti B. Bhattacharya, Dr. Rajendra Chaudhary & Blood Transfusion Services, Department of Pathology, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh |
Dr. Aishwarya Gupta |
Hind Institute of Medical Sciences, Barabanki, Utt |
Barabanki, Uttar Pradesh |
9336560587 |
gupta007aish@gmail.com |
Poster |
Abstract
Introduction: Maintaining a safe and sufficient availability of blood and blood components is essential for planning treatment protocol of critical patients. As safe blood should only come from healthy donors, strict selection and screening of donors need to be done. Though attention is generally centered on satisfying patient demands, equal importance has to be accorded to donor eligibility, particularly to those deferred from donation either temporarily or permanently.
Methodology: A 7 year retrospective study was conducted in the Department of Blood Transfusion Services, Hind Institute of Medical Sciences, Barabanki. The study was aimed to estimate the deferral rate of donors and investigate the underlying causes. A structured questionnaire, along with physical examination, and hemoglobin estimation was used for donor evaluation. Post-donation blood was screened for transfusion-transmissible infections.
Results: 930 (7.20%) out of 12904 potential donors were deferred. Among those, 667 (71.2%) were temporarily deferred and 263 (28.27%) were permanently deferred. Anemia was found to be the most common reason for temporary deferral whereas Hepatitis B surface antigen seroreactivity was the leading cause for permanent deferral.
Conclusion: As a rule voluntary donation should always be encouraged. Due to high donor deferrals, the blood supply chain is under constant pressure and the donor pool is also limited. Those deferred temporarily should be counseled, advised, treated and motivated to return for donation. Attention should also be given to increase the donor pool by encouraging women and novice donors. Education, awareness, and preventative interventions must be employed to develop voluntary blood donation and ensure a safe and adequate blood supply.
Keywords: Blood donor, Deferral, Anemia, Seroreactivity, Blood safety
|
| 101 |
“WT1 Mutations: A Harbinger of Resistant AML to Standard 3+7 Induction Therapy”-
A case series |
1998-09-26 |
Male |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Gaurav Dhingra, Associate Professor, Department of Hematology, All India Institute of Medical Sciences (AIIMS), Bhopal. Dr. Sachin Bansal, Consultant, Department of Hematology, J K Hospital, Bhopal. Dr. Rajnish Joshi, Professor and Head, Department |
Dr. Suriya Nandhana V |
All India Institute of Medical Sciences (AIIMS), B |
Bhopal |
9597931273 |
suriyanandhana1998@gmail.com |
Poster |
Title: “WT1 Mutation: A Harbinger of Resistant AML to Standard 3+7 Induction Therapy”-
A case series
Introduction:
WT1 mutations or high WT1 expression in Acute Myeloid Leukemia (AML) are strongly
associated with failure of standard “3+7” induction chemotherapy. This leads to lower remission
rates, primary refractory disease, and early relapse, underscoring their adverse prognostic
significance.
Methods:
We retrospectively analysed three young adult females with AML harboring WT1 mutations.
Clinical features, cytogenetics, and next-generation sequencing results were documented. All
patients received “3+7” induction chemotherapy but showed refractory disease. They were
subsequently treated with azacitidine plus venetoclax, followed by fludarabine-based salvage
regimens (FLAG-IDA) at relapse. Treatment responses and outcomes were evaluated to assess the
impact of WT1 mutations on resistance.
Results:
All three patients received standard “3+7” induction chemotherapy but demonstrated primary
refractory disease.
Case 1: Mutations included FLT3-ITD (VAF 38.03%) and WT1 frameshift variants
p.Arg3855SerfsTer7 (VAF 35.66%) and p.Ser3386LeufsTer71 (VAF 49.34%). She failed
azacitidine plus venetoclax and subsequently FLAG-IDA, succumbing to septic shock with
intracranial hemorrhage.
Case 2: Mutations included RUNX1 p.Ser318Ter (VAF 44.93%), WT1 p.Arg374AlafsTer16
(VAF 18.7%), and PTPN11 p.Ser502Leu (VAF 35.44%). She relapsed following azacitidine plus
venetoclax and FLAG-IDA, and is currently on palliative care.
Case 3: Mutations included IDH2 p.Arg140Gln (VAF 43.63%) and WT1 p.Ser388LeufsTer6
(VAF 34.62%). She achieved remission after azacitidine plus venetoclax but later relapsed. Upon
FLAG-IDA salvage, she demonstrated transient response but relapsed and succumbed to disease.
None achieved durable remission, confirming the poor outcomes of WT1-mutated AML.
Conclusions:
Inherent WT1 mutations in AML are linked to induction failure and poor prognosis. Although
ELN 2022 doesn’t classify WT1 mutations as adverse-risk, clinical evidence indicates they behave
as a high-risk subtype. Early identification should guide intensified approaches, including
fludarabine-based regimens and timely allogeneic transplantation, to improve survival.
Keywords:
Acute myeloid leukemia, WT1 mutations, Induction failure, Chemoresistance |
| 102 |
The chromosomal landscape of ALL: Cytogenetic Risk Stratification in Pediatric Acute Lymphoblastic Leukemia |
1989-03-21 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Preeti Doshi, Dr. Reena Bharadwaj |
Dr. Shefalika Umare |
Bharati Vidyapeeth Deemed to be University Medical |
Pune |
9663242162 |
umareshefalika@gmail.com |
Oral |
Title: The Chromosomal Landscape of ALL: Cytogenetic Risk Stratification in Pediatric Acute Lymphoblastic Leukemia
Introduction: Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy, with varying survival rates based on cytogenetic abnormalities and risk stratification. Early prognostication and risk-adapted therapy play crucial role in resource-limited settings where access to timely diagnosis and standardized treatment are limited. The need for data regarding distribution of cytogenetic abnormalities in pediatric ALL is paramount to guide personalized treatment. This study aims to estimate cytogenetic risk stratification among pediatric ALL patients and correlate them with other prognostic factors.
Methods: This study was carried out in the Department of Pathology (Haematology), Bharati Hospital, Pune, between December 2023 and May 2025 and included 54 pediatric ALL cases. Cytogenetic analysis was performed and patients were classified into good, intermediate and poor-risk categories. Associations between cytogenetic risk stratification and other prognostic factors such as age, sex, WBC count, ALL subtype, and treatment response were studied.
Results: The mean age of study participants was 7.40 ± 3.89 years. Risk stratification revealed 44.4% of patients in good-risk category, 37% in intermediate-risk, and 18.5% in poor-risk category. B-cell ALL was predominant (83.3%). Subtype, bone marrow findings, and induction phase treatment response were statistically significant with risk stratification (p=0.008, <0.001 and <0.001 respectively). The most frequent cytogenetic findings included t(12;21) (22.22%) and t(9;22)/BCR-ABL (14.81%).
Conclusions: Pediatric ALL remains a significant cause of morbidity and mortality, especially in low- and middle-income countries, where access to timely diagnosis and standardized treatment may be limited. This underscores the importance of early prognostication and risk-adapted therapy, which rely heavily on cytogenetic profiling. This study contributes valuable epidemiological insights and enhances standard of care, thereby improving survival outcomes in pediatric ALL patients.
Key words: Pediatric acute lymphoblastic leukemia, cytogenetic risk stratification |
| 103 |
Hemophagocytic Lymphohistiocytosis Following Autologous Stem Cell Transplant in Hodgkin Lymphoma Patients Previously Treated with Immune Checkpoint Inhibitors: A Case Series |
1992-09-10 |
Male |
Yes |
L-2139 | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
|
Gaurav Lalwani |
Jaslok Hospital & Research Centre |
Mumbai |
9833715559 |
drgauravlalwani@gmail.com |
Poster |
Title: Hemophagocytic Lymphohistiocytosis Following Autologous Stem Cell Transplant in Hodgkin Lymphoma Patients Previously Treated with Immune Checkpoint Inhibitors: A Case Series
Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal hyperinflammatory syndrome characterized by uncontrolled immune activation. While immune checkpoint inhibitors (ICIs) such as nivolumab and pembrolizumab have improved outcomes in relapsed/refractory Hodgkin lymphoma (HL), they may predispose to immune dysregulation. HLH after autologous stem cell transplant (ASCT) is uncommon, and its association with prior ICI exposure is rarely reported.
Methods: We describe three patients with relapsed/refractory HL who underwent ASCT following treatment with ICIs. All patients received BEAM conditioning. Clinical data, laboratory parameters, HLH diagnostic criteria, treatment, and outcomes were analyzed.
Results: All three patients developed HLH within the early post-transplant period. Clinical manifestations included persistent fever, cytopenias, hyperferritinemia, and transaminitis. HLH-2004/2016 diagnostic criteria were fulfilled in each case. All patients required HLH-directed therapy, including corticosteroids and, in some instances, etoposide. Outcomes varied, with one patient achieving recovery and two succumbing to complications. Prior exposure to ICIs was the only common factor identified across all cases.
Conclusions: This case series highlights the potential link between prior ICI therapy and the development of HLH after ASCT in HL patients. Clinicians should maintain a high index of suspicion for HLH in this setting, as early recognition and treatment are critical. Further studies are needed to clarify pathogenesis and to guide management strategies in this rare but serious complication.
Key words: Hodgkin lymphoma, autologous stem cell transplant, immune checkpoint inhibitor, hemophagocytic lymphohistiocytosis, case series |
| 104 |
Decentralization of Multiple Myeloma Care in the Elderly: Challenges and Real-World Experience from a Resource-Constrained Tier II City in Central India |
1989-02-13 |
Female |
Yes |
L-1765 | pay_R |
Malignant |
Plasma cell disorders |
Clinical |
Dr Avinash Gupta, BIMR Hospitals and Gwalior Hematology centre |
Dr Malini Garg |
BIMR Hospitals and Gwalior Hematology centre |
Gwalior |
8826809281 |
drgargmalini@gmail.com |
Oral |
Title: Decentralization of Multiple Myeloma Care in the Elderly: Challenges and Real-World Experience from a Resource-Constrained Tier II City in Central India
Introduction: Managing Multiple Myeloma (MM) in elderly patients poses unique challenges in resource-constrained settings where in treatment decisions are shaped by socioeconomic limitations, restricted access to diagnostics, and dependency on government healthcare schemes like Ayushman Bharat. This study examines real-world outcomes and challenges in decentralizing MM care outside tertiary care centers.
Methods: A retrospective observational study was conducted at a multispecialty hospital in Gwalior, evaluating 18 elderly (≥65 years) patients with NDMM between June 2024 and August 2025. Data collected included demographics, comorbidities, diagnostic barriers, treatment regimens, responses, toxicities, and logistical challenges.
Results: Median age was 72 years(range:65–84), with a male-to-female ratio of 2:1. The most common presentation was chronic kidney disease (CKD)(72%). FISH testing could be performed in only four patients due to financial constraints. Majority(61%,n=11) belonged to ISS-III. Most patients (72%) were able to take treatment because of government schemes. Initial regimens included VCd(n=9), VTd(n=3), Dara-VCd(n=1), and VRd(n=5). With renal improvement, many transitioned to VRd. Of 15 patients completing 3 months of therapy, 8 achieved VGPR and 7 PR. Four patients opted for home-based oral therapy (PCd). At 6 months, 6 of 7 patients achieved VGPR. By 9 months, 5 patients remained in VGPR and were initiated on lenalidomide maintenance. Adverse events included neuropathy(n=2), skin rash(n=2), diarrhea(n=2), and GI bleed(n=1). Two patients succumbed due to pneumonia.
Conclusion: In rural and semi-urban India, conventional triplet regimens remain the mainstay for MM treatment in the elderly. The presence of multiple comorbidities, affordibility, limited access to diagnostics and risk stratification, challenges in response monitoring and socioeconomic barriers necessitate individualized treatment decisions. While global MM therapy is rapidly evolving, real-world application remains restricted.
Key words- Multiple myeloma, elderly, resource-constrained settings
|
| 105 |
C-MYC binding onto TERT promoter failed to rescue RUNX1/ETO related TERT suppression in Acute Myeloid Leukaemia (AML) t (8,21) cells |
1981-12-06 |
Male |
Yes |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
|
EMMANUEL JAIRAJ MOSES |
Advanced Medical and Dental Institute, Universiti |
KEPALA BATAS |
0194363571 |
emmanuel_jm@usm.my |
Oral |
Title: C-MYC binding onto TERT promoter failed to rescue RUNX1/ETO related TERT suppression in Acute Myeloid Leukaemia (AML) t (8,21) cells
Introduction: Telomerase Reverse Transcriptase (TERT) has been shown to be upregulated in various haematologic malignancies including Acute Myeloid Leukaemia (AML). In tandem with this observation, it comes as no surprise that regulation of TERT is tightly controlled in AML as TERT confers self-renewal in most malignancies including AML. Previously, our research group showed that TERT suppression trailed RUNX1/ETO and SKP2 knockdown respectively in t (8,21) acute myeloid leukemia (AML). Interestingly, it was observed that RUNX1/ETO but not SKP2 knockdown resulted in CMYC upregulation at transcript and protein levels. Therefore, this study was carried out to elucidate the underlying mechanism of this unique observation as C-myc is a well-known regulator of TERT
Methods: Binding sites of C-myc on the TERT promoter were identified by bioinformatics analysis. Next, chromatin immunoprecipitation (ChIP) was carried out followed by q-PCR to measure the rate of C-myc binding prior to and after RUNX1/ETO and SKP2 suppression.
Results: It was shown that TERT loss occurred due to RUNX1/ETO and SKP2 suppression in AML t(8;21). Nevertheless, the increase in c-MYC binding on the TERT promoter was only observed in RUNX1/ETO related TERT suppression and not SKP2 related TERT suppression. It is highly likely that the binding of c-MYC was a compensatory mechanism by AML t(8;21) cells to restore TERT expression upon RUNX1/ETO related suppression to maintain a leukaemic state as RUNX1/ETO related TERT suppression also resulted in SKP2 down regulation. Nevertheless, the compensatory mechanism by cMYC to restore TERT expression was not sufficient to overcome RUNX1/ETO related TERT suppression
Conclusion: RUNX1/ETO and SKP2 are driving forces in AML t(8;21) related TERT modulation with Cmyc playing roles to a lesser extent
Key words: AML, TERT, Oncogene, SKP2, c-MYC
|
| 106 |
Acquired thiopurine resistance and mismatch repair aberrations in pediatric B-cell acute lymphoblastic leukemia relapses: A real-world data integrating mutational signatures, clones and clinical thiopurine dosing patterns |
1978-10-16 |
Male |
Yes |
L1148 | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Sharun Garg1, Shweta Palla1, Samuel W Brady2, Sangeetha Kirubandhanan1, Minu Singh1, Sreejesh Sreedharanunni3, Anirban Das4, Amita Trehan1 1Pediatric Hematology-Oncology Unit, Department of Pediatrics, PGIMER, Chandigarh 2Pharmacy & Pharmaceutical Science |
PRATEEK BHATIA |
PGIMER CAHNDIGARH |
CHANDIGARH |
09417186867 |
prateekbhatia16@gmail.com |
Oral |
Title: Acquired thiopurine resistance and mismatch repair aberrations in pediatric B-cell acute lymphoblastic leukemia relapses: A real-world data integrating mutational signatures, clones and clinical thiopurine dosing patterns Introduction: Acquired thiopurine resistance and mismatch repair (MMR) defects are implicated in pediatric B-cell acute lymphoblastic leukemia (B-ALL) relapse. However, there is paucity of real-world genomic and clinical data on this subject. Methods: Pediatric B-ALL relapse cases (2019-2024) were primarily subjected to whole exome sequencing (250x depth; n=70) and partly deep targeted sequencing (>1000x;n=5). We derived per-sample frequencies of resistance genes, single base mutational signatures, TMB-High (≥10/Mb), MSI-H, and TPMT/NUDT15 status. Clinical variables included median weeks off 6-MP therapy and median 6-MP dose. Results: A total of 18/75 (24%) relapse cases showed SBS87 (Thiopurine related), SBS6/15 (MMR related) or Thio-dMMR mutational signature. Thiopurine resistance clones in either NT5C2 (13), PRPS1 (2) or TP53 (7) genes were noted in 19/75 (25%) cases while germline or somatic clones in MMR genes of MSH6 (4), MSH2 (3), PMS2 (7), MLH1(1), PMS1 (4), MSH3 (1), MSH4 (2) were noted in 19/75 (25%). Thiopurine gene resistance and or MMR gene mutations overlapped with either SBS87/6/15/Thio-dMMR signature in 55.5% (10/18) cases. The median weeks off 6-MP therapy was 4 (IQR 2–8); median 6-MP dose 54 (47–60); while TPMT/NUDT15 SNPs were noted in 11/75 (14.6%) cases. TMB-High (>10 mut/Mb) was noted in 10% (7/70) cases while MSI-High was noted in 11% (8/70). TP53 & MSH6 were significantly enriched for TMB-H (OR 15.8, p = 0.046). Directional clinical associations revealed modestly lower 6-MP mean dose to be related with NT5C2 resistant mutations and or SBS87 signature. Conclusions: This real-world data highlights a bidirectional interplay between thiopurine dosing pattern, evolution of resistant mutation and clonal selection including a sub-set predisposed to hypermutations due to MMR aberrations. Hence, there is a need for an integrated clone–signature–dose profiling strategy to guide dosing and genomic surveillance to mitigate relapse risk in pediatric B-ALL cases |
| 107 |
Impact of molecular heterogeneity in Core-binding factor acute myeloid leukemia on treatment outcomes |
1980-10-01 |
Female |
Yes |
L-1593 | pay_Q |
Malignant |
Leukemia & lymphoma |
Laboratory |
G Smeeta1, Aafreen Khan1, Deepshi Thakral 1, Sanjeev Kumar Gupta1, Sameer Bakhshi 2, Ranjit Kumar Sahoo 2, Rachna Seth 3, Ritu Gupta1 1 Department of Laboratory Oncology, Dr. BRAIRCH, AIIMS, New Delhi 2 Department of Medical Oncology, Dr. BRAIRCH, AIIMS, |
G Smeeta1 |
All India Institute of Medical Sciences(AIIMS) |
New Delhi |
9013590875 |
drsmeeta@gmail.com |
Poster |
Title: Impact of molecular heterogeneity in Core-binding factor acute myeloid leukemia on treatment outcomes
Introduction:
Core-binding factor acute myeloid leukemia (CBF-AML),defined by t(8;21)(q22;q22)/RUNX1::RUNX1T1 and inv(16)(p13.1q22)/t(16;16)(p13.1;q22)/CBFB::MYH11, constitutes a distinct biologic subgroup with clinical and genetic heterogeneity.
Methods:
We retrospectively analyzed 260 patients with CBF-AML; and hematological features, immunophenotype, cytogenetic/molecular profiles, measurable residual disease (MRD), and survival outcomes were analysed.
Results:
Among 260 CBF-AML (151 paediatric and 109 adults; median age 16 years, range 1–67years; M:F=2:1), 212 had RUNX1::RUNX1T1 and 48 had CBFB::MYH11. Median hemoglobin was 7.2g/dl (1.7-15g/dl), TLC 16.12×10⁹/L (0.57-811.9×10⁹/L), platelets 27×10⁹/L (1-331×10⁹/L) and LDH 640 IU/L (153-3057IU/L). Median PB and BM blast percentages were 51% (0.5-99%) and 65% (10-100%), respectively. Immunophenotypically, CD34, CD117, CD33, CD13, and HLA-DR were expressed in >95% cases. Aberrant expression of CD56 (72.5% vs 21.6%,P<0.001) and CD19 (55.27% vs 8.1%,p<0.001) was more common in AML with RUNX1::RUNX1T1, while CD64 (33.3% vs 20.2%,p=0.01) and CD36 (25% vs 9.8%, p=0.01) were more commonly associated with CBFB::MYH11. Additional cytogenetic abnormalities (61.1% vs 18.75%,p=0.002) and complex karyotypes (15.5%% vs 0%,p<0.001) were more in cases with RUNX1::RUNX1T1. Complete remission (CR) was achieved in 81.4% and MRD negativity was observed in 69.6% of cases [higher in CBFB::MYH11 (83.3% vs. 66.6%,p=0.26)]. RUNX1::RUNX1T1 AML demonstrated lower TLC compared to the other group (14.5 vs 41.7x109/L,p=0.003) with no significant difference in sex distribution, hemoglobin, platelets, LDH, PB or BM blast percentages, and post-induction morphological CR rates. Survival outcomes favored CBFB::MYH11, with superior overall survival (OS,p=0.03), relapse rate (51.3% vs. 32.5%;p=0.04), and a trend toward improved relapse-free survival (RFS, p=0.05).
Conclusions:
CBF-AML demonstrates clinicopathological heterogeneity. RUNX1::RUNX1T1 is associated with higher relapse risk and inferior survival compared to CBFB::MYH11. Comprehensive cytogenetic/molecular characterization with MRD monitoring is critical for refined risk stratification and therapeutic optimization.
Key words: Core-Binding Factor, AML, RUNX1::RUNX1T1, CBFB::MYH11, survival
|
| 108 |
Aplastic Anemia: A single centre experience from Eastern India |
1990-08-12 |
Male |
Yes |
L-2253 | pay_R |
Benign |
Marrow failure |
Clinical |
Dr Priyanka Samal (Professor and Head, Department of Clinical Hematology), Dr Biswaprakash Patri (Assistant Professor, Department of Clinical Hematology), Dr Sarita Pradhan (Professor, Department of Pathology), Dr Shivangi Harankhedkar (Associate Professo |
Dr Rajat Mohapatra |
IMS and SUM Hospital |
Bhubaneswar |
9437001880 |
rajatm557@gmail.com |
Oral |
Title: Aplastic Anemia: A single centre experience from Eastern India
Introduction: Aplastic Anemia is a rare disease characterized by hypocellular bone marrow and pancytopenia. Immune mediated T cell destruction of hematopoietic stem cells is believed to be the underlying pathophysiology. Eltrombopag in combination with Antithymocyte Globulin and Cyclosporine A has proven efficacy in treating patients with Severe Aplastic Anemia.
Methods: A retrospective study was conducted on Aplastic Anemia patients who presented to IMS and SUM Hospital between January 2019 and December 2024 with respect to their clinico-epidemiological profile, severity, therapy and response.
Results: 62 newly diagnosed Aplastic Anemia patients were analysed. 52% cases were male and 48% cases were female. The median age of presentation was 54 years (4 to 85 years). 61.2% cases were Non severe Aplastic Anemia, 27.4% cases were Severe Aplastic Anemia and 11.4% cases were Very Severe Aplastic Anemia. Most of the patients were treated with Cyclosporine and Eltrombopag. Few cases of Very Severe Aplastic Anemia and Severe Aplastic Anemia received triple therapy with Cyclosporine A, Antithymocyte globulin and Eltrombopag. Some cases underwent Hematopoietic Stem Cell Transplantation. The patients were followed up for a period of 1 year and showed mixed response.
Conclusions: Immunosuppressive therapy with Antithymocyte Globulin, Cyclosporine A and Eltrombopag is an effective therapy for Severe Aplastic Anemia and Very Severe Aplastic Anemia patients who lack a matched sibling donor or are unfit for Hematopoietic Stem Cell Transplant.
Key words: Severe Aplastic Anemia, Very Severe Aplastic Anemia, Triple Therapy, Antithymocyte Globulin, Cyclosporine, Eltrombopag, Hematopoietic Stem Cell Transplantation |
| 109 |
Tracing the Unusual: Aberrant Antigen Expression in Leukemia at a Tertiary Care Hospital |
1991-01-20 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Chintamani Pathak, Dr. Mukul Singh, VMMC & Safdarjung Hospital |
Dr Ramaseshan Somasekar |
VMMC & Safdarjung Hospital |
New Delhi |
9445441515 |
drramaseshan1991@gmail.com |
Oral |
Title: Tracing the Unusual: Aberrant Antigen Expression in Leukemia at a Tertiary Care Hospital
Introduction: Leukemia-associated aberrant immunophenotype (LAIP) refers to abnormal expression of antigens not typically seen in the lineage of origin. Recognition of such aberrancies by flow cytometry is important for accurate diagnosis, prognostication, and measurable residual disease (MRD) monitoring.
Methods: A total of 180 newly diagnosed leukemia cases were analyzed by multiparameter flow cytometry in an observational study conducted from April 2024 to July 2025 at a tertiary care hospital in New Delhi. The cohort comprised 61 cases of B-cell acute lymphoblastic leukemia (B-ALL), 55 cases of acute myeloid leukemia (AML), and 16 cases of T-cell acute lymphoblastic leukemia (T-ALL), among others. Aberrant antigen expression was defined as expression of markers of a non-lineage or unexpected pattern in ≥20% of leukemic blasts.
Results: Aberrant antigen expression was identified in 26 (14.4%) cases. The highest frequency was noted in T-ALL (7/16; 43.8%), followed by B-ALL (13/61; 21.3%) and AML (6/55; 10.9%). In T-ALL, aberrant CD10 expression was most frequent (5 cases; 31.2%), whereas in B-ALL, CD13 expression predominated (7 cases; 11.5%). Among AML cases, the most common aberrancy was CD19 expression (4 cases; 7.3%).
Conclusions: Aberrant antigen expression was documented across all major leukemia subtypes, with the highest proportional frequency in T-ALL. CD13 in B-ALL, CD10 in T-ALL, and CD19 in AML were the most recurrent aberrancies. Identification of these patterns is essential not only for avoiding diagnostic pitfalls and establishing reliable immunophenotypes for MRD monitoring, but also for their prognostic value in risk stratification and guiding therapeutic decisions.
Key words: aberrant antigen expression; flow cytometry; leukemia-associated immunophenotype (LAIP); acute lymphoblastic leukemia; acute myeloid leukemia; T-ALL; measurable residual disease (MRD). |
| 110 |
From Polycythemia to Methemoglobinemia: A Diagnostic Turnaround with Dramatic Recovery |
1989-02-04 |
Male |
Yes |
L-2199 | pay_R |
Benign |
Miscellaneous |
Clinical |
DR PRAKAS KUMAR MANDAL , PROFESSOR DEPARTMENT OF HAEMATOLOGY NRSMCH; DR TUPHAN KANTI DOLAI , PROFESSOR AND HEAD , DEPARTMENT OF HAEMATOLOGY , NRSMCH |
MAYANK PANDEY |
NIL RATAN SARKAR MEDICAL COLLEGE AND HOSPITAL |
KOLKATA |
8910204908 |
vikramadityamp@gmail.com |
Poster |
Title: From Polycythemia to Methemoglobinemia: A Diagnostic Turnaround with Dramatic Recovery
Background: Methemoglobinemia is a rare but potentially life-threatening condition associated with oxidation of divalent ferrous‐iron of hemoglobin (Hb) to ferric‐iron of methemoglobin (MetHb). Methemoglobinemia can result from either inherited or acquired processes.
Case presentation: A 20-year-old male presented with breathing difficulty, headache and gradually progressive bluish discoloration of fingernails, tongue, tip of the nose for 3 months. He was initially diagnosed as a case of polycythemia and received 2 sittings of phlebotomy as well but to no avail. JAK 2 and Exon 12 mutations were done for the patient previously which were negative. He had an oxygen saturation of 85% on room air which did not respond to oxygen therapy.
Diagnosis: His blood investigations showed a haemoglobin of 18.1 gm/dl, with a haematocrit of 58.5%, a TLC of 6800/mm3 without any abnormal cells and Platelet count of 189000/mm3. All other relevant investigations were within normal limits. His ABG showed a normal PaO2 with methemoglobin of 46.8% by co oximetry method and a diagnosis of methemoglobinemia was made.
Treatment: He was treated with high flow oxygen at 10lt/min, Vitamin C tablets and he was given injection methylene blue at a dose of 1mg/kg (50 mg) over 15 mins slow iv. There was a dramatic improvement in the cyanosis and the fingers, tongue and nails turned pink with a methemoglobin level of 7.2% within an hour after administration of methylene blue.
Follow up: The patient is doing well and is on regular follow up. There were no further episodes of cyanosis.
Conclusions: Methemoglobinemia is a potentially life-threatening condition if not promptly diagnosed. Congenital methemoglobinemia can lead to compensatory erythrocytosis and it can be misdiagnosed as a case of Polycythemia.
Key words: cyanosis, methemoglobinemia, erythrocytosis, refractory hypoxemia |
| 111 |
Relapse after MRD negativity in ALL in pediatric age group: A retrospective analysis from a tertiary centre in Eastern India |
1996-03-08 |
Female |
No |
- | H_LK |
Malignant |
Leukemia & lymphoma |
Clinical |
Professor Maitreyee Bhattacharya, Director, IHTM, Medical College Kolkata |
Dr Kajori Nandy |
Instituition of Hematology and Transfusion Medicin |
Kolkata |
9674290449 |
kajorin88@gmail.com |
Oral |
Title: Relapse after MRD negativity in pediatric ALL patients : A retrospective study from a tertiary centre in Eastern India Introduction: Relapse in ALL is prevalent in 10-15% cases of pediatric ALL. Relapse can occur in sanctuary sites like CNS or testis which may escape detection by MRD. Relapse is an unprecedented event in MRD negative patients. In this retrospective study , we have aimed to evaluate factors that might predict relapse in pediatric ALL after achieving MRD negativity. Methods:Pediatric ALL patients ( age 1-18 years) who presented in our hospital from April 2022 to April 2025 and received chemotherapy as per ALL IC BFM 2002 was included in our study. MRD was assessed on Day 78 by multiparameter flowcytometry. The characteristics of the patients who relapsed were studied and compared with those who remained in remission. Results:In There were 112 pediatric ALL patients,out of which 18 died , 11 lost to follow-up. The median age group was 10 years (IQR=5-16 years). Male: female ratio was 43:40. There were 79 B-ALL patients and 4 T- ALL patients, out of which 9 B -ALL and 1 T- ALL patient relapsed. MRD negativity at Day 78 was achieved by 73 patients. There were 24 SRG, 57 IRG and , 2 HRG patients . Most patients (82%) had normal karyotype. Three-fourth of the patients were CNS-1 . Two MRD positive and 8 MRD negative patients relapsed. The median duration of therapy interruption in the relapse group was 14 days (IQR=10,18 days) in induction and 8 days (IQR=2,13 days) in consolidation. The significant factors for relapse were- therapy interruptions during induction (p=0.04) and consolidation (p=0.04) and MRD positivity (p=0.03). Conclusions:Therapy interruptions can lead to relapse even after MRD negativity in ALL, which warrants MRD monitoring to detect early molecular relapse. |
| 112 |
PULMONARY HYPERTENSION IN TRANSFUSION DEPENDENT BETA THALASSEMIA AND ITS CORRELATION WITH SERUM N-TERMINAL PRO-BNP LEVEL |
1978-09-26 |
Male |
Yes |
L-2176 | H_LKO |
Benign |
Anemia |
Clinical |
|
Dr. Subhendu Bera |
IHTM, Medical college, Kolkata |
Kolkata |
9432173033 |
suped26@gmail.com |
Poster |
Title: PULMONARY HYPERTENSION IN TRANSFUSION DEPENDENT BETA THALASSEMIA AND ITS CORRELATION WITH SERUM N-TERMINAL PRO-BNP LEVEL
Introduction: Development of pulmonary hypertension in thalassemia is multifactorial . Prognostic significance of Pro-BNP has been demonstrated in several cardiovascular disorder. Pro -BNP level correlates with severity of pulmonary artery pressure elevation & right ventricular dysfunction. Pro-BNP cleave into an inactive part NT- Pro BNP and biologically active hormone BNP. NT-Pro BNP is highly stable. NT-Pro BNP may be a useful tool for patients in pulmonary hypertension. The increase of NT-Pro BNP is detected early in the course of disease and seems to be reliable indicator for the early detection of cardiac hemosiderosis in TDT patients.
Methods: Patients aged 16 years or more with transfusion dependent beta thalassemia were included. 2D -echocardiography was done to measure the pulmonary artery systolic pressure (PASP) and left ventricular ejection fraction (LVEF). NT-Pro BNP level was also assessed.
Results: Out of 43 participant , PAH was noted in 7 (16.3%). Mean age of the patients with PAH and with out PAH was 24.7 and 18.6 years, respectively (P=0.0001). Three of 7 patients with PAH (42.9%) had undergone splenectomy as against 2 of 36 patients without PAH(5.6%) (P=0.0048). The mean serum ferritin level of patients without PAH was 2175.08 ng/ml, while that of patients with PAH was 4267.00 ng/ml (P=<0.0001). The mean NT-Pro BNP level of patients without PAH and with PAH was 66.08 pg/ml and 144.00 pg/ml respectively (P < 0.0001)
Conclusions: PAH was observed in 16.3% of patients . Older age , splenectomy and high serum ferritin level being important risk factors. NT-Pro BNP can be used as screening test for detecting PAH in transfusion dependent beta thalassemia patients.
Key words: Iron over load, Pulmonary hypertension ,NT-Pro BNP, Beta thalassemia. |
| 113 |
Factors affecting survival and MRD negativity in IRG AML patients in a tertiary centre in Eastern India: |
1996-03-08 |
Female |
No |
- | H_LK |
Malignant |
Leukemia & lymphoma |
Clinical |
Professor Maitreyee Bhattacharya, Director, IHTM, Medical College Kolkata |
Kajori Nandy |
Instituition of Hematology and Transfusion Medicin |
KOLKATA |
9674290449 |
kajorin88@gmail.com |
Oral |
Title:Factors affecting MRD negativity in IRG AML patients in a tertiary centre in Eastern India: Introduction:Intermediate risk group AML is a heterogenous group of AML which consists of several undefined mutations and cytogenetic abnormalities. Poor prognostic factors in this group have not been identified. In this study we aim to identify poor prognostic factors in AML IRG group. Methods:A retrospective analysis was done on patients of IRG AML ( as per ELN 2022 classification) younger than 60 years, who received intensive chemotherapy by 3+7 regimen, followed by HiDAC consolidation from January 2022 till January 2025. Risk factors for MRD positivity and death were studied. Results: There were 105 AML patients, who received intensive chemotherapy- 36 were SRG, 40 were IRG and 29 were HRG. There were 45% males and 55% females, median age was 31 years ( IQR= 20,41 years). Median hemoglobin was 6.5(5.6, 7.2) g/dl , TLC in per cumm was 34400(6527, 59447) and median platelet count in per cumm was 31000(14500, 62250). Organomegaly was present in 9 (22.5%) patients. Most patients had normal karyotype (77.5%) followed by trisomy 8 (7.5%). A majority of the patients did not have any detectable mutation. (42.5%). The maximum number of mutations in a patient was 5. Most commonly expressed mutations were – FLT3-ITD (27.5%), CEBPA (17.5%) , WT1 (15%) , NRAS (15%). Fourteen patients died (35%), 36 achieved remission. MRD positivity was found in 7 patients (17.5%). Presence of organomegaly was significantly associated with induction death (p=0.03). The median age of MRD positive patients was 18 years (16,28.5 years) . Younger age (p=0.048) and female gender (p=0.03) were significantly associated with MRD positivity. Conclusions:No specific mutation could be found as a poor prognostic factor for IRG AML , however other factors may predict poor outcome in IRG AML. Keywords: MRD, IRG, AML |
| 114 |
The Invisible Culprit: Alpha Thalassemia with Poly A Tail Mutation Presenting as Microcytic Anemia |
1990-10-31 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Dr Garima Rakheja , Dr. Shivanshu Gangwar , Dr Prashant Sharma , Dr Shilpa Arora , Dr Vijay Kumar |
Dr. (Maj) Abhishek Sharma |
ABVIMS & Dr. RML HOSPITAL NEW DELHI 110001 |
New Delhi |
8860056960 |
dr.abhishek31123@gmail.com |
Poster |
Title:The Invisible Culprit: Alpha Thalassemia with Poly A Tail Mutation Presenting as Microcytic Anemia
Introduction:Microcytic hypochromic anemia is most often attributed to iron deficiency or β-thalassemia trait. However, alpha thalassemia, particularly HbH disease, may present with overlapping features that complicate diagnosis. We report a case where hematological indices, HPLC, and reticulocyte staining, followed by molecular testing, established the diagnosis of a rare α-globin poly A tail mutation.
Methods:A 16-year-old female with anemia since childhood underwent complete hematological evaluation including CBC with Ret-He, peripheral smear, iron profile, bone marrow aspirate, HPLC, reticulocyte supravital staining, and family screening, followed by molecular analysis.
Results:CBC showed microcytic hypochromic indices with reduced Ret-He. Peripheral smear demonstrated anisopoikilocytosis. The iron profile was normal, ruling out iron deficiency. Bone marrow aspirate revealed erythroid hyperplasia with normoblastic maturation. Reticulocyte supravital staining demonstrated classical HbH ‘golf-ball’ inclusion. HPLC showed a peak at < 1 minute retention time, consistent with HbH disease. Molecular testing confirmed a rare poly A tail mutation in the α-globin gene. Detailed genotypic data will be presented at the conference.
Conclusions:This case highlights the diagnostic challenge of microcytic anemia when reduced Ret-He and microcytosis mimic iron deficiency, but iron studies are normal. HbH disease should be considered as a differential in such scenarios. Definitive diagnosis rests on molecular confirmation, and rare mutations such as poly A tail variants broaden the spectrum of alpha thalassemia in the Indian context.
Key words:Alpha thalassemia, HbH disease, poly A tail mutation, Ret-He, microcytic anemia, diagnostic dilemma.
|
| 115 |
Impact of Varying Emicizumab Concentrations on Standard Coagulation Tests |
1996-11-20 |
Female |
No |
- | H_LKO |
Benign |
Hemeostasis |
Laboratory |
Dr. Rucha Patil (Scientist-D, ICMR-NIIH), Dr. Chandrakala S (Professor and HOD, Department of Hematology, KEM Hospital, Mumbai), Hem Chandra Joshi (Project Associate, ICMR-NIIH), Vedanti Chiplunkar (Project Technical Support, ICMR-NIIH) |
Sayli Raghunath Rasal |
ICMR-National Institute of Immunohaematology |
Mumbai |
7710924572 |
rasalsaylir@gmail.com |
Oral |
Introduction: Emicizumab is a bispecific-monoclonal antibody that mimics activated-FVIII by bridging FIXa and FX, restoring haemostasis. It achieves an annualized bleed rate of zero to one in most patients, even at low-doses. However, its surrogate FVIII-activity, shortens APTT and interferes with one-stage assays, leading to falsely elevated FVIII-levels and false-negative inhibitor results. Accurate FVIII and inhibitor assessment is essential during bleeding or surgery, yet routine tests remain unreliable.
Objective: To identify the minimum Emicizumab concentration that alters APTT, FVIII-assay, ROTEM-CT, and NBA, and to assess dose-dependent changes across tests.
Method:
In-vitro: Emicizumab(30mg/mL) was spiked into FVIII-deficient plasma at dilutions from 1:250 to 1:1,024,000. Levels, APTT, FVIII-activity, and ROTEM-CT were tested in triplicate.
In-vivo: Patient samples on standard or low-dose prophylaxis(3–55 µg/mL) were analyzed for APTT, FVIII, and ROTEM-CT. FVIII-spiked plasma was used for ROTEM-CT equivalence.
Results:
APTT was shortened at all Emicizumab levels, plateauing around 22 seconds above 28 µg/mL. Even at 1 µg/mL, APTT remained shortened(44 sec). In-vivo samples showed similar results. Surrogate FVIII-activity was overestimated, exceeding 150% at >28.6 µg/mL and still detectable(13%) at 1 µg/mL. ROTEM-CT exceeded 2000 sec at <5 µg/mL, consistent with severe-hemophilia. Above 5 µg/mL, CT progressively shortened, indicating moderate to mild patterns, plateauing beyond 50 µg/mL in-vitro and 20 µg/mL in-vivo. Similar CT values were observed in both low and standard-dose prophylaxis. Spiking Emicizumab into a high-titre inhibitor sample(128 BU/mL) gave false-negative results at all dilutions, except at 1 µg/mL(1:32,000), where a low-titre of 4 BU/mL was detected.
Conclusion: Emicizumab shows dose-dependent shortening of APTT and ROTEM-CT, plateauing beyond certain levels. ROTEM-CT indicates that concentrations above 12 µg/mL mimic mild-hemophilia, explaining the efficacy of low-dose prophylaxis. These findings emphasize the need for simpler, cost-effective alternatives to chromogenic bovine assays for accurate FVIII and inhibitor measurement.
Key words: Emicizumab levels, APTT, Surrogate FVIII-activity, ROTEM-CT |
| 116 |
Esophageal mucormycosis-rare case report and review of literature |
1977-07-10 |
Male |
Yes |
L-1223 | H_LKO |
Benign |
Infection & supportive care |
Clinical |
Dr Ketan Chandra Nathani, Divya Krishna, Mofizur Rehman Khan, R.N. Tagore, Mukesh Kumar, Manish Kumar, Department of Hemato-oNCOLOGY |
Dr Avinash kumar singh |
PARAS HMRI, PATNA |
PATNA |
7543015099 |
avinash.pmch@gmail.com |
Poster |
TITLE : Esophageal mucormycosis-rare case report AUTHORS : Avinash kumar singh , Ketan Chandra Nathani, Mofizur Rehman Khan, R.N. TAGORE, ,divya Krishna , Mukesh kumar INTRODUCTION :Mucormycosis is an invasive fungal infection associated with high mortality rates, especially in immunocompromised individuals. CASE SUMMARY : A 25-year-old male with a history of sudden blindness in the right eye was initially diagnosed with type 1 diabetes mellitus after an ophthalmology consultation. Azathioprine was initiated, and one month later, he presented with moderate-grade fever and weakness. Local physician evaluation revealed severe pancytopenia (ANC, 100/cu mm), prompting referral to our facility. Upon admission, azathioprine was discontinued, and the patient was started on intravenous antibiotics (piperacillin-tazobactam), granulocyte colony-stimulating factor (G-CSF), blood components, and supportive care. Despite multiple units of blood transfusion, fever persisted, and antibiotic escalation failed to improve the patient's condition. On day +20, he experienced vomiting and dysphagia, initially attributed to mucositis. Granulocyte transfusion provided temporary relief, but dysphagia persisted. Upper gastrointestinal endoscopy on day +25 revealed a possible esophageal mass, confirmed histopathologically as mucormycosis1. Conventional amphotericin B was initiated, leading to gradual recovery from day +30. The patient was discharged on day +37 with posaconazole, only to be readmitted on day +42 with hematemesis. Residual fungal ulceration was confirmed, prompting a three-week continuation of amphotericin B. Upon recovery, the patient was switched to posaconazole and remains asymptomatic on follow-up Discussion: This case highlights the challenges in managing mucormycosis, particularly in immunocompromised individuals2. Early recognition, discontinuation of immunosuppressive agents, prompt antifungal therapy, and a multidisciplinary approach are crucial for favorable outcomes. The esophagus's involvement, though rare, emphasizes the need for thorough evaluation in patients with persistent symptoms.
Conclusion: Mucormycosis poses a significant threat to immunocompromised individuals, and its multisystem involvement requires a comprehensive management strategy. |
| 117 |
Evaluation of Monocyte HLA-DR Expression and Sepsis Index Using Ratio of Neutrophil CD64 and Monocyte HLA-DR as Biomarkers of Sepsis in Critically Ill Patients |
1994-05-05 |
Male |
No |
- | H_LKO |
Benign |
Miscellaneous |
Clinical |
Dr. Vijay Kumar2, Dr. Ranvinder Kaur3,Dr Garima Rakheja4 , Dr Tanvi Jha5 1Post Graduate Resident, Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi-110001 2Professor and Head, Hematology & Clinical Pathology Unit, Department of Pathology, AB |
Tarun Kasana |
ABVIMS and Dr. RML Hospital, New Delhi-110001 |
Delhi |
09635798861 |
tarunkasana4871@gmail.com |
Oral |
Title:Evaluation of Monocyte HLA-DR Expression and Sepsis Index Using Ratio of Neutrophil CD64 and Monocyte HLA-DR as Biomarkers of Sepsis in Critically Ill Patients
Introduction:Sepsis is a life-threatening condition caused by a dysregulated immune response, leading to organ dysfunction and high mortality. The sepsis index (SI), derived from the nCD64/mHLA-DR ratio, integrates hyperinflammation and immunosuppression into a single measure.
Methods:This prospective study at ABVIMS & Dr. RML Hospital enrolled 75 critically ill adults with traumatic brain injury or stroke, initially free from sepsis. nCD64 and mHLA-DR were measured by flow cytometry at baseline and follow-up, and the sepsis index was calculated to assess diagnostic performance.
Results:The study showed that the sepsis index had excellent diagnostic accuracy (AUC >0.90, p<0.005), peaking early and declining by day 15. Monocyte HLA-DR was significantly reduced (p<0.001), reflecting immunosuppression with gradual recovery, while neutrophil CD64 rose early (p<0.016) but lost predictive value over time. CRP was strongly elevated (p<0.001), complementing the sepsis index as a robust inflammation marker. Higher APACHE II and SOFA scores (p<0.001) aligned with biomarker changes, highlighting their combined utility in assessing sepsis severity and prognosis.
Conclusions:mHLA-DR expression and SI are valuable biomarkers for early detection and immune monitoring in critically ill patients. By integrating markers of both inflammation and immune suppression, provides superior prognostic insight compared to conventional biomarkers, potentially enabling timely and targeted interventions in sepsis management.
Key words:Sepsis, Critically ill, mHLA-DR, nCD64, SI, Flow Cytometry |
| 118 |
Daratumumab Use in Refractory Pure Red Cell Aplasia: Two Case Reports |
1977-07-10 |
Male |
Yes |
- | H_LKO |
Benign |
|
Clinical |
Dr Ketan Chandra Nathani, Divya Krishna, Mofizur Rehman Khan, R.N. Tagore, Mukesh Kumar, Sonal Priyankar, Tejshree Bhusan, Department of Hemato-Oncology and Department of Pathology |
Dr Avinash kumar singh |
PARAS HMRI, PATNA |
PATNA |
7543015099 |
avinash.pmch@gmail.com |
Poster |
Title: Daratumumab Use in Refractory Pure Red Cell Aplasia: Two Case Reports
Introduction: Acquired pure red cell aplasia (PRCA) is a rare disorder characterized by isolated erythroid failure, severe anemia, and reticulocytopenia. Secondary causes include autoimmune diseases, lymphoproliferative disorders, monoclonal gammopathy of undetermined significance (MGUS), thymoma, viral infections (e.g., parvovirus B19), drugs, and post-allogeneic HSCT. Standard therapy involves ciclosporin with corticosteroids; refractory cases may require cyclophosphamide, bortezomib, rituximab, antithymocyte globulin (ATG), or intravenous immunoglobulin (IVIG). Daratumumab, an anti-CD38 monoclonal antibody, depletes autoreactive plasma cells and modulates immune responses, offering a potential therapeutic approach
Objective: To describe clinical outcomes of two adults with transfusion-dependent, refractory acquired PRCA treated with weekly daratumumab following failure of multiple prior therapies.
Case Presentations: - Case 1: A 64-year-old male with idiopathic PRCA, refractory to ciclosporin, steroids, and other agents, received seven weekly doses of daratumumab (initiated July 10, 2025). He demonstrated reduced transfusion needs and clinical improvement without infusion-related reactions or major adverse events. - Case 2: A 74-year-old male with MGUS-associated PRCA, also refractory to prior therapies, received four weekly doses of daratumumab with darbepoetin support. No significant change in transfusion requirement has been observed yet; reassessment is planned after eight doses. Treatment Protocol: Daratumumab was administered at 16 mg/kg weekly.
Results (Interim): Case 1 showed early hematological improvement and reduced transfusion frequency, whereas Case 2 has not yet demonstrated clinical benefit. No major infections, infusion reactions, or safety concerns were recorded
Discussion: Daratumumab is emerging as a promising therapy in refractory PRCA, including idiopathic and plasma cell–associated subtypes. Responses may be rapid but variable. The small sample size and limited follow-up are notable limitations.
Conclusion: Weekly daratumumab demonstrated early efficacy in one of two refractory PRCA patients, with ongoing evaluation in the second. Larger studies are warranted to determine optimal dosing. |
| 119 |
Clinical utility of Immature Platelet Fraction (IPF) in the characterization of thrombocytopenia. |
1995-06-07 |
Female |
No |
- | H_LKO |
Benign |
Platelet disorders |
Clinical |
Dr Vijay Kumar2 , Dr Vishakha Mittal3 ,Dr Garima Baweja4 , Dr Aiusee Nasreen Pooja52Professor & Head, Hematology & Clinical Pathology Unit, Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi-110001 3Professor , Department of Medicine, ABVIMS |
Dr Jyoti Srivastava |
ABVIMS and Dr. RML Hospital, New Delhi-110001 |
New Delhi-110001 |
9454316316 |
drjyotisrivastav06@gmail.com |
Oral |
Title: Clinical utility of Immature Platelet Fraction (IPF) in the characterization of thrombocytopenia.
Introduction: Thrombocytopenia, a platelet count below 150×10³/μL, arises from varied causes, mainly increased peripheral destruction or reduced bone marrow production. Differentiating these is crucial for management. IPF indicates the proportion of newly released, RNA-rich platelets, reflects marrow activity. This study evaluates IPF’s role in distinguishing thrombocytopenia mechanisms and predicting platelet recovery.
Methods: A one-year cross-sectional study at ABVIMS & Dr. RML Hospital enrolled patients with platelet counts <150×10³/μL, classified as increased destruction or decreased production based on clinical and laboratory findings. IPF and other platelet parameters were measured using an automated analyser, and results were statistically compared and correlated with diagnosis and recovery.
Results: Immature Platelet Fraction (IPF) levels were significantly higher in patients with thrombocytopenia due to increased peripheral destruction (like ITP, dengue) compared to those with decreased marrow production.
A cut-off IPF value around 7.95% differentiated peripheral destruction from marrow failure with sensitivity of 88.9% and specificity of 88.2%. IPF values were also predictive of platelet recovery, with higher baseline IPF associated with faster recovery in conditions like ITP and dengue.
Conclusions: IPF is a rapid, reliable, and cost-effective parameter for differentiating thrombocytopenia etiologies and as a useful tool in predicting platelet recovery. Incorporating IPF into routine CBC evaluation can improve diagnostic accuracy and aid timely therapeutic decision-making in thrombocytopenic patients.
Key words: Immature platelet fraction , Thrombocytopenia, ITP.
|
| 120 |
Evaluation of newer reticulocyte parameters (RET-He and DELTA-He) in comparison to the conventional parameters for the diagnosis of iron deficiency anemia in critically ill patients. |
1997-09-30 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
Dr. Vijay Kumar2,Dr. Ranvindar Kaur3,Dr. Pooja Dhamija4, Dr. Garima Rakheja.5 2Professor & Head, Hematology & Clinical Pathology Unit, Dept. of Pathology, ABVIMS, Dr RML Hospital, New Delhi 110001. 3Professor & Head, Department of Critical Care Medicine |
Dr. Swati Singh1, ¹Post Graduate Resident, Department of Pathology, ABVIMS and Dr. RML Hospital,New Delhi 110001. |
ABVIMS, Dr RML Hospital, New Delhi 110001. |
NEW DELHI |
7017998939 |
dr.singhh30@gmail.com |
Oral |
Title: Evaluation of newer reticulocyte parameters (RET-He and DELTA-He) in comparison to the conventional parameters for the diagnosis of iron deficiency anemia in critically ill patients.
Introduction: Anemia is a common complication in critically ill patients, arising from multifactorial pathophysiology and inflammatory-mediated hepcidin upregulation causing iron-restricted erythropoiesis. Conventional iron markers are often unreliable in acute illness. RET-He and DELTA-He as inflammation-independent hematologic indices for early detection of absolute iron deficiency anemia(IDA) and functional iron deficiency(FID) in Intensive care unit(ICU) patients.
Methods: This cross-sectional observational study was conducted from February 2024 to June 2025 in the Department of Pathology, ABVIMS & Dr. RML Hospital. All ICU patients ≥18 years were enrolled. Venous blood samples were processed on Sysmex automated analyser XN 1500. Patients were classified in 5 groups as controls, latent iron deficiency(LID), absolute ID, FID and anemia without ID. Our study compared novel reticulocyte-derived hematological markers with conventional methods for diagnosing IDA.
Results: The study found that mean RET-He(p < 0.001) and DELTA-He(p < 0.001) were significantly lower in IDA patients compared to control. Both parameters showed superior diagnostic performance over the conventional iron parameters. The cut-off of RET-He was ≤ 29.5pg which identified IDA with high accuracy. DELTA-He was the most reliable predictor, with a cut-off of <1.5 pg, accurately identified both absolute and functional ID even in inflammatory states.
Conclusions: RET-He and DELTA-He are highly effective for diagnosing iron deficiency in critically ill patients, outperforming ferritin and transferrin saturation in inflammatory states. RET-He shows exceptional accuracy in detecting both IDA and FID, while DELTA-He remains a strong predictor. Their rapid and reliable performance supports the potential utility of these markers for routine ICU use.
Key words: Anemia, Critically ill patients, Intensive care unit, RET-He, DELTA-He, ferritin, Transferrin saturation, Iron deficiency anemia, Functional iron deficiency, Latent iron deficiency, Inflammation. |
| 121 |
Audit of Critical Value Reporting in Haematology Laboratory: Identifying Gaps for Patient Safety |
1989-04-30 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Laboratory |
Dr Rashi Garg, Dr Priya Singh, Dr Neha Kumari, Dr Manpreet Kaur |
Dr Navpreet Kaur |
Dr BR Ambedkar State Institute of Medical Sciences |
Mohali, Punjab |
9417270848 |
dr.navpreet3489@gmail.com |
Poster |
Title:Audit of Critical Value Reporting in Haematology Laboratory: Identifying Gaps for Patient Safety
Introduction: Background:
Critical values (CVs) in haematology represent laboratory results that indicate potentially life-threatening conditions and require immediate clinical notification. Timely communication of CVs is essential for patient safety and is emphasized in NABL, CAP, and CLSI guidelines. Audits of CV reporting help evaluate compliance with standards and identify system gaps for quality improvement.
Aim:
To audit the process of critical value reporting in the haematology laboratory of a tertiary care institute and assess compliance with predefined standards.
Methods: This was a retrospective audit conducted over 6 months in the haematology laboratory of Dr BR Ambedkar State Institute of Medical Sciences, SAS Nagar, Punjab. Critical values were defined as per institutional SOPs as Hb <7.5 g/dL, platelets <75,000/µL, WBC <2,000/µL or >20,000/µL. The benchmark for performance was ≥95% notification within 30 minutes of result validation. Data were extracted from the critical value register. Parameters analysed included number of CV events, proportion successfully communicated, turnaround time (TAT), documentation completeness.
Results: A total of 552 critical values were generated during the audit period. The median TAT for notification was 30 minutes. Failures were noted in a significant number of cases, mainly due to unavailable contact, incomplete documentation.
Conclusions: The audit demonstrated strengths in turn around time but highlighted gaps in documentation, read-back. Interventions including staff training, reinforcement of SOPs, and LIS-based automated alerts are planned to improve compliance. Regular audits of CV reporting can strengthen patient safety in haematology practice.
Key words: Critical value, haematology, turnaround time, audit, patient safety |
| 122 |
Efficacy and Safety of Autologous Stem Cell Transplant (Auto-SCT) in Relapsed Acute Promyelocytic Leukaemia (APML) Patients in Molecular Remission- A Retrospective Study |
1992-05-08 |
Female |
No |
- | H_LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dr George Abraham |
Dr Pavitra Hegde |
Regional cancer centre |
Trivandrum |
9513553205 |
drpavitra.hegde@gmail.com |
Poster |
Title: Efficacy and Safety of Autologous Stem Cell Transplant (Auto-SCT) in Relapsed Acute Promyelocytic Leukaemia (APML) Patients in Molecular Remission- A Retrospective Study Introduction : APML relapse is uncommon and has an incidence of less than 20%, with higher incidences in those with high-risk disease at baseline. The role of Hematopoietic stem cell transplant (HSCT) in first remission, CR1, is obsolete and is relegated to consolidate patients in second remission, CR2, or beyond, post salvage in molecular remission. Studies showed a superior efficacy in terms of PFS and OS of HSCT over chemotherapy at CR2. Allogenic transplant had higher treatment related mortality compared to AutoSCT and is reserved only for cases with minimal residual disease (MRD) positivity.
There is a scarcity of literature regarding the optimal conditioning regimen for AutoSCT. Commonly used regimens employ TBI and MAC using Bu-Cy. In this Retrospective study we aim to evaluate the efficacy and safety of varied conditioning regimes for autologous transplant in APML relapse in a tertiary care centre over a 15-year period (2012-2025) and identify effective therapeutic strategies.
Method:
Study design: Retrospective cohort study.
Study population: Patient diagnosed with APML relapse in CR2 or beyond, undergoing AutoSCT in Regional Cancer Centre, Trivandrum
Study Period: June 2012 to August 2025(15 years).
Result: The median age of patients was 37(21-50). 4 patients were transplanted at CR2 and 1 1 at CR3. Baseline characteristics and outcomes summarised in Table 1. There was no transplant related mortality. Of the 5 patients transplanted, 4 continue to be in molecular remission while 1 died of non-APML secondary AML relapse. Conclusion: Myeloablative conditioning with BEAM regimen is safe and effective for APML at CR2 during autoSCT.
Keywords: APML, Relapse, HSCT, Remission, Conditioning regimen |
| 123 |
Extended mutation profile of β-thalassemia: Cross-sectional, single-center study |
1986-11-05 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
Dr. Mrinalini Kotru, Dr. Richa Gupta, Dr. Kusum, Dr. Ahmed Ansari |
Dr. Poonam Rani |
University College of Medical Sciences |
Delhi |
9310439362 |
prani@ucms.ac.in |
Oral |
Title: Extended mutation profile of β-thalassemia: Cross-sectional, single-center study
Introduction: β-thalassemia is caused by more than 350 mutations however in India, 5 most common mutations are IVS1–5 (G>C), IVS1-1 (G>T), 619-bp deletion, FS 41/42 (−TCTT), and FS 8/9 (+G) which are responsible for around 80% of the cases. But there are other rare mutations as well which are not routinely studied
Methods: Fifty Hb HPLC-confirmed β-thalassemia cases with HbA2>4% and 50 healthy controls were studied for mutation panel by RT- PCR. The data was analyzed by SPSS v20.0 software and p-value < 0.05 was considered significant.
Results: Mutations were identified in 47/50 cases and 3/50 controls. The most common mutations in cases were IVS-1-5 (G>C) (36%), 16% had FS 41/42 (-TCTT) and C-15 (G>A), FS 8/9 (12%) and FS 16 (-C) in 8% cases. The C-30(G>C), 90 (C>T) and 619 bp deletions were seen in only 2% cases.
The C-15(G>A) heterozygous mutation was found in three healthy controls, two with normal haematological parameters and HPLC. While one control had anemia, positive Mentzer index, normal HPLC however iron deficiency anaemia on iron profile. It might be due to concurrent iron deficiency anaemia.
Conclusions: The most common mutations in our population were IVS 1-5 (G>C) and FS 41/42 (-TCTT), FS 8/9, FS 16 (-C) and C-15 (G>A). Extended mutation profile is required especially when one spouse is BTT and another has family history of β-thalassemia. Frequent presence of C-15 (G>A) mutation in controls as well as cases in our region emphasizes the need to include C-15 (G>A) in mutation panel specifically in our region.
Key words: β-thalassemia, Extended mutation profile, IVS 1-5 (G>C), C-15 (G>A) |
| 124 |
Title: Bedside-to-Bench Germline Testing in Hematological Malignancies via Streamlined Fibroblast Cultures |
1997-11-24 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Nedhi Kumari1, Parampreet Kaur1,Naveen Kaushal2, Anu Kumari1, Shano Naseem1, Jogeshwar Binota1, Manupdesh Singh Sachdeva1, Arihant Jain3,Manish Rohilla4, Reena Das1, Pankaj Malhotra3, Pulkit Rastogi1 1Department of Haematology, Postgraduate Institut |
Nedhi kumari |
PGIMER, Chandigarh |
Chandigarh |
9149575656 |
nedhikumari0191@gmail.com |
Oral |
Title: Bedside-to-Bench Germline Testing in Hematological Malignancies via Streamlined Fibroblast Cultures.
Introduction: Germline variants predisposing to hematological malignancies are increasingly recognized, but their reliable detection requires DNA uncontaminated by blood cells. Unlike solid tumors where peripheral blood serves as a reference, hematologic malignancies pose a unique challenge due to clonal or neoplastic cells in circulation. Alternative non-hematopoietic tissues are therefore required. Skin fibroblasts from punch biopsies are considered the gold standard; however, most published protocols remain research-oriented and are not readily adaptable for clinical application from bedside to laboratory.
Methods: We developed an enzyme-free protocol for culturing dermal fibroblasts from punch biopsies collected during the same sitting and same site (posterior superior iliac spine) as routine bone marrow aspiration/biopsy, allowing both procedures under a single local anesthetic and minimizing patient discomfort. The workflow emphasizes bedside collection, sterile transport, mechanical dissection without enzymatic digestion, optimized plating, culture expansion, and high-yield DNA extraction. Optimization was performed in five patients with non-neoplastic hematological conditions, followed by validation in eighteen patients with acute myeloid leukemia (AML) / myelodysplastic syndromes (MDS).
Results: Fibroblast outgrowth occurred within 7–10 days, with 80–90% confluency achieved by median Day 21 (range: 18–35). Mean DNA yield was 252 ng/μL (range: 53.9–822.5) with high purity (A260/280 ~1.8–2.0). Droplet digital PCR in a polycythemia vera case with JAK2 V617F mutation confirmed absence of somatic clones. Flow cytometry demonstrated >95% CD90+, CD105+, CD26+ fibroblasts, negative for hematopoietic markers (CD45, CD34, CD3, CD19). ICC confirmed SMA+ and Vimentin+ mesenchymal phenotype without CD45 contamination.
Conclusion: This streamlined method—by combining skin and marrow sampling at the same site and sitting—reduces patient discomfort and ensures reproducibility in a clinical laboratory setting. By integrating fibroblast culture into hematopathology workflows, it enables reliable germline DNA analysis in inherited myeloid predisposition syndromes.
Keywords: Skin fibroblast culture, Germline predisposition, hematological malignancies. |
| 125 |
Outcomes of Total Marrow and Lymphoid Irradiation (TMLI)–Based Conditioning in Adult Acute Leukemia and Related Disorders: A Single-Center Experience |
1993-04-26 |
Male |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
|
Kapil Kamalkishor Rathi |
Jaslok Hospital & Research Centre |
Mumbai |
9623541127 |
kkr260493@gmail.com |
Poster |
Title: Outcomes of Total Marrow and Lymphoid Irradiation (TMLI)–Based Conditioning in Adult Acute Leukemia and Related Disorders: A Single-Center Experience
Introduction: Total marrow and lymphoid irradiation (TMLI) is increasingly used as a conditioning platform in allogeneic stem cell transplantation (allo-SCT), offering targeted radiation and reduced off-target toxicity. We present our single-center experience with TMLI-based regimens in adults with acute leukemia and related hematologic malignancies.
Methods: We retrospectively reviewed 14 adults (median age 37, range 23–54) who underwent allo-SCT with TMLI-based conditioning between January 2022 and June 2024. Diagnoses included ALL (n=9), AML (n=2), CML (n=1), and relapsed B-ALL with CNS/testicular involvement (n=1); 12 had high-risk disease. Donors were matched unrelated (n=5), haploidentical (n=3), or HLA-matched related/unrelated (n=6). Peripheral blood stem cells were the graft source in all (median CD34+ dose 6.8×10^6/kg). TMLI (12–13.5 Gy in 6–8 fractions) was combined with chemotherapy backbones including cyclophosphamide, fludarabine, thiotepa, or treosulfan.
Results: Neutrophil engraftment occurred in 13/14 patients (93%) at median day +14 (range +11–30); platelet engraftment at day +15 (range +7–36). One patient had primary graft failure with early death from septic shock. Non-relapse mortality was 7%. Acute GVHD grade II–IV developed in two patients; none had grade IV. Chronic GVHD was limited. Two patients relapsed (14%), both with extramedullary disease. At median 10-month follow-up (range 3–26), overall survival was 78% and disease-free survival 71%. Regimen-related toxicities such as sinusoidal obstruction syndrome, hemorrhagic cystitis, pulmonary, or cardiac dysfunction were not observed.
Conclusions: TMLI-based conditioning is feasible and well tolerated in high-risk adult acute leukemia, achieving reliable engraftment, low toxicity, and encouraging survival. Larger studies with longer follow-up are needed.
Key words: TMLI, acute leukemia, conditioning regimen, allo-SCT, survival |
| 126 |
BONE MARROW TRANSPLANT IN TIER 2 CITY: EXPERIENCE FROM PARAS HMRI, PATNA. |
1977-07-10 |
Male |
Yes |
- | H_LKO |
Malignant |
|
Clinical |
Dr Ketan Chandra Nathani, Mofizur Rehman Khan, R.N. Tagore, Mukesh Kumar, Divya Krishna, Manish Kumar, Deepak,Sonal Priyankar, Tejshree ,Department of Hemato-oNCOLOGY |
Dr Avinash kumar singh |
PARAS HMRI, PATNA |
PATNA |
7543015099 |
avinash.pmch@gmail.com |
Poster |
Title: BONE MARROW TRANSPLANT IN TIER 2 CITY: EXPERIENCE FROM PARAS HMRI, PATNA.
Introduction: HSCT is a potentially curative treatment for various malignant and non -malignant hematologic disorders. Advances in donor matching, conditioning regimens and supportive care has improved outcomes in HSCT. Though complications such as Graft Versus Host disease and Infections remain significant pose significant challenges.
Methods: This is a Retrospective study conducted at Paras HMRI, Patna conducted from 2017 to August 2025. We done have 71 Bone marrow transplants which include 40 Autologous Bone marrow transplant and 31 Allogenic Bone marrow transplant and we intent to present our data. Indications for Autologous Bone marrow Transplant were Multiple Myeloma (Upfront in 29 patients and 6 in Relapse patients), Peripheral T cell Lymphoma-NOS (1 Upfront and 1 Relapse), Relapse DLBCL (1 patient), Relapse T CELL Rich B cell NHL (1 Patient), Relapse Hodgkins (1 Patient). Indications for Allogenic HSCT were Aplastic Anemia (5- Very Severe,
12 - Severe), Inherited Bone Marrow Failure Syndromes (1 patient), AML (Intermediate Risk- 1, Relapse - 3 patients), High Risk MDS (1 patient), Relapse B ALL (5 Patients, 4 MSD and 1 Haploidentical BMT), Chronic Neutrophilic Leukemia (1 patient), Transfusion Dependent Thalassemia (2 patients).
Results: We analysed total 71 patients and we will present our data during conference.
Conclusions: Our Retrospective analysis demonstrates favourable engraftment outcome and survival rates of patients undergoing Haematopoietic Stem Cell Transplant. Though transplant related complications Mucositis, Graft Versus Host Disease and infections continue to impact morbidity and mortality. Continued efforts to refine patients' selection, conditioning regimen, GHHD prophylaxis and supportive care are essential to improve outcomes.
Key words: Bone marrow transplant, Survival outcomes, Engraftment, GVHD. |
| 127 |
Prospective Cohort Study of Renal Involvement in Multiple Myeloma: Clinicopathological Spectrum and Outcomes |
1994-11-21 |
Female |
Yes |
L-2286 | H_LKO |
Malignant |
Plasma cell disorders |
Clinical |
|
MEHAK TREHAN |
ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI |
delhi |
09988232440 |
mehaktrehan21@gmail.com |
Oral |
Title: Prospective Cohort Study of Renal Involvement in Multiple Myeloma: Clinicopathological Spectrum and Outcomes
Introduction Renal involvement is a frequent and clinically significant manifestation of multiple myeloma (MM), occurring in 25–50% of patients at diagnosis. It adversely impacts therapeutic choices, limits use of lenalidomide, and predicts inferior survival. Indian data on the spectrum of renal pathology and its correlation with hematologic outcomes remain limited.
Methods: In this prospective observational study at AIIMS, New Delhi, 98 newly diagnosed MM patients were evaluated between September 2023 and January 2025. Of these, 57 presented with renal impairment, and 45 underwent kidney biopsy. Baseline demographic, biochemical, and histopathological data were collected. Patients were treated with standard induction regimens. Hematologic and renal responses were assessed at six months using International Myeloma Working Group (IMWG) criteria.
Results: Patients with renal involvement were younger (mean age 55 years), predominantly male, and 84% presented with renal complaints. Median creatinine was 2.6 mg/dL, eGFR 24 mL/min/1.73 m², and one-third had nephrotic syndrome. Biopsy revealed paraprotein-associated lesions in 91%: cast nephropathy (35.6%), AL amyloidosis (20%), and monoclonal immunoglobulin deposition disease (24.4%); rare lesions included light-chain proximal tubulopathy and crystal-globulinemic glomerulonephritis. At six months, hematologic response (CR/VGPR) was achieved in 77.8% of the renal cohort versus 95.1% without renal involvement (p=0.0448). However, only 48.9% of renal-involved patients attained a renal response. Renal recovery never occurred without hematologic response, but one in four hematologic responders failed to achieve renal improvement. Multivariable analysis showed elevated baseline creatinine and high cast burden predicted poor hematologic response, while interstitial fibrosis/tubular atrophy (IFTA) independently predicted renal non-response.
Conclusions: Renal impairment in MM signifies distinct clinicopathological features, influences treatment selection, and and predicts inferior depth of hematologic response and incomplete renal recovery. Early biopsy is safe and essential for accurate diagnosis, guiding prognosis, and optimizing therapy. |
| 128 |
SLCO2A1-Mutated Pachydermoperiostosis with Secondary Myelofibrosis: A Rare Case Series and Therapeutic Insight |
1994-11-21 |
Female |
Yes |
L-2286 | H_LKO |
Malignant |
MPN & MDS/ MPN |
Clinical |
|
MEHAK TREHAN |
ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI |
delhi |
09988232440 |
mehaktrehan21@gmail.com |
Poster |
Title: SLCO2A1-Mutated Pachydermoperiostosis with Secondary Myelofibrosis: A Rare Case Series and Therapeutic Insight
Introduction: Pachydermoperiostosis (PDP) is a rare genetic disorder characterized by pachydermia, clubbing, and periostosis, most often linked to SLCO2A1 mutations. Sustained elevation of prostaglandin E2 (PGE2) has been implicated in fibroproliferative changes, including secondary myelofibrosis. Less than 25 such overlap cases have been reported worldwide, and awareness remains limited.
Methods: We describe four young male patients (ages 17–27) presenting with transfusion-dependent anemia, digital clubbing, coarse facial features, and joint swelling. All underwent detailed hematologic, autoimmune, and molecular evaluation. Bone marrow biopsy and reticulin staining confirmed grade 2–4 fibrosis. Targeted sequencing identified pathogenic SLCO2A1 mutations.
Results: All patients demonstrated classic PDP features (pachydermia, periostitis, clubbing). Hematologically, they exhibited leukoerythroblastic blood smears with transfusion-dependent anemia; platelets were preserved. None had JAK2, CALR, MPL, or BCR-ABL1 mutations, ruling out classical myeloproliferative neoplasms. Three patients had compound heterozygous or homozygous SLCO2A1 mutations; one had dual pathogenic variants. Supportive measures included PRBC transfusions, chelation, folate, and trial of erythropoietin/danazol without meaningful benefit. Etoricoxib (COX-2 inhibitor, 60–90 mg/day) with low-dose steroids yielded hematologic improvement in three patients, with hemoglobin rise (4–6 g/dL), reduced spleen size, and decreased transfusion need; one patient achieved transfusion independence for >3 years. Relapse occurred on therapy tapering, underscoring need for prolonged suppression of PGE2-driven pathways.
Conclusions: This series underscores PDP with SLCO2A1 mutations as a rare cause of secondary myelofibrosis in young males. Chronic PGE2 elevation provides a mechanistic link between dermatologic–skeletal features and marrow fibrosis. Early genetic diagnosis is crucial to avoid misclassification as classical MPN, and COX-2 inhibition emerges as a potential disease-modifying therapy. Awareness of this overlap syndrome may improve recognition and targeted management.
Key words: Pachydermoperiostosis, SLCO2A1, Myelofibrosis, Prostaglandin E2, COX-2 inhibitor, Anemia |
| 129 |
Low-Dose Defibrotide for Veno-Occlusive Disease treatment in a Young Adult with Thalassemia Major Undergoing Allogeneic Transplant |
1994-04-17 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Dr. Poornima P , Dr.Anand kumar , Dr.Mahesh.R , Dr.sunil U |
Dr.keerthi.G |
sparsh hospital yeshwanthpur |
Bangalore |
9591236464 |
keerthi_gp@yahoo.in |
Poster |
Title:Low-Dose Defibrotide for Veno-Occlusive Disease treatment in a Young Adult with Thalassemia Major Undergoing Allogeneic Transplant
Introduction: Veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a serious complication following hematopoietic stem cell transplantation (HSCT), especially in high-risk individuals such as patients with thalassemia and hepatic iron overload.
case presentation : A 25-year-old woman with high-risk thalassemia underwent matched sibling donor HSCT. On Day +6 post-transplant, during recovery from sepsis and septic shock, she developed signs suggestive of VOD, including a 8.5-9% weight gain from baseline, direct hyperbilirubinemia (total bilirubin: 3.7 mg/dL), ascites on ultrasound, and platelet transfusion refractoriness. Differential diagnoses included drug-induced liver injury, thrombotic microangiopathy, and ischemic hepatitis. However, based on EBMT criteria and a HokUS score of 4, a diagnosis of moderate VOD was made, with severity upgraded due to pre-existing hepatic iron deposition.
management and outcome : The patient was started on low-dose defibrotide (100 mg IV every 6 hours), along with 3 days of Pulse dose methylprednisolone(250mg) and was tapered over 10days , fluid restriction, and intravenous furosemide. She responded well, with gradual resolution of ascites, weight loss, and normalization of bilirubin. A total of 10 days of defibrotide therapy was administered. Serial ultrasounds confirmed hepatic improvement, and diuretics were successfully tapered.
Conclusions: This case highlights the importance of early recognition and a multidisciplinary treatment approach in managing VOD in high-risk HSCT recipients. The use of low-dose defibrotide, combined with supportive care, proved effective in reversing moderate VOD, suggesting its potential utility in resource-limited or individualized treatment settings. However, defibrotide is a very expensive drug, and in developing countries like India, its affordability remains a major challenge. Furthermore, the drug is not commercially available in India and requires importation, posing additional barriers to timely access and treatment. |
| 130 |
Utility of Baseline PANDA patterns in Acute Myeloid Leukemias: a single centre experience |
1993-09-30 |
Female |
No |
- | 52429 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Ms. Kritika K. Pandey, Mr. Rahul Bharti, Mr. Nausha Nusrat Waris, Ms. Swati Apurva, Mr. Ramvilas Chauhan, Mr. Yogendra Kharde, Mr. Sagar Kumar Pandey, Dr. Seema Biswas, Prof (Dr.) Neha Singh. Hematopathology Laboratory, Tata Memorial Centre (HBCH & MPMMCC |
KRITIKA KAUSHAL PANDEY |
TATA MEMORIAL CENTRE (HBCH/MPMMCC) |
VARANASI |
9892616139 |
speedgallop@gmail.com |
Poster |
Title: Utility of Baseline PANDA patterns in Acute Myeloid Leukemias: a single centre experience
Introduction: PANDA (Peroxidase and Nuclear Density Analysis) patterns have been described in flow cytometry-based ADVIA 2120i automated hematology analysers. The peroxidase patterns represent different levels of cellular myeloperoxidase ranging from P0-P6. In combination with three nuclear density patterns D0-D2, they can be used as a diagnostic tool in the workup of haematolymphoid malignancies. Moreover, Myeloperoxidase intracellular index (MPXI) can be used to identify partial or complete deficiency of MPO. In 24*7 emergency laboratories, these parameters can help in clinching immediate provisional diagnosis.
Methods: It was a retrospective observational study involving patients of newly diagnosed Acute Myeloid Leukemia patients, in which PANDA patterns and MPXI were compared with the morphological diagnosis based on differentiation.
Results:50 cases of acute promyelocytic leukemia (APML) and 150 cases of non-APL AMLs were included in the study. All APML patients showed P6D1 pattern, exhibiting a classical “C-shaped” graph. Median MPXI in APML patients was 31.5 [range: 5.4-42.4], with 96.5% patients having MPXI >10. P4D1 and P1-P2/D1 patterns showed strong correlation with M2 and M0/M7 subtypes respectively. No P5 pattern was noted in our subset of patients. P2D1 subgroup showed significant heterogeneity in terms of differentiation, with 42.5%, 32.5% and 22.5% belonging to M1, M5 and M2 subtypes respectively.
Conclusions:P6DI plus MPXI >10 is very sensitive indicator of APML diagnosis in emergency oncology laboratory settings. Also, PANDA patterns were stable across most AML patients except those with P2D1 pattern, which hence require careful morphologic evaluation.
Key words: Acute Myeloid Leukemia, myeloperoxidase |
| 131 |
Evaluation of the quality assurance of Pneumatic Tube Systems (PTS) in basic hematology laboratory: a single Centre experience. |
1990-10-23 |
Female |
No |
- | 52422 |
Benign |
Miscellaneous |
Laboratory |
Authors and Affiliations: Mrs. Swati Apurva, Mr. Rahul Bharti, Mr. Nausha Nusrat Waris, Ms. Kritika K. Pandey, Mr. Ramvilas Chauhan, Mr. Yogendra Kharde, Mr. Sagar Kumar Pandey, Dr. Seema Biswas, Prof. (Dr.) Neha Singh. Hematopathology Laboratory, Tata M |
MRS. SWATI APURVA |
TATA MEMORIAL CENTRE (HBCH/MPMMCC), VARANASI |
VARANASI |
9113372822 |
apurvaswati842@gmail.com |
Poster |
Title: Evaluation of the quality assurance of Pneumatic Tube Systems (PTS) in basic hematology laboratory: a single centre experience.
Introduction: In hospitals, pneumatic chute systems, or Pneumatic Tube Systems (PTS), are internal logistics solutions that transport small items like lab samples, medications, and documents through a network of tubes using compressed air or vacuum. These systems consist of stations for sending and receiving, and special carriers that hold items as they travel quickly and securely through the tubes. PTS improves hospital efficiency by rapidly delivering critical items to departments such as the lab, pharmacy, and operating room, enhancing staff productivity and patient care.
Methods: We performed the comparative analysis of the results of different hemogram and coagulation parameters in thirty patients, processed by both manually-transferred and PTS methods.
Results: The median TLC, platelet count and RBC count of the samples was 7.39*10^9/L, 187*10^9/L and 3.7510^12/L respectively. Mean haemoglobin, prothrombin time (PT) and activated partial thromboplastin time (APTT) was 11.49±2.18g/dl, 12.92secs and 29.65 secs respectively. Coefficient of Variation (CV) <5 was observed (between the two methodologies) in 26/30, 23/30, 29/30 and 29/30 WBC, platelet count, PT/INR and APTT values respectively. Moreover, in terms of haemoglobin and RBC count, CV <5 was noted in all the samples.
Conclusions: PTS is a reliable solution which gives accurate and precise results in high throughput lab settings and should be validated for quality assurance purposes before applying in routine practice for improved patient care.
Key words: Pneumatic Tube Systems, coagulation, hemogram |
| 132 |
SMAD1/SMAD4 as Master Regulators of Hepcidin Expression: Evaluating Their Potential as Biomarkers for Iron Dysregulation in β-Thalassemia Subtypes
|
1997-02-06 |
Female |
No |
- | pay_Q |
Benign |
Anemia |
Laboratory |
Kirti Upadhyay, Nitu Nigam, Nishant Verma, Swasti Sinha, Rashmi Kushwaha |
Kirti Upadhyay |
King George's Medical University |
Lucknow |
6393933750 |
kirtirks777@gmail.com |
Poster |
Title: SMAD1/SMAD4 as Master Regulators of Hepcidin Expression: Evaluating Their Potential as Biomarkers for Iron Dysregulation in β-Thalassemia Subtypes
Introduction: Hepcidin, the key regulator of systemic iron homeostasis, is controlled primarily through the BMP/SMAD signaling pathway. Dysregulation of this mechanism contributes to abnormal iron loading in β-thalassemia. This study investigated the regulatory roles of SMAD1 and SMAD4 in hepcidin expression and explored their potential as biomarkers across β-thalassemia subtypes.
Methods: A cross-sectional observational study was performed on 135 pediatric subjects, categorized as β-thalassemia major (n = 30), intermedia (n = 30), minor (n = 30), and healthy controls (n = 45). Serum concentrations of hepcidin, SMAD1, and SMAD4 were quantified. Hemoglobin variant profiling was conducted using HPLC. Statistical analyses included ANOVA, post hoc comparisons, and multinomial logistic regression.
Results: Results showed significant group differences for hepcidin (p = 0.036) and SMAD1 (p = 0.002). Hepcidin was significantly reduced in β-thalassemia major compared to controls (p = 0.048), while SMAD1 was lowest in intermedia and highest in minor (p = 0.001). Logistic regression revealed hepcidin as a negative predictor for β-thalassemia major (OR = 0.60, p = 0.011) and SMAD1 as a negative predictor for intermedia (OR = 0.83, p = 0.023). SMAD4 did not reach statistical significance.
Conclusions: SMAD1 and hepcidin emerged as key modulators of iron regulation, highlighting dysregulation of the BMP/SMAD pathway in β-thalassemia. These findings support their potential as biomarkers for iron overload risk stratification. Larger longitudinal studies are warranted to validate these results and clarify the mechanistic role of the BMP/SMAD pathway in β-thalassemia pathophysiology.
Key words: β-thalassemia, hepcidin, SMAD1, SMAD4, BMP/SMAD pathway, iron homeostasis, biomarkers |
| 133 |
TITLE: Evaluation of the role of CD36 expression by flow cytometry in identifying the Ph/Ph-like molecular signatures and its correlation with treatment outcomes. |
1988-02-18 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Shabana Azad, Dharmendra K Mishra, Priyanshi Singh, Dr. Pradeep Arumugam, Dr. Deepali Saxena, Rohitkumar Kori, Anil Yadav, Dr. Seema Biswas, Dr. Parichay Singh, Dr. Raghwesh Ranjan, Prof. (Dr.) Neha Singh Hematopathology Laboratory, Tata Memorial Cent |
Nilesh U Dhole |
Tata Memorial Centre (HBCH & MPMMCC), Varanasi |
Varanasi |
9730497347 |
nileshdhole2012@gmail.com |
Poster |
TITLE: Evaluation of the role of CD36 expression by flow cytometry in identifying the Ph/Ph-like molecular signatures and its correlation with treatment outcomes.
INTRODUCTION: CD36 expression on lymphoblasts in pediatric Precursor B Lymphoblastic Leukemia (B-ALL) is associated with negative impact on treatment outcomes. Studies have shown that CD36-positive B-ALL cases have worse survival rates and are less likely to respond to initial therapy compared to CD36-negative cases.
METHODS: We retrospectively analysed all newly diagnosed pediatric B-ALL patients over the past five years and tried to establish correlation between CD36 expression and molecular signatures and treatment outcomes of patients treated with risk-adapted ICiCLE protocol.
RESULTS: Out of five-hundred and fifty five patients in whom CD36 expression was studied by flow cytometry, it was positive overall in only 4.5% (25/555) cases and 13.85%(9/65) of patients in the Philadelphia-positive/Ph-like BALL (Ph+/Ph-like) subgroup. The association of CD36 expression with Ph+/Ph-like subgroup was statistically significant (p<0.01) in comparison to other molecular signatures. CD36-positive patients had pronicity towards anemia and thrombocytopenia and three patients had CNS-III disease. Majority of the CD36+ patients were classified into the high-risk group (68%; 17/25) based on ICiCLE risk-adapted protocol. Post-induction MRD ≥0.01% was seen in 36% of CD36-positive cases overall and 22.2% of CD36+ (Ph+/Ph-like) subgroup in particular. 2-year relapse-free survival (RFS) rates and 2-year overall survival (OS) rates were 88% and 93.9% versus 80% and 85.5% in the CD36+ and CD36-ve patients respectively. Within the (Ph+/Ph-like) subgroup, 2-year relapse-free survival (RFS) rates and 2-year overall survival (OS) rates were 88.8% and 88.8% versus 87.5% and 80.3% in the CD36+ and CD36-ve patients respectively.
CONCLUSION: CD36 expression may serve as a surrogate marker for identifying the (Ph+/Ph-like) subgroup. However, it does not impact the RFS and OS of pediatric B-ALL patients.
Key words: Philadelphia-positive, Precursor-B lymphoblastic Leukemia, OS, RFS
|
| 134 |
A Rare Case of Acute Myeloid Leukemia with NUP214::ABL1 Fusion with basophilia: Expanding the Spectrum of Myeloid Neoplasms |
1989-02-13 |
Female |
Yes |
L-1765 | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Malini Garg - BIMR Hospitals and Gwalior Hematology centre, Dr Mohan Galande - Unipath laboratory Ahmedabad, Dr Neeraj Arora - Unipath Laboratory Ahmedabad |
Dr Avinash Gupta |
BIMR Hospitals and Gwalior hematology centre |
Gwalior |
9827086734 |
avidr03@gmail.com |
Poster |
A Rare Case of Acute Myeloid Leukemia with NUP214::ABL1 Fusion with basophilia: Expanding the Spectrum of Myeloid Neoplasms
Avinash Gupta, Malini Garg, Mohan Galande, Neeraj Arora
Introduction:
The NUP214::ABL1 fusion gene encodes a constitutively active tyrosine kinase, commonly associated with T-cell acute lymphoblastic leukemia (T-ALL) but rarely reported in acute myeloid leukemia (AML). To date, only one prior case of AML and one case of myelodysplastic syndrome (MDS) with this fusion have been described. We report a rare case of AML with NUP214::ABL1 fusion and marked basophilia.
Case Report:
A 52-year-old male presented with prolonged fever, fatigue, and history of recurrent blood transfusion since 3-4 months. Clinical examination revealed pallor and moderate splenomegaly. Complete hemogram showed anemia (Hb: 6.1 g/dL), leukocytosis (WBC: 30,730/cmm) and thrombocytopenia (57,000/cmm). Peripheral smear indicated a left shift with dysplastic neutrophils and 15% blasts. Bone marrow aspirate revealed 72 % blasts and marked basophilia. Flow cytometry identified abnormal myeloblasts (11%) expressing CD13, CD117, CD34, CD38, and CD123. A distinct population of basophilic precursors (11%) with aberrant immunophenotype was also noted.
Cytogenetic analysis demonstrated a complex karyotype: 47,XY,-5,+8,-14,add(15)(q26),der(17)del(17)(p11.2)del(17)(q23),+21,+mar. Next-generation sequencing (NGS) identified a NUP214::ABL1 fusion involving exon 31 of NUP214 and exon 2 of ABL1, along with a pathogenic NRAS G12C mutation (VAF 1.71%).
These findings suggest a diagnosis of AML with possible evolution from MDS/MPN, given the dysplasia, left shift, and basophilia. The prognostic significance of NUP214::ABL1 in myeloid neoplasms remains unclear.
Conclusion:.
This case underscores the importance of molecular testing in AML and expands the clinical spectrum of NUP214::ABL1 fusion beyond lymphoid neoplasms. While this fusion has been implicated in T-ALL and shown sensitivity to tyrosine kinase inhibitors (TKIs), its role in myeloid malignancies warrants further study. Further investigation is essential to understand its prognostic and therapeutic implications in AML.
Keyword- AML, NUP214, Basophilia
|
| 135 |
Classical Hodgkin Lymphoma with Secondary HLH
and ATT-Induced Hepatic Failure: A Diagnostic and
Therapeutic Challenge |
1999-11-01 |
Female |
No |
- | 11053 |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Jasashwi Chakraborty , Dr Debottam Bandyopadhyay,Dr Shreya Bhattacharya |
Dr . Koyena Bhattacharya |
Manipal Hospitals , Dhakuria |
Kolkata |
9674709625 |
koyenabhattacharya@gmail.com |
Poster |
Title:Classical Hodgkin Lymphoma with Secondary HLH
and ATT-Induced Hepatic Failure: A Diagnostic and
Therapeutic Challenge
Introduction:Anti-tubercular therapy (ATT)–related hepatotoxicity is common in
tuberculosis-endemic regions. When persistent systemic features coexist with hepatic dysfunction,
it may obscure an underlying hematological malignancy. Hemophagocytic lymphohistiocytosis
(HLH) further complicates diagnosis and management.
Methods:A 21-year-old male initially presented with weakness, fever, and cervical
lymphadenopathy, for which he was empirically started on ATT. After 5 months, fever and
lymphadenopathy persisted, and new-onset progressive jaundice developed. Laboratory evaluation
revealed rising bilirubin, peaking at 21.39 mg/dL, deranged liver enzymes, pancytopenia,
hepatosplenomegaly, and coagulopathy in the form of recurrent epistaxis. Laboratory evaluation
also revealed deranged PT/INR values, consistent with impaired hepatic synthetic function. He also
had evidence of systemic inflammation with CRP 332 mg/L, managed with intravenous IV broad
spectrum antibiotics. Additional labs showed LDH 607 U/L, triglycerides 410 mg/dL, and ferritin
>15,000 ng/mL. The HScore was 169, corresponding to a 40–50% probability of HLH.
FNAC was inconclusive, but excisional lymph node biopsy with immunohistochemistry confirmed
Classical Hodgkin Lymphoma (CD30-positive). PET-CT demonstrated metabolically active disease
in supraclavicular, bilateral paratracheal, paraesophageal, portocaval, periportal, splenic,
peripancreatic, and bilateral common iliac lymph nodes, with bone marrow involvement and
osseous metastasis. In view of HLH, intravenous dexamethasone was initiated. Because of
ATT-induced hepatic failure, conventional chemotherapy was contraindicated. The patient was
started on Brentuximab Vedotin–AVD regimen with modified dosage adjustments tailored to hepatic
dysfunction.
Results:gradual decline in bilirubin and clinical improvement.
Conclusions:This case illustrates the diagnostic dilemma of differentiating ATT-induced hepatic
failure from lymphoma-associated dysfunction. The coexistence of Classical Hodgkin Lymphoma,
HLH, and sepsis with extensive nodal and osseous disease highlights the importance of early
diagnostic precision. Incorporating HScore and tailoring therapy with BV-AVD, along with infection
control, enabled recovery despite profound hepatic compromise
Key words:Hodgkin Lymphoma, Hemophagocytic Lymphohistiocytosis, ATT-induced hepatic failure BV-AVD |
| 136 |
Evaluation of circulating plasma cells in newly diagnosed multiple myeloma patients and correlation with response to treatment. |
1985-12-02 |
Male |
Yes |
L-1554 | H_LKO |
Malignant |
Plasma cell disorders |
Laboratory |
Dr. Deepali Saxena1, Mr. Dharmendra Kumar Mishra1, Dr.Shabana Azad1, Dr.Seema Biswas1, Dr Prateek Das1, Ms Priyanshi Singh1, Mr Nilesh Dhole1, Mr RohitKumar Kori1, Mr Anil Yadav3, Dr. Ravindra Kumar2, Dr Anil Kumar Singh2, Dr. B.K Mishra2, Prof (Dr.) Neha |
Dr. Pradeep Arumugam |
Tata Memorial Centre (HBCH & MPMMMCC) |
Varanasi |
9791598555 |
pradspathem@gmail.com |
Oral |
Introduction: Circulating plasma cells (CPC) is an independent prognostic factor in newly diagnosed multiple myeloma patients and associated with shorter survival. Quantification of the circulating clonal CPCs by flowcytometry predicts treatment responses and risk assessment in multiple myeloma.
Objectives: To study the correlation of CPC with FISH results and treatment response post 6 cycles of bortezomib-based chemotherapy in myeloma patients.
Methods: This is a prospective study conducted on ninety-nine newly diagnosed multiple myeloma patients for one year. Next Generation flow cytometry performed on peripheral blood using customized ten color myeloma panel by lyse-wash stain method. Clinical History and other findings were obtained from electronic-medical records. The prognostic impact of CPC on progression-free survival (PFS) was computed using the Kaplan–Meier curve and compared using log-rank test for time-to-event analyses.
Results: Out of a total of 99 newly diagnosed myeloma patients,71/99 (71.7%) had CPCs at baseline ranging from 0.0037-41.07%. Median age at presentation was 59.5 years [range 30-80 years] with a M: F ratio of 2.3:1. IgA gammopathy was observed in 9% (11/99) patients and light chain myeloma in 13.1% (13/99) respectively. Serum free light chain ratio ranged from 0.0006-461.9. Poor risk features such as hypodiploidy, TP53 deletion,1q gain, IgH-FGFR3 etc. were seen in 42.4% (42/99) patients. There was significant correlation of positive-CPC with poor-risk cytogenetic features (p<0.001) and International Staging System (ISS)-III (p=0.02). There was no significant correlation between presence of CPC and poor-responders (PR or less) post-6 cycles or 1-year progression free survival. Median follow-up duration was 15 months.
Conclusion: CPC is a promising biomarker that may serve as an independent predictor of prognosis irrespective of cytogenetics status and ISS staging. However, its impact on survival outcomes needs to be studied further using larger cohort of myeloma patients for longer follow-up.
Key words: Circulating Plasma cells (CPC), Multiple Myeloma, FISH.
|
| 137 |
Comparison of differential count in leucopenic samples by the regular and low WBC mode of the automated hematology analyzer along with the manual differential count. |
1995-04-25 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Laboratory |
Dr Maitreyi Patwardhan, Dr Vidisha Mahajan, Dr Shanaz Khodaiji - Department of Haematology, Lab Medicine, P.D.Hinduja Hospital and Medical Research Centre |
Dr. Aanchal Bishnoi |
P.D. Hinduja Hospital & Medical Research Centre |
Mumbai |
9829412449 |
aanchalbishnoi07@gmail.com |
Poster |
Title:Comparison of differential count in leucopenic samples by the regular and low WBC mode of the automated hematology analyzer along with the manual differential count.
Authors:-Dr Aanchal Bishnoi, Dr Maitreyi Patwardhan, Dr Vidisha Mahajan, Dr Shanaz Khodaiji
PD Hinduja hospital and Medical Research Centre
Introduction:Accurate leukocyte differential counts are critical in clinical decision-making, especially in leukopenic patients where low cell counts challenge automated hematology analyzers. Modern analyzers incorporate specialized low WBC (LW) modes to enhance accuracy, but their performance requires validation against normal WBC (NW) modes and manual differentials.
Methods:A total of 240 leukopenic samples were analyzed. Patient characteristics included 155 males (64.6%) and 85 females (35.4%); 214 (89.2%) samples were from oncology patients and 26 (10.8%) from non-oncology patients. Samples were categorized into WBC ranges: <200/µL (n=25), 200–499/µL (n=23), 500–999/µL (n=57), 1000–1499/µL (n=62), and 1500–2000/µL (n=72). Differential counts from LW and NW modes were compared with manual counts using correlation analysis, Bland-Altman plots, and accuracy assessment.
Results:Strong correlations were observed for major leukocyte subsets (neutrophils, lymphocytes, monocytes; ρ=0.90–0.97, p<0.0001). Moderate correlations were noted for eosinophils, basophils, immature granulocytes, and NRBCs (ρ=0.45–0.72). Bland-Altman analysis demonstrated minimal bias between LW/NW modes and manual counts. Accuracy across WBC categories showed no statistically significant differences between LW and NW modes.
Conclusions:The LW mode performs equivalently to the NW mode across leukopenic ranges and demonstrates strong concordance with manual differentials. Its reliability in severely leukopenic samples validates its use in routine hematology practice, supporting accurate and timely clinical decision-making.
Key words:Leukopenia, Hematology analyzer, Low WBC mode, Differential count, Automated cell counters
|
| 138 |
EVALUATION OF THE ROLE OF LEUKEMIC STEM CELL ANTIGENS AND IMMUNE ESCAPE MECHANISMS IN PROGNOSTICATION OF ADULT ACUTE MYELOID LEUKEMIA (AML) PATIENTS |
1991-11-17 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Pradeep Arumugam1, Dr Prateek Das1, Mr.Dharmendra Kumar Mishra1, Dr. Kartavya Mistry1, Ms Priyanshi Singh1, Mr Abhishek Yadav1, Mr Rohit Kumar Kori1, Dr.Shabana Azad1, Mr Nilesh Dhole1, Dr. Anil Singh2, Dr.Seema Biswas1, Dr. B.K.Mishra2, Prof (Dr.) Ne |
Dr. Deepali Saxena |
Tata Memorial Centre (HBCH & MPMMCC), Varanasi. Ho |
Varanasi |
8527915667 |
deepalisaxena1611@gmail.com |
Oral |
TITLE: EVALUATION OF THE ROLE OF LEUKEMIC STEM CELL ANTIGENS AND IMMUNE ESCAPE MECHANISMS IN PROGNOSTICATION OF ADULT ACUTE MYELOID LEUKEMIA PATIENTS
INTRODUCTION: Leukemic stem cell antigens(LSC) including CD123, CD25, CLL-1 and CD32 induce relapse and chemo-resistance in AML. Higher T-regulatory cells(T-Regs) and PD-1 in AML patients at diagnosis play a suppressive role in host antitumor immune response and can be used as a biomarker for predicting chemosensitivity.
OBJECTIVES: To study the expression of LSC antigens on leukemic blasts and T-regulatory cells(CD25+/CD4+/CD127-/dim) as well as immune check-point marker PD-1(CD279) in peripheral blood of adult AML cases and find out their correlation with ELN-2022 risk stratification, MRD status post 2cycles of chemotherapy and 1-year-event-free survival(EFS).
METHODS: It was a pilot prospective study involving de-novo AML patients≥ 18 years of age in a one-year period.
RESULTS: A total of 128patients were included in the study. Median TLC at presentation was 24.49 x109/L. Median age at presentation was 45years. 57.8%, 18.9% and 23.1%patients belonged to ELN favourable, intermediate and adverse risk categories, respectively. LSC antigens such as CLL-1, CD25, CD123 and CD32 were positive in 84.3%, 6.25%, 76.5% and 6.25% cases respectively. CD25 and CD32 are mutually exclusive. CLL1 expression correlated strongly with favourable ELN-risk category(P=0.016), while CD123 expression was associated with higher mutation burden(≥ 3 mutations) in our study. T-Regs>2.5% were found in 42.9% patients while PD1 positivity was seen in 45.3%cases. Interestingly LSCs, T-regs percentage and PD1 expression did not show any significant correlation with MRD status and EFS unlike published literature.
CONCLUSION: CLL-1 and CD123 are frequently expressed antigens on abnormal myeloid blasts and should be included in all AML-MRD panels for improved sensitivity. Unlike western literature, our cohort showed no association of immune-regulatory mechanisms or LSC antigens with prognosis or outcomes.
KEY WORDS:Leukemic stem cell, AML, PD-1, T-regulatory cells.
|
| 139 |
Rare presentation of T-cell Acute Lymphoblastic Leukemia in Pregnancy: A Case Report |
1989-12-20 |
Female |
Yes |
L-2298 | H_LKO |
Malignant |
Rare hematological malignancies |
Laboratory |
Dr Sangeeta Rai |
Dr Saumya Pandey |
Heritage Institute of Medical Sciences |
VARANASI |
9971779676 |
saumyalh89@gmail.com |
Oral |
Title: Rare presentation of T-cell Acute Lymphoblastic Leukemia in Pregnancy: A Case Report
Introduction: Acute lymphoblastic Leukemia (ALL) during pregnancy is exceptionally rare
and presents one of the most complex clinical dilemmas in medicine—balancing maternal
survival against fetal safety. Among its subtypes, T-cell ALL is particularly uncommon and
notoriously aggressive, with very limited published data to guide management.
Case Presentation: We report the case of a 26-year-old primigravida at 16 weeks of
gestation who presented with progressive lymphadenopathy, fever, and anorexia.
Laboratory evaluation revealed marked leucocytosis (114.2 × 10³/µL), profound
lymphocytosis (84%), and thrombocytopenia (65 × 10³/µL). Peripheral smear
demonstrated numerous medium-to-large lymphoid blasts, and flow cytometry confirmed
T-cell ALL. Given the urgency of initiating intensive chemotherapy, medical termination of
pregnancy was undertaken. Despite induction therapy and transient improvement, the
patient experienced early relapse and succumbed to disease within five months of
diagnosis.
Results and Conclusions:: This case highlights the devastating course of T-ALL in pregnancy, where
therapeutic decisions are constrained by gestational age and drug toxicity. It underscores
the necessity of early recognition through vigilant antenatal screening, rapid
multidisciplinary decision-making, and the urgent need for safer, targeted therapies that
can protect both maternal and fetal outcomes.
Key words: T-cell acute lymphoblastic Leukemia, pregnancy, hematological malignancy,
maternal prognosis, case report
|
| 140 |
Not Always ‘Normal’: Decoding the Hidden β-Thalassemia Mutations in Antenatal Women with Positive Mentzer Index And HbA2 <4% |
1997-06-27 |
Female |
No |
- | H-LKO |
Benign |
Anemia |
Laboratory |
Mrinalini Kotru, Ahmad Ansari, Amita Suneja, A G Radhika, Poonam Rani ; department of pathology, University College of Medical Sciences and GTB Hospital, Delhi-110095B |
Kusum Singh |
University college of medical sciences |
New Delhi |
9368677252 |
kusumsikarwar276@gmail.com |
Poster |
Title: Not Always ‘Normal’: Decoding the Hidden β-Thalassemia Mutations in Antenatal Women with Positive Mentzer Index And HbA2 <4%
Introduction: Thalassemia is an autosomal recessive hemoglobinopathy with diverse molecular defects causing β-globin deficiency. Screening with Mentzer index and HbA2 often misses silent carriers. This study investigates mutation profile in antenatal women with positive Mentzer index but HbA2 <4%, aiding genetic counselling. At present, there is a paucity of mutational data on thalassemia, which prompted us to undertake this study
Methods: This cross-sectional study was conducted in the Department of Pathology, University College of Medical Sciences from April 2024 to August 2025. A total of 15 antenatal women with positive Mentzer index but HbA2 >2% and <4% were included to avoid co-inheritance of alpha thalassemia. Their complete blood counts were checked and Mentzer Index was calculated and HPLC was done. Mentzer Index <13 points to diagnosis of beta thalassemia and >13 indicates iron deficiency anemia. Molecular studies including PCR and Gel Electrophoresis were done to identify the mutation profile.
Results: The frequency of mutation IVS-1,5 and IVS-1,1 is seen in this cohort of patients
Conclusions: Hence, Mentzer index is more sensitive than HPLC in detecting beta thalassemia mutations prompting us to do molecular studies in positive Mentzer index even if HbA2 <4%.
Key words: Beta Thalassemia, Mentzer index, HbA2, mutations |
| 141 |
Outcomes of Haploidentical Stem Cell Transplant in patient with leukemia: A Retrospective Analysis of 100 Patients |
1994-05-23 |
Male |
Yes |
L-2242 | L-224 |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Swapnil Tripathi, Mansi, Rohan Halder, Akansha Singh, Mayank Soni, Rajat Jain, Vipul Sheth, Narendra Agrawal. Dinesh Bhurani A |
Mansi |
Rajiv Gandhi Cancer Institute and Research Centre |
Delhi |
8595475236 |
mansihemat@gmail.com |
Poster |
Title: Outcomes of Haploidentical Stem Cell Transplant in patient with leukemia: A Retrospective Analysis of 100 Patients
Introduction:Haploidentical hematopoietic stem cell transplantation (Haplo-HSCT) has significantly transformed curative treatment options for acute leukemia by broadening stem cell donor availability from 30% with matched sibling donors to nearly 100%. It also provides a strong graft-versus-leukemia effect, and the incorporation of post-transplant cyclophosphamide has further enhanced long-term survival.
Methods:This retrospective study evaluated 100 leukemia patients who underwent Haplo-HSCT. Data included demographics, donor-recipient compatibility, conditioning regimens, CD34⁺ cell dose, engraftment, chimerism, complications, relapse, and survival. Most common condition was acute myeloid leukemia(58%) followed by acute lymphoblatic leukemia(38%). Conditioning was myeloablative (MAC, 55%), reduced-intensity (RIC, 40%), or non-myeloablative (NMA, 5%). Engraftment was defined as ANC >500/µL for three consecutive days or platelets >20,000/µL for seven days without transfusion.
Results:The median age was 35 years (range 9–63); 72% were male. Median CD34⁺ dose was 6.9 × 10⁶/kg. Median neutrophil and platelet engraftment occurred on day 16. Complications included veno-occlusive disease (6%), CMV reactivation (41%), BK viremia (15%), and hemorrhagic cystitis (5%). Acute GVHD developed in 26% (most commonly gut), while chronic GVHD occurred in 17% (predominantly skin). primary graft failure occurred in 5%. By day +30, 86% achieved full donor chimerism, with 77% maintaining it at day +90. Transplant-related mortality at 100 days was 8%. Relapse occurred in 28% at a median of 126 days. Relapse-free survival was 48% at one year and 40.7% at two years, with non-relapse mortality at 12%. Overall survival was 68% with follow up 2 years.
Conclusions:Haplo-HSCT is a feasible and effective strategy for leukemia patients without HLA-matched donors. It ensures high engraftment, manageable GVHD incidence, and promising survival outcomes. Optimization of conditioning, infection surveillance, and early GVHD management may further enhance results.
Key words: Haploidentical HSCT, leukemia, GVHD |
| 142 |
ACUTE ERYTHROID LEUKAEMIA- RAREST AND AGGRESSIVE FACE OF ACUTE MYELOID LEUKAEMIA |
1995-08-22 |
Male |
No |
- | pay_R |
Malignant |
Rare hematological malignancies |
Clinical |
|
Dr kamaldeep rawat |
Vardhman mahavir medical college and safdarajung h |
New delhi |
9760011851 |
Krawat22here@gmail.com |
Poster |
Title: ACUTE ERYTHROID LEUKAEMIA- RAREST AND AGGRESSIVE FACE OF ACUTE MYELOID LEUKAEMIA
Authors: Dr. Kamaldeep Rawat, Dr Akansha Gautam, Dr Neelam Sahani, Dr. Chintamani Pathak, Department of Pathology, VMMC and Safdarjung Hospital, New Delhi
Introduction: Acute erythroid leukaemia (AEL) is the rarest and most aggressive form of Acute Myeloid Leukaemia (AML), representing less than 1% of cases. It is defined by uncontrolled proliferation of immature erythroid precursors, commonly associated with Tp53 mutations. It usually affects elderly men (>60year) and may arise de novo or may evolve from prior cytotoxic therapy or myelodysplastic syndrome (MDS). The clinical presentation is usually non-specific often mimicking nutritional anaemias or other hematological conditions making diagnosis particularly challenging.
Methods:Here we present a case of a 55year old female who presented to Safdarjung Hospital with complaints of generalised weakness, fatigue and fever with history of blood transfusion and no other significant history of infective etiology. On examination, pallor was present with no hepatosplenomegaly or lymphadenopathy. Serum folate and Vitamin B12 levels were within normal limits
Results:Laboratory investigations and Peripheral smear showed pancytopenia. Bone marrow aspirate smears and bone marrow biopsy were adequate for opinion and hypercellular which showed erythroid series predominance (>80% marrow cellularity) with suppression of myelopoiesis and megakaryopoeisis. Bone marrow biopsy revealed large atypical cells in small clusters along with many atypical mitoses. Further, Immunohistochemistry confirmed the diagnosis of AEL.
Conclusions:AEL is a rare, aggressive and often under-recognized AML subtype with poor prognosis. It often mimics nutritional deficiency anaemias or other hematological conditions making timely diagnosis difficult. This case highlights the importance of recognizing erythroid predominance in pancytopenic marrow and applying ancillary techniques for confirmation. Early and accurate diagnosis not only directs management but also impacts survival outcome, making awareness of this entity essential.
Key words:Acute Erythroid leukaemia, pancytopenia, Acute myeloid leukemia. |
| 143 |
Transfusion acquired abnormal peak in HPLC chromatogram: a case report |
2001-09-12 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Dr. Richa Pawar, Deptt of Pathology, Pt. B.D.Sharma PGIMS, Rohtak |
Aishanya GUPTA |
T.S.Misra Medical College, Lucknow |
Lucknow |
9896719379 |
aishanyag12@gmail.com |
Poster |
Title: Transfusion acquired abnormal peak in HPLC chromatogram: a case report
Introduction: Transfusion-acquired abnormal peaks on high performance liquid chromatography (HPLC) occurs when asymptomatic carrier of abnormal hemoglobin variant, that is not detected by routine donor screening, donates blood which is transfused to the recipient. These are not uncommon in a country like India, where high prevalence of carrier state exists. It is not possible to screen all donor units for abnormal hemoglobin by special tests like HPLC. It may lead to unexpected and confusing results. Fortunately, effects of such transfused units are transient and rarely cause serious complications. Insufficient information about the transfusion history may create a diagnostic dilemma and chances of misdiagnosis. Negative family history, transient nature of peak and history of blood transfusion helps to solve the diagnostic dilemma.
Methods: Presenting a case report of young female who was being investigated for severe anemia. History of menorrhagia was present. Lab investigations revealed decreased red blood cell indices and microcytic hypochromic picture with polychromasia. HPLC was performed.
Results: HPLC showed increase in Hb F and erroneous peak in D-Window but at low percentage. Family study did not reveal abnormal peak in any of the family members. Patient gave history of multiple blood transfusion from different places due to severe anemia including three days before HPLC study. Due to normal family screening and history of blood transfusion, repeat HPLC was done after a month which revealed decrease in percentage of erroneous peaks confirming the diagnosis of Transfusion -acquired hemoglobinopathy.
Conclusion: The abnormal peaks in recipient blood are not due to actual hemoglobinopathy but rather due to donated blood. HPLC should be performed either before transfusion or after three months of transfusion to avoid diagnostic confusion.
Key words: Transfusion, Transient, Abnormal peak, Hemoglobinopathy |
| 144 |
DIAGNOSTIC ACCURACY OF RETICULOCYTE HEMOGLOBIN EQUIVALENT (RET- He) IN IDENTIFYING IRON DEFICIENCY ANEMIA |
1991-06-01 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Dr. Khuraijam Bembem2, Dr. Garima Baweja3, Dr. Vijay Kumar4. 2Professor, Hematology and Clinical Pathology Unit, Department of Pathology, ABVIMS & Dr. Ram Manohar Lohia Hospital New Delhi-110001 3Specialist, Hematology and Clinical Pathology Unit, Departm |
Dr Shivanshu Gangwar |
ABVIMS and Dr RML Hospital |
New Delhi |
9773678722 |
Shivanshugangwarucms@gmail.com |
Oral |
TITLE: DIAGNOSTIC ACCURACY OF RETICULOCYTE HEMOGLOBIN EQUIVALENT (RET- He) IN IDENTIFYING IRON DEFICIENCY ANEMIA
Introduction: Iron Deficiency Anemia (IDA) remains the most prevalent nutritional anemia worldwide. Accurate and early diagnosis is essential to prevent complications. Conventional iron profile, such as serum ferritin, serum iron, transferrin saturation, and total iron-binding capacity (TIBC) are often unreliable in the presence of inflammation or chronic illness. Ret-He measures hemoglobin content in immature red cells and serves as a real-time marker of functional iron availability for erythropoiesis.
Methods: This cross-sectional observational study is being conducted over one year in the Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi. A total of 50 patients (18–65 years) with microcytic hypochromic anemia are being enrolled. Patients with macrocytic anemia, recent transfusions (<1 month), or those on iron or erythropoietin therapy are excluded. Blood samples are being analyzed for Ret-He using a Sysmex XN-series analyzer, along with conventional iron studies.
Results: Statistical analysis involves descriptive statistics, Pearson correlation between Ret-He and iron indices, and ROC curve analysis to assess sensitivity and specificity. Based on prior studies, a strong positive correlation between Ret-He and serum ferritin/serum iron are expected, with significant diagnostic accuracy in identifying IDA (p < 0.05). Data collection and analysis are ongoing, and the complete results with final statistical outcomes will be presented at the conference.
Conclusion: In previous studies, Ret-He may serve as a reliable, non-invasive, and real-time marker for diagnosing iron deficiency anemia, where conventional iron markers are confounded by inflammation/comorbidities. Its incorporation into routine hematological analysis has the potential to improve diagnostic accuracy and enable timely intervention for IDA. Final conclusions will be drawn once the complete study results are available.
Keywords: Iron Deficiency Anemia, Microcytic Hypochromic Anemia, Reticulocyte Hemoglobin Equivalent, Iron Profile.
|
| 145 |
Double Hit Lymphomas: Relevance of Immunohistochemistry in the Era of Florescent in-Situ Hybridization based on updated WHO criteria |
1988-12-08 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Hiba Thankayathil,,Neshahel O K,Sajna P V,Prasanth Parameshwaran1,Binshad Ameer K,Vijayalalakshmi Nair |
ANN THOMAS |
MVR Cancer Centre and Reseach Institute,Kozhikode, |
CALICUT |
9497148512 |
drannthomas@mvrccri.co |
Oral |
Double Hit Lymphomas: Relevance of Immunohistochemistry in the Era of Florescent in-Situ Hybridization based on updated WHO criteria
Introduction: Diffuse large B-cell lymphoma (DLBCL) is heterogeneous, with a subset showing concurrent MYC and Bcl2 rearrangements -"Double-hit" lymphoma (DHL)- associated with poor prognosis . Fluorescent in situ hybridization (FISH) remains the diagnostic gold standard, while immunohiostochemistry(IHC) has been explored as potential screening tool.Studies indicate that IHC based strategies may miss over a quarter of DHL cases. With the updated WHO criteria excluding BCL6 rearrangement from DHL definition, this study assesses IHC’s role under current criteria.
Methods: From 805 DLBCL cases over six years, 100 underwent dual colour break apart FISH testing for MYC, BCl6 and BCL2 .Histopathology, IHC and clinicopathological data were reviewed.IHC positivity for MYC and Bcl2 was defined at ≥ 40% and ≥ 50% cutoffs.. Cell of origin (COO) was assigned using the Han’s algorithm.
Results DHL incidence was 12.4% (14/100). Out 100 DLBCL cases,MYC IHC was positive in 84%, but only 16% were MYC FISH-positive. BCL2 IHC was positive in 77%, with 43% FISH positivity. Double protein expression (DPE) (MYC and BCL2) occurred in 68 cases, of which 14 cases were DHL. Mean cMYC positivity by IHC among the 13 positive cases was 73.46%. All DHL were germinal center B-cell (GCB) with mean Ki-67 index of 85%. No significant associations were found between DHL and age, LDH or extranodal disease.
Conclusion A screening strategy restricting FISH testing to tumors of GCB subtype would reduce the need for FISH testing to approximately 65% of the population while detecting >99% of DHL cases. In contrast using DPE as screening tool offers no advantage over GCB subtyping and has a lower positive predictive value. A combination of GCB phenotype and c-MYC positivity of >70% by IHC is more likely a DHL. |
| 146 |
Effectiveness of Imatinib in Modifying the Complications of Sickle Cell Syndromes : Interim Analysis from a Pilot Study |
1988-07-29 |
Male |
Yes |
L-2190 | pay_R |
Benign |
Anemia |
Clinical |
Prakas Kumar mandal (Professor), Abhishek Shrama (Assistant Professor), Subhra Kamal Saha (Senior Resident), Pratibha Singh (Senior Resident),Mayank Pandey (Senior Resident), Tuphan Kanti Dolai (Professor) |
Suprotim Ghosh |
Nil Ratan Sircar Medical College & Hospital |
Kolkata |
9477736822 |
suprotim_ghosh@rediffmail.com |
Oral |
Title : “Effectiveness of Imatinib in Modifying the Complications of Sickle Cell Syndromes : Interim analysis from a pilot study”
Introduction :
Sickle Cell Disease (SCD) is characterized by recurrent vaso-occlusive crises (VOCs, the leading cause of morbidity, hospitalization, and reduced quality of life. Hydroxyurea remains the only disease-modifying therapy in India, with its limited beneficial effects. Recent evidence suggests that Imatinib, a tyrosine kinase inhibitor may attenuate vaso-occlusive episodes by several mechanisms like inhibiting Band 3 phosphorylation, mast cell stabilisation, and vasculopathy etc. Repurposing Imatinib in preventing VOC in SCD is not well-explored.
Objectives:
To evaluate the effectiveness of Imatinib,in reducing frequency and severity of VOCs as well as transfusion burden.
Methods:
This is an interim analysis from a prospective, single-arm (interventional) pilot study,being conducted at Hematology Department, NRS Medical College, Kolkata. Eligible adult SCD patients ,on hydroxyurea for ≥ 6 months and ≥1 VOCs in the preceding year were enrolled. Participants received Imatinib 100 mg orally twice daily in addition to hydroxyurea. Clinical events, transfusion requirements, hematological & biochemical parameters were recorded and compared with baseline values.
Results:
Among the first cohort of enrolled patients (n = 15), addition of Imatinib, in a short term follow up , resulted in reduction in median frequency of VOCs and hospitalization episodes than the pre-treatment period. Transfusion requirements showed a downward trend, while biochemical indices remained stable. Imatinib was generally well tolerated, with acceptable hematological toxicity and other mild adverse effects.
Conclusion:
Preliminary findings from this ongoing study suggest that Imatinib, when added to hydroxyurea, can be synergistic in effectively reducing painful crises and hospitalization in SCD without significant toxicity.Though long term follow up data is awaited, these results usher in larger, controlled trials to establish its therapeutic role in SCD management.
Keywords : Sickle Cell disease, vaso-oclussive crisis, Imatinib |
| 147 |
MULTIPLE MYELOMA WITH CO-EXISTING CHRONIC LYMPHOCYTIC LEUKEMIA
|
1995-01-19 |
Male |
No |
- | pay_R |
Malignant |
Plasma cell disorders |
Laboratory |
|
MADHVEESH JOSHI |
AIIMS |
BATHINDA |
8439481198 |
maddyjoshi2016@gmail.com |
Poster |
Title:MULTIPLE MYELOMA WITH CO-EXISTING CHRONIC LYMPHOCYTIC LEUKEMIA
Introduction:Multiple myeloma (MM) and chronic lymphocytic leukemia (CLL) are both clonal B-cell malignancies with distinct pathophysiology and clinical manifestations.
Methods:CRAB criteria , Ultrasonography , MRI findings ,CBC ,PBF, Bone marrow aspiration, Bone marrow biopsy
Results:Bone marrow biopsy Revealed hypercellular marrow (Cellularity of 85-90%) exhiting diffuse sheets and nodular aggregates of plasma cells along with numerous large nodular lymphoid aggregates.
Bone marrow aspiration revealed shows hypercellular marrow 20% of plasma cells included mature and immature forms noted.38% Lymphocytes was seen. Erythroid & myeloid precursor and megakaryocytes are normal in morphology and maturation.
Conclusions:CLL and PCM uncommonly present together in the same patient.
Key words:Multiple myeloma, Chronic Lymphocytic Leukemia,Co-existing,CRAB criteria,MRI findings. |
| 148 |
HPLC in Hemoglobinopathies : Experience at a Tertiary Care Hospital |
1966-09-06 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
Dr Prema Saldanha ( Pathologist ) and Mr Mohammed Ansar (Msc Hematology) |
Dr Indira.S.Puthran |
Yenepoya Medical College, Mangalore, 575018 |
Yenepoya Medical College, Mangalore |
9740342864 |
drindira17@yenepoya.edu.in |
Poster |
Title: HPLC in Hemoglobinopathies : Experience at a Tertiary Care Hospital
Authors:
Dr Indira. S.Puthran, Dr Prema Saldanha, Mr Mohammed Ansar
Introduction: Hémoglobinopathies are the most common inherited disorders worldwide. According to WHO, about 5 % of the global population carry a hemoglobinopathy gene India bears a significant burden , contributing to almost 10 % of global thalassemia cases. High performance liquid chromatography ( HPLC) is a rapid, sensitive and reproducible method for hemoglobin fraction analysis.
Methods: This study was carried out at a tertiary care hospital from January 2021 to December 2024. A total of 242 patients (aged 1 day to 72 years ) with microcytic hypochromic anemia and clinical suspicion of hemoglobinopathy were evaluated. Complete blood counts and peripheral smear examinations were performed, followed by HPLC (Biorad D-10 ) to quantify HbA,HbA2, HbF and variant fractions.
Results: Of the 242 patients, hemoglobinopathy was detected in total 69 cases ( 28 %) .
HPLC detected diverse hemoglobin patterns : β thalassemia trait in 56 cases , δ β thalassemia in 3 cases , Hb D- β thalassemia in 4 cases , HbE- β thalassemia in 2 cases , δ β thalassemia trait or hereditary persistence of foetal haemoglobin ( HPFH) in 2 cases, Hb S in 1 case and
Hb S - β thalassemia in 1 case.
Conclusions:
Our experience highlights HPLC as a robust, rapid and highly reliable tool for diagnosing hemoglobinopathies. Its integration into routine diagnostics workflows facilitates early diagnosis, genetic counseling and appropriate clinical management of hemoglobinopathies.
Key words:
Hemoglobinopathy, HPLC, Thalassemia, HPFH
|
| 149 |
Seeing the Unseen: Detecting Minimal Residual Disease in Morphological Remission |
1999-06-23 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Epshita Das, Dr. Chintamani Pathak |
DR. NIBIR CHAKMA |
VMMC and Safdarjung Hospital |
New Delhi |
8851764970 |
nibirchakma@gmail.com |
Poster |
Title: Seeing the Unseen: Detecting Minimal Residual Disease in Morphological Remission
Introduction: Acute lymphoblastic leukaemia (ALL) is characterised by aggressive proliferation of lymphoblasts of either B-cell (B-ALL) or T cell (T-ALL). Measurable/Minimal residual disease (MRD) is the strongest prognostic predictor of relapse and survival outcome in ALL. In B-ALL, distinguishing leukemic cells from regenerative B-cell precursors are of utmost importance during MRD assay by multiparameter flow cytometry (MFC). This case series highlights the essential contribution of flow cytometry in supporting traditional bone marrow assessment for the detection of MRD.
Methods: A total of 36 known cases of B-cell ALL at end induction were studied between January 2023-July 2025 in the Department of Pathology, VMMC & Safdarjung Hospital. Peripheral blood and bone marrow aspirate specimens were evaluated for morphological remission and MRD by MFC.
Results: On microscopic examination of all the samples, 35/36 cases showed morphological remission on bone marrow without presence of any blasts. However, 1/36 cases demonstrated 3% atypical cells in BMA smears. Notably, 8/36 (25%) cases which appeared to be in morphological remission on marrow analysis were still found to harbor residual disease by FCM.
Conclusions: Despite absence of morphologically identifiable leukemic blasts, MRD was detectable using more sensitive techniques like MFC. This series underscores the importance of incorporating MRD assessment with MFC alongside conventional bone marrow examination in post-induction patients to improve risk stratification and guide timely interventions in B-ALL. MRD monitoring is now a consequential tool, serving both as a surveillance biomarker and for risk-adapted therapy in acute leukemias. Implementing MRD detection with FCM into routine practice, as shown in these cases, can improve patient outcomes through early relapse detection and timely interventions.
Key words: Acute B-cell lymphoblastic leukaemia, morphological remission, measurable
residual disease, multiparameter flow cytometry |
| 150 |
The Myeloid–Monocytic Interface: Diagnostic Insights in Acute Myelomonocytic Leukaemia. |
1993-07-05 |
Male |
Yes |
L-2301 | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Amrutraj Patil, Amit Nisal, Abhipsa Raut, Anuja Patil, Rachana Lakhe, Reena Bharadwaj |
Amrutraj Patil |
Bharati Vidyapeeth(Deemed to be University) Medica |
Pune |
7722022999 |
dr.amrutrajpatil93@gmail.com |
Oral |
The Myeloid–Monocytic Interface: Diagnostic Insights in Acute Myelomonocytic Leukaemia.
Introduction: Acute myelomonocytic leukaemia (AML-M4) is a subtype of acute myeloid leukaemia, accounting for approximately 5–8% of cases. It is characterized by ≥20% blasts in the bone marrow, with both granulocytic and monocytic components comprising at least 20%. Peripheral blood monocytosis (≥5×10⁹/L) and cytochemical confirmation of monocytic differentiation are characteristic. The granulocytic component may predominantly show neutrophilic differentiation, though eosinophilic or, rarely, basophilic differentiation may also occur. Early diagnosis relies on an integrated approach combining morphology, cytochemistry, immunophenotyping, and cytogenetics.
Methods: A retrospective analysis of newly diagnosed AML cases was conducted between January 2020 and August 2025 in the Haematology section, Department of Pathology, Bharati Vidyapeeth (DTU) Medical College Hospital and Research Centre, Pune. Forty cases of AML, across all ages and both genders, were evaluated. Of these, five cases were identified as AML-M4. Reports of Complete blood counts, peripheral smear, bone marrow aspirates and flowcytometry reports were retrieved through digital records. Findings were correlated with morphological features. Cytogenetic and molecular analysis was advised in these cases.
Results:Forty cases were diagnosed as AML. Out of which, 5 (5.95%) cases of AML M4 were diagnosed with a predominance of males (60%) followed by females (40%). Blood smears showed the presence of peripheral blasts in 4 (80%) out of 5 cases. One case showed monocytosis. Myeloperoxidase stain showed blasts with MPO Positivity in all the cases. Immunophenotyping showed presence of immature blasts expressing myeloid and monocytic markers. The most commonly expressed antigens were CD 117, CD13, CD33 and CD 64. One of these five cases had inversion of chromosome 16. This patient showed eosinophils with abnormal granules in bone marrow aspirate.
Conclusion: AML-M4 is a morphologically overlapping entity.Morphology, cytochemistry, and immunophenotyping are essential, while cytogenetic and molecular studies provide crucial prognostic value |
| 151 |
CTLA-4 Haploinsufficiency: Report of sustained response to long term treatment with Abatacept |
1996-03-05 |
Male |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Nishant R Tiwari, Mohamad Khawandanah |
Nishant R Tiwari |
Oklahoma University Medical Center |
Oklahoma City |
9049355543 |
dr.nishant.tiwari.1996@gmail.com |
Poster |
Introduction: CTLA-4 haploinsufficiency (CHAI) is a rare immune dysregulation disorder presenting with lymphopenia, autoimmune cytopenias, enteropathy, and hypogammaglobulinemia. We report a case successfully managed with abatacept.
Case Report: A 16-year-old male presented with lymphopenia, microcytic anemia, immune thrombocytopenia (ITP), autoimmune hemorrhagic cystitis, and hypogammaglobulinemia. Next-generation sequencing identified a pathogenic CTLA4 variant, c.407C>T (p.Pro136Leu), confirming CHAI. His mother carried the same mutation asymptomatically. The patient was started on weekly, off-label abatacept. Treatment led to the resolution of his hemolytic anemia and ITP, with significant improvement in his cystitis symptoms. Although allogeneic hematopoietic stem cell transplant (HSCT) was recommended as a curative option, the patient declined. He has remained on abatacept for over four years with a sustained response and no significant complications.
Discussion: Abatacept, a CTLA-4 fusion protein, mitigates autoimmune manifestations in CHAI by compensating for the deficient protein. While allogeneic HSCT is curative, it is not always feasible. This case adds to limited evidence supporting abatacept as a safe and effective long-term therapy for controlling CHAI. Further multicenter studies are needed to establish definitive treatment guidelines for this rare condition. |
| 152 |
Evaluation of Novel Hematology Analyzer Parameters – Microcytic Red Cells (Micro-R) and Hypochromic Red Cells (Hypo-He) in Differentiating Iron Deficiency Anemia and Beta Thalassemia Trait
|
1992-09-06 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Dr. Taruna Rajpal2, Dr. Vijay Kumar3, 2Senior Medical Officer, Hematology and Clinical Pathology Unit Department of Pathology, ABVIMS & Dr. Ram Manohar Lohia Hospital New Delhi-110001 3Professor and Head, Hematology and Clinical Pathology Unit, Department |
Dr Pooja Dhamija |
ABVIMS and Dr RML Hospital |
New Delhi |
9650745237 |
drpoojadhamija23@gmail.com |
Oral |
Title: Evaluation of Novel Hematology Analyzer Parameters – Microcytic Red Cells (Micro-R) and Hypochromic Red Cells (Hypo-He) in Differentiating Iron Deficiency Anemia and Beta Thalassemia Trait
Introduction: Iron Deficiency Anemia (IDA) and Beta Thalassemia Trait (BTT) are two common causes of microcytic hypochromic anemia, indistinguishable on routine complete blood counts. Diagnostic methods such as serum ferritin and HbA2 quantification (via Hb-HPLC) are accurate but limited by cost and accessibility. Advanced hematology analyzers provide additional parameters, including Micro-R and Hypo-He, which may serve as rapid, reliable tools to differentiate IDA from BTT. The Micro-R/Hypo-He ratio has emerged as a rapid and cost-effective tool to discriminate IDA from BTT.
Methods: This cross-sectional observational study is being conducted in the Department of Pathology, Dr. RML Hospital, New Delhi. A total of 50 patients (18–65 years) with microcytic hypochromic anemia are being enrolled. Patients with mixed deficiency states, recent transfusions (<1 month), chronic kidney disease are excluded. Blood samples are being analyzed for Micro-R and Hypo-He using a Sysmex XN-series analyzer, along with iron profile (serum ferritin, serum iron, TIBC, transferrin saturation).
Results: Statistical analysis involves descriptive statistics, Pearson correlation between Micro-R /Hypo-He and iron profile. ROC curve analysis to assess sensitivity and specificity. Prior studies show strong positive correlation between Micro-R/Hypo-He and serum ferritin/iron with significant diagnostic accuracy in differentiating IDA from BTT (p < 0.05). Data collection and analysis are ongoing, and the complete results with final statistical outcomes will be presented at the conference.
Conclusions: Previous studies suggest that Micro-R and Hypo-He, serve as a reliable marker for differentiating IDA from BTT. Its incorporation into routine hematological analysis has the potential to improve diagnostic accuracy and enable timely intervention. Final conclusions will be drawn once the complete study results are available.
Key words: β-Thalassemia Trait, Micro-R, Hypo-He, IDA, Iron profile |
| 153 |
Double Trouble: Tuberculosis in childhood acute leukemia: Clinical outcome and impact on therapy in a tertiary care center in India
|
1995-09-27 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
DR PURVA KANVINDE, DR RITIKA KHURANA, DR MINNIE BODHANWALA, DR SANGEETA MUDALIAR |
DR SHRIYA AGARWAL |
Bai Jerbai Wadia Hospital for Children |
Mumbai |
9769092989 |
agarwalshriya27@gmail.com |
Oral |
Title:Double Trouble: Tuberculosis in childhood acute leukemia: Clinical outcome and impact on therapy in a tertiary care center in India
Introduction:Children with acute leukemia (AL) are at high risk of bacterial, fungal infections, reactivation of latent infections like tuberculosis (TB)
Methods:Retrospective analysis of medical records of AL patients with coexistent TB over 10 years (January 2015- December 2024).
Results:Out of 690 patients of AL, 22 patients were diagnosed as TB on clinico-radiological with/without microbiological evidence. Commonest was Acute lymphoblastic leukemia (96%) and Acute myeloid leukemia (4%). Phase of therapy was maintenance (59%), intensive therapy (31%), and 10% were on anti-tubercular treatment (ATT) when AL developed. All had persistent fever and 40% had neutropenia. TB involvement was lung in 45% (7- consolidation,2 pleural effusion, 1 miliary), lymph nodes (LN) 18%, abdominal (ileocecal region) 18%, bone 9% and 1 case of ocular and tubercular meningitis (TBM). Diagnosis confirmed by bronchoalveolar lavage 32%, LN biopsy 18%, cold abscess drainage 10%, orbital mass biopsy and cerebrospinal fluid analysis 1 case each and only clinic-radiological basis 32%. Multidrug resistant (MDR) 20%, pre extensively resistant (Pre-XDR) 20% and XDR 13% was noted. Median delay in diagnosis of TB was 4 weeks (10-75 days-ocular TB). Delay in chemotherapy was seen in 40% and modification of chemotherapy in 27%. Hepatotoxicity developed in 1 (transaminitis), ATT was modified. Child with TBM developed Immune reconstitution inflammatory syndrome and required steroids. Children who developed AL on ATT did not require modification of treatment. Response to ATT was seen in all patients, completed in 78% and 9% are on continuation phase. Conclusion: In TB-endemic regions, a high index of suspicion is needed in malignancy-related febrile illnesses, as TB can flare at any stage of leukemia treatment. Optimal management requires balancing chemotherapy and ATT to achieve remission, control TB, and limit toxicities. |
| 154 |
A Comparative Study on Platelet Function in Newly Diagnosed Cases of Multiple Myeloma With Versus Without Renal Dysfunction |
2025-10-30 |
Female |
Yes |
L-2172 | 56068 |
Malignant |
Plasma cell disorders |
Clinical |
Dr. Ruth K.Tara, Dr. Arnab Chattopadhay, Dr. M. Bhattacharyya |
Dr Sweety Kumari |
IHTM, Medical College Kolkata |
Kolkata |
08789725060 |
ysweety71@gmail.com |
Poster |
Title: A Comparative Study on Platelet Function in Newly Diagnosed Cases of Multiple Myeloma With Versus Without Renal Dysfunction
Introduction: Multiple myeloma (MM) is a rare, incurable bone marrow cancer characterized by the clonal proliferation of plasma cells, which can disrupt normal hematopoiesis and lead to various complications, including alterations in platelet function. Patients with MM frequently experience coagulation disorders, including both thrombotic and bleeding complications. While severe bleeding is often associated with prolonged bleeding times, the impact of compromised primary hemostasis on bleeding has not been systematically studied. This research, titled "A Comparative Study on Platelet Function Test in Newly Diagnosed Cases of Multiple Myeloma with and without Renal Dysfunction," aims to investigate the prevalence of platelet dysfunction in newly diagnosed MM patients
Methodology :This was a hospital-based, cross-sectional observational study conducted at the Institute of Hematology and Transfusion Medicine (IHTM) in Kolkata. The study population consisted of 50 newly diagnosed MM patients. These patients were divided into two groups: 25 with deranged renal function and 25 with normal renal function. Platelet function was assessed using a PFA100 analyzer, and data was analyzed using standard statistical methods with SPSS software
Result: A trend toward a higher frequency of platelet function test (PFT) derangement was observed in patients with renal derangement. In the group without renal derangement, 29.6% (8/27) had PFT derangement, while in the group with renal derangement, 56.0% (14/25) had PFT derangement. The statistical analysis using Fisher's exact test yielded a P-value of 0.091, indicating that this difference did not reach statistical significance but was suggestive of a trend that warrants further study.
Conclusion: The study concluded that there is a trend toward a higher prevalence of platelet dysfunction in multiple myeloma patients with renal dysfunction compared to those with normal renal function. The findings may help guide |
| 155 |
ENDOCRINE COMPLICATIONS FOLLOWING HEMATOPOIETIC STEM CELL TRANSPLANT FOR BETA THALASSEMIA IN CHILDHOOD AND ADOLESCENCE |
1994-02-17 |
Female |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dinesh Bhurani(Unit Head and HOD, Dept of Hematology,RGCIRC),Richa Arora Agarwal(Endocrinologist,Child Clinic and Endocrine Centre Rohini),Narendra Agrawal(Unit Head , Dept of Hematology,RGCIRC),Vipul Sheth(Unit Head , Dept of Hematology RGCIRC),Rohan Hal |
Reshmi Harikumar Pillai |
Rajiv Gandhi Cancer Institute and Research Centre |
DELHI |
09746108254 |
hp.reshmi@gmail.com |
Poster |
Title:ENDOCRINE COMPLICATIONS FOLLOWING HEMATOPOIETIC STEM CELL TRANSPLANT FOR BETA THALASSEMIA IN CHILDHOOD AND ADOLESCENCE Introduction:Allogenic hematopoietic stem cell transplantation (HSCT) remains the only currently available technique with curative potential in transfusion-dependent Beta-thalassemia . The endocrine organs contain actively replicating cells that are more susceptible to the deleterious effects of chemotherapy/radiation. Methods: The subjects of this study were children diagnosed with Thalassemia major who underwent a HSCT between 2021-2024 at the department of Hematology, Rajiv Gandhi Cancer Institute and Research Centre. Results: A total of 59 subjects (39 males and 20 females) were included in this study . The mean age at HSCT was 8.21 ± 2.81 years. Among 59 post-transplant thalassemic patients analyzed, 55 cases(93.2%) suffered from endocrine complications. Growth failure (Height SDS < -2) was the most prevalent endocrine complication, affecting 79.7% (n = 47) of the cohort, with a male predominance (n = 30) and a mean age of 9.29 years. The associated mean serum ferritin level in this group was 4193.32 ng/mL. Vitamin D deficiency (44.1%, n = 26) was equally distributed among males and females, with a slightly higher mean age (10.04 years), and ferritin levels averaging 3834.62 ng/mL. Hypothyroidism was seen in 28.8% (n = 17) of patients, predominantly in males with a younger mean age of 7.92 years and ferritin levels averaging 4388.24 ng/mL. Less common complications included hypocalcemia (8.5%) and adrenal insufficency (5.1%). Childhood diabetes was not reported. Eight patients were eligible for the assessment of delayed puberty, out of which 6 patients had delayed puberty, more commonly in females (n = 4). Notably 11(18.6%) cases suffered from either acute or chronic GvHD.
Conclusions: As endocrine complications are relatively common after HSCT in children,further research is required to establish an optimized conditioning regimen that might modify the risk of endocrine sequelae. |
| 156 |
Can CD38 serve as a surrogate maker for identifying IGHV unmutated status: our perspective |
1992-10-25 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Sushmita Singh, Priyanshi Singh, Dharmendra K Mishra, Nilesh U Dhole, Snehal Jaiswar, Sonali Batwal, Anil Yadav, Dr. Anil Singh, Dr. B. K. Mishra, Dr. Seema Biswas, Prof. (Dr.) Neha Singh Hematopathology Laboratory, Tata Memorial Centre (HBCH & MPMMCC), V |
Rohitkumar Kori |
Tata Memorial Centre (HBCH & MPMMCC) |
Varanasi |
8553109433 |
rohit.kori@rocketmail.com |
Poster |
TITLE: Can CD38 serve as a surrogate marker for identifying IGHV unmutated status: our perspective
Introduction: The somatic hypermutation status of the immunoglobulin heavy variable (IGHV) gene is a stable and independent prognostic marker in chronic lymphocytic leukemia (CLL). Assessment at diagnosis stratifies patients into two subgroups: IGHV-mutated CLL (>2% deviation from germline), associated with indolent disease, prolonged survival, and better response to chemoimmunotherapy, and IGHV-unmutated CLL, linked to aggressive behaviour and poor outcomes. High expression of CD38, del(17p), and CD49d are also known adverse prognostic indicators.
Methods: We retrospectively analyzed IGHV mutation status by Sanger sequencing in newly diagnosed CLL patients receiving treatment and evaluated correlations with FISH abnormalities and immunophenotypic markers, including CD38 and CD49d.
Results: IGHV mutation data were available for 40 patients (median age: 63 years). Six patients showed unproductive rearrangements, while 34 had productive rearrangements; 18 were mutated (79.17–97.89%). VH3-30 was the most frequently involved region, followed by VH4-39 and VH4-59. CD38 upregulation was significantly associated with IGHV-unmutated status (p = 0.002). Common FISH abnormalities were del(13q14), del(11q22), and trisomy 12. Recurrent mutations included SF3B1, NOTCH1, and ATM. No significant correlation was observed between IGHV status and CD49d positivity >30% or adverse cytogenetic profiles. Overall response rates to frontline therapy were 92.85%.
Conclusion: Given the complexity and cost of IGHV testing, CD38 expression by flow cytometry may serve as a practical surrogate marker for identifying patients likely to have an unmutated IGHV status, particularly in resource-limited settings.
Keywords: CLL, Sequencing, Flowcytometry, Mutations |
| 157 |
The Silent Bleeder: Prevalence and Variants of Von Willebrand Disease in Uttar Pradesh |
1997-01-21 |
Female |
No |
- | H_LKO |
Benign |
Platelet disorders |
Clinical |
Dr. Rashmi Kushwaha, Dr. Mili Jain, Dr. Sanjay Mishra, Dr. S.P. Verma, Dr. Suresh Babu |
Dr. Pragya Namdev |
King George Medical University |
Lucknow |
8299348677 |
drpragyanamdev@gmail.com |
Oral |
Title: The Silent Bleeder: Prevalence and Variants of Von Willebrand Disease in Uttar Pradesh
Authors: Dr. Pragya Namdev1, Dr. Rashmi Kushwaha1, Dr. Mili Jain1, Dr. Sanjay Mishra1, Dr. S.P. Verma2, Dr. Suresh Babu1
1. Department of Pathology, KGMU, Lucknow
2. Department of Clinical Haematology, KGMU, Lucknow
Introduction: Von Willebrand disease (VWD) is the most common inherited bleeding disorder worldwide, but data from Uttar Pradesh remain limited. Regional epidemiological studies are essential to understand its burden and clinical spectrum for better diagnosis and management.
Methods: A retrospective study was conducted at department of Pathology, King George’s Medical University from 2007-2024. Patients with a history of mucocutaneous bleeding, easy bruising, or unexplained prolonged bleeding time were included. Clinical details, bleeding scores, and family history were recorded. Laboratory evaluation included CBC, PT, aPTT, bleeding time, VWF antigen, aggregation with ADP and ristocetin and factor VIII levels. VWD subtypes were classified according to ISTH criteria.
Results: Among 270 patients evaluated for bleeding disorders, VWD was diagnosed in 67 cases, giving a prevalence of 24.8%. Patient’s age range from 8 months to 67 years; with 40 females and 27 males. The most common presenting symptoms were epistaxis, menorrhagia, and gum bleeding. Distribution of subtypes revealed 42% Type 1, 27% Type 2 (2A, 2B, 2M, 2N), and 30% Type 3. Severe forms (Type 3) were more prevalent in consanguineous families.
Conclusions: Von Willebrand disease contributes significantly to the burden of bleeding disorders in Uttar Pradesh, with Type 1 being the most common subtype. Increased awareness, early diagnosis, and subtype characterization are crucial for appropriate management and genetic counselling.
Key words: von Willebrand disease, prevalence, variants, Uttar Pradesh, inherited bleeding disorder |
| 158 |
Surveillance and bacteriological profile pre-intensive chemotherapy in acute leukemia patients and association with culture during febrile neutropenia – a cross - sectional study |
1993-01-05 |
Female |
Yes |
L-2236 | 52422 |
Malignant |
Leukemia & lymphoma |
Clinical |
|
RESHMA BENSON |
AIIMS Rishikesh |
Rishikesh |
9789097178 |
drreshmabenson@gmail.com |
Poster |
Title: Surveillance and bacteriological profile pre-intensive chemotherapy in acute leukemia patients and association with culture during febrile neutropenia – a cross - sectional study
Introduction: Initiation of empiric antibiotics, modified based on clinical signs and culture positivity is the current norm in management of Febrile Neutropenia (FN). Identification of patients with previous colonisation with Multi Drug Resistant (MDR) organisms is important in deciding the antibiotic of choice.
Methods: The cross-sectional study included 231 patients with acute leukemia, who received intensive chemotherapy regimens, in AIIMS Rishikesh, from October 2023 to April 2025. Surveillance cultures - throat swab and stool or rectal swab cultures were sent before initiation of chemotherapy.
Results: The study included 231 admissions for intensive chemotherapy. The median age was 14 years (IQR 6-26.75). Surveillance culture was positive in 32 admissions (Group 1), and negative in 199 admissions (Group 2). Of the surveillance culture isolates, 88.2% were Gram Negative Bacteria (GNB), while 11.8% were Gram Positive Bacteria (GPB). The most common GNB isolate was Klebsiella pneumoniae (30%). Of the GNB isolates, 47% was sensitive and 53% were MDR. All the 4 GPB isolates were MDR. The proportion of blood culture positivity during FN was higher in group 1, which was statistically significant (p=0.049, OR - 2.2). There was no association between surveillance culture isolate and blood culture isolate (p=0.96), and the resistance pattern of isolates in surveillance culture and blood culture (p=0.662). There was no statistically significant difference between the incidence of FN (P=0.47) and FN duration in both groups (p=0.197).
Conclusions: As per the findings of this study, there is no association with surveillance cultures and blood culture isolates during FN and there was limited evidence to suggest utility of surveillance cultures as a guide to predict multidrug resistant infections during FN.
Key words: acute leukemia, neutropenia, culture |
| 159 |
HALP Score: The Anchor in Myeloma Survival Predictions |
1998-05-27 |
Female |
No |
- | H_LKO |
Malignant |
Plasma cell disorders |
Laboratory |
Dr. Amit Nisal, Dr. Anuja Patil, Dr. Reena Bharadwaj |
Dr. Kalyani Bhamre |
Bharati Vidyapeeth (Deemed to be university)medica |
Pune |
9637296366 |
kalyanibhamre27@gmail.com |
Oral |
Title: HALP Score: The Anchor in Myeloma Survival Predictions
Introduction: Plasma cell myeloma is the second most common haematologic malignancy which presents after the fifth decade of life. It is characterised by accumulation of monoclonal plasma cells in the bone marrow associated with monoclonal immunoglobulin synthesis and osteolytic bone lesions. Various prognostic indicators are used in myeloma such as Beta 2-microglobulin, Plasma cell labelling index (PCLI), Cytogenetics and gene expression profiling. HALP score is recently explored in the prognosis of plasma cell myeloma.
Methods: This was a retrospective cohort study of 52 diagnosed cases of plasma cell myeloma which included cases from previous five years. Laboratory investigations were retrieved for values of Haemoglobin, Serum Albumin levels, Absolute Lymphocyte count and platelet count. The HALP score was calculated using formula: Haemoglobin (g/L) × Albumin (g/L) × Lymphocyte (/L)/ Platelet Count (/L). The patient’s relatives were called and the longevity of patients was recorded. The outcome of patients was compared with HALP score.
Result: Out of 52 patients 34 (65.4%) were male while 18 (34.6%) were female. Out of these, 23 (44.2%) patients are alive and 29 (55.8%) succumbed to the disease. The mean HALP score was 45.68 (SD- 29.06) in alive patients and 17.19 (SD- 23.62) in those who died. Using ROC curve analysis, we obtained 27.15 as the optimal HALP score cutoff to predict survival. Low score group HALP < 27.15 (n=31) and high score group > 27.15 (n=21). Patients above this threshold (n=21) had good outcomes- 20 survived and only 1 died. In contrast, those below 27.15 (n=31) fared poorly, with only 3 survivors and 28 deaths.
Conclusion: In plasma cell myeloma, a high HALP score predicts notably better survival, while low scores signal poor outcomes highlighting HALP as a robust, accessible prognostic marker.
Keywords: Plasma cell myeloma, HALP
|
| 160 |
B-cell Acute Lymphoblastic Leukemia (B-ALL) with Eosinophilia-A Rare Subtype
|
1997-12-12 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Ankita Soni- Associate Professor, Dr Manjit Kaur Rana- Head of The Department |
Dr Anushree Mondal |
AIIMS BATHINDA |
AIIMS BATHINDA |
08346970260 |
anushreemondal997@gmail.com |
Oral |
Title: B-cell Acute Lymphoblastic Leukemia (B-ALL) with Eosinophilia-A Rare Subtype
Authors- Dr Anushree Mondal, Dr Ankita Soni, Dr Manjit Kaur Rana
INTRODUCTION B-cell acute lymphoblastic leukemia (B-ALL) is a hematologic malignancy characterized by the clonal proliferation of immature B-lymphoid precursors. In rare instances, B-ALL is associated with marked eosinophilia. This subtype represents less than 1% of all B-ALL cases. Eosinophilia in this context is often reactive, driven by the overproduction of cytokines (particularly interleukin-3 [IL-3], IL-5, and GM-CSF) secreted either by leukemic blasts or an abnormal T-cell population. Clinically, patients may present with non-specific symptoms such as skin rash, urticaria, fatigue, or respiratory complaints. Eosinophilia may precede overt leukemia signs by weeks or months, and peripheral blood smears often lack blasts, making diagnosis challenging.
CASE DESCRIPTION
A 11 year old female presented to the emergency department with urticaria (hives) and generalized itching. A peripheral blood smear (PBS) revealed 59% eosinophils, but notably no blast cells were detected. Bone Marrow examination reveals normocellular marrow showing presence of normal looking hematopoietic elements exhibiting prominence of eosinophils and its precursors. Interspersed are seen 18% blasts. Other Findings- CD-10 bright positive, CD-19 dim Positive, TDT- moderate positive,CD-34 moderate positive confirming a diagnosis of B‑cell acute lymphoblastic leukemia (B‑ALL) coexisting with significant eosinophilia. CDKN2A, CDKN2B deletions are seen on NGS, an adverse prognostic marker in ALL patients
DISCUSSION
B-lymphoblastic leukemia/lymphoma (B-ALL) is most commonly associated with specific genetic abnormalities, particularly rearrangements involving the PDGFRB, PDGFRA, or FGFR1 genes. These genetic fusions activate tyrosine kinase signaling, leading to proliferation of both lymphoblasts and eosinophils. Cases with targetable tyrosine kinase fusions (e.g., PDGFRB) respond well to TKI therapy and have a better prognosis. In contrast, patients with complex karyotypes or without targetable mutations may have poorer outcomes. |
| 161 |
MOLECULAR LANDSCAPE AND SURVIVAL ANALYSIS OF PEDIATRIC PRECURSOR B LYMPHOBLASTIC LEUKEMIA: A SINGLE CENTRE EXPERIENCE |
1991-11-17 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Shabana Azad1, Dr. Pradeep Armugum1, Mr RohitKumar Kori1, Mr Nilesh Dhole1, Mr Dharmendra Mishra1, Mr Anil Yadav3 Dr. Seema Biswas1,Dr. Parichay Singh2, Dr. Raghwesh Ranjan2, Dr. Neha Singh1 AFFILIATIONS: Haematopathology Laboratory 1, Pediatric Hemat |
Dr. Deepali Saxena |
Tata Memorial Centre (HBCH & MPMMCC), Varanasi. Ho |
Varanasi |
8527915667 |
deepalisaxena1611@gmail.com |
Oral |
TITLE: MOLECULAR LANDSCAPE AND SURVIVAL ANALYSIS OF PEDIATRIC PRECURSOR B LYMPHOBLASTIC LEUKEMIA: A SINGLE CENTRE EXPERIENCE
INTRODUCTION: Accurate risk stratification including Measurable Residual Disease (MRD) status and molecular profiling is essential for the effective management of pediatric precursor B-Acute Lymphoblastic Leukaemia(B-ALL).
OBJECTIVES: To assess the clinico-hematological and molecular characteristics of pediatric B-ALL patients and analyze their correlation with MRD status and survival outcomes.
METHODS: This retrospective study included all pediatric newly diagnosed B-ALL patients (<15 years) over the past five years.
RESULTS: Our cohort comprised of 568 pediatric B-ALL patients with a male predominance. Based on molecular signatures as per the revised WHO 2022 classification of B-ALL, High-Hyperdiploidy followed by ETV6:RUNX1 fusion and Philadelphia(Ph) positive were the common subgroups in our study. On comparing the five common molecular subgroups, BCR::ABL positive and Ph-like subgroups together were significantly different from the others in-terms of End of Induction-MRD(EOI-MRD) positivity(p= 0.0013), CNS involvement (p= 0.025) and higher relapse rates(p=0.024). Surprisingly, higher EOI-MRD positivity rates were observed in the High-Hyperdiploidy cases. There was no significant difference between the subgroups in terms of mortality. In our study, 12.85%, 50.7% and 36.4% patients belonged to the standard, intermediate and high-risk groups respectively. The Relapse free survival(RFS) between the risk groups were statistically significant(p<0.001). There was significant difference in the Overall survival(OS) between the EOI-MRD positive and negative cases(p=0.002).
CONCLUSION: This is one of the largest retrospective observational studies from the Eastern part of India involving financially-challenged patients, which discusses important aspects of prognostic factors and their impact of RFS and/or OS. Moreover, EOI-MRD still emerges as the most important prognostic indicator of OS, across resource-sufficient and resource-constrained settings.
KEYWORDS: Precursor B-cell lymphoblastic leukemia, NGS, Flow cytometry, Minimal Residual Disease
|
| 162 |
"Spotting Iron Deficiency Before It Strikes : RET-He & IRF in First Trimester." |
1993-06-21 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Dr.Vijay Kumar, Dr.Ashok Kumar, Dr.Garima Rakheja. Professor & Head, Hematology & Cl. Pathology Unit, Department of Pathology, ABVIMS & Dr. RML Hospital, New Delhi-110001. Director Professor, Department of Obstetrics & Gynaecology & Director, ABVIMS & Dr |
Dr. Swathi R |
ABVIMS & Dr. RML Hospital, New Delhi. |
New Delhi |
9789253478 |
drswathpath93@gmail.com |
Oral |
Title: "Spotting Iron Deficiency Before It Strikes : RET-He & IRF in First Trimester ."
Introduction: Iron deficiency anemia (IDA) is the most common nutritional deficiency in pregnancy and a major contributor to maternal and perinatal morbidity. Conventional iron studies are costly, not universally available, and may be affected by acute phase reactions. Newer hematological parameters such as Reticulocyte Hemoglobin Equivalent (RET-He) and Immature Reticulocyte Fraction (IRF) provide rapid, cost-effective alternatives for early detection.
Methods: A cross-sectional observational study was conducted between August 2022 and February 2024 on first trimester pregnant women attending antenatal clinics of ABVIMS & Dr. RML Hospital, New Delhi. Women with Hb <11 g/dL and serum ferritin <15 ng/mL were included; those on hematinics, with history of blood transfusion, chronic inflammation, or hemoglobinopathies were excluded. Age-matched controls (Hb >11 g/dL) were enrolled. Venous blood samples were collected in K2EDTA vials and analyzed using Sysmex XN-1000 for complete blood counts including RET-He and IRF. Results were compared with conventional iron studies (Serum Iron, TIBC, Transferrin Saturation and Ferritin) to assess diagnostic accuracy.
Results: RET-He showed high sensitivity (96.5%) and specificity (98.8%) in detecting early iron deficiency, performing better than traditional red cell indices. IRF was useful in assessing erythropoietic activity and complemented RET-He. Diagnostic accuracy (97.6%) was excellent, with AUC values of 1 for IRF and 0.997 for RET-He. Optimal cut-offs were >16.7% for IRF and ≤ 28.2 pg for RET-He. Combined use of RET-He and IRF improved early detection and facilitated timely intervention.
Conclusions: RET-He and IRF are reliable, easily available, and cost-effective markers for early diagnosis of IDA in pregnancy. Incorporating them into routine antenatal screening can enable prompt management, reducing maternal and fetal complications.
Key words: Iron deficiency anemia, pregnancy, RET-He, IRF, early diagnosis. |
| 163 |
When Youth Meet Chronicity:Chronic Myeloid Leukaemia in young cohort group |
1994-10-09 |
Male |
No |
- | T2508 |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. ALOK RANJAN |
Dr.KUMAR ANUPAM |
Indira gandhi institute of medical sciences |
Patna |
8292279949 |
anupamgahlot0910@gmail.com |
Oral |
Title:When youth meet chronicity: Chronic Myeloid Leukaemia in young cohort group
Introduction:Chronic Myeloid Leukaemia (CML), a myeloproliferative neoplasm predominantly affecting older adults, presents unique diagnostic, and therapeutic challenges while occurring in adolescents and young adults (AYA; aged 15–39 years). According to global data (2-3)% of Leukaemias in children and 9% in adolescents are CML, which is approximately 2% of total diagnosed CML cases. Data specific to this population remain sparse.
Methods: We present a total of 40 cases compiled from 2021 till 2025 of this age group diagnosed with chronic myeloid leukaemia. We analysed Clinical presentation, Treatment response, Overall survival, Treatment related adverse effects, Compliance of patients, Duration taken to achieve deep major molecular response, initial SOKAL scoring, percentage IS of BCR-ABL.
Results:The median age at diagnosis was assessed along with a male-to-female ratio, the most common presenting symptoms. Most patients were started on first-line tyrosine kinase inhibitors (TKIs), with imatinib being the most used due to financial constraints of most patients. Major molecular response (MMR) was assessed at 6 and 12 months of initiating treatment using RTPCR technique. Treatment adherence challenges were also documented which were primarily due to socioeconomic factors and treatment related adverse effects. Long-term tolerability was generally favourable; with grade 3/4 toxicities observed in some cases.
Conclusions:
CML in the adolescent and young adult population is biologically similar to adult CML but is compounded by unique psychosocial and compliance challenges. Early diagnosis, molecular monitoring, and tailored support systems are vital to improving long-term outcomes in this age group.
Key words:CML/CML in young/Adolescence CML/young malignancy |
| 164 |
Durable Remission in Relapsed/Refractory DLBCL Through CD20 CAR T-Cell Therapy |
1984-07-15 |
Male |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dr.Nishant Mittal, Dr.Bharat Patodiya, Dr.Bryan Liu |
B. Sai Sree Reddy |
PI CANCER CARE |
Hyderabad |
7989433700 |
saisreebasireddy@gmail.com |
Poster |
Title: Durable Remission in Relapsed/Refractory DLBCL Through CD20 CAR T-Cell Therapy
Authors: Sai Sree Reddy, Dr. Nishant Mittal, Dr. Bharat Patodiya, Dr. Bryan Liu
Introduction:Relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after multiple treatments presents a tough clinical hurdle. Resistance to rituximab, an anti-CD20 antibody, narrows therapeutic choices. CD20-directed chimeric antigen receptor (CAR) T-cell therapy offers a new approach, using the patient’s T cells to attack CD20-positive lymphoma cells.
Methods: A 47-year-old woman with aggressive, treatment-resistant relapsed DLBCL, previously treated with R-CHOP, R-ICE, and planned ASCT, experienced two relapses after rituximab, confirming resistance. She showed ECOG status 3, widespread lymph node enlargement, spleen and bone marrow involvement, and LDH levels exceeding 1200 U/L. With few options left, she entered a trial for CD20 CAR T-cell therapy. T cells, collected via leukapheresis, were modified with a lentiviral vector carrying a CD20-specific CAR with a 4-1BB domain. After lymphodepleting chemotherapy with fludarabine and cyclophosphamide, she received 2 × 10^6 CAR T cells/kg. Treatment included tocilizumab and steroids for Grade 2 cytokine release syndrome (CRS) and steroids for Grade 1 immune effector cell-associated neurotoxicity syndrome (ICANS).
Results: At 30 days post-infusion, PET-CT revealed a 72% tumor reduction and significant lymph node shrinkage. By three months, she achieved full metabolic and radiographic remission, sustained at one year. She opted against post-remission ASCT.
Conclusions
CD20 CAR T-cell therapy revolutionizes care for refractory DLBCL, delivering lasting remission and better survival. Supported by Cancerfax, this case shows how innovative immunotherapy turns resistant blood cancers into manageable conditions, enhancing patient hope and life quality.
Keywords: Diffuse large B-cell lymphoma, CD20 CAR T-cell therapy, immunotherapy, rituximab-resistant, blood cancers, lasting remission
|
| 165 |
Rare atypical BCR-ABL transcripts in CML: a case series
|
1996-01-16 |
Female |
No |
- | 52421 |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Mrs. Sonali Batwal, Ms. Sushmita Singh,Ms. Snehal Jaiswar Mr. Rohit Kumar Kori, Mr. Nilesh U Dhole, Dr. Pradeep Arumugam,Dr. Deepali Saxena,Dr. Seema Biswas,Dr. Anil Singh,Dr.B.K Mishra, Prof (Dr.) Neha Singh. Hematopathology Laboratory, Tata Memorial C |
Mrs. SONALI BATWAL |
TATA MEMORIAL CENTRE(HBCH/MPMMCC),VARANASI. |
VARANASI |
9450296547 |
sonalibatwal13@gmail.com |
Poster |
Title: Rare atypical BCR-ABL transcripts in CML: a case series.
Introduction: Atypical BCR-ABL transcripts are unusual BCR-ABL fusion gene variants found in about 1-2% of CML and some cases of Precursor B-ALL. It is crucial to detect atypical transcripts because patients often benefit from tyrosine kinase inhibitor (TKI) therapy, but their response can be variable, requiring Nested-PCR or RNA sequencing based molecular testing at follow up time-points.
Methods: It was a three-year retrospective observational study involving newly diagnosed cases of Philadelphia-positive CML and BALL, in whom RT-PCR for BCR::ABL was positive using typical and/or atypical set of BCR::ABL fusion primers.
Results: Out of eleven-hundred positive cases, only seven patients (0.6%) had atypical BCR::ABL fusion variants, including two cases of Ph-positive BALL, three cases of CML in chronic phase and one case each of CML in accelerated phase and myeloid blast crisis respectively. Age at presentation varied from 15-55 years. e13a3, e8a2 and e6a2 type of atypical variants were seen in two patients each while one patient showed e13a1 variant. Six of these patients presented with moderate to severe anemia. Additional karyotypic abnormalities in the form of der (9;12), trisomy 21 and t(9;18) were observed in two patients. One patients had CNS –III status while another presented with pleural effusion. Both cases of Nano variants (e6a2) presented in progressive phase. One of these patients died due to atypical infections within six months while the other had multiple osteolytic skeletal lesions mimicking myeloma. All seven patients were started on TKIs, Imatinib 400 mg or Dasatinib 100mg.Nested–PCR was positive in two patients at twelve months post-TKI therapy, including one case of e8a2 and another of e13a1. Follow-up duration in months varied from 6-36 months.
Conclusions: The uncommon variant transcripts can result in phenotypic variability and affect response to TKI therapy.
Key words: CML,RT-PCR,TKI. |
| 166 |
Ferritin, Fibringen and Beyond: Hemostatic Crossroads in Hemophagocytic Syndrome |
1998-09-22 |
Female |
No |
- | 52351 |
Benign |
Hemeostasis |
Laboratory |
Dr Deepa Rani, Associate Professor, Dept of Pathology, IMS BHU; Prof LP Meena, Head and Professor, Dept of General Medicine, IMS BHU; Dr Priyanka Aggarwal, Associate Professor, Dept of Pediatrics, IMS BHU |
Dr Atreyee Chakrabarty |
Institute of Medical Sciences, Banaras Hindu Unive |
Varanasi |
9336987599 |
classicatreyee@gmail.com |
Oral |
Title: Ferritin, Fibringen and Beyond: Hemostatic Crossroads in Hemophagocytic Syndrome
Authors: Dr Atreyee Chakrabarty, Dr Deepa Rani, Prof LP Meena, Dr Priyanka Aggarwal
Introduction: Hemophagocytic syndrome is a rare, rapidly progressing condition marked by uncontrolled immune activation, cytokine storms, and dysregulated inflammation, which can result in multi-organ failure and tissue destruction, making it a life-threatening disorder.
Methods: This study included thirty cases (December 2023 to December 2024) at the Division of Hematopathology, BHU, and the Central Laboratory of Clinical Investigation, Sir Sunderlal Hospital, in collaboration with the Departments of General Medicine and Pediatrics. Informed consent was obtained, and clinical data was collected from records. Blood samples were analyzed for CBC, peripheral smear, liver profile, triglycerides, ferritin, coagulation profile and bone marrow aspiration. Molecular studies were not performed.
Results: Of the thirty cases, 27% were pediatric, and 73% adults, with a gender distribution of 53% male and 47% female. Fever was observed in most (82%) of the patients, with weakness and fatigue in 34.5% and shortness of breath in 31%. Other frequently associated symptoms included chills, bleeding, cough, abdominal pain, lymphadenopathy, and jaundice Less frequent complaints were vomiting, diarrhea, rash, seizures, and altered sensorium; weight loss, headache, myalgia, and nausea were rare. Hepatomegaly was seen in 53%, and splenomegaly in 60%. Immunosuppression was noted in 33%. Hematological findings included moderate anemia, low TLC, thrombocytopenia, and trilineage cytopenia. Ferritin was elevated in 60%, elevated PT was observed in 30% of the patients, prolonged aPTT in 29%, and elevated INR in 72%. An H score >169 was seen in 76%, with HLH probability ranging from <1% to >99%.
Conclusions: Timely diagnosis and management are crucial to prevent complications. Future research should focus on the molecular genetics of hemophagocytic syndrome.
Key words: Hemophagocytic lymphohistiocytosis, Hemophagocytic syndrome, Hemostasis, Cytopenia, Ferritin, H score |
| 167 |
Identification and quantification of circulating myeloid derived suppressor cells |
1993-04-28 |
Male |
No |
- | T2508 |
Benign |
Miscellaneous |
Laboratory |
Dr. Prerna Arora |
Dr. Ank Vaish |
Maulana Azad Medical College |
Delhi |
8882525852 |
drankvaish@gmail.com |
Oral |
Title: Identification and quantification of circulating myeloid derived suppressor cells Introduction:Breast cancer is the leading cause of cancer-related deaths in women, with immune evasion largely driven by the accumulation of myeloid-derived suppressor cells (MDSCs). MDSCs are heterogeneous population of immature myeloid cells and myeloid progenitor cells and suppress immune function by inhibiting T-cell proliferation and activation through cytokine release and Treg expansion to promote tumor immune escape. This study involved evaluation of circulating MDSCs and its subsets (Early stage MDSC (eMDSC , Polymorphonuclear MDSC (PMN-MDSC) and Monocytic MDSC(Mo MDSC) in peripheral blood in patients of benign and malignant breast lesions. Methods:A prospective observational study was conducted over 1 year duration . EDTA peripheral blood samples from 60 patients of breast lesions were analysed for MDSCs using multiparametric flow cytometry by 3 laser, 10 colour instrument , to identify PMN-MDSCs, Mo-MDSCs, and e-MDSCs. The quantification of MDSCs was done in percentage and levels compared in benign and malignant breast lesions as well as compared with healthy controls. Paired sample analysis was undertaken in cases with surgery and or chemotherapy.
Results: Significantly elevated circulating total MDSCs was observed in malignant cases as compared with benign and control groups . Among subsets, Mo-MDSCs were markedly higher in malignancy and showed correlation with presence of metastasis. PMN-MDSCs exhibited a numerical rise but without statistical significance, while e-MDSCs were comparable across groups. Post-surgery and post-chemotherapy samples demonstrated a reduction in total MDSCs, highlighting their dynamic association with tumor burden. ROC curve analysis indicated moderate discriminatory ability of MDSCs in differentiating malignant from benign lesions. Conclusions:MDSC expansion is specific to malignancy and absent in benign lesions. Mo- MDSCs are the dominant immunosuppressive subset in breast cancer.Tumor removal or systemic therapy causes a sharp reduction in circulating MDSCs, suggesting they can serve as a marker of tumor |
| 168 |
The Genetic Link to Young Stroke: Role of MTHFR Polymorphisms |
1998-11-03 |
Female |
No |
- | H_LK |
Benign |
Miscellaneous |
Laboratory |
Sanjna Deshmukh Rachana lakhe Anu Christopher Preeti Doshi Amit Nisal Reena Bharadwaj |
Sanjna Deshmukh |
Bharati vidyapeeth medical college |
Pune |
7020151050 |
drsanjnadeshmukh@gmail.com |
Oral |
Title: Genetic Link to Young Stroke: Role of MTHFR Polymorphisms
Introduction: Ischaemic stroke in young adults (18–45 years) poses a serious clinical and socioeconomic challenge, with many cases being cryptogenic. Thus, necessitates identifying underlying genetic predispositions. One such cause is Methytetrahydrofolate reductase gene polymorphism, which impairs homocysteine metabolism. Variants such as C677T and A1298C reduce enzymatic activity, leading to hyperhomocysteinemia, a risk factor for endothelial dysfunction, platelet activation, and impaired fibrinolysis, thereby promoting thrombosis. Detection of this polymorphism helps identify a pro-thrombotic state and alter long-term management, including the need for follow-up or lifelong anticoagulation therapy.
Methods: This cross-sectional study included 48 patients (18–45 years) with radiologically confirmed ischaemic stroke. Venous blood samples were collected, and MTHFR polymorphisms (C677T, A1298C) were analysed using PCR. Where available, serum homocysteine and vitamin B12 levels were recorded. Statistical analysis assessed the prevalence of polymorphisms and their association with biochemical parameters.
Results: Among 48 patients, A1298C mutation was detected in 56.3% (31.3% heterozygous, 25% homozygous) and C677T mutation in 22.9% (20.8% heterozygous, 2.1% homozygous). A1298C carriers had significantly higher serum homocysteine than non-carriers (p = 0.04), while no association was seen with vitamin B12 (p = 0.89). The C677T mutation showed a non-significant trend toward higher homocysteine (p = 0.13) and no correlation with vitamin B12 (p = 0.71).
Conclusions: This study demonstrates a high prevalence of MTHFR polymorphisms, particularly A1298C, in young ischaemic stroke patients, with a significant association with hyperhomocysteinemia. Overall, a substantial proportion of patients carried at least one MTHFR polymorphism, emphasizing the importance of genetic screening and biochemical profiling to identify high-risk individuals and guide preventive and therapeutic strategies in the Indian population.
Key words: Homocysteine, ischaemic stroke, MTHFR polymorphism, young stroke |
| 169 |
IMPACT OF HAEMATOLOGICAL DONOR VARIABLES ON PLATELETPHERESIS YIELD |
1981-02-24 |
Female |
No |
- | 56081 |
Benign |
Transfusion medicine |
Laboratory |
Dr. Tanya Tripathi |
Dr. Farhanaaz Ghani |
Career Institute of Medical Sciences and Hospital |
Lucknow |
8077125908 |
farhaghani14@gmail.com |
Oral |
Title: IMPACT OF HAEMATOLOGICAL DONOR VARIABLES ON PLATELETPHERESIS YIELD
Introduction: Single donor platelets (SDP) obtained by plateletpheresis are increasingly used due to their higher purity, reduced risk of alloimmunization and lower incidence of transfusion reactions. However, the yield of SDP is influenced by several donor-related factors such as age, sex, weight, pre-donation hemoglobin concentration, platelet count and other hematological parameters.
Methods: A study was conducted at the Blood Bank of Career Institute of Medical Sciences, Lucknow and a total of 50 plateletpheresis were observed. All the donors were screened and selected as per the donor eligibility criteria laid down by the Drugs Controller of India and the procedures were performed stringently as per standard operating procedures (SOP’s) of the department.
Results: Post plateletpheresis all the donor variables were re-evaluated. Platelet yield show that there was a positive significance with pre donation platelet count whereas age, sex, weight and hemoglobin concentration did not show any significant change in the platelet yield.
Conclusions: Automated cell separators have significantly improved SDP quality and collection efficiency. The correlation between platelet yield and pre-donation count underlines the importance of personalizing collection parameters.
Key words: Donor, platelet, plateletpheresis and single donor platelet. |
| 170 |
From Facial Palsy to Fatal Leukemia: An Unusual Presentation of Aggressive Natural Killer Cell Leukemia |
1994-01-05 |
Female |
No |
- | pay_ |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Saba, Dr. C Pathak, Dr. M. Singh |
Dr Anubha Singh |
VMMC and Safdarjung hospital, New Delhi |
New Delhi |
8726127355 |
anubha.annu.singh@gmail.com |
Poster |
Title: From Facial Palsy to Fatal Leukemia: An Unusual Presentation of Aggressive Natural Killer Cell Leukemia
Introduction: Aggressive natural killer cell Leukemia (ANKL) is an extremely rare haematological malignancy characterized by the systemic proliferation of mature NK cells with a fulminant clinical course and extremely poor prognosis. This lymphoproliferative disorder predominantly affects young adults with a median age of 40 years and shows a higher prevalence in Asian populations. ANKL typically presents with fever, B-symptoms, hepatosplenomegaly, pancytopenia, and is frequently associated with Epstein-Barr virus infection.
Methods: A 30-year-old male with congenital left-sided facial palsy developed progressive haematochezia, weight loss, and weakness over six months. The evaluation included a complete blood count, peripheral blood smear examination, bone marrow aspiration and biopsy, immunohistochemistry, and flow cytometry. The patient underwent serial monitoring with repeated peripheral smears, and finally, bone marrow evaluation was done during hospitalization.
Results: : Initial presentation revealed severe anaemia, thrombocytopenia, and nucleated red blood cells with left shift on peripheral smear. Bone marrow aspirate demonstrated 32% atypical cells with prominent nucleoli and basophilic agranular cytoplasm. Bone marrow biopsy revealed hypercellular marrow with >30% atypical NK cells showing similar morphology to peripheral smear findings. Flow cytometry was performed, which confirmed the above findings, showing a distinctive immunophenotype positive for NK cell lineage.
Conclusions: This case highlights the diagnostic challenges of ANKL, particularly the progression from initially normal peripheral smears to overt leukemic presentation, revealing the importance of flow cytometry in early diagnosis. Despite aggressive supportive care, the patient's clinical deterioration and, sadly, demise emphasize the urgent need for early recognition and innovative therapeutic approaches.
Key words: ANKL, Leukemia, flow cytometry |
| 171 |
Phase I study to evaluate the feasibility and safety of addition of Ruxolitinib to a standard BFM-90 regimen in adolescent/adult Ph-like ALL. |
1990-07-15 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Authors: Dr. Neha Sharma, Dr. Hasmukh Jain, Dr. Thomas Eipe, Dr. Manju Sengar, Dr. Alok Shetty, Dr. Lingaraj Nayak, Dr, Bhausaheb Bagal, Bhuvaneshwary Bhamare, Dr. Girish B S, Dr Meghana C S. Affiliation of all the Authors: Tata Memorial Centre, Mumbai |
Dr. Neha Sharma |
Tata Memorial Centre |
Mumbai |
8828499662 |
nehasharma060189@gmail.com |
Oral |
Title: Phase I study to evaluate the feasibility and safety of addition of Ruxolitinib to BFM-90 regimen in adolescent/adult Ph-like ALL.
Introduction: Ph-like ALL is associated with high-risk clinical features and has high-risk of treatment failure. Several genetic aberrations were identified in Ph-like ALL, with more than 60 rearrangements in 15 kinase or cytokine receptor genes. Majority of these alterations converge on a limited number of pathways that can be effectively targeted in vivo by inhibiting either the ABL-class or the JAK-STAT pathway. In this trial, we test the hypothesis that addition of JAK1/2 inhibitor Ruxolitinib to the conventional chemotherapy is safe and feasible.
Methods: ALL patients aged ≥ 15 years, with Ph-like expression profile; adequate organ function and ECOG PS 0-3 were eligible. Patients were enrolled into escalating dose cohorts as per rolling 6 design after EC approval (CTRI:CTRI/2021/02/031251). 11 patients were enrolled in Phase II Induction/Reinduction with five in each Cohort 1 (Ruxolitinib 10mg BD 14 days) and Cohort 2 (Ruxolitinib 10mg BD 28 days) and one patient in cohort 3 (Ruxolitinib 15mg BD 14 days). The primary endpoint was safety and tolerability of oral Ruxolitinib.
Results: A total of 11 male patients with median age of 20 were enrolled since April 2022. Genetic aberrations included PAX5 (n=5), CRFL2 (n=2), PAX5 and CRFL2 both (n=3), JAK2 along with PAX5 and CRFL2 (n=1). 6 were MRD positive during initiation of Ruxolitinib. 5 patients had infection related complication (lung=1, skin=2, varicella-zoster=1, otitis-externa=1). Febrile neutropenia reported in 2 patients, Grade 3 transaminitis reported in 2 patients, Grade ≥ 3 anemia in 11 patients, thrombocytopenia in 8 patients and neutropenia in 8 patients. Out of 11 patients, 9 are alive with 1 patient alive with disease, remaining patients are in CR. Conclusion: Ruxolitinib is safe in combination with chemotherapy.
Keyword: Ruxolitinib |
| 172 |
Unusual presentations of myeloproliferative neoplasm |
1995-10-29 |
Female |
Yes |
L-2064 | H_LKO |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Pronati Gupta1, Subhajit Hajra1, Sankar Sengupta1, Prantar Chakrabarti2 Affiliation: 1Lab Hematology, Department of Lab Medicine, Chittaranjan national Cancer Institute, Kolkata 2 Manipal hospitals Mukundapur, Kolkata |
Debirupa De |
Chittaranjan national Cancer Institute, Newtown K |
Kolkata |
8910447658 |
debirupa.de@gmail.com |
Poster |
Title: Unusual presentations of myeloproliferative neoplasm
Authors:
DEBIRUPA DE1, Pronati Gupta1, Subhajit Hajra1, Sankar Sengupta1, Prantar Chakrabarti2
Affiliation:
1Lab Hematology, Department of Lab Medicine, Chittaranjan national Cancer Institute, Newtown Kolkata
2 Manipal hospitals Mukundapur, Kolkata
Correspondence: Dr. Pronati Gupta, In charge, Lab Hematology
Introduction:
Myeloproliferative neoplasms (MPNs) are a category of myeloid neoplasms characterized by ceaseless production of white blood cells, erythrocytes, and/or platelets. Diagnostic evaluation continues to depend on correlation between clinical features, molecular diagnostics, and morphological evaluation. The process is determined by marrow environment, growth and transcription factors giving rise to a heterogeneous group of disorders sometimes with overlaps, border line findings or transition to another subtype. Here in we describe such cases with uncommon presentations.
Case history:
Case 1:
A 60year female presented with melena since1 week. Radiological findings revealed only mild hepatomegaly. A complete blood count showed a WBC 33.8x103/ul and platelet count of 3200x103/ul along with 2% blasts and basophilia. Karyotyping also revealed Philadelphia chromosome confirming CML. Bone marrow studies revealed increased megakaryocytes with variation in size and loose clustering. Further investigation revealed coexistence for JAK2 mutations.
Case 2:
A 77year male presented with bicytopenia and just palpable spleen. A complete blood count showed a WBC 2.92x103/ul, Hemoglobin of 7gm/dl and platelet count of 239x103 /ul along with 3% blasts and giant platelets. Cytogenetics showed isolated deletion on q arm of chromosome 5. Bone marrow studies revealed cellular marrow with increase in blasts, abnormal megakaryocytes and coarse reticulin fibers. Pathogenic mutations identified were TP53, CALR, SF3B1 and RUNX1.
Conclusion:
The diagnosis and stratification of MPN sometimes can be challenging with atypical clinical and laboratory presentations. Using a multiparameter approach is indicated for facilitating prompt and accurate diagnosis along with prognostication of these neoplasms, improving treatment of affected patients.
Key words:
Myeloproliferative neoplasm, myelodysplastic neoplasms, mutations
|
| 173 |
AML in Disguise: A Case of Acute Myeloid Leukemia Masquerading as Acute Erythroid Leukemia |
2001-01-24 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Epshita Das(Senior Resident), Dr. Neelam Sahani(Professor), Dr. Chitnamani Pathak(Professor) |
Dr. Tina Sharma |
Vardhman Mahavir Medical College and Safdarjung Ho |
New Delhi |
7793023439 |
twinkletsharma@gmail.com |
Poster |
TITLE:
AML in Disguise: A Case of Acute Myeloid Leukemia Masquerading as Acute Erythroid Leukemia
AUTHORS: Dr. Tina Sharma, Dr. Epshita Das, Dr. Neelam Sahani, Dr. Chintamani Pathak, Department of Pathology, VMMC and Safdarjung Hospital, New Delhi
INTRODUCTION:
Acute myeloid leukemia (AML) represents neoplastic proliferation of myeloid blasts in the bone marrow and peripheral blood. Diagnosis of AML with overt erythroid hyperplasia might mimic acute erythroid leukemia (AEL) on morphology causing significant diagnostic dilemma. Hence, differentiating AEL from AML is of utmost importance considering its rarity and aggressive clinical course. This case report underscores the morphological diagnostic dilemma and the need of integrating immunophenotyping by flow cytometry (FCM) for leukemia classification.
METHODS:
A 35-year-old male presented with weakness and bilateral pedal edema for 1 month. There was no history of weight loss, lymphadenopathy or hepatosplenomegaly.
Laboratory investigations revealed anemia, leukocytosis and thrombocytopenia. Iron studies, LFT, KFT were within normal limits. Peripheral and bone marrow aspirate (BMA) smears were examined.
RESULTS:
Peripheral smear showed leucoerythroblastic picture with presence of more than 40% blasts resembling those of erythroid lineage. BMA smears were hypercellular with 55% blasts showing more than 80% cells of erythroid lineage with predominance of early erythroblasts, many showing features of dyserythropoeisis. Based on morphology, a provisional diagnosis of acute leukemia, possibly AEL was made. However, FCM subsequently confirmed the diagnosis of AML over AEL.
CONCLUSION:
Despite obvious morphologic criteria defined by the WHO, AEL overlaps with erythroid-rich AML and Myelodysplastic syndrome. This case highlights the critical role of immunophenotyping by FCM in the precise diagnosis and classification of acute leukemias, especially when morphology alone is ambiguous.
Hence differentiation between erythroid-rich AML and AEL is necessary for prognostic consideration as AEL carries a dismal prognosis.
KEY WORDS:
Acute myeloid leukemia with erythroid hyperplasia, Acute erythroid leukemia, flow cytometry |
| 174 |
Triple therapy with Azacitidine, Venetoclax, and Sorafenib in FLT3-ITD Acute Myeloid Leukemia: A Single-Centre Experience from North India |
1986-05-20 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Poorvi Kapoor, Dr Sayan Sinha Roy, Dr Sanjeev, Dr Manish Kumar Singh, Dr Dinesh Chandra, Dr Khaliqur Rahman, Dr Ruchi Gupta, Dr Rajesh Kashyap |
Mona Vijayran |
SGPGIMS, Lucknow |
Lucknow |
8707076379 |
monavijayran1@gmail.com |
Poster |
Title:Triple therapy with Azacitidine, Venetoclax, and Sorafenib in FLT3-ITD Acute Myeloid Leukemia: A Single-Centre Experience from North India
Introduction: Triple therapy incorporating Azacitidine, Venetoclax with Sorafenib in FLT3-ITD AML has been reported by Maiti et al. (2021) in a Phase 2 study. They reported overall response rate of 80%. In India, sorafenib costs between ₹1500–₹2500 for 30 tablets. While other FLT3 inhibitors approved in the relapsed setting (gilteritinib and quizartinib) are largely unaffordable in LMIC settings, sorafenib represents a more accessible option. We present our single-centre experience with the triple therapy in this context.
Methods: We retrospectively analyzed outcome data of patients who received Azacitidine, Venetoclax and Sorafenib for FLT3-ITD AML at SGPGIMS, Lucknow over 1.5 years (January 2024–July 2025). Treatment regimen: Azacitidine-75 mg/m² for 7 days. Venetoclax-100 mg OD for 7 days (1 patient received 14 days) with posaconazole 300mg daily, Sorafenib- 400 mg twice daily for variable durations - 21 days (n=3), 28 days (n=2), and 14 days (n=1, de novo).
Results: Six patients (4 males, 2 females; all >18 years) received AZA–VEN–SOR. Disease setting included 5 R/R and 1 de novo case.Responses after 1 cycle were as follows: one complete response (CR) with MRD negativity in the de novo patient; three complete responses with incomplete count recovery (CRi), of which two achieved MRD negativity; one case of aplasia (in the patient treated with venetoclax for 14 days) who subsequently underwent HSCT and had MRD positivity; and one patient with no response. Overall response rate (ORR = CR + CRi) was 4/6, with MRD negativity achieved in 3 of 5 evaluable patients. Three patients had received prior midostaurin.
Conclusions: In LMIC settings, sorafenib-based triple therapy is an affordable and feasible salvage option in R/R FLT3-ITD AML. While numbers are small, this regimen demonstrated meaningful activity and warrants further evaluation in larger, prospective cohorts. |
| 175 |
Silent cerebral infarcts: A retrospective review of neurological injury secondary to prevalent Sickle Cell Disease. |
1995-10-12 |
Female |
No |
- | 52426 |
Benign |
Anemia |
Clinical |
|
Pratima Patil |
B J Wadia Children's Hospital |
Mumbai |
08554999712 |
pratimapatil75@gmail.com |
Oral |
Silent cerebral infarcts: A retrospective review of neurological injury secondary to prevalent Sickle Cell Disease.
Dr. Pratima Patil, Dr. Sangeeta Mudaliar, Dr. Purva Kanvinde, Dr. Ritika Khurrana, Dr. Sreyashi Biswas
Department of Paediatric Hematology, B J Wadia Children’s Hospital, Mumbai
Introduction: Sickle cell disease (SCD), particularly homozygous sickle cell anemia (HbSS), is associated with a significantly increased risk of ischemic stroke in children, primarily due to cerebrovascular vasculopathy. Early detection of stroke risk is critical in improving outcomes and preventing irreversible neurological damage.(1) TCD enables timely identification of high-risk individuals, allowing for early intervention with transfusion therapy or, in select cases, hydroxyurea or hematopoietic stem cell transplantation.
Objective: To evaluate the role of Transcranial Doppler (TCD) ultrasonography in the screening and management of stroke risk in children with sickle homozygous disease.
Methods: A 5-year retrospective study of the patients enrolled with Homozygous Sickle Cell Disease with Transcranial Doppler to screen for cerebral infarcts. TCD is a non-invasive, bedside technique used to measure blood flow velocities in the cerebral arteries. In SCD patients, elevated velocities—particularly in the middle cerebral and internal carotid arteries—are indicative of arterial stenosis and increased stroke risk. TCD with PSV >120 cm/s had shown CNS events.
Results: Out of 40 Sickle Homozygous children enrolled from 2020-2025, 4 patients presented with CNS event (10%), 10 (25%) children had abnormal TCD readings on annual screening. 3 out of 4 who presented with CNS event (75%) required Exchange transfusion in PICU, had abnormal TCD at presentation and gradually normalized over every 8 weekly follow-up TCD.
Conclusion: TCD is an essential, evidence-based tool in the prevention of stroke in children with homozygous sickle cell disease. Its implementation has led to a significant reduction in primary stroke incidence and should remain a cornerstone of comprehensive SCD management programs. Children with abnormal TCD values underwent MRI Brain preemptively to look for any silent cerebral infarcts without any neurological manifestations.
Keywords: Sickle cell disease, TCD, Cerebral infarct
|
| 176 |
CLINICAL PROFILE AND TREATMENT OF PATIENTS WITH IMMUNE THROMBOCYTOPENIA IN A TERTIARY CARE CENTER |
1992-05-10 |
Female |
No |
- | pay_R |
Benign |
Platelet disorders |
Clinical |
Shilpa prabhu, Akshata Nayak U , Sharat Damodar |
Anusha Reddy |
Narayana Hrudayalaya bengaluru |
Bengaluru |
8971551858 |
anusha.micro9@gmail.com |
Oral |
Title: CLINICAL PROFILE AND TREATMENT OF PATIENTS WITH IMMUNE THROMBOCYTOPENIA IN A TERTIARY CARE CENTER
Authors: Anusha Reddy , Shilpa prabhu, Akshata Nayak U ,Sharat Damodar
Introduction: In our study we assessed the clinical and laboratory profile of Primary ITP among adults , which included parameters such as the incidence, age sex distribution among adults, various modes of presentation, correlation between thrombocytopenia & bleeding manifestations modalities of treatment and response of the patients
Methods: This prospective observational study included 85 adult primary ITP patients diagnosed between January 2023 to 2025 data on clinical features, first- & second-line treatment responses, and adverse effects were collected. Responses were assessed at 1, 3, 6, and 12 months
Results: Median age was 37 years with Females being 66% of the population. Common bleeding manifestations were Petechiae (88.2%), purpura (64.7%), epistaxis (37.6%).Initial therapy was Steroids alone (40%), Steroid + IVIG (50.6%), Upfront TPO-RA (9.4%).Response rates at 1 month, over half (54.1%) achieved complete response (CR) to initial therapy, & 1./3rd (34.1%) had partial response (PR).By 3 months, CR remained stable (52.9%), but 10.6% had relapsed, indicating the need for close follow-up. At 6 months, the best overall response was noted: 65.9% CR and only 2.3% non-responders, showing the benefit of timely second-line therapy in relapsing patients .By 12 months, 87.1% (CR + PR) of patients had an effective platelet response, with very low refractoriness (1.2%).Relapse rates remained steady at ~11.8% after 3 months. Second-line therapy included eltrombopag, rituximab, azathioprine/MMF/CSA. Eltrombopag showed best sustained CR (82.1%) at 12 months.
Conclusions: Steroids remain an effective first-line therapy for adult ITP, inducing remission in over 50% at 1 month. TPO receptor agonists, especially eltrombopag, show excellent efficacy and safety and are viable second-line options even in early or upfront settings.
Keywords-Immune thrombocytopenia, Platelet count , second line therapy |
| 177 |
Pediatric Acute promyelocytic leukemia : A case series highlighting the rare entity |
1996-10-15 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. P singh, Dr. C Pathak, Dr. M singh |
Dr. Arunkumar M |
Vardhman mahavir medical college and Safdarjung ho |
New delhi |
9610449846 |
Arun.eee417@gmail.com |
Oral |
Title of Paper
Pediatric Acute promyelocytic leukemia : A case series highlighting the rare entity.
Introduction:
Acute Promyelocytic Leukemia (APML) is a distinct subtype of acute myeloid leukemia defined by the PML::RARA fusion gene resulting from a characteristic translocation. Although more frequent in adults, APML is rare in children, representing only a minor proportion of pediatric leukemias. Early recognition is vital due to the high risk of fatal coagulopathy if diagnosis and treatment are delayed. This case series presents the clinical features, hematological morphology and immunophenotypic profile of pediatric APML.
Methods:
Four newly diagnosed pediatric cases over one year were studied, each confirmed to harbor PML::RARA rearrangement. Evaluation included peripheral blood smear, bone marrow aspirate cytomorphology, and multiparameter flow cytometry.
Results:
The mean age at presentation was between 7 and 12years. One patient demonstrated deranged coagulation, while three had leukocytosis with thrombocytopenia. Morphology revealed two hypergranular (classic) and two microgranular variants, with bone marrow findings consistent with WHO criteria. Flow cytometry findings confirmed the immunophenotyping of APML in which one microgranular case co-expressed CD34, while other hypergranular case showed aberrant expression of HLA-DR, CD34, and TdT markers associated with higher-risk disease and poor prognosis.
Conclusion:
Although cytogenetic confirmation is essential, flow cytometry provides rapid recognition of APML, which is crucial in resource-constrained settings where timely intervention can be lifesaving. This series highlights the variability of immunophenotypic expression in pediatric APML and emphasizes the association of CD34 with the microgranular variant. Timely identification through flow cytometry plays a pivotal role in enhancing survival in this uncommon but aggressive pediatric leukemia.
Keywords:
APML, PML: RARA, flow cytometry, immunophenotyping, microgranular, hypergranular, aberrant expression
|
| 178 |
Development and validation of an ELISA based protocol to detect plasma anti-asparaginase IgG in paediatric patients with Acute Lymphoblastic Leukaemia |
1997-11-19 |
Female |
No |
- | 12345 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Srijani Goswami 1, Annwesha Roy 1, Trina Dutta 1, Bishwaranjan Jana 1, Bony Dasgupta1 , Asmita Ganguly 1, Neerajana Datta 1, Pritam Singha Roy 2, Mayur Parihar 1,, Shekhar Krishnan 1, 2 1 Tata Translational Cancer Research Centre, Tata Medical Center, Ko |
Srijani Goswami |
Tata Translational Cancer Research Centre, Tata Me |
KOLKATA |
7003425584 |
srijanid97@gmail.com |
Oral |
Title: Development and validation of an ELISA based protocol to detect plasma anti- asparaginase IgG in paediatric patients with Acute Lymphoblastic Leukaemia
Introduction: L-asparaginase therapy for paediatric Acute Lymphoblastic Leukaemia (ALL) is frequently complicated by clinical hypersensitivity and drug-inactivation (silent-inactivation), potentially driven by anti-asparaginase antibodies (AAA). Limited progress in addressing this issue stems from the unavailability of commercial immunogenicity testing kits. To overcome this challenge, we developed a custom ELISA for detecting AAAs in clinical setting, facilitating timely drug discontinuation and/or shifting to alternative drug formulations to minimise toxicities and improve treatment outcomes.
Methods: MaxiSorp microplates were coated with PEGylated-asparaginase (PEGasp) and 5-methoxy polyethylene glycol (PEG) at six concentrations to optimise antigen coating. AAA detection employed goat anti-human IgG secondary antibody at four dilutions (1:1000–1:20,000). Assay linearity was assessed using normal human plasma (NHP) and plasma from a hypersensitive patient (dilutions 1:200–1:25,600). Negative controls included plasma from 23 healthy volunteers and 22 drug-naïve ALL patients. Antibody positivity was defined as >1.5× the third quartile of controls at OD450. Patients negative for IgG were additionally screened for IgM and IgE using HRP-conjugated secondary antibodies specific for the isotypes.
Results: Optimal antigen coating was 1 µg/mL for both PEGasp and PEG, with secondary antibody dilutions of 1:1000 and 1:5000, respectively. Linearity was maintained across 1:800–1:3200 plasma dilutions. ROC analysis identified 1:3200 as the reporting dilution, with positivity cutoffs of ≥0.123 (PEGasp) and ≥0.146 (PEG). Inter and intra-assay variability remained <20%. The assay detected AAA in 6/8 hypersensitivity cases and 13/13 silent-inactivation cases. No significant differences were observed in IgM or IgE isotypes among IgG-negative patients which requires further evaluation.
Conclusion: The validated ELISA reliably detects AAA against PEGasp and PEG in patients experiencing drug-inactivation, providing a valuable co-diagnostic tool to support clinical decision-making.
Keywords: ALL, Asparaginase, silent-inactivation, ELISA, anti-drug antibodies, co-diagnostics |
| 179 |
Predictive significance of early bone marrow MRD response assessment in acute myeloid leukemia patients treated with venetoclax plus decitabine induction therapy: real-world data from India |
1994-07-06 |
Male |
Yes |
L-2211 | T2508 |
Malignant |
Leukemia & lymphoma |
Clinical |
Reshma Benson1, Paras Satadeve1, Adamya Gupta1, Bibhant Shah1, Prisla Maria Dalton1, Kavya Ronanki1, Karthik kumar1, Sashi Kant Singh1, Jhasaketan Nayak1, Nikhil Nagpal1, Neha Singh2, Harish Chandra2, Uttam Kumar Nath1 1 Department of Medical Oncology, He |
ARJUN KACHHWAHA |
AIIMS Rishikesh |
RISHIKESH |
9074756344 |
drarjunk95@gmail.com |
Oral |
Title: Predictive significance of early bone marrow MRD response assessment in acute myeloid leukemia patients treated with venetoclax plus decitabine induction therapy: real-world data from India. Introduction: The standard 3+7 regimen for acute myeloid leukemia (AML) is not feasible for many patients due to advanced age or poor performance status. Venetoclax (VEN) with hypomethylating agents (HMA) has emerged as an alternative low-intensity regimen. Methods: Seventy-two newly diagnosed AML patients treated between February 2023 and June 2025 received venetoclax (100 mg/day for 14 days) with decitabine. Bone marrow morphology and flow cytometric MRD were assessed on day 14 and after two cycles. G-CSF was given post-day 14. Responders received either high-dose cytarabine consolidation or continued VEN+decitabine. Results: Median age was 42.5 years; 60% were female. ELN 2022 risk categories were favourable (27%), intermediate (54%), and adverse (19%). FLT3 (24%) and NPM1 (23%) mutations were most frequent; 50% had a normal karyotype. At presentation, ECOG was 3–4, with median hemoglobin 7.1 g/dL, WBC 37.4×10⁹/L, and platelets 47.2×10⁹/L. Day 14 marrow showed <5% blasts in 22% and MRD negativity in 8%. After two cycles, 46% achieved CR/CRi and 38% attained MRD negativity. Median cycle interval was 40 days. Thirteen percent died in cycle 1 and 4% in cycle 2. Thirty percent required escalation to 3+7, 29% received cytarabine consolidation, and 25% continued VEN+decitabine. Allogeneic transplant was performed in 4.2%. Major baseline complications included invasive fungal infection (78%) and tumor lysis (24%). Hematologic toxicities included grade 4 anemia (89%), thrombocytopenia (91%), and febrile neutropenia (64%). Non-hematologic toxicities included pneumonia (84%) and septic shock (70%). At median 9-month follow-up, 53% were alive, 48% in remission, with relapse in 12%. Median overall survival was 17 months (95% CI, 9–25). Conclusions: Generic VEN+decitabine was effective and tolerable in AML patients unfit for intensive induction, with manageable toxicities. |
| 180 |
Tolerability and Efficacy of Lenalidomide Maintenance Post-Autologous Stem Cell Transplant in Relapsed/refractory Hodgkin Lymphoma |
1993-04-30 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Anu Korula |
Dr Velagapudi Sai Rajesh |
Christian Medical college |
Vellore |
09494606828 |
sairajesh499@gmail.com |
Oral |
Title: Tolerability and Efficacy of Lenalidomide Maintenance Post-Autologous Stem Cell Transplant in Relapsed/refractory Hodgkin Lymphoma
Introduction: Approximately 20-30% of patients who undergo autologous stem cell transplant (ASCT) for relapsed/refractory Hodgkin lymphoma (R/R HL) will relapse. Lenalidomide maintenance at 25mg (28/28) as a post-ASCT strategy to reduce relapse is associated with hematological toxicity, however there is no data on the efficacy/tolerability of lower doses.
Methods: Retrospective analysis of post-ASCT outcomes in R/R HL between January 2010-December 2023, stratified by risk (High risk (HR) vs Standard risk (SR)) and lenalidomide maintenance (Yes/No). HR definition - any one criteria (1) Primary refractory (2) early relapse (<1year post-primary therapy) (3) ≥2 salvage regimens pre-transplant (4) not in CR prior to ASCT. Lenalidomide dose was either 10mg or 20mg (21/28) at physician discretion. Patients who relapsed <3months post-ASCT were excluded from outcome analysis.
Demographics, toxicities and outcomes were collected from electronic medical records.
Results: 145 pateints underwent ASCT for R/R HL (HR n=125 and SR n=20). In the HR group, 6 patients relapsed <100 days post-ASCT. In 17/119 (14.2%), lenalidomide maintenance was used at doses 10mg (n=11) and 20mg (n=6), with median duration of therapy 619 days (range 74-1849). Hematologic toxicity included anemia (11%), neutropenia (28%), and thrombocytopenia (17%), with grade 4 toxicity in 1 patient resulting in discontinuation.
The 2-year progression-free survival (PFS) in the lenalidomide group was 81.6 + 9.6% versus 75.5 + 4.4% in those who did not receive lenalidomide (p=0.996), with median days to relapse 467 versus 270 respectively. The 2-year PFS was 94.7 + 5% in the SR group.
Conclusions: Lenalidomide maintenance post-ASCT was well tolerated with manageable hematologic toxicities, though in this retrospective cohort it did not prolong 2-year PFS in high-risk patients. Whether longer-duration/indefinite lenalidomide therapy would reduce relapse risk should be studied in prospective trials. |
| 181 |
A single centre prospective observational study to compare the outcomes and toxicities of Azacitidine + Venetoclax (AZA + VEN) with 3+7 induction chemotherapy (IC) with Cytarabine and Daunorubicin in patients with Acute Myeloid Leukemia (AML) |
2000-11-06 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Manju Sengar, Arvind Vaidyanathan, Hasmukh Jain, Alok Shetty, Lingaraj Nayak, Bhausaheb Bagal, Meghana C S, Shafak Madan, Namrata Bhostekar, Mahwash Fatima Syed & Department of Medical Oncology, Adult Hematolymphoid Unit, Tata Memorial Hospital, Parel, Mu |
Girish B S |
Tata Memorial Hospital |
Mumbai |
7026878236 |
girishsharma70268@gmail.com |
Poster |
Introduction: AML induction with 3+7 (IC) regimen is limited to patients with good performance status, organ function and absence of severe infections. In India, induction-mortality ranges from 10-25%, compounded by significant financial burdens from extensive supportive care. Azacitidine-Venetoclax (Aza-Ven) has emerged as an option for patients ineligible for IC-induction. Considering the resource & logistical-constraints in our country, this study was conducted to compare the outcomes and toxicities of IC versus Aza-Ven in newly diagnosed AML patients.
Methodology: This prospective observational study enrolled de-novo, treatment naïve AML patients aged ≥18-years, assigned to IC or Aza-Ven per the joint-clinic decision. Patient unwilling to participate were excluded. The primary endpoint was induction-related mortality, with secondary endpoints of grade 3/4 AE, change in QoL (FACT-Leu-V4), treatment costs, time-toxicity and CR-rates (assessed post-one-cycle of Aza-Ven and one-course of IC).
Results: 135 participants were included, with 63 in IC & 72 in Aza-Ven group. ECOG ≥2 (29.1% vs 11.1%), poor-risk AML (12.7% vs 37.5%) and baseline fungal pneumonia (3.2% vs 51.4%) were more in Aza-Ven group. Induction-related mortality was comparable between the groups (7.9% vs 8.3%). Febrile neutropenia (95.2% vs 80.6%), mucositis (69.8% vs 11.1%), diarrhoea (60.3% vs 15.3%) and grade>2 non-haematological toxicities (66.7% vs 20.8%) occurred more with IC. No significant change in the QoL between the groups. Mean cost was 275180.1 (29165–1289039) in IC and 242750.18 (22449–1438309) in Aza-Ven. Time-toxicity (24.13±3.391 vs 18.93±5.58 days) and hospitalization days (22.13±5.42 vs 7.82±9.87) were higher in IC. CR/CRi post-induction were higher in IC (74.6% vs 43.1%), including CR (28.6% vs 12.5%) and flow MRD-negativity (68.3% vs 27.8%).
Conclusion
3+7 remains the standard for medically-fit patients with AML, however for those who are unfit, Aza-Ven represents a reasonable alternative, offering acceptable CR-rates while balancing the efficacy with patient safety and resource-constraints.
Keywords: AML, Azacitidine-Venetoclax, Intensive-Chemotherapy. Treatment Outcomes
|
| 182 |
When broken red cells whisper cancer: The haematological disguise |
1992-11-14 |
Female |
Yes |
L-2293 | H_LKO |
Benign |
Anemia |
Laboratory |
Dr Diva Sutreja (Fellow in diagnostic haematology), Dr Anuja Patil (Assistant professor), Dr Rachana Lakhe (Associate professor), Dr Amit R Nisal (Professor, Lab Director), Department of Pathology, Bharati Vidyapeeth (Deemed to be University) Medical Col |
Dr Srilekha |
Bharati Vidyapeeth (Deemed to be University) Medic |
Pune |
9663028331 |
lekha.ach@gmail.com |
Poster |
Title: When broken red cells whisper cancer: The haematological disguise
Introduction: Cancer-associated thrombotic microangiopathy (Ca-TMA) refers to a group of disorders characterized by microvascular thrombosis, thrombocytopenia, and ischemic end-organ damage. TMA patients with malignancy results from cancer-related coagulopathy or tumor-induced TMA (Ti-TMA) as a paraneoplastic syndrome or as an adverse effect of anticancer drugs (drug-induced TMA or Di-TMA). Ca-TMAs are more likely to involve respiratory symptoms and bone pain at presentation and have an inadequate response to plasma exchange. The objective of the present narrative is to provide a general perspective in diagnosis that allow clinicians to manage TMA in patients with solid tumors who develop anemia and thrombocytopenia due to frequent overlapping causes.
Methods:
Case 1: A 44-year-old female, presented with progressive dyspnoea, weakness, tachycardia and anorexia. She had thrombocytopenia with 49,000/cumm platelets and severe anaemia of 6.6 g/dl hemoglobin. Peripheral smear suggested leucoerythroblastic anaemia with evidence of haemolysis with schistocyte index of 10%. ADAMTS13 level was 0.09 IU/ml. Bone marrow examination showed myelonecrosis and FNAC from the Virchow’s node showed adenocarcinoma deposits.
Case 2: A 61-year-male, known case of carcinoma colon presented with altered sensorium and cough. Complete blood counts revealed anaemia with evidence of haemolysis, thrombocytopenia and schistocyte index of 3%. Bone marrow examination showed adenocarcinoma deposits.
Results and conclusions: Ca-TMA is not a common presentation of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia. Early diagnosis and differentiation from TTP or atypical hemolytic uremic syndrome help avoid unwarranted plasma exchange or immune-modulating therapies. Disseminated malignancy, especially adenocarcinoma should be suspected in presence of TMA presenting with atypical characteristics of TTP.
Key words: Adenocarcinoma, Cancer associated thrombotic microangiopathy (Ca-TMA), Microangiopathic haemolytic anaemia (MAHA), Thrombotic microangiopathy (TMA), thrombotic thrombocytopenic purpura (TTP), Schistocytes. |
| 183 |
SEASONAL VARIATION IN THE INCIDENCE OF ACUTE PROMYELOCYTIC LEUKEMIA |
1985-07-30 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Prof M Bhattacharyya , Director, IHTM |
Dr Bharti Sahni |
Institute of Hematology and Transfusion Medicine |
kolkata |
7870114833 |
drbsahni3007@gmail.com |
Oral |
Title: SEASONAL VARIATION IN THE INCIDENCE OF ACUTE PROMYELOCYTIC LEUKEMIA
Introduction: Acute promyelocytic leukemia (APL) is a biologically and clinically distinct subtype of acute myeloid leukemia. Etiological and seasonal factors that play a role in APL are still unclear.
Methods: A retrospective, observational study based on APL record at the Institute of Hematology and Transfusion Medicine June 2009 to August 2025 was processed. The collected data of 67 diagnosed (APL) patients at this centre for 16 years was analysed, and APL presenting in each month of the year was also assessed for any evidence of seasonal variation in incidence.
Results: Sixty seven cases of APL were included in this study: The mean age was 28.1 ± 14.4 years (minimum 15 and maximum 45). We found a pronounced peak of APL occurrence in December and January (within winter months) 41/67 (61.1%) which declined to an average of 4/67 (5.97%) in February to April months, further declining to 2/67 (2.98%) patients in August and September. This trend was repeated periodically through all studied 16 years.
Conclusions: Seasonal pattern of APL was observed. Investigation of specific seasonal risk factors would be informative in explaining the etiology behind the observed seasonal variation.
Key words: Acute Promyelocytic Leukemia, Seasonal , Incidence |
| 184 |
Megakaryocytic Morphometry in Myeloproliferative Neoplasms: Diagnostic and Fibrosis-Linked Signatures |
1995-08-18 |
Female |
No |
- | pay_R |
Malignant |
MPN & MDS/ MPN |
Clinical |
|
Saudamini Agarwal |
Rohilkhand Medical College and Hospital |
Bareilly |
8052566999 |
saudamini.agarwal@yahoo.com |
Oral |
Title: Megakaryocytic Morphometry in Myeloproliferative Neoplasms: Diagnostic and Fibrosis-Linked Signatures
Introduction: Megakaryocyte (MK) morphology and marrow fibrosis are central to the diagnosis of myeloproliferative neoplasms (MPNs). In chronic myeloid leukemia (CML), bone marrow trephines typically demonstrate increased small, hypolobated (“dwarf”) MKs in loose clusters, usually with absent or minimal fibrosis in chronic phase, though higher grades may occur in advanced disease. Reactive marrows, by contrast, show morphologically normal MKs without abnormal clustering. Despite their diagnostic relevance, MK features are usually described qualitatively, leading to inter-observer variability. Incorporating structured evaluation and morphometric analysis may improve objectivity and reproducibility.
Methods: This is a retrospective, cross-sectional pilot study being conducted in the Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly. Archived bone marrow trephines diagnosed as MPNs are being compared with reactive controls. Inclusion requires ≥15 evaluable MKs and an interpretable reticulin stain; poorly preserved biopsies are excluded. MK morphology is being assessed for size, nuclear lobulation, cytoplasmic granularity, clustering, and distribution, with correlation to reticulin fibrosis grades. In parallel, digital morphometric analysis is being performed to measure cell diameter, cell area, and clustering indices. Clinical and hematological parameters, including platelet counts, are being recorded. Per-case medians and interquartile ranges are being derived. Planned analyses include group-wise comparisons, correlations with fibrosis and platelet counts, and evaluation of inter-observer reproducibility. The findings will be used to identify reliable diagnostic features and to propose a composite MK scoring framework for validation in future studies.
Results: The study is ongoing, and morphologic and morphometric data are being compiled.
Conclusions: This pilot is expected to yield insights into the diagnostic and fibrosis-linked significance of megakaryocytic alterations and may provide the basis for a reproducible scoring framework in MPNs.
Key words: Megakaryocytes, morphometry, chronic myeloid leukemia, fibrosis, scoring system |
| 185 |
Demographic and Molecular Profile of Acute Myeloid Leukemia: A Real-World Experience from Eastern India Compared with International Cohorts |
1995-01-20 |
Female |
No |
- | 52422 |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Priyanka Samal |
Dr. Anchal Tandon |
IMS & SUM |
Bhubaneswar Urban |
08057546947 |
tandonanchal2@gmail.com |
Oral |
Title: Demographic and Molecular Profile of Acute Myeloid Leukemia: A Real-World Experience from Eastern India Compared with International Cohorts
Introduction: Acute Myeloid Leukemia (AML) exhibits marked heterogeneity in clinical and molecular characteristics. While Western registries report a median age of ~65 years with well-defined mutation frequencies, Indian data suggest younger onset and distinct genomic patterns.
Methods: We retrospectively analyzed 128 AML patients (excluding APL) diagnosed at a tertiary center in Odisha (Jan 2023–Dec 2024). Clinical, cytogenetic, and molecular profiles were compared with international datasets (SEER, ELN) and Indian cohorts.
Results:The median age was 45 years (range 17–75), nearly two decades younger than Western cohorts, with a male:female ratio of 1.2:1. Mutational analysis revealed NPM1 (14.8%), FLT3 (18%), t(8;21) (5.5%), and absence of inv(16). TP53/complex karyotype was rare (<5%). Compared with international cohorts, NPM1 was significantly under-represented, while t(8;21) was slightly enriched.
Conclusions: AML in Eastern India demonstrates earlier presentation and a distinct mutational landscape, notably lower NPM1 frequency and absent inv(16). These findings highlight the need for region-specific risk stratification and adaptation of global prognostic models.
Key words: AML, NGS, Demography, Molecular profile. |
| 186 |
Unmasking Plasma cell leukemias: Diagnostic challenges in a rare and aggressive entity |
1994-08-25 |
Female |
No |
- | H_LKO |
Malignant |
Rare hematological malignancies |
Clinical |
|
Mavara Elahi Dad |
Heritage Institute of Medical Sciences |
Varanasi |
7985473316 |
elahimavara74gmail.com |
Poster |
Title : Unmasking plasma cell leukemia : Diagnostic challenges in a rare and aggressive entity
Mavara Elahi Dad , Neeraj Singh, Ila Singh, Vatsala Kishore, Ajamal Singh Bhayal
Background : Plasma cell leukemia is a rare and aggressive variant of multiple myeloma characterized by the presence of circulating plasma cells in peripheral blood. It accounts for less than 5 % of all the plasma cell dyscrasias and presents with distinct clinical, laboratory and prognostic features. Early diagnosis is crucial due to its rapid progression and poor prognosis.
Case presentation: A 50 years male presented with complaints of fatigue and bodyache from one month and shortness of breath from 2 days. His blood workup was suggestive of pancytopenia and general blood picture showed anisopoikilocytic normochromic blood picture (Dimorphic anemia) along with thrombocytopenia grade 3 with leucopenia and presence of atypical plasmacytoid cell population.
Bone marrow aspirate taken from sternum was cellular for age and revealed plasma cells increased in number (95%) showing high nucleocytoplasmic ratio, eccentric nuclei and conspicuous nucleoli. Bone marrow biopsy taken from right posterior superior iliac spine showed dense population of atypical plasmacytoid population having high nucleocytoplasmic ratio, conspicuous nucleoli and rim of basophilic cytoplasm suggestive of Plasma cell leukemia
The diagnosis was confirmed by flow cytometry showing CD38 +, CD 138+, CD 56- phenotype.
Conclusion: Plasma cell leukemia is a rare and aggressive malignancy that poses significant diagnostic challenges. Early recognition and standardized diagnostic approaches are vital for timely treatment and improved outcomes.
Keywords: Atypical plasmacytoid population, Plasma cell dyscrasia |
| 187 |
The Study of Serum Homocysteine Levels in Cases of Diffuse Cutaneous Systemic Sclerosis |
1998-12-02 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Dr B K Kundu, Professor, Department of General Medicine, ABVIMS and Dr.Ram Manohar Lohia Hospital, New Delhi-110001.Dr Vijay Kumar, Professor and Head, Hematology and Clinical Pathology Unit, Department of Pathology, ABVIMS and Dr Ram Manohar Lohia Hospit |
Dr Lakkadasu Sai Vineela |
ABVIMS and Dr Ram Manohar Lohia Hospital, New Delh |
New Delhi |
9550586722 |
lakkadasuvineela@gmail.com |
Oral |
Title :The Study of Serum Homocysteine Levels in Cases of Diffuse Cutaneous Systemic Sclerosis
Introduction: Diffuse cutaneous systemic sclerosis (dcSSc) is a severe autoimmune disorder characterized by fibrosis and vascular dysfunction. Homocysteine, a sulfur-containing amino acid, is increasingly recognized for its role in endothelial dysfunction, inflammation, and fibrosis, making it a potential biomarker for disease activity in dcSSc.
Methods :This cross-sectional observational study included 30 patients with dcSSc diagnosed per ACR/EULAR 2013 criteria at a tertiary care centre from February 2024 to June 2025. Data collected included clinical history, Modified Rodnan Skin Score (MRSS), inflammatory markers (ESR, CRP), HRCT findings, RVSP measurements, and serum homocysteine levels. Homocysteine ≥15 μmol/L was considered elevated. Statistical analysis was performed using R software; p < 0.05 was considered significant.
Results: The mean serum homocysteine level was 13.82 ± 6.38 μmol/L, with 30% of patients exhibiting hyperhomocysteinemia. Elevated homocysteine levels were significantly associated with higher MRSS scores (mean: 36.56 vs. 30.48; p = 0.048), elevated ESR (mean: 42.67 vs. 30.90 mm/hr; p = 0.022), and increased RVSP values (mean: 38.33 vs. 25.99 mm Hg; p = 0.015). NSIP-pattern ILD was more prevalent in patients with raised homocysteine.
Conclusions: Elevated homocysteine levels are associated with greater skin fibrosis, systemic inflammation, and pulmonary hypertension in dcSSc. Homocysteine may serve as a useful, accessible biomarker for disease severity and vascular involvement in systemic sclerosis.
Key words: Systemic sclerosis, homocysteine, MRSS, inflammation, pulmonary hypertension, ILD |
| 188 |
Marrow Masquerade: Metastatic Carcinoma with Prominent Plasmacytosis from an Occult Primary
|
1999-08-17 |
Female |
No |
- | pay_R |
Malignant |
Plasma cell disorders |
Clinical |
Dr Shivanshu Gangwar2; 2Senior Resident, Department of Pathology, ABVIMS, Dr RML Hospital, New Delhi, Dr Garima Rakheja3; 3Assistant Professor, Haematology and Clinical Pathology, Department of Pathology, ABVIMS, Dr RML Hospital, New Delhi, Dr Nagina Agar |
Dr Sukriti, Post Graduate, Department of Pathology ABVIMS, Dr RML Hospital, New Delhi |
ABVIMS, Dr RML Hospital, New Delhi |
Delhi |
7982984080 |
guptasukriti18@gmail.com |
Poster |
Title: Marrow Masquerade: Metastatic Carcinoma with Prominent Plasmacytosis from an Occult Primary
Introduction: Cancer of unknown primary (CUP) accounts for 2–5% of all malignancies. Bone marrow involvement is uncommon and often signals advanced disease. Prominent plasmacytosis in this setting is unusual and may distract from the underlying pathology, adding to the diagnostic challenge of CUP.
Methods: Clinical, imaging, bone marrow morphology, immunohistochemistry (IHC), and serum protein studies were reviewed for an elderly female presenting with systemic lesions and marrow involvement. Literature was examined for reports of plasmacytosis in marrow metastases.
Results: A 65-year-old female presented with weakness, anorexia, abdominal pain, and dyspnea. CECT revealed multiple lesions in lung, liver, adrenals, and bones. Bone marrow aspirate/biopsy demonstrated clusters of malignant epithelial cells with a conspicuous plasmacytosis (~20–30% plasma cells). An extensive IHC panel identified carcinoma cells (pan-CK positive), while plasma cells showed no atypia. Serum electrophoresis and immunofixation excluded monoclonality, confirming the plasmacytosis as reactive. Despite comprehensive evaluation, the primary tumor site remained elusive, and the case was classified as CUP with marrow metastasis. Literature indicates that plasmacytosis in marrow metastases is rare (≈1–3% cases), but can complicate interpretation in CUP.
Conclusions: While plasmacytosis in marrow metastases is not diagnostic of myeloma, it can obscure the true picture in CUP. Careful integration of morphology, extensive IHC, and immunofixation is essential to recognize reactive plasmacytosis and focus on identifying the metastatic carcinoma. Awareness of this masquerade helps avoid misdirection and supports accurate patient management.
Key words: Cancer of unknown primary; bone marrow metastasis; plasmacytosis; diagnostic challenge; immunohistochemistry; immunofixation; marrow biopsy |
| 189 |
Study of Extended Neutrophil Parameters (NEUT-X, NEUT-Y) and Immature Platelet Fraction (IPF) as Early Indicators of Sepsis in Burn Injury Patients |
1996-08-10 |
Female |
No |
- | H_LKO |
Benign |
Infection & supportive care |
Laboratory |
Dr. Vijay Kumar², Dr. Sameek Bhattacharya³, Dr. Garima Rakheja⁴ ² Professor & Head, Haematology & Clinical Pathology Unit, Department of Pathology, ABVIMS & Dr RML Hospital, New Delhi-110001 ³Professor, Head of Department, Dept. of Burns and Plastic Su |
Dr. Divya Tiwari |
ABVIMS & Dr. RML Hospital, New Delhi-110001 |
New Delhi |
9650460217 |
doctordivya10@gmail.com |
Oral |
Title: Study of Extended Neutrophil Parameters (NEUT-X, NEUT-Y) and Immature Platelet Fraction (IPF) as Early Indicators of Sepsis in Burn Injury Patients
Authors:
Dr. Divya Tiwari¹, Dr. Vijay Kumar², Dr. Sameek Bhattacharya³, Dr. Garima Rakheja⁴
Introduction: Burn injuries often progress to sepsis, a major cause of mortality. Early diagnosis is challenging, due to overlap with systemic inflammatory response syndrome (SIRS). Extended neutrophil parameters (NEUT-X, NEUT-Y) and Immature Platelet Fraction (IPF), measurable on automated haematology analysers, may offer rapid, accessible biomarkers for early detection.
Methods: A prospective observational study was conducted on 40 adult burn patients (≥15% Total Body Surface Area) and 40 healthy controls, between August 2022 and February 2024. Patients were categorized as septic or non-septic using American Burn Association criteria. IPF, NEUT-X, and NEUT-Y were analysed on the Sysmex XN-1500 at multiple time points (days 1–21). ROC curves, sensitivity, specificity, PPV, and NPV were calculated.
Results: Sepsis developed in 45% of the 40 burn injury patients, with higher incidence in older individuals (mean age 41years) and in Females (66.7%). Septic patients demonstrated consistently higher IPF (p<0.0001) and NEUT-Y (p<0.0001) values compared to non-septic patients, with differences evident early in the clinical course (<3 days). NEUT-X showed occasional, but less consistent discriminatory power (p=0.105). ROC analysis indicated strong diagnostic potential for NEUT-Y (Sensitivity-66.67%, Specificity- 95.45%, PPV-92.3%, NPV-77.8%) and IPF (Sensitivity-84.62%, Specificity-100 %, PPV-100%, NPV- 91.7%) at specific early time points post-injury.
Conclusion: IPF and NEUT-Y prove to be rapid, cost-effective, and easily obtainable markers for early detection of sepsis in burn patients, while NEUT-X has variable predictive value. Integrating these parameters with conventional sepsis biomarkers could enhance diagnostic accuracy and improve outcomes.
Key words: Burn injury, Sepsis, Immature Platelet Fraction, NEUT-X, NEUT-Y, Biomarkers
|
| 190 |
Next-Generation AI at Your Fingertip: MorphX,A Fingerprick CBC Analyzer with Integrated
Real-Time peripheral Smear examination |
1990-02-10 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
DR. TUSHAR SEHGAL |
DR.MEGHA SHARMA |
NEURANICS LAB PVT LTD |
GURUGRAM, HARYANA |
9717084712 |
meghambbs10@gmail.com |
Poster |
Title: Next-Generation AI at Your Fingertip: MorphX,A Fingerprick CBC Analyzer with Integrated
Real-Time peripheral Smear examination
Introduction:MorphX is an indigenously developed, AI-powered, point-of-care hematology device designed to
deliver rapid and cost-effective CBC results from capillary and venous samples. With increasing
demand for decentralized diagnostics in India, this study aims to assess MorphX’s performance versus
an established automated hematology analyzer at All India Institute of Medical Sciences
(AIIMS),New Delhi.
Methods:This was a prospective, single-center, blinded clinical trial conducted in the Department of Laboratory
Medicine, AIIMS, New Delhi.
● Sample Size: 540 total (500 abnormal leftover patient samples + 40 healthy individuals)
● Comparisons Made:
1. Venous samples on MorphX vs. Sysmex
2. Capillary vs. venous samples on MorphX
● Parameters Evaluated: WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW, PLT,
differential counts
● Statistical Tools: Parameter-wise concordance, correlation coefficients (R²), CV%,
Bland-Altman plots
Results:Preliminary results indicate high correlation of MorphX with Sysmex for key parameters:
● Hemoglobin (R² =0.96 ),TLC (R² = 0.99),Platelet Count (R² =0.8 )
Repeatability (CV%) was under 10% for all major parameters.
● Sensitivity and Specificity is >90 % for anemia detection. Capillary vs. venous sample
concordance was within clinically acceptable limits, establishing the feasibility of MorphX in
finger-prick-based CBC testing. The image-based AI algorithm also successfully flagged
morphologic anomalies including microcytosis and thrombocytopenia with high accuracy.
Conclusions:MorphX demonstrates strong analytical agreement with a standard hematology analyzer and presents
a viable, indigenous point-of-care solution for rapid CBC testing. Its performance with both capillary
and venous samples supports its application in rural, emergency, and community healthcare settings in
India.
Key words:MorphX, CBC analyzer, point-of-care testing, artificial intelligence, hematology, digital pathology,
indigenization, Sysmex comparison |
| 191 |
Comparative Diagnostic Accuracy of Discrimination indices in HPLC confirmed Beta- Thalassemia Trait cases in anaemic pregnant women |
1994-07-08 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
Amit Nisal, Anuja Patil, Reena Bharadwaj |
Abhipsa Raut |
Bharati Vidyapeeth (Deemed to be University) Medic |
Pune |
9938503223 |
abhipsa.raut@gmail.com |
Oral |
Title:
Comparative Diagnostic Accuracy of Discrimination indices in HPLC confirmed Beta- Thalassemia Trait cases in anaemic pregnant women
Authors: Abhipsa Raut, Amit Nisal, Anuja Patil, Reena Bharadwaj
Introduction:
Beta thalassemia trait (BTT) is a common hereditary hemoglobinopathy with significant implications in antenatal women due to the risk of affected offspring. Early detection is essential for genetic counselling and prevention. Various red cell discrimination indices have been proposed to screen for BTT, but their diagnostic accuracy varies. This study aimed to evaluate commonly used indices against high-performance liquid chromatography (HPLC), the gold standard.
Methods:
A total of 849 antenatal women were screened. Complete blood counts were used to calculate various discrimination indices (Mentzer, Shrivastav, Ricerca, Hisham, Shine & Lal, MCHD). HPLC was performed for confirmation of BTT. Sensitivity, specificity, and area under the ROC curve (AUC) were calculated for each index using HPLC as reference.
Results:
Of the 849 women, 67 (7.9%) were confirmed as BTT on HPLC. Among the indices, the Shrivastav Index demonstrated the highest diagnostic accuracy, with ROC curve analysis showing strong sensitivity and specificity. Ricerca, Hisham, and MCHD indices showed moderate performance, identifying some BTT cases but with reduced accuracy compared to Shrivastav. In contrast, the Mentzer and Shine & Lal indices performed poorly, with ROC curves near the reference line, indicating limited reliability in this population.
Conclusions:
Among the evaluated indices, the Shrivastav Index emerged as the most reliable screening tool for BTT in antenatal women, demonstrating high diagnostic accuracy when validated against HPLC. Mentzer and Shine & Lal indices were found to be unreliable in this population. In resource-limited settings, Shrivastav Index may serve as an effective preliminary screening tool before confirmatory HPLC, thereby aiding in cost-effective antenatal screening strategies.
Keywords:
Beta thalassemia trait, antenatal screening, discrimination indices, HPLC, ROC curve, Shrivastav Index
|
| 192 |
HIDE & SEEK: THE DIAGNOSTIC DILEMMA OF T-CELL NODULES |
1997-05-03 |
Female |
No |
- | H_LKO |
Benign |
Marrow failure |
Clinical |
Dr. Taruna Bansal²/ Dr. Subhash Giri ³/ Dr. Vijay Kumar ⁴ ; ²Senior Medical Officer, Haematology and Clinical Pathology Unit, Department of Pathology, ABVIMS & Dr. R.M.L Hospital New Delhi-110001 ; ³Professor and Head of Unit, Department of Medicine, ABV |
Dr. ANURADHA ; Postgraduate Resident, Department of Pathology, ABVIMS & Dr. R. M. L. Hospital New Delhi-110001 |
ABVIMS & Dr. R.M.L. Hospital New Delhi-110001 |
New Delhi- 110001 |
9599610538 |
anu351997@gmail.com |
Poster |
Title: Hide & Seek: The Diagnostic Dilemma of T-Cell Nodules
Introduction: Refractory anemia in young adults require careful evaluation to identify the underlying cause. The possible etiologies such as nutritional deficiencies, autoimmune disorders, chronic infections and haematolymphoid neoplasm must be considered. Notably, Bone marrow T-cell aggregates may mimic malignancy, creating significant diagnostic challenge.
Methods: A 20-year-old female presented to the OPD with complaints of weakness and intermittent loose stools. On Examination the patient was pale. There was no icterus, lymphadenopathy or any organomegaly. The patient underwent a detailed evaluation for persistent anemia, unresponsive to hematinics therapy and multiple blood transfusions. Investigations included complete blood count, peripheral smear, bone marrow aspiration and biopsy, immunohistochemistry panel, autoimmune profile (ANA), high performance liquid chromatography (HPLC), screening of infection markers and abdominal ultrasound.
Results: Peripheral smear revealed moderate anisopoikilocytosis with normocytic normochromic RBCs, a normal leucocyte count with mild shift to left, and adequate platelet count. Bone marrow aspirate findings were unremarkable. The Hb HPLC of the patient was normal and the autoimmune profile was inconclusive. The bone marrow biopsy, however, demonstrated prominence of nodular aggregates of T-cells with scattered background B lymphocyte. No granuloma, dysplasia or blasts were detected. An immunohistochemistry panel of CD34, CD20, CD15, CD30, CD68, CD79a, CD3, CD5, CD4, CD8 was done which suggested a reactive T-cell proliferation.
Conclusions: Reactive T-cell nodular aggregates can be easily misdiagnosed as T cell lymphomas. Clinical and laboratory correlation with careful integration of morphological assessment and immunohistochemistry is essential to avoid overdiagnosis resulting in an unnecessary mismanagement. It highlights the importance of Immunohistochemistry to distinguish between reactive and neoplastic T-cell proliferation, which in turn ensures accurate diagnosis and effective clinical management.
Key Words: Refractory anemia, Nodular aggregates of T-cells, Immunohistochemistry |
| 193 |
Steroids, Sclerosis, and a Sprinkle of Aspirin: Outsmarting Pancytopenia in GHDD |
1998-05-20 |
Male |
No |
- | H_LKO |
Benign |
Marrow failure |
Clinical |
Dr. Archana Rampuri, Senior Resident in the Department of Clinical Haematology, St. Johns Medical College Hospital, Dr. Muhammad Mohsin, Consultant Haematologist, Barnsley Hospital NHS Foundation Trust, Gaurav Raj, Intern, Kempegowda Institute of Medica |
Dr. Tejas S |
St Johns Medical College Hospital |
Bangalore |
8105640452 |
stejas20598@gmail.com |
Oral |
Title: Steroids, Sclerosis, and a Sprinkle of Aspirin: Outsmarting Pancytopenia in GHDD
Authors: Tejas S, Archana Rampuria, Gaurav Raj, Muhammad Mohsin, Seetharam Anandram
Background: Ghosal hematodiaphyseal dysplasia (GHDD) is a rare genetic disorder characterized by diaphyseal bone dysplasia and corticosteroid-responsive cytopenias. It is an autosomal recessive disorder caused by mutations in the TBXAS1 gene; fewer than 20 cases were reported worldwide. The hallmark feature is prompt response to corticosteroid therapy, distinguishing it from other skeletal dysplasias. Recent advances include the emergence of NSAIDs as targeted therapy. Low-dose long-term NSAID treatment has demonstrated to be effective, offering steroid-sparing alternatives as TBXAS1 metabolises prostaglandin into thromboxane A2, hence hypothesizes the use of NSAIDs.
Case Presentation: We report a 32-year-old male with a 3-month history of progressive dyspnea and fatigue. He received 8 units of packed red blood cells and 30 platelet concentrates prior to presentation. Initial investigations revealed severe pancytopenia (Hb 9.5 g/dL, WBC 4000/μL, platelets 14,000/μL), elevated ferritin (1360 ng/mL). Bone marrow aspiration was technically challenging due to bone sclerosis, with trephine biopsy showing hypoplastic marrow with areas of fibrosis and necrosis. PET-CT demonstrated diffuse osteosclerosis, endosteal thickening and marrow hyperdensity throughout the appendicular skeleton.
Diagnosis and Management: Clinical exome sequencing revealed compound heterozygous mutations in TBXAS1: c.1235G>A (p.Arg412Gln) in exon 11 and c.856C>T (p.Arg286Ter) in exon 9, confirming GHDD. The patient was started on prednisolone 1 mg/kg daily, resulting in gradual improvement in cytopenias over three months (Hb improved to 11.2 g/dL, platelets to 114,000/μL) without further transfusion requirements. Aspirin 150 mg daily was added, facilitating steroid tapering.
Conclusion: GHDD should be considered in patients with refractory pancytopenia with bone sclerosis, particularly in challenging bone marrow aspirations. This case highlights the importance of early recognition and genetic testing enabling targeted therapy with corticosteroids and NSAIDs and excellent steroid-response in GHDD.
|
| 194 |
An Observational Study of Pediatric Fanconi Anemia: Clinical Profile, Cytogenetic Features, and Hematologic Response to Anabolic Steroids. |
1996-05-27 |
Male |
No |
- | pay_R |
Benign |
Marrow failure |
Clinical |
Aditi Agarwal, Priyanka Aggarwal, Vineeta Gupta, Division of Pediatric Hematology Oncology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi |
Chandradeep Srivastava |
Institute of Medical Sciences |
Varanasi |
9695843555 |
chandradeep27051995@gmail.com |
Oral |
Title: An Observational Study of Pediatric Fanconi Anemia: Clinical Profile, Cytogenetic Features, and Hematologic Response to Anabolic Steroids.
Introduction: Fanconi anemia (FA) is a rare inherited bone marrow failure syndrome marked by congenital anomalies, chromosomal instability, progressive pancytopenia, and increased malignancy risk. The objective of this study is to evaluate the clinical, hematologic, and molecular profile of children with FA and assess hematologic response to anabolic steroid therapy.
Methods: A single-center retrospective observational study was conducted on 32 children diagnosed with FA between 2017 and 2025 at a tertiary care center. Diagnosis was confirmed by clinical features, chromosomal breakage analysis, and/or genetic testing. Clinical findings, congenital anomalies, hematologic parameters, and response to steroid therapy were reviewed.
Results: Among 32 patients (19 males, 13 females), the median age at diagnosis was 8.27 years (range: 3–13). MMC test was positive in 25/32 (78.1%). Genetic analysis (available for 14) showed mutations in FANCA (n=5), FANCG (n=2), FANCL (n=1), and FANCE (n=1); no mutations were found in 5 out of 15 cases. Clinical features included café-au-lait spots (66.7%), short stature (60%), abnormal facies (46.7%), thumb/radial anomalies (43.3%), renal anomalies (26.7%), and skin pigmentation (70%). Pancytopenia was present in 90%. Nearly twenty percent of patients with positive MMC had a normal phenotype. Thirty received oxymetholone, and 2 received danazol. Hematologic response (≥50% increase in ≥1 cytopenia within 6 months) was seen in 21/32 (65.6%); 19/30 on oxymetholone and 2/2 on danazol. Adverse effects included mild virilization (n=2), hypertension (n=1), and peliosis hepatitis (n=1), managed conservatively
Conclusions: FA shows variable clinical manifestations and progressive marrow failure. Anabolic steroids provide hematologic benefits. MMC testing remains a useful diagnostic tool; genetic analysis aids in subtype classification and therapy planning.
Keywords: Fanconi anemia, Pediatric bone marrow failure, Chromosomal breakage analysis, Anabolic steroid therapy |
| 195 |
When Blasts Don’t Mean Leukemia: The Enigma of Transient Abnormal Myelopoiesis in a Neonate with Down Syndrome |
1993-01-15 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. EPSHITA DAS, Dr. NEHA AGGARWAL, Dr. NEELAM SAHANI, Dr. CHINTAMANI PATHAK |
Dr. PRABHAT KUMAR |
Vardhman Mahavir Medical College, New Delhi |
New Delhi |
7895246665 |
prabhat008k@hotmail.com |
Poster |
Title: When Blasts Don’t Mean Leukemia: The Enigma of Transient Abnormal Myelopoiesis in a Neonate with Down Syndrome
Authors: Dr. Prabhat Kumar, Dr. Epshita Das, Dr. Neha Aggarwal, Dr. Neelam Sahani, Dr. Chintamani Pathak
Introduction: Transient abnormal myelopoiesis (TAM) is a preleukaemic syndrome characterized by clonal proliferation of megakaryoblasts affecting 10-30% neonates with Down syndrome. It manifests with circulating blasts, cytopenias, or organomegaly. Although self-resolving in the majority, TAM may engender severe complications including hepatic fibrosis, coagulopathy, and multi-organ failure. One-third cases subsequently evolve into acute megakaryoblastic leukaemia, underscoring the imperative of early detection and vigilant surveillance.
Methods: A 34-week preterm female neonate, weighing 2.2 kg, with features of Down syndrome presented with respiratory distress, sepsis, right-sided pleural effusion, jaundice and hepatosplenomegaly. Hematological evaluation revealed anemia, marked leucocytosis with 76% blasts on peripheral smear examination. Flow cytometry (FCM) established megakaryoblastic lineage of these blasts. Management comprised of CPAP, followed by intubation and ICD insertion for effusion along with antibiotics, phototherapy, and blood transfusion. Subsequent evaluation demonstrated a progressive decline in leukocyte counts, consistent with the transient nature of the disorder. Karyotyping established trisomy 21. Tandem mass spectrometry was unremarkable. A final diagnosis of Transient Abnormal Myelopoiesis was established.
Results: TAM can masquerade as acute leukemia, presenting with leukocytosis, serous effusions, and multi-organ involvement that create a treacherous diagnostic pitfall. Despite being designated “transient,” its clinical trajectory is unpredictable and occasionally fulminant. FCM aided the diagnosis by demonstrating the megakaryoblastic lineage. This case exemplifies that TAM, though self-resolving, necessitates heightened clinical vigilance, meticulous monitoring, and diligent follow-up to anticipate leukemic progression.
Conclusions: TAM mandates prompt recognition, not merely to obviate unwarranted chemotherapy but also to facilitate timely anticipation of leukemic evolution and thereby optimize survival outcomes.
Key words: Transient abnormal myelopoiesis, Down’s syndrome, FCM, AML |
| 196 |
Marrow Speaks, Enzymes Murmur: The Enigma of Niemann–Pick with Chitotriosidase Pseudodeficiency |
1996-10-16 |
Male |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
1. Dr Garima Rakheja-2Assistant Professor, Haematology and Clinical Pathology Unit, Department of Pathology ABVIMS & Dr. Ram Manohar Lohia Hospital New Delhi-110001 |
Aiman Zahid |
ABVIMS and Dr Ram Manohar Lohia Hospital, Delhi |
Delhi |
8178761032 |
aimanzahid1610@gmail.com |
Poster |
Title: Marrow Speaks, Enzymes Murmur: The Enigma of Niemann–Pick with Chitotriosidase Pseudodeficiency Introduction: Lysosomal storage disorders (LSDs) may reveal characteristic marrow findings, yet diagnosis can be obscured when histochemistry and enzyme assays appear discordant. This case highlights such a diagnostic enigma. Methods: A 24-year-old female with transfusion history, severe cytopenias, and massive splenomegaly was initially suspected to have immune-mediated cytopenias due to positive direct and indirect Coombs tests (DCT/ICT). Complete blood counts (CBC), bone marrow examination with special stains, and lysosomal enzyme assays were performed. Results: CBC showed pancytopenia with hemoglobin 3 g/dL, total leukocyte count ~1,000/µL, and platelets ~30,000/µL, along with macrocytosis. Marrow aspirate and biopsy demonstrated infiltration by foamy histiocytes replacing hematopoiesis. Periodic acid–Schiff (PAS) staining was strongly positive and diastase resistant, a finding described in fewer than 10% of Niemann–Pick disease type C (NPC) cases. Although NPC is a trafficking defect due to NPC1/NPC2 mutations affecting intracellular lipid transport rather than sphingomyelinase activity, abnormal accumulation of secondary glycolipids and glycoproteins can occasionally result in PAS positivity. Enzyme assays showed normal β-glucosidase, excluding Gaucher disease, and normal acid sphingomyelinase, excluding Niemann–Pick disease types A and B (NPA/B). DCT and ICT positivity, likely transfusion related, were initially misleading. Crucially, chitotriosidase activity was undetectable, consistent with a pseudodeficiency allele present in ~5–6% of the population. This explained the discordance between marrow suspicion and apparently “normal” enzyme results. Absence of skeletal deformities, retinal abnormalities, or mucopolysaccharidotic features (MPS) further argued against Gaucher disease, NPA/B, and MPS, narrowing the differential towards NPC. Conclusions: This case highlights NPC’s diagnostic challenges. Rare PAS positivity can mimic Gaucher or mucopolysaccharidoses. Chitotriosidase pseudodeficiency is a critical pitfall masking LSDs. Integrated clinicopathological correlation is essential, with NPC1/NPC2 genetic testing providing definitive diagnosis. Keywords: Niemann–Pick disease typeC (NPC), lysosomal storage disorder(LSD),chitotriosidase pseudodeficiency, periodic acid–Schiff(PAS), bone marrow, splenomegaly, cytopenias |
| 197 |
INFECTIOUS ETIOLOGIES OF PYREXIA OF UNKNOWN ORIGIN: INSIGHTS FROM BONE MARROW DIAGNOSIS |
1994-07-07 |
Female |
No |
- | H_LKO |
Benign |
Infection & supportive care |
Laboratory |
Dr. Rashmi Kushwaha1, Dr. Mili Jain1, Dr. Sanjay Mishra1, Dr. Geeta Yadav1, Dr. S.P. Verma2, Dr. Suresh Babu1 1. Department of Pathology, KGMU, Lucknow 2. Department of Clinical Haematology, KGMU, Lucknow |
Dr. Manisha Jaiswal |
King George Medical University |
Lucknow |
9335681760 |
manishaaqua.jaiswal3@gmail.com |
Poster |
Title: INFECTIOUS ETIOLOGIES OF PYREXIA OF UNKNOWN ORIGIN: INSIGHTS FROM BONE MARROW DIAGNOSIS
Introduction: Bone marrow aspiration (BMA) is primarily used to investigate haematological disorders, but it can also reveal systemic infections, including parasitic infestations. Although rare, the identification of organisms in bone marrow smears can be critical in diagnosing diseases that may not be detected through peripheral blood or serology, especially in patients with prolonged fever, cytopenia, and organomegaly.
Methods: A retrospective study was conducted on 11,263 bone marrow aspiration samples received at King George Medical University over the years 2020 to 2025 till July. All smears were stained with Leishman-Giemsa stain and examined microscopically for the presence of infectious organisms.
Results: Out of 11,263 bone marrow aspirations performed, 31 cases (0.28%) revealed various infectious organisms. The most commonly detected organism was Plasmodium species (19 cases, 61.3%), followed by Leishmania donovani (7 cases, 22.6%), Wuchereria bancrofti (3 cases, 9.7%) and Histoplasma capsulatum (2 cases, 6.4%). Common clinical features among these patients included prolonged fever, hepatosplenomegaly, and pancytopenia. In several instances, bone marrow examination provided the first definitive diagnosis, particularly when peripheral smears and serological tests were inconclusive, highlighting its crucial role in diagnosing infections with atypical presentations.
Conclusions: Parasitic and fungal infections in bone marrow are rare but clinically significant, especially in endemic regions. Careful morphological examination of bone marrow smears can uncover hidden infections and play a pivotal role in timely diagnosis and management. This study underscores the need for awareness among clinicians and pathologists to consider parasitic and fungal causes in patients with unexplained systemic symptoms
Key words: Bone Marrow Aspiration, Infectious Etiologies, Parasitic Infections, Fungal Infections, Cytopenia |
| 198 |
T-Lymphoid Blast Crisis of Chronic Myeloid Leukemia with Aberrant CD33 Expression: A Rare Diagnostic Challenge |
1995-11-27 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Akansha Gautam (SR), Dr Neelam Sahani (PROFESSOR), Dr. Chintamani Pathak (PROFESSOR) |
Dr KRISHNAPRIYA CHANDRAN |
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HO |
New Delhi |
8547081702 |
drkrishnapriyachandran@gmail.com |
Poster |
Title
T-Lymphoid Blast Crisis of Chronic Myeloid Leukemia with Aberrant CD33 Expression: A Rare Diagnostic Challenge
Authors
Dr. Krishnapriya Chandran, Dr. Akansha Gautam, Dr Neelam Sahani, Dr. Chintamani Pathak.
Department of Pathology, VMMC & Safdarjung Hospital, New Delhi
Introduction
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the BCR-ABL1 fusion gene.The disease typically presents in the chronic phase, with only 1–2% of cases progressing to blast crisis, most commonly of myeloid lineage. Among the lymphoid transformations, which account for 20–30% of blast crises, B-cell acute lymphoblastic leukemia (ALL) is more frequently encountered, whereas T-cell lineage involvement is exceedingly rare. We present an unusual case of T-lymphoid blast crisis in a patient with CML, further distinguished by aberrant CD33 expression.
Methods
A 42-year-old male, previously diagnosed with BCR-ABL1 positive CML and on tyrosine kinase inhibitor (TKI) therapy, presented with severe body pain, anorexia, and gastrointestinal bleeding. Hematological evaluation revealed pancytopenia.Peripheral smear demonstrated 70% circulating blasts. Flow cytometry confirmed blasts of T-cell lineage, along with aberrant myeloid marker CD33.
Results
The patient initially responded to TKI therapy clinically. However, subsequent disease progression led to transformation into blast crisis. The presence of T-lymphoid blasts with aberrant myeloid antigen expression highlights the diagnostic complexity and biological heterogeneity of CML progression. This rare entity poses significant challenges in classification and therapeutic decision-making, necessitating combined TKI and ALL-directed chemotherapy approaches.
Conclusion
T-lymphoid blast crisis of CML with aberrant CD33 expression is a rare but clinically important phenomenon. Early recognition is crucial, as it impacts both prognosis and treatment strategy. This case highlights the need for comprehensive immunophenotypic evaluation by flowcytometry in blast crises of CML.
Keywords
Chronic myeloid leukemia, T-lymphoid blast crisis, Aberrant CD33, BCR-ABL1.
|
| 199 |
Prospective Study of Early Nilotinib Switch in Chronic Myeloid Leukemia Patients on Imatinib: Cancer Institute (WIA) Experience |
1983-11-15 |
Male |
Yes |
L-1564 | H_LKO |
Malignant |
MPN & MDS/ MPN |
Clinical |
Jayachandran Perumal Kalaiyarasi, Dept of Medical Oncology, Cancer Institute WIA. Trivadi S Ganesan, Professor Medical Oncology, Chief scientist-Cancer biology, Sri Ramachandra Institute of Higher |
Parathan Karunakaran |
Cancer Institute WIA |
Chennai |
8220773477 |
drparathan@gmail.com |
Oral |
Title: Prospective Study of Early Nilotinib Switch in Chronic Myeloid Leukemia Patients on Imatinib: Cancer Institute (WIA) Experience. Introduction:A significant proportion of Chronic myeloid leukemia patients fail to achieve the 6th month target BCR-ABL <1%. We studied if an early switch to Nilotinib will help them attain MMR early. Methods:A single centre prospective study of untreated patients with CML-CP. Patients were initially treated with Imatinib and those who failed to achieve of <1% BCR-ABL1 transcript (IS) at 6 months were switched to Nilotinib. Results:154 patients were recruited between 2016-2020. Median age was 40 years (range:18-70). SOKAL score was high in 40% of patients. Thirty-six of 154 patients went off protocol therapy by six months. The reasons were break in therapy(16), death(3), use of alternate TKI(2), lost follow up(13) and progression to blast crisis(2). Among the remaining 118 patients, 72% achieved the molecular target of <1% BCR-ABL(IS) at 6 months. Eleven of the 33 patients could not be switched to nilotinib due to kinase domain mutation(6), lost to follow up(4) and consent withdrawal(1). Twenty-two patients were switched to nilotinib. Compliance was affected due to the pandemic in 35% of patients. Overall, patients who had BCR ABL <1% at 6 months achieved MMR in 5.7 months, while who did not achieve BCR ABL <1% and were shifted to Nilotinib took 22 months. At 48 months 95.29% of the entire study cohort had attained MMR. At a median follow up of 88.9 months, the median overall survival was not reached. Overall outcome was to TIDEL II study which analysed a similar research question. Conclusions:An early switch to nilotinib, fails to fully overcome the poor outcomes associated with failure to achieve molecular targets. Imatinib as the frontline therapy for CML in chronic phase remains an attractive option. Keywords: CML, early switch, nilotinib |
| 200 |
Frequency and Clinical Correlates of IKZF1 Deletion in Acute Lymphoblastic Leukemia: A FISH-Based Study |
1989-04-10 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Shailja Rathore1, Praveen Sharma1, Venus Thakur1, Vikash Kaushik1, Anand Balakrishnan1, Richa Jain3, Arihant Jain2, Alka Khadwal2, Amita Trehan3, MUS Sachdeva1, Nabhajit Mallik1, Pankaj Malhotra2, Reena Das1, Sreejesh Sreedharanunni1 1Departments of Hema |
Anshu Anshu |
PGIMER, Chandigarh |
Chandigarh |
9915382470 |
anshusees1089@gmail.com |
Poster |
Title: Frequency and Clinical Correlates of IKZF1 Deletion in Acute Lymphoblastic Leukemia (ALL): A FISH-Based Study
Introduction: IKZF1 (Ikaros) deletion is a recurrent abnormality in ALL, linked with poor prognosis. Most prior studies have used MLPA for detection. Here, we report IKZF1 deletion frequency and clinical correlates using fluorescence in situ hybridization (FISH) and explore its relationship with BCR-ABL1 status.
Methods: Bone marrow samples from 106 ALL patients were evaluated for IKZF1 deletion by FISH. Clinical parameters (age, sex, TLC, BCR-ABL1) were analyzed. Continuous variables were compared using the Mann–Whitney U test, and categorical variables with Fisher’s exact test.
Results: IKZF1 deletion was detected in 35 patients (33%). The male/female was 77/29. Overall cohort had a median age of 11 years (IQR 5–24.8; range 1–79) and median TLC 7.9 ×10⁹/L (IQR 3.3–41.0; range 0.9–32.3). IKZF1-deleted cases were significantly older (median 23, IQR 8.5–32.5) vs non-deleted (median 9, IQR 4–18; p = 0.0035) and had higher TLC (median 19.4, IQR 4.1–61.4 vs 7.39, IQR 3.0–29.4; p = 0.063). Deletion was more frequent in >12 yrs (21/48, 44%) than ≤12 yrs (14/58, 24%; p = 0.039). Importantly, IKZF1 deletion showed a strong association with BCR-ABL1 positivity (22.9% vs 2.8%, p = 0.002).
Conclusions: IKZF1 deletion was present in one-third of ALL cases, detected by FISH. It correlated with older age, higher prevalence in adolescents/adults, and enrichment in BCR-ABL1-positive cases. FISH-based IKZF1 testing may thus provide a robust tool for prognostic stratification alongside fusion status in ALL.
Key words: FISH, IKZF1, ALL, BCR-ABL1 |
| 201 |
THE HEMATOLOGICAL PROFILE AND HIGH PERFORMANCE LIQUID CHROMATOGRAPHY FINDINGS IN SICKLE CELL DISORDERS
|
1962-12-10 |
Female |
Yes |
L- 2205 | H_LKO |
Benign |
Anemia |
Laboratory |
Dr Ketki Mendhey, Senior Resident |
Dr Anne Wilkinson |
NKP Salve Institute of Medical Sciences & Research |
Nagpur |
9823269369 |
anne_cerry@yahoo.co.in |
Oral |
Title: THE HEMATOLOGICAL PROFILE AND HIGH PERFORMANCE LIQUID CHROMATOGRAPHY FINDINGS IN SICKLE CELL DISORDERS
Introduction: Sickle cell disorders are one of the commonest single gene disorders. In India the disease is found predominantly amongst certain high-risk communities belonging to scheduled caste, scheduled tribe and other backward classes. Hemoglobin S causes polymerization of hemoglobin and the red cell sickles on exposure to low oxygen tension. Hemolysis causes the RBC indices to vary. HPLC separates the hemoglobin fractions and helps in diagnosis of hemoglobinopathies. Methods: This study was carried out at a tertiary care hospital after Institute Ethics Committee approval and patients consent. Based on the HPLC findings we had 260 cases of sickle cell disorders. The clinical details and hematological parameters from the 5 part cell counter were studied. The data was documented on MS Excel sheet and analysed. Results: Of the 260 patients, 185 (71.2%) were females and 75(28.8%) were males. Majority of them had AS pattern (190 patients) followed by SS pattern (62 patients). We also had 4 cases of compound heterozygous for HbS with hereditary persistence of fetal hemoglobin, 3 compound heterozygous for HbS beta thalassemia and1 case of compound heterozygous for HbS-E disease. Most of our cases belonged to the scheduled caste (135 patients). The mean Hb of patients with sickle cell trait(AS) was 9.75g/dL, sickle cell disease(SS) was 9.66g/dL and of HbS-E disease was 9.1g/dL. The mean RBC count was 4.3806 x 106/uL, 4.59 x 106/uL and 3.87 x 106/uL, the mean RDW 17.37%, 18.24 % and 14.9 %, the mean HbA2 was 2.74%, 2.61% and 39.0%, mean HbF was 1.93%, 19.49% and 2.4% respectively for AS,SS patterns and HbS-E disease.
Conclusion: This research contributes significantly to the knowledge of the hematological profile in Sickle cell disorders in India.
Key words: RBC parameters, Sickle cell disorders |
| 202 |
UNMASKING THE HIDDEN SHADOWS OF A MIRACLE DRUG OF TARGETED THERAPY: A RARE CASE SERIES |
1990-12-11 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
DR VRINDA KULKARNI ( DEPARTMENT OF CLINICAL HEMATOLOGY ) |
DR NILANJANA DHAR CHOUDHURY |
TOPIWALA NATIONAL MEDICAL COLLEGE AND BYL NAIR CHA |
MUMBAI |
9903462523 |
drnilanjanadc@gmail.com |
Poster |
TITLE:
UNMASKING THE HIDDEN SHADOWS OF A MIRACLE DRUG OF TARGETED THERAPY: A RARE CASE SERIES
AUTHORS: NILANJANA CHOUDHURY , VRINDA KULKARNI
INTRODUCTION:
Imatinib, the first-in-class tyrosine kinase inhibitor (TKI), has revolutionised chronic myeloid leukaemia (CML) treatment , particularly in chronic phase. Although its adverse effect profile is generally predictable and manageable, exceedingly rare toxicities occasionally emerge. Adverse effects with Imatinib are reported in upto 30–40% patients; however, most are mild to moderate.
Severe or rare toxicities — lichenoid eruptions, interstitial lung disease (ILD) , serosal effusions, or pigmentary disorders — occur in less than 1–2% cases and remain sparsely documented. These manifestations are underreported and often pose diagnostic and therapeutic challenges, making their recognition valuable for clinical practice.
METHODS:
We retrospectively reviewed five CML patients in chronic phase on Imatinib who developed rare toxicities. Detailed clinical evaluation, laboratory investigations, histopathological/radiological findings, management , outcomes were analysed.
RESULTS:
Five distinct and rare adverse events were identified:
Case 1 , 2: Lichenoid drug eruptions, presenting with violaceous, pruritic cutaneous lesions, confirmed on histopathology, a dermatological manifestation scarcely described with Imatinib.
Case 3: Development of melasma characterised by diffuse facial hyperpigmentation - a rare , paradoxical finding with TKI exposure.
Case 4: ILD presenting with dyspnea ; radiological evidence of diffuse interstitial changes.
Case 5: Recurrent pleural effusions necessitating repeated drainage ; eventual cessation of Imatinib.
All cases required exclusion of alternative etiologies before attributing causality to Imatinib. Management involved dose modification, discontinuation, or switching to second-generation TKIs, with subsequent clinical improvement.
CONCLUSION:
This study represents one of the rarest documented spectrums of Imatinib-induced toxicities, ranging from cutaneous , pigmentary disorders to pulmonary , serosal complications. ILD , melasma , in particular, underscores the novelty of our observations. Reporting such rare toxicities enriches the limited literature, emphasises the critical need for vigilance in patients receiving long-term Imatinib therapy.
KEYWORDS: CML , Imatinib adverse effects , TKIs
|
| 203 |
Risk Stratification, MRD assessment and Clinical Outcomes in Paediatric BCP-ALL: Insights from a Real-World Cohort |
1990-06-02 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Manish K Singh, SGPGI; Dr Mona Vijayaran, SGPGI; Dr Souvik Saha, SGPGI; Dr Sayan SInha Roy, SGPGI; Dr Sanjeev, SGPGI; Dr Dinesh Chandra, SGPGI; Dr Khaliqur Rehman, SGPGI; Dr Ruchi Gupta, SGPGI; Dr Rajesh Kashyap, SGPGI |
Poorvi Kapoor |
Dr Ram Manohar Lohia Institute of Medical Sciences |
Lucknow |
9739237617 |
doctorpoorvikapoor@gmail.com |
Oral |
Title: Risk Stratification, MRD assessment and Clinical Outcomes in Paediatric BCP-ALL: Insights from a Real-World Cohort
Introduction: While survival rates for paediatric B-cell precursor acute lymphoblastic leukaemia (BCP-ALL) approach 90% in the West, outcomes in India remain poorer. This study evaluated BFM risk stratification, cytogenetic profile, treatment outcomes, and complications in children with BCP-ALL treated on the BFM-95 protocol.
Methods: We retrospectively analysed 163 paediatric BCP-ALL patients (Jan 2020–Aug 2024) in our institute. Children ≤10 years comprised 61.9% (n=101) and 11–18 years 38.0% (n=62). Demographic and baseline data were retrieved from electronic records. Cytogenetic risk was determined using an in-house FISH strategy. Minimal residual disease (MRD) was assessed by 9/10-color flow cytometry. Endpoints included post-induction MRD, relapse-free survival, and overall survival.
Results: Median age was 8 years (5 months–18 years); median TLC was 12,700/mm³ (300–667,000). Based on BFM-95, 21.5% were standard risk, 48.5% moderate risk, and 30.1% high risk. Cytogenetic stratification showed 41.7% standard, 37.4% intermediate, and 20.9% high risk. Pre-induction mortality occurred in 8 patients (4.9%) and induction failure in another 8 (4.9%). MRD positivity was seen in 12.9% post-induction A (n=139), 1.5% post-induction B (n=135), and 2.3% post-consolidation (n=129). Relapse occurred in 17.42% patients who initiated therapy (n= 155) with 55.6% experiencing therapy delays due to infections. Overall mortality was 24.5% (38/155).
Conclusions: This analysis underscores the gap between Indian and global outcomes in paediatric BCP-ALL. Despite protocol-based therapy, treatment interruptions, infections, and induction-related mortality contribute significantly to suboptimal survival. Optimising supportive care and timely therapy delivery remain critical to improving outcomes.
Key words: BCP-ALL, paediatric, cytogenetic risk stratification, outcomes, real-world, BFM 95 |
| 204 |
Frequency and Clinical Correlates of NUP98 Rearrangements in Acute Leukemias: An Indian Cohort Study |
1990-08-11 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
|
Shailja Rathore |
PGIMER Chandigarh |
Chandigarh |
8146738376 |
shailja1730@gmail.com |
Poster |
Title: Frequency and Clinical Correlates of NUP98 Rearrangements in Acute Leukemias: An Indian Cohort Study
Introduction: NUP98 gene rearrangements are uncommon but biologically important aberrations in acute leukemias. They have been reported to be associated with aggressive disease, younger age, and co-occurrence with other high-risk cytogenetic events in Western cohorts. However, their frequency and clinico-biological associations in Indian patients remain underexplored.
Methods: We retrospectively reviewed 181 consecutive acute leukemia/MDS cases referred for fluorescence in situ hybridization (FISH) testing in our department. All cases were analyzed using a standardized probe panel including 5q/5p, 7q/CEN7, CEN8, 20q, KMT2A break-apart (BA), NUP98 BA, MECOM BA, and TP53/CEN17 probes. Clinical variables such as age, sex, total leukocyte count (TLC), and diagnostic category were correlated with NUP98 rearrangement status.
Results: NUP98 rearrangements were identified in 4 of 181 patients (2.2%). The median age of NUP98-positive patients was 26.5 years (IQR:19.5–33.5) compared to 50.5 years (IQR:30.8–61.3) in the NUP98-negative group (p = 0.081), suggesting a trend toward younger presentation. Median TLC was substantially higher in NUP98-positive cases (129 ×10⁹/L, IQR 31.3–274.1) compared with NUP98-negative cases (6.4 ×10⁹/L, IQR 3.0–29.5; p = 0.065). There were no significant differences in gender distribution (p = 0.25) or diagnostic subtype (p - 1.0). Importantly, three of four patients had NUP98 rearrangement as the sole cytogenetic abnormality, while one patient with chronic myeloid leukemia in blast crisis demonstrated a concurrent BCR::ABL1 fusion.
Conclusions: NUP98 rearrangements were detected in 2.2% of acute leukemias/MDS and were characterized by younger age at diagnosis and markedly elevated TLC, although statistical significance was not achieved. Systematic inclusion of NUP98 FISH testing in acute leukemia workups is warranted to better define its clinical impact in Indian patients.
Key words: NUP98, leukemia, fluorescence in situ hybridization |
| 205 |
Blood counts beyond numbers: Utility of Neutrophil to Lymphocyte ratio, Lymphocyte to Monocyte ratio and Platelet to Lymphocyte ratio as Early Diagnostic Parameters in Ovarian Neoplasms |
2005-06-09 |
Male |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Laboratory |
Dr Taruna Rajpal-Senior Medical Officer, Haematology and Clinical Pathology Unit, Department of Pathology, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi-110001; Dr Vijay Kumar- Professor and Head, Haematology and Clinical Pathology Unit, Department |
Divya Agarwal |
ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi |
New Delhi |
9667736585 |
32divyaagarwal2023@gmail.com |
Oral |
Title:
Blood counts beyond numbers: Utility of Neutrophil to Lymphocyte ratio, Lymphocyte to Monocyte ratio and Platelet to Lymphocyte ratio as Early Diagnostic Parameters in Ovarian Neoplasms
Introduction:
Ovarian cancer, one of the most lethal gynaecological malignancy, is often diagnosed at advanced stages. In ovarian cancer, tumor-driven inflammation modifies circulating leukocytes, promoting angiogenesis, tumor proliferation, and metastasis. This cascade ultimately manifests as elevated systemic inflammatory markers.
In recent years, blood-count-derived markers like NLR (Neutrophil to Lymphocyte ratio), PLR (Platelet to Lymphocyte ratio) and LMR(Lymphocyte to Monocyte ratio) have emerged as reliable markers for systemic inflammation in various malignancies. Elevated NLR, PLR and LMR correlate with poor outcomes, but their diagnostic value in ovarian cancer remains under-explored. This study aimed to evaluate the diagnostic significance of NLR, PLR and LMR in ovarian neoplasms.
Methodology:
A retrospective study was conducted at ABVIMS and Dr Ram Manohar Lohia Hospital using the data from the January 2022-July 2025, in all the ovarian specimens submitted for histopathological examination. The histopathological diagnosis was obtained from the records and classified under benign and malignant ovarian neoplasms. Their hemogram was acquired using Sysmex XN-1000 haematological analysers. The CBC ratios namely NLR,LMR and PLR were calculated from the obtained values of the absolute differential leucocyte counts. Appropriate stastical tests were applied to compare the values of NLR, LMR and PLR between the benign and malignant ovarian neoplasms.
Results and Conclusions:
The detailed result analysis and conclusion will be presented during the conference.
Key words:
Ovarian cancer
NLR- Neutrophil to Lymphocyte Ratio
LMR- Lymphocyte to Monocyte Ratio
PLR- Platelet to Lymphocyte Ratio
CBC- Complete Blood Count |
| 206 |
The Enigma of Dysplasia and an Unsolved Query in Marrow |
2025-11-02 |
Male |
No |
- | pay_R |
Malignant |
Myelodysplastic syndrome |
Clinical |
Dr Subhashree Samantray (MH-BBSR), Dr Sambit Bhuyan (MH-BBSR), Dr Nachiketa Mohapatra (MH-BBSR), Dr Nabanita |
Dr Sandeep Abhijit Pattnaik |
Manipal Hospitals (East), Bhubaneswar |
Bhubaneswar |
09439494913 |
sandeep.abhijit89@gmail.com |
Oral |
Title: The enigma of dysplasia and an unsolved query in marrow
Introduction: Myelodysplastic syndromes are a group of clonal haematopoietic neoplasms characterised by peripheral blood cytopenias and morphologic dysplasias. While primary myelodysplasia is mostly derived from an ongoing clonal evolution, there is considerable debate on etiologies for secondary myelodysplasias. Herein, we highlight a case which deepens the debate but blurs the lines of distinction between primary and secondary myelodysplastic syndromes.
Methods: Present study is a case of 20 year old immunocompetent male admitted at a tertiary level cancer center of eastern India with complaints of fever, chills , occasional vomiting for one month with late onset blurring of vision. Laboratory investigations included hematological, biochemical, microbiological, bone marrow and radiological workup including CECT abdomen, endoscopies. Antibiotic escalations were as per in-house stewardship. Results: Our patient had pancytopenia with hemoglobin 4g/dL, TLC 2300cells/cumm (normal differentials) and platelets 60-70,000cells/cumm at presentation. Blood culture was positive for Pantonea spp. with high CRP (240) and low procalcitonin (<1). Fever was refractory to two lines of broad spectrum antibiotics. Bone marrow culture showed Escherichia coli, aspirate showed a myeloid maturation arrest at metamyelo/myelocyte stage, biopsy was normocellular with discrete non-necrotising epitheloid granulomas. Flowcytometry suggested myelodysplastic syndrome with definitive CD13 loss in 64.5% of granulocytes along with abnormal maturation pattern in CD33, CD38, CD45, CD117, HLADR, CD123 and subset CD36+. No evidence of other systemic tuberculosis was identified. An exponential rise in ferritin (400 to 3000ng/mL) in four days was attributed to secondary HLH which was managed with anti-tubercular therapy only (without steroids). NGS reported normal.
Conclusions: This case highlights the diagnostic complexity of marrow tuberculosis presenting with concurrent dysplastic changes in an immunocompetent young adult. The fundamental question of primary myelodysplasia predisposed to tuberculous infection or TB induced secondary dysplasia remains unresolved.
Key words:myelodyplasia, extrapulmonary, tuberculosis
|
| 207 |
Does the baseline PML: RARA isoform impact the prognostic outcome of APML patients: our perspective |
1994-06-30 |
Female |
No |
- | 11056 |
Malignant |
|
Laboratory |
Ms. Sushmita Singh, Ms. Sonali Batwal, Mr. RohitKumar Kori, Mr. Nilesh U Dhole, Dr. Pradeep Arumugam, Dr. Deepali Saxena, Dr. Seema Biswas, Dr. Anil Singh, Dr. B. K. Mishra, Prof. Dr. Neha Singh. Hematopathology Laboratory, Tata Memorial Centre (HBCH & M |
Ms. Snehal Jaiswar |
TATA MEMORIAL CENTER (HBCH/MPMMCC), VARANASI |
VARANASI |
9819985639 |
sjaiswar1994@gmail.com |
Poster |
Title: Does the baseline PML: RARA isoform impact the prognostic outcome of APML patients: our perspective
Introduction: PML-RARA fusion gene isoforms are generated by a reciprocal translocation between chromosomes 15 and 17 in the PML gene and the RARA gene. The three main PML-RARA isoforms are the long (bcr1), variant (bcr2), and short (bcr3) forms, each differing in the location of their breakpoints on the PML and RARA genes. These isoforms are a result of different splicing events and can influence the clinical presentation and treatment of APL.
Methods: It was a three-year retrospective observational study involving newly diagnosed cases of acute promyelocytic leukemia, in which RT-PCR was positive for different PML::RARA isoforms.
Results: Out of seventy-five newly diagnosed APML patients, only one patient had ZBTB16: RARA fusion. Median age at presentation was 27 years. Mean haemoglobin, median TLC and median platelet count at baseline were 7.55±2.05 g/dl, 10.33 [0.34-158.2] *10^9/L and 17 [4-374] *10^9/L respectively. 52.6% patients belonged to Sanz high-risk category. 28.98% patients presented with DIC. CD2, CD56 and CD7 were aberrantly expressed in 17.1%, 6.6% and 2.63% patients by flow cytometry. BCR1, BCR2 and BCR3 isoforms of PML: RARA fusion transcript were observed in 68.9%, 4.0% and 27.0% cases respectively. Majority of pediatric cases had BCR1 isoform (93.3%). Post-induction MRD by RQ-PCR for PML::RARA varied between 0.0 - 43.28 %. PI-MRD >0.01% was seen in 39.2% cases while post-consolidation MRD was nil in all patients. 2-YEAR overall survival rates was 90.5% in our study. No statistically significant correlation was observed between PML: RARA isoforms and Sanz scores, MRD positivity as well as 2-year OS.
Conclusions: PML: RARA isoforms are useful for MRD monitoring at follow up timepoints but they do not impact prognosis or survival outcomes in APML patients.
Key words : APML, RQ-PCR, flow cytometry |
| 208 |
Clinicopathological spectrum and outcome of patients with acquired coagulation
factor inhibitors |
1997-05-07 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Laboratory |
Dr Dinesh Chandra, Additional Professor, SGPGI Lucknow |
Induparkavi M |
SGPGI |
Lucknow |
8971298251 |
induparkavi@gmail.com |
Oral |
Title: Clinicopathological spectrum and outcome of patients with acquired coagulation factor inhibitors Background: Acquired Coagulation Factor Inhibitors (aCFI) are a rare group of bleeding disorders, most commonly against factor VIII and von Willebrand factor (VWF). Inhibitors against other coagulation factors are rare, therefore, not much is known about their presentation and management. Aims: To evaluate the clinical phenotype and treatment outcome of patients with aCFI. Methods: A retrospective analysis of all the patients with aCFI, diagnosed and treated between January 2020 and july 2025, was carried out using clinical and laboratory details from electronic medical records. Diagnosis was established based on the clinical presentation, coagulation profile, specific factor assays, inhibitor screening and Bethesda assay. Patients of congenital factor deficiency with inhibitors were excluded. Results: 23 patients (11 male and 12 female), median age of 46 years (11 – 73 years) were diagnosed with acquired CFI. Median duration from first symptoms to diagnosis was 17 days (7-40 days). There were 5 patients of acquired hemophilia A (AHA), three patients of lupus anticoagulant with hypoprothrombinaemia syndrome (LA-HPS), 9 cases of acquired Von Willebrand disease (VWD), 2 cases each of acquired FX inhibitor, FV and heparin like anticoagulant. The degree of bleeding symptoms varied from asymptomatic to severe. Patients with AHA and LA-HPS, presented with severe bleeding as compared to other aCFI. An underlying cause for the acquired inhibitor was observed in fifteen patients, while in the rest, it was idiopathic. Patients of acquired VWD and FX inhibitors were treated conservatively, while other patients were managed using FFP, bypassing agents (rFVII and/or FEIBA), corticosteroids and/or Rituximab. Four patients did not achieve remission and died due to excessive bleeding. Conclusions: High index of suspicion, prompt diagnosis and starting of early immunosuppressive therapy is mandated for inhibitor eradication to reduce mortality. |
| 209 |
Disseminated Tuberculosis Presenting as Persistent Fever Post-Allogeneic Transplant in a TP53-Mutated AML Patient |
1994-01-22 |
Female |
No |
- | H_LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
|
Dr. Yesheswini. N. Naik |
HealthCare Global enterprises limited |
Bangalore |
7411280720 |
Yesheswinin22@gmail.com |
Poster |
Title: Disseminated Tuberculosis Presenting as Persistent Fever Post-Allogeneic Transplant in a TP53-Mutated AML Patient.
Introduction: Infections are common complications post-allogeneic hematopoietic stem cell transplant (allo-HSCT), and in endemic regions, tuberculosis (TB) should be considered in cases of unexplained fever. We report a rare case of disseminated TB diagnosed via bone marrow biopsy in a post-transplant patient with TP53-mutated AML.
Methods: A 58-year-old female was diagnosed in December 2025 with therapy-related TP53-mutated acute myeloid leukemia (AML), following prior cytotoxic therapy. She achieved remission with decitabine and venetoclax, and subsequently underwent a matched unrelated donor (MUD) transplant using a conditioning regimen of fludarabine, treosulfan, and rabbit anti-thymocyte globulin (ATG). Chronic GVHD prophylaxis included methotrexate, cyclosporine, ruxolitinib (Jakavi), and mycophenolate mofetil (MMF).
Results:
One month post-transplant, the patient developed persistent fever. Extensive workup—including blood cultures, procalcitonin, and viral PCRs (EBV, CMV, adenovirus)—was negative. Despite broad-spectrum intravenous antibiotics, the fever persisted. Bone marrow aspiration and biopsy revealed few epithelioid histiocytes forming granulomas. Ziehl-Neelsen (ZN) stain was positive, and TB PCR confirmed Mycobacterium tuberculosis complex, with negative results for Mycobacteria other than tuberculosis (MOTT). Anti-tubercular therapy (ATT) was initiated, leading to marked clinical improvement. A repeat bone marrow biopsy after two months of intensive ATT showed complete resolution of granulomas.
Conclusions:
This case underscores the need to consider disseminated TB in post-transplant patients presenting with unexplained fever, especially in TB-endemic regions. Bone marrow evaluation and molecular diagnostics were pivotal in establishing the diagnosis and initiating timely treatment, resulting in favorable clinical outcomes.
Key words: disseminated tuberculosis, matched unrelated donor transplant ( MUD), TP53 Mutated, AML |
| 210 |
Role of Busulfan Therapeutic Drug Monitoring in Improving Outcomes of Hematopoietic Cell Transplantation |
1994-01-22 |
Female |
No |
- | H_LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
|
Dr. Yesheswini. N. Naik |
HealthCare Global enterprises limited ( HCG hospit |
Bangalore |
6411280720 |
Yesheswinin22@gmail.com |
Poster |
Title:
Role of Busulfan Therapeutic Drug Monitoring in Improving Outcomes of Hematopoietic Cell Transplantation
Introduction:
Busulfan (Bu) is an alkylating agent used in conditioning regimens for hematopoietic cell transplantation (HCT). The intravenous (IV) formulation has become more widely used due to its predictable pharmacokinetics (PK). However, busulfan has a narrow therapeutic window: high exposure is linked to toxicities like veno-occlusive disease (VOD), while underexposure increases the risk of graft rejection or relapse. Therapeutic drug monitoring (TDM) is essential for optimizing drug levels during HCT.
Methods:
After an initial dose of 3.2 mg/kg/day busulfan, blood samples were collected at 0h, 2h, 3h, 4h, and 6h for TDM. Plasma busulfan concentrations were quantified to guide dosing adjustments. These adjustments were made in six out of seven patients (86%), all of whom achieved 100% engraftment. Adverse effects, including mucositis and VOD, were monitored.
Results:
No cases of Veno-occlusive disease (VOD) were observed in the study cohort. All seven patients (100%) successfully engrafted following dose adjustments.
Conclusions:
TDM of busulfan is crucial for ensuring optimal dosing in HCT. Dosing adjustments based on TDM effectively prevented both toxicity and graft failure, as demonstrated by the 100% engraftment rate and the absence of VOD. Monitoring busulfan levels can significantly improve clinical outcomes in HCT.
Key words:
Therapeutic Drug Monitoring, Busulfan, Veno-occlusive Disease (VOD), Graft Failure |
| 211 |
MOLECULAR ASPECT OF SICKLE CELL ANEMIA |
1967-02-07 |
Female |
Yes |
L-1247 | H_LKO |
Benign |
Anemia |
Laboratory |
DR,MADHU SINGH CMO |
DR.MADHU SINGH |
NTPC NEAR RAIBAREILLY |
Raibareli |
07440226880 |
madhu569singh@gmail.com |
Oral |
Title: MOLECULAR ASPECT OF SICKLE CELL ANEMIA(DR.MADHU SINGH CMO NTPC UNCHAHAR) Introduction:Sickle cell disease was first described in the medical literature in 1910 by James Herrick, who observed the unusual, sickle-shaped red blood cells in a patient from the Caribbean. Initially, the disease wasn't fully understood, but subsequent research identified it as a genetic condition caused by a mutation in the hemoglobin gene. The primary cause of SCD is a mutation in the gene responsible for producing hemoglobin, the protein that carries oxygen in red blood cells. leading to various health complications. Patients with SCD . METHOD---Hb SOLUBILTY TEST SICKLE TEST MOLECULAR TEST--HPLC 3. Elution: . 4. Detection: 5. Analysis
RESULT--
are presented as a chromatogram, showing the different hemoglobin types and their percentages, allowing for the identification of sickle cell trait or disease. Genetic Basis: Other methods: ARMS (Amplification-refractory mutation system) PCR: This method uses primers that are specific to either the normal or mutated allele, allowing for direct detection of the mutation. DNA sequencing: This provides the most detailed information about the genetic mutation. CONCLUSION---CONCLUSION--- molecular testing in SCD includes their use as prognostic tools and recent molecular diagnosis approaches. However, despite carrying major advantages, molecular testing may also present some limitations, such as high cost, limited accessibility in many countries, and limited information using targeted approaches. |
| 212 |
Touch and Go: Rapid diagnosis (3 hours) of Burkitt lymphoma using FISH on touch imprint Cytology |
1995-04-24 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Sipra Rani Patel1, Asish Rath2, Sushant Vinarkar2, Niharendu Ghara3, Deepak Kumar Mishra2 , Mayur Parihar1. Department of Cytogenetics1, Department of Laboratory Hematology2, Department of Paediatric Haematology-Oncology3, Tata Medical Center, Kolkata |
Dipali Akolekar |
Department of cytogenetics, Tata Medical Center |
Kolkata |
8459233592 |
ddakolekar@gmail.com |
Oral |
Title:
Touch and Go: Rapid diagnosis (3 hours) of Burkitt lymphoma using FISH on touch imprint Cytology
Introduction:
Burkitt lymphoma (BL) is an aggressive mature B-cell non-Hodgkin lymphoma (NHL) and is rapidly fatal if not treated early. An accurate and rapid diagnosis is essential to initiate early treatment. c-MYC gene rearrangements are characteristic and serve as a reliable biomarker to establish the diagnosis.
We present our experience of using touch imprint cytology smears for Fluorescent in-Situ Hybridisation (FISH) analysis with c-MYC break-apart probe to establish rapid diagnosis.
Methods:
Touch imprint smears were taken immediately after the biopsy procedure in patients with suspected BL. A rapid FISH analysis for c-MYC oncogene rearrangement was performed on imprint smears using ZytoLight ® SPEC MYC Dual Color Break Apart Probe with a short hybridization and the results were communicated within 3 hours.
Results: The imprint cytology FISH analysis was performed on eight patients. The entire process, from taking imprints post-biopsy to FISH analysis, was carried out within three hours.
The patients had a mean age of 11.1 years with a male-to-female ratio of 3:1. Biopsy sites included cervical lymph nodes, mesentery, pelvic mass, breast mass and bowel wall thickening.
c-MYC gene rearrangement was seen in 4/8 patients. Treatment with modified Inter-B-NHL-Ritux 2010 protocol was started on all the positive patients on day 1. Subsequent histopathological examination of the biopsy samples confirmed the diagnosis, with the report being released by day 6. Of the remaining 4 patients, one was diagnosed as T- ALL and the other three as high-grade B-cell NHL.
Conclusions: Imprint cytology FISH allows for rapid and precise diagnosis of Burkitt lymphoma, fulfilling the essential diagnostic criteria. Early diagnosis and prompt treatment improve overall survival with marked reduction in tumor burden and tumor lysis syndrome.
Keywords: Rapid FISH, Imprint Cytology, c-MYC, Burkitt Lymphoma
|
| 213 |
DONOR–RECIPIENT WEIGHT RATIO AS A PREDICTOR OF OPTIMAL CD34⁺ YIELD: EVIDENCE FOR P/D-GUIDED PLERIXAFOR USE IN PAEDIATRIC PBSC DONORS
|
1991-09-27 |
Female |
No |
- | H_LKO |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Nutan Joshi, Yamuna Naik , Mithun Abraham Prakash , Venkatachalam R, Sujith K, Phanindra D V, Sushil Selvarajan, Sharon Lionel, Uday Kulkarni, Anu Korula, Kavitha M Lakshmi, Vikram Mathews, Biju George, Aby Abraham |
Nutan Joshi |
Department of Haematology, Christian Medical Colle |
Vellore |
08169185143 |
Nutanjoshi27@gmail.com |
Oral |
Introduction
Adequate CD34⁺ cell dose is critical for successful allo-SCT, but donor–recipient weight disparity often limits PBSC yield despite G-CSF mobilization. We assessed whether the Patient/Donor (P/D) weight ratio predicts mobilization outcomes in pediatric donors and can guide early plerixafor use.
Methods
This retrospective study analyzed pediatric PBSC donors (<18 years) at our center, between January 2015 and December 2024. We analyzed demographics, P/D ratio, pre-harvest TLC, mobilization strategy, harvest volume, CD34⁺ yield, and need for second-day apheresis. Donors were stratified into: Group A (P/D <1), Group B (1–1.5), and Group C (>1.5). Optimal yield was defined as ≥5 × 10⁶ CD34⁺ cells/kg. ROC analysis was used to predict optimal ratio. Outcomes were compared in subgroups with and without upfront plerixafor.
Results
The study included 503 pediatric donors (median age 9 years, 48.5% male), with most being MSD (84.5%). Median CD34⁺ yield was 10.33 ×10⁶/kg, optimal yield achieved 87%, median P/D ratio was 1.06. ROC analysis showed P/D ratio strongly predicted optimal yield (AUC 0.811, p<0.001), is 1. Optimal harvest rates were 96.6% (228/236) in Group A , 89.7% (113/126) in Group B, and 68.8% (97/141) in Group C.
In Group C, 17 donors received plerixafor as early rescue 16/17 (94.1%) achieved optimal yield on day 1, compared to 81/124 (65.3%) without plerixafor (p=0.022; OR≈8.5). One donor with an extreme P/D ratio of 4.48 failed to achieve optimal yield despite upfront plerixafor and required second day harvest. In Group B, 4 donors given upfront plerixafor also had 100% success, but overall rates were already high, and difference was not statistically significant (p=1.0).
Conclusions
P/D ratio, with a critical cutoff near 1, strongly predicts CD34⁺ mobilization success; early plerixafor use in donors with P/D >1.5 significantly improves yield, reduces second-day harvests, and enhances donor safety.
Keywords
P/D ratio, Plerixafor
|
| 214 |
Sirolimus in Chronic ITP: A Promising Option for Difficult-to-Treat Patients |
1991-09-27 |
Female |
No |
- | H_LKO |
Benign |
Platelet disorders |
Clinical |
Nutan Joshi, Mithun Abraham Prakash, Yamuna Naik, Venkatachalam R, Sujith K, , Sushil Selvarajan, Sharon Lionel, Anu Korula, Kavitha M Lakshmi, Vikram Mathews, Biju George, Aby Abraham, Uday Kulkarni , Department of Haematology, Christian Medical College |
Nutan Joshi |
Department of Haematology, Christian Medical Colle |
Vellore |
08169185143 |
Nutanjoshi27@gmail.com |
Poster |
Introduction : Chronic immune thrombocytopenia (ITP) remains a therapeutic challenge, with limited durable responses to conventional therapies. Sirolimus, an mTOR inhibitor, has shown potential efficacy in small series but real-world data are scarce. We evaluated the clinical outcomes, response rates, and safety of sirolimus for chronic ITP.
Methods: This retrospective study included chronic ITP patients who received sirolimus at our center between January 2016 to October 2022. Baseline demographics, prior therapies, dose, response rates at 3, 6 and 12 months, and adverse events were analysed.
Results: Total 78 patients including 27 (34.6%) males, received rescue for chronic ITP during study period. The median age at diagnosis was 33 (2–71) years. Fifty-nine were steroid-refractory and 19 steroid-dependent. The median number of prior lines before sirolimus was 4 (median 4, range 2–8). Sirolimus was given at a median dose of 1 mg (0.5–4.0). Median time from diagnosis to initiation of sirolimus was 31.2 (2.5 to 373.4) months. Median duration of sirolimus therapy was 14.3 (1.8 to 74.6) months. 62 patients continued treatment at least for 3 months. Amongst them at 3 months, Overall response rate was 54.8% {13 (20.9%) complete response, 21 (33.8%) Response (R)}. At 6 months, 10 had CR and 22 had R. 26 (41.9%) patients were in remission (CR /R) at the end of 1 year. Nine patients experienced adverse events, with six discontinuations due to side effects. (2 - oral ulcers, 2 -GI symptoms, 1 - drug induced pneumonitis and 1 - suspected TMA)
Conclusion: Sirolimus demonstrated clinical activity in these heavily pretreated patients, with a subset achieving durable responses. While generally tolerable, adverse events led to discontinuation in some patients. This also underscores need of prospective studies which could potentially change the therapeutic landscape for chronic ITP.
Key words : Sirolimus , ITP
|
| 215 |
Look-Alike Cells, Different Outcomes: Distinguishing Hematogones from Leukemic Blasts |
2003-11-11 |
Male |
No |
- | pay_R |
Benign |
Infection & supportive care |
Laboratory |
Dr. Taruna Rajpal(Senior Medical Officer, Department of Pathology, ABVIMS & Dr. Ram Manohar Lohia Hospital New Delhi-110001), Dr. Garima Rakheja(Assistant Professor, Department of Pathology, ABVIMS & Dr. Ram Manohar Lohia Hospital New Delhi-110001),Dr. Vi |
Udit Kapahi |
ABVIMS & Dr. Ram Manohar Lohia Hospital |
New Delhi-110001 |
9810629788 |
udit.kapahi@gmail.com |
Poster |
Title: Look-Alike Cells, Different Outcomes: Distinguishing Hematogones from Leukemic Blasts
Introduction: Hematogones are benign B-lymphoid precursors commonly seen in the bone marrow, particularly in response to viral infections (e.g. AIDS,CMV), chemotherapy or marrow injury. Their morphological similarity to lymphoblasts often leads to diagnostic confusion with acute lymphoblastic leukemia (ALL).
Methods: A 58-year-old female presented to medicine OPD with complaints of fever, generalized weakness and epistaxis for 15 days. There was a past history of tuberculosis 8 year ago. On examination, petechiae were noted over bilateral upper limb and lower limb along with pallor. No organomegaly was seen. The patient underwent thorough clinical and laboratory evaluation. Investigations included complete blood count with peripheral blood smear, bone marrow aspiration and biopsy, immunohistochemistry application and screening for infection markers.
Results: The complete blood count with peripheral smear revealed pancytopenia (Hb 6.9 g/dL, TLC 630/µL, platelets <10,000/µL). Bone marrow aspirate smears were markedly hemodiluted, while biopsy showed sheets of CD34 positive cells, initially raising suspicion for acute leukemia. However, further work-up with immunohistochemistry demonstrated positivity for CD34, TdT, CD19, with a pattern favoring hematogones rather than leukemic blasts. HSV and Parvovirus B19 assay were positive. The absence of organomegaly and absence of relevant immunophenotypic markers further supported hematogone hyperplasia instead of acute lymphoblastic leukemia.
Conclusions: Hematogones closely mimic lymphoblasts morphologically and can pose a diagnostic dilemma. Accurate distinction requires clinical correlation, immunophenotyping, and Flow Cytometric evaluation to avoid misdiagnosis. Usually hematological follow-up and confirmation with flow cytometry are required for a definitive diagnosis This case highlights the significance of Immunohistochemistry for differentiation of hematogones from leukemis blasts, even when Flow Cytometry evaluation was not available in this case.
Key words: Hematogones, Acute lymphoblastic leukemia, Pancytopenia, Immunohistochemistry, |
| 216 |
Efficacy of ABD Grouping PAD for Neonatal Blood Grouping |
1994-12-24 |
Male |
No |
- | 11056 |
Benign |
Transfusion medicine |
Laboratory |
|
Dr. Tanveer Ahmed |
UCMS & GTB Hospital |
Delhi |
8587865966 |
pathologytanveer@gmail.com |
Poster |
Title: Efficacy of ABD Grouping PAD for Neonatal Blood Grouping
Authors: Tanveer Ahmed, Richa Gupta, Aditi Goel, Mrinalini Kotru, Anshuja Singla
Introduction: Neonatal blood grouping is a critical component of early neonatal care. Conventional methods like Slide, Conventional Tube Technique (CTT), and Column Agglutination Test (CAT) are limited by factors such as low sensitivity, time consumption, requirement for expensive equipment, and need for larger blood volumes—challenges particularly significant in neonates. ABD pad is a new device that confirms ABD blood group in neonates by forward grouping, ready to use device and allow easy identification of the test and interpretation of findings. It offers rapid blood group determination using minimal blood volume without the need for specialized equipment or expertise.
Methods: A cross-sectional study was conducted from April 2024 to August 2025 in the Department of Pathology (Regional Blood Transfusion Centre), at the University College of Medical Sciences and GTB Hospital, Delhi. A total of 598 neonatal samples received for blood grouping were tested using CTT (gold standard), CAT, and the ABD grouping pad. Samples were excluded if hemolysed, inadequate, DCT-positive, or if maternal Rh isoimmunization was present. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the ABD pad were calculated against CTT. Cohen’s Kappa was used to assess agreement.
Results: The ABD grouping pad demonstrated a sensitivity and specificity of 100%, with PPV and NPV also at 100%, indicating perfect diagnostic accuracy compared to the gold standard. Cohen’s Kappa coefficient was 1.000 (p < 0.001), denoting near-perfect agreement with CTT. No discrepancies were observed between the ABD pad and the standard methods.
Conclusions: ABD grouping pad is a highly accurate and reliable method for neonatal blood grouping, offering a practical alternative to conventional techniques, especially in low-resource settings. It simplifies the procedure, reduces turnaround. |
| 217 |
A Retrospective Analysis Comparing PET-CT with Bone Marrow Biopsy for Detection of Bone Marrow Involvement in Diffuse Large B cell lymphoma |
1989-06-16 |
Male |
No |
- | H_LK |
Malignant |
Leukemia & lymphoma |
Clinical |
Mithun Abraham, Sujith K, Sharon Lionel, Uday Kulkarni, Biju George, Aby Abraham, Vikram Mathews and Anu Korula |
Naresh Gupta |
Christian Medical College,Vellore |
Ranipet |
09500189303 |
nareshdoc.genmed@gmail.com |
Oral |
Title:A Retrospective Analysis Comparing PET-CT with Bone Marrow Biopsy for Detection of Bone Marrow Involvement in Diffuse Large B cell lymphoma
Introduction:: In Diffuse Large B-cell lymphoma (DLBCL), assessment of Bone Marrow Involvement (BMI) with Bone Marrow Biopsy (BMB) is recommended for staging/prognostication; however, BMI is often patchy/focal, and BMB is an invasive procedure that maybe unnecessary in the era of PET-CT
Methods:We retrospectively analyzed newly diagnosed DLBCL patients from January 2018 to December 2023. Data on clinical features, BMB, and PET-CT were retrieved from electronic records. BMB was the reference standard for BMI. Continuous variables were analysed with t-test/Mann–Whitney U test and categorical variables with Chi-square/Fisher’s exact test
Results:Among 730 patients, 536 underwent BMB, with BMI detected in 69/536 (12.8%) and 163(30.4%) also underwent PET-CT. BMB showed involvement in 19/163 (11.6%), of which 18 were PET-CT positive. PET-CT identified additional lesions in 16 BMB-negative patients, including multifocal (n=4; median SUV 25), unifocal (n=7; median SUV 13), and diffuse (n=5) uptake. These patients had elevated LDH (median 630 U/L), extranodal disease (68.7%), and bulky disease (37.5%). The remaining 128/163 (78.5%) were negative on both tests. Using BMB as the reference standard, PET-CT demonstrated a sensitivity of 94.7%. With PET-CT as a hypothetical reference standard, BMB demonstrated a sensitivity of 52.9%
Conclusions:With BMB as gold standard, PET-CT has a high sensitivity in detecting marrow involvement in DLBCL. PET-CT can detect additional focal FDG-avid areas that should be correlated with degree of FDG avidity and high-risk disease parameters. The high sensitivity of PET-CT raises the possibility of a new gold standard in DLBCL, allowing omission of staging BM biopsy, similar to the current standard in Hodgkin Lymphoma.
Key words:Diffuse Large B-Cell Lymphoma, Bone Marrow Involvement, Bone Marrow Biopsy, Positron Emission Tomography–Computed Tomography.
|
| 218 |
Acute Myeloid leukemia with RAM Immunophenotype: A unique cellular signature of prognostic significance. |
1996-07-12 |
Male |
No |
- | pay_Q |
Malignant |
Leukemia & lymphoma |
Laboratory |
Amit Nisal, Srilekha Acharya, Anuja Patil, Amrutraj Patil, Rachana Lakhe, Reena Bharadwaj |
Dr. Pouras Patil |
Bharati Vidyapeeth (Deemed to be) Medical College |
Pune |
7798893111 |
pouraspatil10@gmail.com |
Poster |
Title: Acute Myeloid leukaemia with RAM Immunophenotype: A unique cellular signature of prognostic significance. Authors: Pouras Patil, Amit Nisal, Srilekha Acharya, Anuja Patil, Amrutraj Patil, Rachana Lakhe, Reena Bharadwaj Introduction Acute myeloid leukaemia (AML) is a heterogeneous hematologic malignancy characterized by clonal proliferation of myeloid precursors. Rare immunophenotypic subtypes such as the RAM phenotype are linked with poor prognosis and high induction failure rates. RAM phenotype AML is defined by strong CD56 expression with weak or absent CD45, HLA-DR, and CD38. Early diagnosis and intensive treatment are needed, though outcomes are generally unfavourable. Case Report A 3-year-old male presented with intermittent fever for one-month, bilateral neck swelling for three weeks, and petechial rash for five days. Examination revealed pallor, tachycardia, wide pulse pressure, cervical and inguinal lymphadenopathy, hepatomegaly, and petechiae over the lower limbs. Methods Laboratory findings showed pancytopenia with 52% blasts on smear. Bone marrow aspirate was hypercellular with 92% blasts and few myeloid precursors. Myeloperoxidase staining was positive in 10% blasts, suggesting AML without maturation (M1 FAB subtype). Flow cytometry revealed dim CD45, CD38 and bright CD56 with myeloid markers; HLA-DR was negative, consistent with RAM phenotype. Molecular studies detected K-RAS mutation. Results Management included transfusions, PICU care, and induction chemotherapy (Daunorubicin, Cytarabine, Etoposide). Parents were counselled for hematopoietic stem cell transplant (HSCT) and HLA typing was initiated, but they declined, and the patient was discharged against medical advice. The child relapsed within months with abdominal pain, vomiting, and blasts (45%) on counts. Conclusion AML with RAM phenotype is a rapidly progressive leukaemia subtype with high risk of early relapse. Prompt recognition, immunophenotyping, molecular studies, and early transplant consideration are essential to improve prognosis. Key words: Acute Myeloid Leukaemia (AML), RAM Immunophenotype, CD56 expression, HLA-DR negative, CD45 dim, Flow cytometry, K-RAS mutation, Pancytopenia, Induction chemotherapy. |
| 219 |
MORPHOLOGICAL SPECTRUM OF INFECTIONS IN BONE MARROW |
1996-12-26 |
Female |
No |
- | H_LKO |
Benign |
Infection & supportive care |
Laboratory |
Tejaswini Waghmare- Professor(Addln.), Seth G.S. Medical College and K.E.M. Hospital |
Shagufta Khan |
Seth G.S. Medical College and K.E.M. Hospital |
Mumbai |
9823358058 |
shaguftak07@yahoo.com |
Oral |
Title: MORPHOLOGICAL SPECTRUM OF INFECTIONS IN BONE MARROW
Authors: Tejaswini Waghmare, Shagufta Khan
Introduction: Bone marrow examination is vital in diagnosis and prognosis of hematological and non-hematological disorders. It is indicated in cases of fever of unknown origin, cytopenias, treatment response in leukemias and assessing staging in malignancies like lymphomas. Bone marrow response to infection is widely variable, depending on etiological agent and chronicity of infection, age of individual and presence of comorbidities.
Methods: A retrospective study was performed which included bone marrows diagnostic of infectious etiology from January 2018 to December 2024. Detailed clinical history, clinical examination and other investigations were retrieved and correlated.
Results: Total of 30 bone marrow cases over a period of 7 years were included in this study. A wide age range (1.5-71 years) was noted with male predominance (2:1). Majority of the patients presented with fever (76.7%). The most common clinical sign was splenomegaly (50.0%) and pancytopenia (46.7%) was the most common hematological finding. Based on morphological findings, cases were categorized into tuberculous (16 cases), viral (11 cases), parasitic (1 case), fungal (1 case) and mixed infections (1 case). Bone marrow was hypercellular in 13 cases, normocellular in 6 cases, hypocellular in 8 cases and variably cellular in 3 cases. Erythroid hyperplasia (12 cases) was the most common marrow finding.
Conclusions: The study and utility of bone marrow examination in the diagnosis of infections has not yet been well established. Bone marrow examination is important for etiological diagnosis and further treatment in infective conditions, particularly those presenting with fever of unknown origin and cytopenias. It is more helpful in cases where alternate diagnostic modalities have been unyielding. The knowledge and awareness of such findings elevates utility of bone marrow examination beyond hematolymphoid malignancies.
Key words: Bone marrow, pancytopenia, fever of unknown origin, infections |
| 220 |
Pleuropulmonary manifestations in Lymphomas |
1999-04-10 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Co-Authors: Dr. Pradeep Vaideeswar, Dr. Tejaswini Waghmare, Affiliation: Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai |
Dr. Puspanjali Sahoo |
Seth GS Medical College and KEM Hospital, Mumbai. |
Mumbai |
7008132009 |
puspanjali10sahoo@gmail.com |
Oral |
Title:Pleuropulmonary Manifestations in Lymphomas
Introduction: Lymphomas encompassing both Hodgkin and Non-Hodgkin, often exhibit multisystem involvement, with pleura and lungs being common but under-diagnosed sites. Pleuropulmonary manifestations may be due to primary or secondary lymphoma resulting from direct tumor infiltration, lymphatic spread, hematogenous dissemination or pleural seeding and effusion.
Methods:A retrospective observational analysis of autopsy-based case series was performed at a tertiary-care center in patients of lymphoma with pleuropulmonary involvement. Clinical presentation, gross findings and histopathological features of pleuropulmonary involvement were evaluated along with associated other systemic dissemination for clinico-pathological correlation.
Results:A total of 9 cases were reviewed in patients aged from 17 months to 71 years with male:female ratio 7:2. Common presenting symptoms were respiratory distress (44%), generalized weakness (44%), fever (33%), generalized edema (33%), abdominal pain (33%), diarrhea (33%), and weight loss (22%). Gross examination revealed pleural thickening (78%), nodular deposits (33%), subpleural consolidation (33%), and hilar lymphadenopathy (33%). Out of 9 cases, 2 were Hodgkin’s (mixed cellularity and nodular sclerosis subtypes) and 7 were Non-Hodgkin’s including 3 cases of Diffuse large B-cell lymphoma and 1 case each of EBV-negative lymphomatoid granulomatosis, high-grade T-cell lymphoma, ALK-negative anaplastic large cell lymphoma and Sjögren’s syndrome associated MALToma. Microscopically, there was diffuse infiltration of atypical lymphoid cells involving bronchioles, alveolar septa, peribronchovascular regions, pleura and pulmonary vasculature. Advanced diseases showed dissemination to heart, thyroid, liver, spleen, kidney, pancreas and gastrointestinal tract.
Conclusions:Pleuropulmonary manifestations of lymphomas are diverse, ranging from localized nodules to diffuse infiltrative disease with systemic spread. These often mimic bacterial, mycobacterial or fungal infections and inflammatory diseases leading to misdiagnosis and delayed treatment. Autopsy remains an invaluable tool to delineate the spectrum of pleuropulmonary involvement, improve diagnostic accuracy and enhance clinical awareness.
Key words:Autopsy, Lymphoma, Hodgkin, Non-Hodgkin, Pleuropulmonary manifestations |
| 221 |
Bleeding Through the Decade: Clinical and Demographic Trends of Bleeding Disorders in Maharashtra |
1991-06-17 |
Female |
No |
- | H_LKO |
Benign |
Hemeostasis |
Clinical |
Dr. Kirti Pardeshi, Associate Professor , Department of Patholog, MPGIMER, Nashik |
Dr. Duhita Kodare, Assistant Professor, Department of Pathology, MPGIMER, Nashik |
MPGIMER, Nashik |
Nashik |
9920646428 |
dkodare@gmail.com |
Oral |
Title: Bleeding Through the Decade: Clinical and Demographic Trends of Bleeding Disorders in Maharashtra
Authors : Dr. Duhita Kodare, Dr. Kirti Pardeshi
Introduction : Hereditary bleeding disorders, including Hemophilia A (HA), Hemophilia B (HB), and Von Willebrand Disease (VWD), are genetic conditions characterized by deficiencies in clotting factors. Despite well-documented clinical features, regional demographic variations and genetic pattern of inheritance remain understudied in Indian populations.
Methods: A 10 years (2014-2024) retrospective analysis was conducted on 472 patients diagnosed with HA, HB, VWD, and other rare clotting factor deficiencies at the Day Care Centre, District Hospital, Nashik.
Results: HA (82.8%) was the most prevalent, followed by HB (13.5%) and VWD (2.5%). Other rare factor deficiencies ( Factor V, VII, and XIII), were noted. Median age at time of diagnosis was delayed, 7 years for HA, 4 years for HB, and 17 years for VWD. Notably, 2% of HA cases were female, reflecting complex inheritance patterns. Severe disease (factor level <1%) was present in 56.9% of HA and 48.4% of HB patients. Familial clustering was evident, with 17.9% of HA and 21.8% of HB patients reporting affected siblings, and 31% of HA cases having affected maternal uncles. The most common initial symptom was knee joint bleeds (29%). Recombinant factor use for prophylaxis was low (2% HA, 3% HB),on-demand therapy (plasma derived factors) was significant (85% HA, 82% HB) . Geographically, Nashik city had the highest case rate (20%), followed by Malegaon, Sinnar, and Pimpalgaon talukas, highlighting healthcare access and awareness disparities.
Conclusion: This study reveals delayed diagnosis, familial clustering, and complex female inheritance patterns, offering insights into regional disparities in diagnosis and treatment access. These findings stress the need for genetic counseling, family screening, and improved prophylaxis access in resource-limited settings.
Keywords: Female Hemophilia ,bleeding disorders , genetic , VWD, Nashik
|
| 222 |
Experience with Dose Intensified OEPA/ COPDAC chemotherapy in pediatric and adolescent Hodgkin Lymphoma: A single-center study |
1996-07-16 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Khushi Jha, Payal Malhotra, Sandeep Jain, Gauri Kapoor |
Heena Gajiwala |
Rajiv Gandhi Cancer Institute & Research Center, D |
Delhi |
9726773888 |
heenagajiwala@gmail.com |
Poster |
Title: Experience with Dose Intensified OEPA/COPDAC chemotherapy in pediatric and adolescent Hodgkin Lymphoma: A single-center study
Introduction: Hodgkin lymphoma(HL) in pediatric and adolescent populations is highly curable. While the ABVD regimen(doxorubicin, bleomycin, vinblastine, dacarbazine) has been standard, its efficacy is limited in advanced-stage disease. OEPA/COPDAC(vincristine, etoposide, prednisone, doxorubicin /cyclophosphamide, vincristine, prednisone, dacarbazine), used in the EURONET-PHL-C2 protocol, offers a dose-intensified, risk-adapted alternative with promising outcomes especially in high-risk patients.
Aim: To evaluate clinical outcomes and toxicities of the OEPA/COPDAC regimen in pediatric and adolescent HL.
Methods: This retrospective single-center study included children and adolescents <18 years with newly diagnosed HL, treated with OEPA/COPDAC per EURONET-PHL-C2 protocol between March 2020 and July 2024. Data on demographics, staging, risk stratification, treatment response, toxicities(graded by CTCAE v5.0) and survival(overall, OS and event free, EFS) were analyzed using descriptive statistics and Kaplan–Meier survival estimates.
Results: Sixty patients (mean age 10(3-18 years); 71% male) were studied, 43% had B symptoms, 45% bulky disease, and mixed cellularity HL was most common(58.3%). Risk groups included Treatment Level(TL) TL-1: 20%, TL-2(23.3%),TL-3(56.6%). After two OEPA cycles, 81.6% achieved complete remission, 18.3% partial remission; all six adverse events(2 relapses, 4 refractory) were in TL-3. Three-year OS/EFS rates were: TL-1/TL-2 100%/100%; TL-3 100%/82.3%. Toxicities included febrile neutropenia(31.5%), gastrointestinal toxicity(30%), neuropathy(23.7%), mucositis and supportive care hospitalization(55.2%); with no treatment-related deaths. Compared to published data with ABVD(5-year EFS 60–65% advanced-stage), OEPA/COPDAC delivered better 3-year EFS(82.3%, TL-3) but higher toxicity(febrile neutropenia 31.5% vs. 5–8%), and hospitalization(55.2% vs. ~5%).
Conclusions: We observed OEPA/COPDAC chemotherapy to provide better early response and OS and EFS, particularly in TL3 pediatric patients. The regimen was associated with a higher burden of acute toxicity, hence underscores the need for vigilant supportive care and close clinical monitoring during treatment.
Key words: dose-intensified OEPA/COPDAC chemotherapy regimen; treatment response; survival; toxicity; supportive care. |
| 223 |
A comprehensive longitudinal study to understand disease burden and its risk factors in a cohort of Indian sickle cell disease patients. |
1989-10-03 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
Co-authors: Dr. Vinod Umare1, Dr. Amrutha Jose2, Dr. Manisha Madkaikar1,2, Dr. Anita Nadkarni1,2 Institutes: ICMR-Centre for Research Management and Control of Haemoglobinopathies, Chandrapur1, ICMR-National Institute of Immunohaematology, Mumbai2 |
Mr. Nikhil Shinde1 |
ICMR- Centre for Research Manaement and Control of |
Chandrapur, Maharashtra |
9029296489 |
nikhilshinde0310@gmail.com |
Oral |
Title: A comprehensive longitudinal study to understand disease burden and its risk factors in a cohort of Indian sickle cell disease patients. Introduction: Sickle cell disease (SCD) is a major health burden in India. In SCD, natural history from birth to death is poorly understood due to inter-patient variability in degree of severity and clinical manifestation. There is limited data on spectrum of organ damage and its progression in Indian SCD patients. Methods: Clinical investigations of 100 SCD individuals such as X-ray and MRI of hips, transcranial doppler or MRI of brain, ultrasonography of abdomen, spirometry of lung, ECG and 2 D echo of heart and ophthalmology were conducted. Laboratory investigations comprising hemotological indices, biochemical parameters (markers of hemolysis, cytokines, endothelial activation, and coagulation activation) and genetic modifiers were performed. Results: At baseline, the organ damage such as 53/96 (55.2%) avascular necrosis of femoral head i.e. Ficat stage (I-IV), 14/58 (24.1%) neurological events, 51/100 (51%) hepatomegaly/altered echotexture of liver, 30/100 (30%) cholelithiasis/chronic cholecystitis, 24/100 (24%) autosplenoctomy and 6/96 (6.2%) mixed blockage of lung were detected. After 2 years follow-up, among 71 SCD individuals, the progression of organ damage involving femoral head, gall bladder, spleen was observed in 8/71 (11.3%), 7/71 (9.9%), 5/71 (7.0%) cases respectively. No abnormalities such as pulmonary hypertension [Tricuspid regurgitation velocity ≥ 2.5 m/sec], time-averaged mean maximum velocity ≥ 170cm/sec), proliferative sickle retinopathy was observed in the cohort. Risk factors identified were age, Hb, HCT for AVNF, conjugated bilirubin for liver and spleen, hospitalization rate for gall bladder dysfunction. Conclusions: The progression of organ damage involving the hip, brain, lungs, liver, gall bladder and spleen is evident as the age progresses. Comprehensive check-up at regular intervals is required for the identification of early organ dysfunction and to prevent chronic organ damage.
Key words: Sickle cell disease, AVNF |
| 224 |
Role of T-cell Subset in predicting steroid response in Newly Diagnosed Immune Thrombocytopenia |
1994-10-19 |
Female |
No |
- | H_LKO |
Benign |
Platelet disorders |
Clinical |
Dr Mili Jain1, Prof Rashmi Kushwaha1, Dr Sanjay Mishra1, Dr S.P. Verma2, 1-Department of Pathology, King George’s Medical University, Lucknow, Uttar Pradesh 2-Department of Clinical Haematology, King George’s Medical University, Lucknow, Uttar Pradesh |
Radhika Singh |
King George's Medical University |
King George's Medical University |
6393662725 |
itsradz19@gmail.com |
Poster |
Title: Role of T-cell Subset in predicting steroid response in Newly Diagnosed Immune Thrombocytopenia
Introduction: Immune Thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by isolated thrombocytopenia. While autoantibody-mediated platelet destruction is well established, T cells do play a pivotal role in disease pathogenesis and modulation of treatment response.
Methods: 30 newly diagnosed adult ITP cases were prospectively enrolled over a period of 24 months. Baseline and post steroid (day 30) peripheral blood sample was analyzed for percentage and absolute count of T cells (CD45+CD3+), Helper T cells Th (CD45+CD3+CD4+), Cytotoxic T cells Tc (CD45+CD3+CD8+) and Treg cells (CD45+CD3+, CD4+CD25brightCD127dim) by multiparametric flowcytometry on BD FACS Lyric. 14 control samples were analysed simultaneously. Response to steroid was recorded as per the IWGITP.
Results: The percentage and absolute count of the T cells, Th and Tc were higher in ITP versus controls. Treg percentage (p=0.00) and absolute count was lower in ITP versus controls. Follow up testing after four weeks of steroid therapy showed significant (<0.05) increase in T cell, Th, Tc, Treg percentage and absolute count. Five patients were categorised as non-responders. In comparison to responders the Tregs percentage in non-responder were low at follow up (p=0.055)
Conclusions: The study revealed immune dysregulation in newly diagnosed ITP with reduced Tregs and elevated T cells, Th, Tc. Responders showed Treg restoration and platelet recovery post-steroids, unlike non-responders. Steroid therapy led to increase in CD4⁺, CD8⁺, and Tregs, indicating both haematological improvement and reversal of immune imbalance. These findings support use of T-cell profiling as predictive marker for steroid response.
Key words: Immune Thrombocytopenia (ITP), T-cell subsets, Regulatory T cells (Tregs), CD4+ T lymphocytes, CD8+ T lymphocytes, Corticosteroid response, Flow cytometry, Predictive biomarker |
| 225 |
Clinical Relevance of Morphological features in R-ISS stratification of Multiple Myeloma |
1995-06-22 |
Female |
No |
- | H_LKO |
Malignant |
Plasma cell disorders |
Laboratory |
Sreya P B, M C Savithri, C G Geetha, Ashwin Oommen Philip, Unnikrishnan P, Sreeraj Vasudevan, Affiliation: KUHS |
AMAANA RASHEED |
Amala Institute of Medical Sciences |
Thrissur |
9544553269 |
dr.amaanarasheed@gmail.com |
Poster |
Title: Clinical Relevance of Morphological features in R-ISS stratification of Multiple Myeloma Introduction: Multiple myeloma(MM) is a heterogeneous entity with variable course. Plasma cells found in bone marrow smears are characterised by extremely high diversity of morphology. The diagnosis of MM was established according to criteria of International Myeloma Working Group. For Staging FISH for myeloma was sent and analysed for CDKN2C/CKS1B(1p32/1q21, deletion 13q,t (14;16),t (4;14),t(11;14) ,deletion 17p, chromosome 1p loss and chromosome 1q gain. Methods: Material collected from 58 patients was evaluated at diagnosis and then correlated with staging. All the cases diagnosed as multiple myeloma for period of 1 year, from August 2024-August 2025 in the department of hematopathology at Amala Institute of Medical Sciences were included. R-ISS staging was done by collecting data from medical records. Results: Median age at diagnosis was 63 with range of (47-78). Myeloma was more common in females (53%) compared to males (47%). By morphology majority of the cases (n=28) had mature morphology,10 with plasmablastic morphology,15 had multinucleate cells and 5 had fibrosis. 44 of the patients didn’t have any high risk mutations. CDKN2C/CKS1B1 was the highest (n=6),four had deletion 13q, two each had t(11;14) and t(4;14). While staging majority of the patients fell into RISS stage 2(n=33),stage 1(n=11),stage 3(n=14). The cases with fibrosis were stage 3,as well as plasmablastic morphology were stage 3.
Morphology R-ISS 1 R-ISS 2 R-ISS 3 Mature 9 26 9 Immature 2 5 3 Fibrosis 0 2 2 P value – 0.65
Conclusions : We conclude that myeloma cell morphology even though doesn’t correlate with staging,it could have a prognostic potential. However larger studies with associations with survival is needed to conclude.
Key words: Multiple myeloma, morphology, R-ISS, prognosis. |
| 226 |
Acute myelomonocytic leukaemia with eosinophilia : A distinct AML subtype with favourable prognosis |
1997-05-30 |
Female |
No |
- | H_LKO |
Malignant |
|
Clinical |
Dr.Amit nisal, Dr.Parineeta shelke, Dr.Reena bhardwaj |
Dr. Devanshi baxi |
Bharati Vidyapeeth (Deemed to be) University Medic |
Pune |
9755387507 |
devanshibaxi09@gmail.com |
Poster |
TITLE- Acute Myelomonocytic Leukemia with Eosinophilia: A Distinct AML Subtype with Favorable Prognosis
Authors: Devanshi Baxi, Amit Nisal, Parineeta Shelke, Reena Bharadwaj
Institute- Bharati Vidyapeeth (Deemed to be) University Medical College Hospital and Research Center, Pune.
Introduction
Acute myeloid leukaemia is a hematological malignancy in which there is abnormal proliferation of myeloid precursors in peripheral blood and bone marrow. Acute myelomonocytic leukaemia is characterized by presence of blasts and immature cells of both myeloid and monocytic lineage. There are more than 20% cells of monocytic lineage along with more than 20% of blasts. Clinical features include fever, weight loss, fatigue, anaemia and organomegaly. Acute myelomonocytic leukaemia with eosinophilia (AML-M4Eo) is a distinct type morphologically characterized by presence of eosinophils with abnormal granules and shows inversion of chromosome 16 on cytogenetic analysis.
Case report
14 year old boy presented with complaints of low-grade fever since two weeks not subsided with medicines. On examination hepatosplenomegaly is noted. On investigations, peripheral blood smear showed marked leucocytosis with monocytosis and about 40% blasts. Bone marrow aspirate showed hypercellularity with 35% blasts and increased monocytes on differential count. MPO staining showed few blasts with MPO positivity. Eosinophils with abnormal granules were noted. A morphologic diagnosis of acute myelomonocytic leukaemia AML-M4Eo was given. NGS report confirmed fusion gene CBFB::MYH11 due to inversion of 16 chromosome. On Day 15 of chemotherapy bone marrow was done which showed marrow in morphologic remission (< 5% blasts).
CONCLUSION
AML-M4Eo has a favourable prognosis which can be diagnosed by FISH and molecular studies. In addition to percentage of blasts and other abnormal cells, identification of eosinophils with abnormal granules is important. Further testing can be done in such cases to confirm the diagnosis for this subtype which has a favourable prognosis.
|
| 227 |
Clinical profile and response rates of Imatinib failure CML-CP patients on higher dose of Imatinib |
1981-05-31 |
Male |
No |
- | RBqJR |
Malignant |
MPN & MDS/ MPN |
Clinical |
|
HABEEB NASEEM |
INSTITUTE OF HAEMATOLOGY AND TRANSFUSION MEDICINE, |
Kolkata |
9846788006 |
habeebnaseem@gmail.com |
Oral |
Title:Clinical profile and response rates of Imatinib failure CML-CP patients on higher dose of Imatinib
Author:Dr.HABEEB NASEEM
Introduction:Chronic myelogenous leukemia is one of the leading hematological malignancies in the country. Resistance to imatinib, which is widely used due to its cost effectiveness and safety profile is a matter of concern, which lead to the choice of second-generation TKI or escalating the dose of imatinib. This study was conducted on 188 patients with imatinib failure CML-CP who were on a higher dose of imatinib to determine their clinical and molecular responses before starting imatinib and their response rates after starting a higher dose of imatinib for 12 months.
Methods: Retrospective data collection and analysis were performed on 188 patients with imatinib failure who were taking > 400 mg of imatinib per day. Molecular and hematological responses before and 12 months after starting the higher dose of TKI were analyzed.
Results:188 Imatinib failure patients were included in study. It consisted of 132 (70%) males and 56 (30%) females. Majority of patients were of intermediate risk as per SOKAL index (55%) and ELTS index (53%) at the detection of disease.90(48%) patients had primary resistance and 98 (52%) had secondary resistance. Ten (5.3%), 40(21%), and 14 (7%) patients achieved early molecular response, major cytogenetic response, and major molecular response, respectively, after starting high-dose TKI. Fourteen (7%) patients progressed to AP/BC during treatment. Total of 62 (74%) patients who lost CHR ,achieved and maintained a complete haematological response during 12 months of high-dose imatinib treatment.
Conclusions: Dose escalation of imatinib can still be a reasonable practice in imatinib failure patients as it shows response rates almost similar to those of second-generation TKIs, as demonstrated in different studies, considering its low cost and low side effect profile.
Key words:Chronic myeloid leukemia, Imatinib resistance, High dose Imatinib |
| 228 |
Differential epigenetic and gene expression profile based on response to decitabine therapy in activating fetal hemoglobin (HbF) among HbE/β-thalassemia patients. |
1993-01-26 |
Male |
No |
- | H_LKO |
Benign |
Miscellaneous |
Laboratory |
Jyoti Shaw, IHTM, Medical college Kolkata, Souvik Karmakar, Indian Statistical Institute-Kolkata, Prof. Maitreyee Bhattacharyya, IHTM, Medical college Kolkata, Prof. Raghunath Chatterjee, Indian Statistical Institiute-Kolkata. |
Shantanab Das |
Indian Statistical Institute. |
Kolkata. |
7980466410 |
shantanabdas.isi@gmail.com |
Oral |
Title: Differential epigenetic and gene expression profile based on response to decitabine therapy in activating fetal hemoglobin (HbF) among HbE/β-thalassemia patients.
Introduction: β-thalassemia, caused by HBB gene mutations, leads to impaired β-globin synthesis and severe anemia requiring lifelong transfusions. Persistence of fetal hemoglobin (HbF) reduces disease severity. Decitabine, a DNMT1 inhibitor, has been shown to induce HbF in about half of HbE-β-thalassemia patients. This study explored molecular mechanisms underlying differential response.
Methods: HbE/β-thalassemia patients were recruited, and NRBCs were isolated for DNA methylation and mRNA-seq analysis. Patients received 0.2 mg/kg decitabine subcutaneously twice weekly for 12 weeks. Hemoglobin and HbF were monitored via CBC and HPLC. Responders and non-responders were identified, and epigenetic and gene expression profiles were compared.
Results: Based on the stringent criteria, we have recruited 44 patients in the study to date. We have generated methylome and transcriptome data for 24 patients, where 18 were responders and 6 were non-responders. Around 80% of the differentially expressed genes showed upregulation in responders compared to non-responders. Gene ontology and GSEA with the differentially expressed genes showed porphyrin-containing compound metabolic process, heme metabolic process, and heme biosynthetic process as the top biological processes. Enrichment analysis showed that genes involved in these biological processes were upregulated in responders. Genome-wide methylation data revealed that the differentially methylated probes (DMPs) were distinct clusters for non-responders and responders. Overlap of the DMPs with different genomic regions showed that 29.2% of the DMPs correspond to the promoter regions. GSEA, considering 7 different databases, showed epigenetically regulated differentially upregulated genes were involved in abnormality of the heme biosynthetic pathway, abnormal erythrocyte morphology, and reticulocytosis.
Conclusions: Epigenetically regulated genes among the responders contributed to the heme biosynthesis related pathways, which may be enhancing the HbF.
Key words: Decitabine, β-thalassemia, DNA Methylation, mRNA-Seq, Gene-ontology, GSEA. |
| 229 |
Fulminant Hemophagocytic Lymphohistiocytosis in an 8-Year-Old: A Race Against Time |
1998-12-09 |
Male |
No |
- | pay_R |
Benign |
Infection & supportive care |
Clinical |
Dr. Su |
Dr. Juwain Shehzad Nehil |
All India Institute of Medical Sciences (Kalyani) |
Kalyani |
8939062912 |
juwain.path_pgt24@aiimskalyani.edu.in |
Oral |
Title: Fulminant Hemophagocytic Lymphohistiocytosis in an 8 Year Old: A Race Against Time
Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rapidly progressive, life threatening hyperinflammatory syndrome in children. Early recognition is crucial, yet diagnosis is often delayed due to its nonspecific presentation.
Case Report : We report an 8-year-old girl who presented with six days of high-grade fever, progressive lethargy, and abdominal distension. Examination revealed pallor, petechiae, hepatosplenomegaly, and hemodynamic instability. Emergency laboratory workup showed severe anemia, thrombocytopenia, hyperferritinemia, hypertriglyceridemia, and hypofibrinogenemia. Flow cytometry demonstrated markedly reduced NK cell numbers, and a bedside bone marrow aspirate confirmed hemophagocytosis. The patient met seven of eight HLH-2004 diagnostic criteria. Despite an expedited diagnostic process and preparation for HLH directed therapy, she deteriorated rapidly and succumbed before treatment could be initiated.
Conclusions: This case highlights the fulminant nature of HLH and the razor-thin therapeutic window. Reduced NK cell counts, extreme hyperferritinemia, and cytopenias were critical diagnostic clues. The case underscores the importance of protocol driven emergency panels, integrated bedside diagnostics, and heightened clinical suspicion to initiate treatment without delay. Pediatric HLH can mimic common infections but progresses with devastating speed. This case emphasizes that even short delays in recognition and therapy can be fatal, reinforcing the need for rapid, integrated diagnostics and early initiation of treatment protocols in suspected HLH.
Key words: Hemophagocytic lymphohistiocytosis (HLH), Pediatric hyperinflammatory syndrome, Bone marrow hemophagocytosis, NK cell dysfunction |
| 230 |
Monocyte Distribution Width as Predictor of Sepsis in Patients with Systemic Inflammatory Response Syndrome |
1998-12-22 |
Male |
No |
- | pay_R |
Benign |
Infection & supportive care |
Laboratory |
Dr Geeta Kampani, Professor and Head, Department of Medicine, ABVIMS & Dr. Ram Manohar Lohia Hospital New Delhi -110001; Dr Vijay Kumar, Professor and Head, Haematology and Clinical Pathology Unit, Department of Pathology, ABVIMS & Dr. Ram Manohar Lohia H |
Dr Abhinav Arya, Post Graduate Resident, Department of Medicine, ABVIMS & Dr. Ram Manohar Lohia Hospital New Delhi-110001 |
ABVIMS & Dr. Ram Manohar Lohia Hospital New Delhi |
New Delhi |
9997933372 |
abhiarya3913@gmail.com |
Oral |
Title: Monocyte Distribution Width as Predictor of Sepsis in Patients with Systemic Inflammatory Response Syndrome Introduction: Sepsis continues to be a major cause of hospital mortality, with outcomes closely linked to speed of diagnosis and treatment. Traditional biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT) are useful but may be costly, slow to process, and sometimes insensitive in early disease. Monocyte Distribution Width (MDW) has emerged as an early sepsis marker on Beckman Coulter analyzers. Its Sysmex equivalent, Monocyte Width (MO-WZ), is readily available from routine complete blood counts, but clinical validation remains limited, especially in the Indian context. Methods: We conducted a prospective observational study at ABVIMS & Dr. RML Hospital, New Delhi, between February 2024 and June 2025. 120 adult patients meeting SIRS criteria were enrolled. Within 24 hours of admission, MO-WZ was measured using a Sysmex XN-1500 analyzer, alongside quantitative CRP and PCT. Sepsis and septic shock were defined according to Sepsis-3 criteria. ROC analysis determined optimal cut-offs, sensitivity, specificity, predictive values, and AUC & compared with qCRP & PCT with additional outcomes-mortality, ICU requirement & need for ventilatory support. Results: Of total patients, 89 (74.17%) developed sepsis. MO-WZ ≥809.0 predicted sepsis with an AUC of 0.945 (95% CI 0.907–0.983), sensitivity 95.51%, and specificity 87.1%. PCT ≥1.0 ng/mL showed an AUC of 0.937, sensitivity 89.89%, specificity 93.55%. qCRP ≥12.2 mg/L had an AUC of 0.900, sensitivity 74.16%, specificity 87.1%. Higher MO-WZ values were also linked to septic shock (≥935.0; AUC 0.852), ventilatory support (≥890.0; AUC 0.867), and mortality (≥935.0; AUC 0.854). Conclusions: MO-WZ offers rapid, cost-effective, and highly accurate detection of sepsis in SIRS patients, with performance comparable to PCT and qCRP. Its additional prognostic value supports its integration into early sepsis screening protocols. Key words: MO-WZ, Monocyte Distribution Width, Sepsis, SIRS, Sysmex XN-1500, qCRP, Procalcitonin |
| 231 |
AI-driven discovery of hematopoietic targets in traditional botanicals: A systems approach to chemotherapy-induced cytopenias |
1988-08-04 |
Male |
No |
- | pay_R |
Malignant |
|
Laboratory |
Co-Author: Dr. Kiran Wankhede; Affiliation: Medical Care Centre Trust, Kashiben Gordhandas Patel Children Hospital, Vadodara, Gujarat |
Sanket Charola |
Department of Botany, Faculty of Science, The Maha |
Vadodara |
7046776364 |
sanket.charola-botany@msubaroda.ac.in |
Oral |
Title: AI-driven discovery of hematopoietic targets in traditional botanicals: A systems approach to chemotherapy-induced cytopenias
Introduction: Botanical formulations have been long sought as adjunctive therapies in chemotherapy to mitigate hematopoietic suppression and aid in the patient recovery. AI-integrated Network pharmacology approach can be used for systematically mapping bioactive compounds to hematopoietic targets and signaling pathways of selected medicinal plants.
Methods: Drawing from Indian ethnopharmacological relevance, Withania somnifera and Spinacia oleracea were selected for their reputed role in modulating hematopoiesis and alleviating blood-related disorders. Phytochemical data were retrieved from Pharmacopeia, TCMSP, IMPPAT, and ChEMBL databases. Bioactive compounds were screened for drug-likeness and oral bioavailability using SwissADME, yielding key phytochemicals like Ferulic acid, Quercetin, Kaempferol, and Withanolides. Target prediction was performed using SwissTargetPrediction and STITCH, focusing on hematopoietic regulators including erythropoietin (EPO), thrombopoietin (TPO), granulocyte colony-stimulating factor (G-CSF), and transcription factors such as STAT3 and GATA1.
Results: Disease-target mapping using GeneCards and DisGeNET focused on chemotherapy-induced cytopenias and hematopoietic stem cell proliferation. Protein-protein interaction networks constructed using STRING and visualized in Cytoscape revealed multi-target modulations by selected phytochemicals. Key regulatory nodes included markers of apoptosis (CASP3, BCL2), cell cycle regulators (CDKs), and iron metabolism genes (TFRC, FTH1), all implicated in hematopoietic recovery during chemotherapy. Subsequent pathway enrichment analysis via KEGG and Reactome confirmed synergistic modulation of JAK-STAT, PI3K-Akt, and HIF-1 signaling pathways, implicating role of these compounds in restoring hematopoietic function.
Conclusions: This novel study presents a mechanistic model for the myeloprotective effects of traditionally known herbs, grounded in AI-integrated network pharmacology. By combining compound screening, target prediction, and systems-level modelling, we demonstrate a rational approach for validating Indian traditional knowledge and accelerating drug discovery from botanical sources. This approach enables optimized phytotherapeutic interventions to complement conventional cancer care and mitigate hematopoietic suppression.
Key words: Network Pharmacology, Hematopoiesis, Botanicals, Chemotherapy-induced cytopenia, Phytotherapeutics |
| 232 |
Unmonitored Clozapine Therapy Leading to Acute Promyelocytic
Leukemia (AML-M3) in a Young Female with Schizophrenia |
1997-10-12 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Naish Akhtar, Dr. Lalit Khawse, Dr. Shraddha Saxena |
Dr. Alimaa |
Chirayu Medical College and Hospital |
Bhopal |
9455695379 |
alimaapathak97@gmail.com |
Poster |
Title:Unmonitored Clozapine Therapy Leading to Acute Promyelocytic
Leukemia (AML-M3) in a Young Female with Schizophrenia
Introduction:Clozapine is an atypical antipsychotic regarded as a mainstay in managing treatment-resistant
schizophrenia. While its hematological risks—particularly agranulocytosis—are well-recognized,
progression to acute myeloid leukemia is rare and underreported. This case underlines potential life-
threatening complications when hematological monitoring schedules are not followed, emphasizing
the need for strict adherence to surveillance protocols.
Methods: Prospective Case Study
Results:This case highlights a rare but serious consequence of clozapine therapy. Current evidence and
regulatory guidelines require regular blood monitoring to prevent clozapine-induced hematological
complications, but lapses may result in catastrophic outcomes. Clinicians must maintain vigilance for
hematologic malignancies in this population and promptly investigate unexplained symptoms.
Multidisciplinary collaboration is crucial for optimal outcomes.
Conclusions:Strict compliance with recommended monitoring protocols for clozapine therapy is essential to
prevent delayed diagnosis of life-threatening hematological disorders like AML-M3. Early detection
through routine testing enables timely intervention and safer psychiatric care.
Key words:Clozapine,hematological complications,agranulocytosis,pancytopenia, Acute Promyelocytic Leukemia (AML-M3) |
| 233 |
Teclistamab in Relapsed/Refractory Multiple Myeloma: An Initial Indian Experience |
1995-10-17 |
Female |
Yes |
L-2149 | H_LKO |
Malignant |
Plasma cell disorders |
Clinical |
Vivek Mohan, Rahul Naithani |
Disha Kakar |
Artemis Hospitals |
Gurugram, Haryana |
8168042432 |
dishathesis@gmail.com |
Poster |
Title:Teclistamab in Relapsed/Refractory Multiple Myeloma: An Initial Indian Experience
Introduction:With significant advancements in multiple myeloma (MM) treatment, triple-class refractory cases are increasing. Teclistamab, a BCMA-CD3 bispecific antibody, has shown promising efficacy in clinical trials. However, its real-world utility, particularly in India, remains limited. This study presents the second documented Indian experience with teclistamab monotherapy in heavily pretreated relapsed/refractory multiple myeloma (RRMM) patients.
Methods:We describe two male patients with relapsed/refractory multiple myeloma treated with teclistamab after multiple prior therapies. Patient 1, a 64-year-old male, relapsed after multiple prior lines and autologous stem cell transplant with significant extramedullary involvement. Despite teclistamab treatment, he showed no response and continued to progress. Patient 2, a 61-year-old male with dialysis-dependent renal failure, had been treated with multiple regimens before teclistamab. He achieved a very good partial response (VGPR) but succumbed to infectious complications, septic shock and peritonitis, after four months of treatment.
Results:Both patients experienced poor outcomes, contrasting with the results from the clinical trials and international data. The patients’ comorbidities, advanced disease and significant extramedullary involvement may have contributed to these outcomes. Teclistamab's safety profile included significant infectious and hematologic toxicities, such as neutropenia and recurrent infections, which emphasize the importance of supportive care in real-world settings.
Conclusions:Our initial Indian experience with teclistamab in RRMM highlights the challenges of its use in heavily pretreated patients, particularly in those with extramedullary disease. This underscores the need for individualized patient selection and real-world data to better understand its safety and efficacy in diverse populations.
Key words:Teclistamab, Bispecific therapy, Relapsed/refractory multiple myeloma |
| 234 |
Enhancing Health Record Digitization Using AI-Powered Ambient Clinical Intelligence Solutions - A Pilot Study |
1999-11-30 |
Female |
No |
- | pay_ |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Alok Shetty- Assistant Professor, Tata Memorial Hospital , Dr. Manju Sengar- professor and HOD, Tata Memorial Hopsital , Dr. Hasmukh Jain- Professor Tata Memorial Hospital , Ms. Anukriti Chaudhari - Founder , Foster Health ,Mr. Akshay Gupta, Foster |
Dr C S Meghana |
Tata Memorial Hospital |
Tata Memorial Hopspital |
6363036746 |
meghana6746@gmail.com |
Poster |
Title: Enhancing Health Record Digitization Using AI-Powered Ambient Clinical Intelligence Solutions - A Pilot Study
Investigators: Dr C S Meghana, Dr. Alok Shetty, Dr. Manju Sengar, Dr. Hasmukh Jain, Ms. Anukriti Chaudhari, Mr. Akshay Gupta, Mr. Sai Modalavalasa, Dr. C. S. Pramesh, Dr Girish BS
Introduction: Electronic health records (EHR) are key to improving cancer care, due to complexity and multi-disciplinary nature. However, EHR adoption is limited in low-middle income countries, partly due to high patient-to-provider ratios. Voice-enabled documentation tools offer potential to increase digitization, but ambient noise, diverse linguistic patterns, infrastructure constraints hinder adoption.
Methods We evaluated a voice-AI tool in the hematolymphoid malignancy unit (300 daily outpatients) at a tertiary cancer Centre. Clinicians documented notes on paper, later entered into EMR by data operators. The AI system handled cancer terminology, dialect-influenced accents, proper nouns, with adaptive spell-check for vocabulary expansion. The study included patients who gave written informed consent and the compared AI notes with the manually entered notes in EHR in terms of accuracy, clinical meaningfulness on a 10-point scale, documentation time, and missed entries.
Results: Low-cost, vendor-agnostic microphones achieved required signal quality. Three clinicians used adaptive spell-check to expand vocabulary by 800+ words. 300 clinical encounters were included. AI reduced note recording time by 79% (6 minutes manual vs. 1.28 minutes AI). AI notes scored 9.1/10 for meaningfulness, were 100% hallucination-free, showed 45% fewer physician review comments than manual entries (30% vs. 55%). AI-related comments primarily involved untrained drug names, while manual errors included completeness issues, spelling mistakes, abbreviations, and incorrect tenses.
Conclusions: This study demonstrates feasibility of deploying voice-AI documentation in high volume oncology settings. The validated system offers a blueprint for voice-enabled documentation to be integrated in clinical workflows (discharges, telemedicine, tumour boards) without disruption
Keywords: AI, Electronic Records Forms, Cancer
|
| 235 |
Unmasking Non-Hodgkin Lymphoma in Adolescent and Young Adult with Atypical Presentations: Report of Two Cases |
1991-09-24 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Arvind Ahuja, Nirupma P Khan, Vijay Kumar |
Rachel Cynthia Tirkey |
ABVIMS & Dr. RML Hospital |
New Delhi |
9646882257 |
rachelcynthia2491@gmail.com |
Poster |
Title: Unmasking Non-Hodgkin Lymphoma in Adolescent and Young Adult with Atypical Presentations: Report of Two Cases
Introduction: Non-Hodgkin Lymphoma (NHL) is rare in adolescents and young adult populations, often presenting diagnostic challenges due to atypical manifestations, especially in the absence of peripheral lymphadenopathy. Unusual extranodal presentations can mimic other systemic conditions, often delaying diagnosis and necessitating histopathology and immunohistochemistry for subtyping and management.
Methods:
Case 1: NHL with enterovesical fistula (EVF) masquerading as tuberculosis.
A 15-year-old male on antitubercular therapy, newly diagnosed with hepatitis B and C, presented with persistent fever, abdominal pain and fecaluria. A suspicion of EVF and intestinal perforation on clinical examination was further confirmed on contrast enhanced computed tomography of whole abdomen (CECT-WA), which additionally revealed multiple mesenteric lymphadenopathies. He underwent exploratory laparotomy with ileal resection and repair of bladder wall.
Case 2: NHL with obstructive jaundice masquerading as periampullary carcinoma
A 28-year-old female presented with abdominal pain and jaundice with clay-colored stool. Laboratory investigations revealed obstructive jaundice and elevated CA 19.9. CECT-WA identified a duodenal growth causing mass effect on pancreas and common bile duct. Endoscopy guided duodenal biopsy was done.
Results:
Case1: Microscopic examination of ileum, bladder, omentum and mesenteric lymph node revealed diffuse large B-cell lymphoma (DLBCL), activated B cell type. Unfortunately, post surgery, he succumbed to his illness. Case 2: Duodenal biopsy revealed DLBCL, germinal centre type. Following percutaneous biliary drainage, she was started on chemotherapy (R-CHOP regimen). Conclusions: These cases underscore the diagnostic challenges of NHL in young population due to rare extranodal presentations, such as EVF and obstructive jaundice. Both clinicians and pathologists must keep a high index of suspicion for lymphoma in young patients with acute illness presentations, as prompt histopathological confirmation of the diagnosis is critical for timely management and improved outcomes.
Keywords: NHL, extranodal, enterovesical fistula, jaundice |
| 236 |
CLASSIFICATION AND RISK STRATIFICATION OF ACUTE MYELOID LEUKEMIA PATIENTS USING NEXT GENERATION SEQUENCING AND CYTOGENETICS AS PER ELN 2022: A SINGLE CENTRE STUDY |
1995-10-28 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
GAURAV DHINGRA, ASSOCIATE PROFESSOR, MEDICAL ONCOLOGY AND HEMATOLOGY, AIIMS BHOPAL, SACHIN BANSAL, ASSISTANT PROFESSOR, MEDICAL ONCOLOGY AND HEMATOLOGY, AIIMS BHOPAL, GARIMA GOEL, PROFESSOR, PATHOLOGY AND LAB MEDICINE, AIIMS BHOPAL, UJJAWAL KHURANNA, ADDI |
PRATIK MINJ |
AIIMS BHOPAL |
BHOPAL |
8871426838 |
pratikminj619@gmail.com |
Poster |
Title: CLASSIFICATION AND RISK STRATIFICATION OF ACUTE MYELOID LEUKEMIA PATIENTS USING NEXT GENERATION SEQUENCING AND CYTOGENETICS AS PER ELN 2022: A SINGLE CENTRE STUDY
Introduction:
Acute Myeloid Leukemia (AML) is a heterogeneous hematologic malignancy characterized by diverse genetic alterations, immunophenotypic patterns and cytogenetic abnormalities. Comprehensive characterization through next-generation sequencing (NGS), cytogenetics, and immunophenotyping is essential for accurate risk stratification under ELN 2022 guidelines, which directly influences treatment decisions. This study evaluates the mutational spectrum, immunophenotypic features, and risk categories of AML patients at our centre.
Methods:
Study Design: Retrospective single-centre study.
Sample Size: 30 newly diagnosed AML patients (2024–2025).
Molecular Testing: Karyotyping, NGS.
Immunophenotyping: 8–10 colour flow cytometry.
Analysis: Mutation frequency, flow cytometric correlations and ELN 2022 risk stratification
Results:
Variant allele frequency of more than 10% was considered significant and the patients were categorised into the following categories:
AML with recurrent genetic abnormality: 16
AML with mutated TP53: 1
AML with myelodysplasia-related gene mutation: 3
AML with myelodysplasia-related cytogenetic abnormality: 4
AML not otherwise specified: 6
Risk stratification: According to ELN 2022, a predominance of intermediate and adverse risk categories was observed
Conclusions:
Our cohort highlights the mutational heterogeneity of AML and reinforces the utility of NGS combined with flow cytometry and cytogenetics for risk-adapted classification. Integrating mutation data with flow findings refines diagnosis and prognostication. ELN 2022 stratification revealed a predominance of intermediate and adverse-risk AML, underscoring the need for early molecular testing and risk-adapted therapy.
Key words: AML, ELN 2022, NGS immunophenotyping, karyotyping |
| 237 |
Concordance and Discordance Between Bone Marrow Aspiration and Biopsy in Plasma Cell Proliferative Disorders- A Retrospective Study |
1981-11-27 |
Female |
No |
- | H_LKO |
Malignant |
Plasma cell disorders |
Laboratory |
Dr.Pradyumn Singh |
Dr. Nilam Bhasker |
DR.RMLIMS, Lucknow |
Lucknow |
08808692995 |
nilam2711@gmail.com |
Oral |
Title: Concordance and Discordance Between Bone Marrow Aspiration and Biopsy in Plasma Cell Proliferative Disorders- A Retrospective Study. Introduction: Plasma cell proliferative disorders (PCPD)require PBS examination and accurate bone marrow evaluation for diagnosis, prognosis, classification, and management. Bone marrow aspiration and biopsy are performed together to provide cytological detail in BMA, whereas BMB offers architectural patterns and quantification of plasma cell infiltration. Discrepancies in their diagnostic yield by BMA & BMB, can influence interpretation and patient management. Methods: We retrospectively analyzed 336 paired bone marrow aspiration and biopsy samples from January 2019 to June 2025 in single institute. Bone marrow findings (Bone marrow aspiration and biopsy) were taken as the reference standard, concordance, discordance, and the role of immunohistochemistry (IHC) with serum light chain assay were evaluated. Results: Among 336 cases, 259 (77.1%) showed concordance results, including 240 (71.4%) positive and 19 (5.7%) negative and discordance results were observed in 77 cases (22.9 %) on both modalities (BMA & BMB), where aspiration frequently underestimated plasma cell infiltration compared with biopsy. IHC marker CD 138 and serum light chain assay-kappa and lambda light chain restriction showed positive results in 235 cases (69.95 %) of plasma cell proliferative disorder. 101 cases (30.05%) showed non-neoplastic plasma cell proliferation or other entities. The study population was predominantly in older adults with male predominance, in line with the typical epidemiology of multiple myeloma. Conclusions: Bone marrow aspiration and Biopsy showed good overall concordance; however, discordance was seen in nearly one-fourth of cases, with aspiration often underestimating plasma cell infiltration. About one-third of patients had non-neoplastic or reactive plasma cell proliferation. These findings emphasize that biopsy, supported by IHC, is crucial for precise diagnosis and appropriate management of plasma cell disorders.
Keywords: Plasma cell proliferative disorders (PCPD), IHC, light chain assay, BMA, BMB. |
| 238 |
Clinical and Immunological Perspectives on Inhibitor Development: The Role of B-Regulatory Cells in Hemophilia A |
1994-06-05 |
Female |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
Prof Rashmi Kushwaha |
Sana Parveen |
King George Medical University |
Lucknow |
6396646487 |
dr.sanaparveen111@gmail.com |
Poster |
Title: Clinical and Immunological Perspectives on Inhibitor Development: The Role of B-Regulatory Cells in Hemophilia A
Introduction: Hemophilia A is an X-linked recessive bleeding disorder caused by FVIII deficiency, leading to impaired clotting and recurrent bleeds. Development of inhibitors against FVIII is a major complication, reducing treatment efficacy. B-regulatory cells may contribute to the immune mechanisms underlying inhibitor formation.
Methods: 55 Hemophilia A Patients of all age groups were prospectively enrolled. Peripheral blood samples were analyzed for coagulation parameters (PT, APTT, mixing studies), FVIII activity, and inhibitor titers using the Bethesda assay. Complete blood counts were performed, and flow cytometry was used to quantify circulating B regulatory cells (CD19⁺ CD24^hi CD38^hi) and other lymphocyte subsets via multicolor staining and sequential gating on the BD FACS Lyric cytometer.
Results: Inhibitor-positive patients (n=27) had a significantly younger mean age at presentation (p=0.009) and earlier age of first symptom (p=0.040) as compared to inhibitor-negative patients (n=28). Family history of bleeding was more among inhibitor-positive cases (p=0.049). rFVIII exposure was also higher in this group. Immunologically, inhibitor-positive patients demonstrated significantly higher CD19⁺ B-cell counts (p=0.030) and lower B-regulatory cell levels (p=0.004). High inhibitor titer patients showed markedly lower B-regulatory cells (p=0.014).
Conclusions: The study revealed that inhibitor-positive Hemophilia A patients have impaired immune regulation, characterized by reduced B-regulatory cells, elevated CD19⁺ B cells. Still, no significant correlation with inhibitor titers was seen. Inhibitor-positive patients were younger, had early clinical presentation, and received FVIII transfusion at a younger age; all of these are associated with a higher risk of inhibitor formation. Our findings suggest that both clinical and immunological factors contribute to inhibitor formation and emphasise the importance of early immunomodulatory interventions in managing Hemophilia A.
Key words: Hemophilia A, B-regulatory cells, inhibitor titers, Bethesda assay, immune regulation. |
| 239 |
Utility of Clot waveforms in Lupus anticoagulant testing |
1990-04-17 |
Female |
No |
- | Payme |
Benign |
Hemeostasis |
Laboratory |
Sujay Prasad, Pradeep Kumar V, Saikumar Hosur, Ashwin Anil Pillai, Sharat Kumar |
Swathi Kulkarni |
Neuberg Anand Reference Laboratory |
Bengaluru |
8867199726 |
drswathik@neubergdiagnostics.com |
Oral |
Title: Utility of Clot waveforms in Lupus Anticoagulant testing
Authors: Swathi Kulkarni, Sujay Prasad, Pradeep Kumar V, Saikumar Hosur, Ashwin Anil Pillai, Sharat Kumar
Introduction: Lupus anticoagulant (LA) is a key laboratory criterion for diagnosing antiphospholipid syndrome (APS). According to the latest ISTH guidelines, at least two clot-based tests using different principles should be performed before LA can be excluded. In our laboratory, we employ lupus-sensitive aPTT and dRVVT, with thrombin time also included to rule out clinical anticoagulant interference, as anticoagulants may cause false-positive or false-negative LA results.
Methods: We retrospectively analyzed 2,466 laboratory records from patients with suspected APS over a 15-month period (January 2024 to March 2025). Antiphospholipid antibody (aPL) testing included LA, anti-cardiolipin antibody (IgG/IgM), and anti-β2 glycoprotein I (IgG/IgM). This study specifically focuses on the interpretation of LA test results, with a particular emphasis on the analysis of clot waveforms. Testing was performed using the Sysmex CN-3000 analyzer, and waveform patterns were qualitatively assessed across LA-negative, LA-positive, and anticoagulant-treated samples, alongside interpretation of numerical data.
Results: The mean age of patients was 33.9 years (range: 7–84), with a female-to-male ratio of 3.3:1. The overall aPL positivity rate was 18.2%, with LA being the most frequent (7.5%) and more prevalent in males. 17% of the total LA positive cases showed anticoagulant interferences. Clot waveform analysis (CWA) demonstrated distinct waveform patterns between LA-positive, LA-negative, and anticoagulated samples, providing significant value in recognizing false LA positivity.
Conclusions: Clot waveform analysis on the Sysmex CN-3000 provides added interpretive value in LA testing. Integration of waveform patterns with the numerical data of standard clotting assays improves discrimination between true LA positivity and anticoagulant interference, particularly when clinical information is limited.
Key words: Antiphospholipid Syndrome (APS), Lupus Anticoagulant (LA), Clot Waveform Analysis (CWA) |
| 240 |
Cell Counter Scatterplot as a powerful tool in recognising Acute Leukemia with Normal and Low White Cell Count |
1989-05-09 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Sujay Prasad, Dr Ananthvikas Jayaram, Dr Swathi Kulkarni |
Dr Pradeep Kumar V |
Neuberg Anand Reference Laboratory |
Bangalore |
(+91)8095830169 |
docpradeepa@outlook.com |
Oral |
Title: Cell Counter Scatterplot as a powerful tool in recognizing Acute Leukemia with Normal and Low White Cell Count Introduction: Acute Leukemia is the common malignancies encountered in hematology laboratory. Early diagnosis is always a key. The cell counter in addition to numerical data provides various scatterplots which can be highly efficient screening tool in recognizing the abnormal cell population and provide clue on provisional characterization of Acute Leukemia. This study was conducted with following objectives: (1) To analyse the prevalence of Acute Leukemia with normal and low WBC count. (2) To analyse scatter pattern in types of Acute Leukemia. (3) To identify peculiar scatter pattern with respect to APML and making it a powerful screening tool Methods: This prospective study was conducted over a period of 12 months spanning from November 2023 till October 2024. Samples were processed in Sysmex XN 1000 analyser and Cell counter scatterplots were analysed in all the cases of Acute Leukemia and observed for particular pattern with respect to different Acute Leukemias. Results: A total of 137 Acute Leukemic cases were analyzed in this period. 64 out of 137 cases presented with normal total count or less than normal count set for that particular age. 19 cases of APML were included in these 137 cases of which 9 cases showed normal or low WBC count. Scatterplot pattern provided clues and were distinct with subtypes of Acute Leukemia. Conclusions: Scatterplot patterns can be a great screening tool particularly in samples with low WBC count. The scatterplot provides a suspicion on the particular abnormal cell to be looked at. This study is also a unique one in analyzing a scatterplot obtained with only CBC mode. In addition, scatterplot patterns can be utilized in training lab personnel and assist screening large number of samples and remote reporting |
| 241 |
Trephine Biopsy and Bone Marrow Necrosis: A Diagnostic Complexity |
1967-10-31 |
Female |
Yes |
L 1003 | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
|
Dr Rajeshwari Handigund Consultant Pathologist |
KAHER Jawaharlal Nehru Medical College & KLES Dr P |
Belagavi |
7996365090 |
docrajeshwari@gmail.com |
Oral |
Title: Trephine Biopsy and Bone Marrow Necrosis: A Diagnostic Complexity
NAME OF THE AUTHOR: Dr Rajeshwari Handigund
Consultant HI Tech Laboratory, Tutor Department of Pathology
INSTITUTE AFFILIATION: KAHER Jawaharlal Nehru Medical College &
KLES Dr Prabhakar Kore hospital & Medical Research Centre Belagavi
EMAIL docrajeshwari@gmail.com
Introduction: Bone marrow necrosis (BMN) is a rare but critical finding on trephine biopsy. Bone marrow necrosis is seen in leukemia, lymphoma, metastatic tumors, sickle cell anemia, and systemic lupus erythematosus.
Objectives: To recognize morphological features, and understand the role of repeat biopsies and other tools in establishing a diagnosis and prognosis of BMN. To know various underlying conditions associated with BMN.
Methods: Study Design: Retrospectively, from January 2024 to August 2025.
Patient Selection: Reviewed the medical record of patients diagnosed with bone marrow necrosis on bone marrow aspiration and trephine biopsy.
Results: Of the total 695 trephine biopsies 9 biopsies were reported as BMN(1.29%). Marrow aspiration of the 9 cases, 5(55.55%) had diluted hemorrhagic aspirate, while others had sepsis with HLH, NHL and multiple myeloma, autoimmune disorder respectively. Trephine biopsy of all cases revealed BMN, to the extent of 75-90% of the biopsy. 5 cases(55.55%) had scanty or no viable cells. For one case IHC could be performed and diagnosis of NHL was confirmed.
Conclusions:Any diluted bone marrow aspirate should be complemented by a trephine biopsy for morphological examination to determine the necrosis pattern and stage, search for infectious etiologies, identify any hematolymphoid malignancies or non-necrotic tumor cells. Immunohistochemistry can be a valuable addition to the morphological examination. It has potential in providing crucial insights into the underlying cause of BMN.
Key words:Trephine biopsy, Bone marrow necrosis, Leukemia, Sepsis |
| 242 |
Utility of Immature Reticulocyte Fraction in detecting iron deficiency in chronic
disorders after Iron supplementation: A comparative study. |
1990-01-25 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Dr. Mrinalini Kotru |
Dr. Bhanvi Solanki |
UCMS & GTB Hospital, Delhi. |
Delhi |
9990541240 |
bhanvisolanki999@gmail.com |
Oral |
Title: Utility of Immature Reticulocyte Fraction in detecting iron deficiency in chronic disorders after Iron supplementation: A comparative study.
Introduction: Diagnosing iron deficiency anemia (IDA), especially when coexisting with chronic conditions like anemia of chronic disease (ACD), remains difficult. Soluble transferrin receptor (sTfR) is a reliable marker but is not widely accessible. Since response to iron therapy is a dependable diagnostic indicator, the Immature Reticulocyte Fraction (IRF) could serve as a practical, cost-effective alternative for early detection and monitoring.
Methods: A longitudinal interventional study was conducted at UCMS & GTB Hospital, Delhi, involving 60 patients—30 each with IDA and ACD. Complete blood count including IRF was measured on Days 0, 2, and 7. Serum ferritin and sTfR levels were assessed on Days 0 and 7 using ELISA. Data analysis was performed using SPSS.
Results:
• IRF increased significantly by Day 7 in IDA (8.03 ± 3.80) compared to ACD (5.67 ± 3.95, p=0.006). A significant rise was observed from baseline in IDA on Days 2 and 7 (p<0.001), while ACD showed a delayed rise only on Day 7 (p=0.001).
• ARC was similar at baseline but significantly higher in IDA by Day 7 (135.7 vs. 48.4, p<0.001).
• Ferritin levels were higher in ACD at baseline and remained so (p<0.001), with both groups showing modest increases without significant trend differences (p=0.83).
• sTfR was elevated in IDA at both time points (p<0.001), with a more pronounced decline over time (p=0.031).
• IRF changes correlated strongly with ARC and sTfR, especially in IDA.
Conclusions: IRF shows a prompt and marked increase in IDA, offering a prompt and accessible means to differentiate IDA from ACD and to monitor iron therapy, making it a valuable diagnostic adjunct in resource-limited settings.
Key words: IRF, IDA, ACD, sTfR, S.ferritin. |
| 243 |
My First Experience of Treating an Elderly Patient with CAR-T cell therapy |
1996-01-25 |
Female |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dr Abhishek Raj, Dr Vishnu Hari, Dr Imam Akhtar, Dr Adithya J, Dr Dinesh Pendharkar |
Dr Chandrima Mukherjee |
Sarvodaya Hospital & Research Centre, Faridabad |
Faridabad |
9669865459 |
drchandrimamedonc@gmail.com |
Oral |
Introduction: Chimeric antigen receptor (CAR)-T cell therapy is an approved treatment for relapsed/refractory (R/R) large B-cell lymphoma, but most trials focus patients ≤ 65 years. Data from India, especially in elderly patients, is limited. We present our first experience using QARTEMI (varnimcabtagene autoleucel), an indigenous CD19-directed second-generation CAR-T product, in a 70-year-old man.
Case Summary: A 70-year-old male, with Stage IV DLBCL, (R-IPI 2) achieved complete remission after six cycles of R-CHOP in February 2025. He was on follow up, when in May 2025, a metabolically active cutaneous nodule in the left arm indicated early relapse within 3 months of primary treatment. Bone marrow biopsy was negative. Autologous stem cell transplantation was deemed inappropriate due to age and treatment-related mortality risk. . Cost considerations led to selecting indigenous product i.e. QARTEMI.
He underwent Leukapheresis on 16 July 2025. Bridging therapy included 1# of R-CVP followed by adiotherapy to axilla (27 Gy/15 fractions). Lymphodepletion with fludarabine and cyclophosphamide was administered from Day -5 to -3. QARTEMI CAR-T cells (30 ml, 5×10⁶ cells/kg) were infused fractionally: 10% on D-0 (i.e. 19/8/25), 30% on D+3, and 60% on D+6. No immediate complications were noted during and after infusion. Patient was regularly monitored for signs of CRS & ICANS. On D+7, patient developed a single episode of grade 1 CRS, with a fever of 100.5 F. Blood culture showed Acinetobacter spp. and received empirical antibiotics, fever resolved within 24 hrs. Patient did not have any significant acute toxicities during his course of stay, neither requiring escalation to higher antibiotics nor requiring transfusion/ growth factor support.
Conclusions: Indigenous CAR-T cell therapy, like QARTEMI, can be successfully used in an elderly patient with appropriate bridging and lymphodepletion protocols, without significant toxicities. |
| 244 |
Early experience with Polatuzumab Vedotin plus Glofitamab as bridging therapy prior to CD19-Directed CAR T-Cell Therapy in R/R B-cell lymphoma: A Single Center Retrospective study |
1994-10-19 |
Male |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Thomas Eipe1, Alok Shetty1, Manju Sengar1, Neha Sharma1, Lingaraj Nayak1, Bhausaheb Bagal1, Anupa John1, Sahitya Rao1, BS Girish1, CS Meghana1, Devanshi Kalra2, Smrithi Ravi Kumar2, Anjali Jaiswal2, Yuktam Yadav2, Atharva Karulkar2, Rahul Purwar2, Hasmukh |
Thomas Eipe |
Tata Memorial Centre |
Mumbai |
8754745379 |
thomas7eipe@gmail.com |
Oral |
Title
Early experience with Polatuzumab Vedotin plus Glofitamab as bridging therapy prior to CD19-Directed CAR T-Cell Therapy in R/R B-cell lymphoma: A Single Center Retrospective study
Background
Bridging therapy (BT) prior to CAR T-cell therapy is required due to high disease burden and prolonged manufacturing timelines. The Polatuzumab-Vedotin plus Glofitamab (Pola-Glofit) regimen has demonstrated synergistic activity in r/r DLBCL in early-phase trials. We evaluate safety and efficacy of Pola-Glofit as BT prior to talicabtagene autoleucel (Tali-cel) in patients (pts) with r/r BCL.
Methods
Pts ≥15 years with r/r BCL who received Pola-Glofit as BT between November 15, 2023 and July 31, 2025 were analysed. BT schedule: Cycle 1 – Obinutuzumab or Rituximab (Day 1), Pola (Day 2), and Glofit (Day 8 and 15); subsequent cycles included Pola and Glofit on Day 1. Response and toxicities were graded per standard criteria.
Results
At data cutoff (31July2025), 17 pts received Pola-Glofit as BT. The median age was 53 years (range 21-72), 47% females. Median number of previous treatment lines were 2 (range 1-5), 13pts had advanced disease, 8pts had bulky disease and 3pts had bone marrow involvement. All pts received at least one cycle of Pola-Glofit (range 1-3).
16/17 pts underwent response assessment post BT. 10/16 pts (63%) achieved an ORR with CR in 3 pts. One pt had SD and 5 patients had PD of whom 2 pts died before Tali-cel.
CRS occurred in 5 patients, all grade≤2 and managed with tocilizumab. No neurological toxicities, ICU admission, treatment-related deaths due to BT. The median vein-to-vein time was 58 days (range 40-118).
Conclusion
The combination of Pola-Glofit as bridging therapy in r/r B-cell lymphoma was well tolerated and showed encouraging activity, achieving early disease control in majority of patients, just after one cycle.
Keywords
Bridging therapy, anti-CD19 CAR T-cell therapy, Polatuzumab-vedotin, Glofitamab
|
| 245 |
Comparision analysis of consecutive-day vs alternate-day high-dose cytarabine consolidation chemotherapy in acute myeloid leukemia: A Randomized controlled trial |
1994-04-17 |
Female |
No |
- | CICAg |
Malignant |
Leukemia & lymphoma |
Clinical |
Kavya Ronanki1, Bibhant Shah1,Prisla Maria Dalton1, Reshma Benson1, Arjun Kachhwaha1, Nikhil Nagpal1,Adamya Gupta1, Paras Satadeve1,Uttam Kumar Nath1, Amit Sehrawat1 1 Department of Medical Oncology Hematology, All India Institute of Medical Sciences, R |
Kavya Ronanki |
AIIMS RISHIKESH |
AIIMS Rishikesh |
9493276304 |
kavyaronanki@gmail.com |
Oral |
Comparision analysis of consecutive-day vs alternate-day high-dose cytarabine consolidation chemotherapy in acute myeloid leukemia: A Randomized controlled trial
INTRODUCTION
High-dose cytarabine (HiDAC) is the standard consolidation after complete remission (CR) in Acute myeloid leukaemia(AML), the standard schedule being 1.5-3 g/m2/dose q12 hourly on days 1, 3, & 5 (HiDAC-135). Delivering HiDAC on three consecutive days (HiDAC-123), could be a better option,reducing inpatient days and costs.
AIM
To compare the effects of two different schedules of HiDAC, namely consecutive (HiDAC-123) versus alternative day (HiDAC-135), in terms of treatment outcome & adverse events (AE) .
METHOD
This is a Single-center, randomized controlled trial. Eligible patients were randomized to: HiDAC-123 / HiDAC-135. Cytarabine 1.5 g/m² q12h was given over 3 h.Patients were monitored for cytopenias & other AE. Supportive care including granulocyte colony stimulating factor(G-CSF)& blood products. Outcomes included time to neutrophil and platelet recovery, grade 3/4 febrile neutropenia, red cell/platelet transfusions, G-CSF doses & hospital stay.
RESULTS
59 patients were treated (HiDAC-123, n=31; HiDAC-135, n=28).Mean age was 30.74 Years;. Male: female was 1.4:1. Groups were comparable at baseline. Based on ELN 2022 risk, 47.4% favorable-risk ,13.5% intermediate-risk & 38.9% adverse-risk. HiDAC-123 achieved significantly faster recovery: neutrophils 13.87±1.80 vs 17.46±3.01 days (p<0.001), platelets 13.58±1.84 vs 18.04±3.77 days (p<0.001). All patients developed grade 4 neutropenia. Median platelet units were lower with HiDAC-123 (8 [6,11.5]) vs 11 [8,13] (p=0.09).Mean G-CSF doses were reduced (9.32±2.05 vs 18.5±2.92; p<0.001) and length of stay was shorter (14.52±2.37 vs 18.5±2.92 days; p<0.001) with no statistically significant difference in red blood cell requirement. No grade 3–4 non-hematologic AE or treatment-related deaths occurred.
CONCLUSION
In our single-institution experience, the condensed consecutive-day schedule HiDAC-123 accelerated hematologic recovery, reduced GCSF use & shortened hospitalization compared to the HiDAC-135 regimen. These findings suggest that HiDAC-123 may be a more favorable schedule.
Keywords-Aml,HIDAC
|
| 246 |
ORAL AZACITIDINE MAINTENANCE THERAPY FOR ACUTE MYELOID LEUKEMIA IN REMISSION: REAL-WORLD EXPERIENCE IN AN INDIAN POPULATION |
1989-05-06 |
Male |
Yes |
L-2188 | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
SHAILENDRA PRASAD VERMA, SWASTHI SINHA, GAURAV DATTA, P RAGHUVEER, ARITRA SAHA, RAJKUMAR MAURYA |
AKSHAY MIDDINTI |
KING GEORGE'S MEDICAL UNIVERSITY |
LUCKNOW |
8790766790 |
akshaymiddinti@gmail.com |
Oral |
Title: ORAL AZACITIDINE MAINTENANCE THERAPY FOR ACUTE MYELOID LEUKEMIA IN REMISSION: REAL-WORLD EXPERIENCE IN AN INDIAN POPULATION
Introduction: Induction therapy for Acute Myeloid Leukemia is designed to achieve complete remission, but relapses remain frequent despite intensive chemotherapy. In September 2021, oral Azacitidine was launched in India as a maintenance therapy for AML patients in remission who are ineligible for hematopoietic stem cell transplant. By lowering relapse risk, it offers a potential survival benefit, but real-world evidence from Indian populations is limited.
AIM: To evaluate real-world safety, and outcomes of oral-azacitidine as maintenance in AML patients in remission following intensive chemotherapy.
METHODS: A retrospective review of medical records was conducted for patients diagnosed with de novo AML in remission and treated with oral Azacitidine as maintenance at KGMU, Lucknow. Data were collected for patients who received or are currently on oral Azacitidine from October-2021 to August-2025. Time-to-event outcomes were analyzed using the Kaplan-Meier methods.
RESULTS: Twenty-eight patients received oral azacitidine during the study period (52% male, 48% female; median age 28.8 years. Common mutations were AML/ETO (36%), NPM1 (24%), and FLT3-ITD (24%). ELN 2022 risk stratification: favorable(48%), intermediate(44%), and adverse(8%). Most(92%) received “3+7” induction, 8% received hypomethylating agents. Reasons for not proceeding to HSCT included ineligibility, unaffordability, or patient preference. Oral azacitidine was administered for 14 days of each 28-day cycle; 28% with FLT3 mutations also received Midostaurin. Median OS was 43.8 months (95% CI: 36.2–51.8), with 1-year OS 92.9% and 2-year OS 71.4%. Median RFS was 43.2 months (95% CI: 35.8–50.1), with 1-year RFS 85.7% and 2-year RFS 64.3%.
CONCLUSION: Oral azacitidine maintenance was associated with encouraging survival outcomes in in AML patients not proceeding to HSCT. More than half remained relapse-free at 2 years, supporting its role as an effective post-remission strategy in Indian settings. |
| 247 |
Looking Beyond Leukaemia: The Significance of CD45-Negative Populations in Bone Marrow Evaluation |
1996-07-20 |
Female |
No |
- | H_LK |
Malignant |
Rare hematological malignancies |
Laboratory |
Prabhat S Kumar, Anjali Saroha, Shagun Wadhwa, P. Lalita Jyotsna*, Pragya Jain, Mrinalini Kotru |
LUBNA SIDDIQUI |
UNIVERSITY COLLEGE OF MEDICAL SCIENCES AND GTB HOS |
DELHI |
7678483165 |
lubna2096@gmail.com |
Poster |
Title: Looking Beyond Leukemia: The Significance of CD45-Negative Populations in Bone Marrow Evaluation
Introduction: CD45 negativity in atypical bone marrow populations should raise suspicion for non-hematopoietic malignancies to avoid misdiagnosis as acute leukemia.
Methods: A 2-year-old girl presented with a one-month history of fever and pallor. Clinical examination revealed inguinal lymphadenopathy, hepatosplenomegaly, periorbital ecchymosis, and conjunctival bleeding, along with features of raised intracranial pressure, leading to a provisional diagnosis of Acute Leukaemia with CNS involvement. Complete blood count showed severe normocytic normochromic anaemia (Hb 5.9 g/dL), thrombocytopenia (15,000/mm³), and a leukoerythroblastic picture (TLC 30,300/mm³) with 31 nRBCs/100 WBCs and 6% atypical cells, 2–2.5 times the size of small mature lymphocytes, with a high nuclear-to-cytoplasmic ratio, scant agranular blue cytoplasm, and prominent nucleoli. The bone marrow aspirate showed clusters of similar atypical cells with vacuolation, blebbing, multinucleation, and strong block PAS positivity, while being negative for MPO and SBB. Flow cytometry revealed CD45 negativity, with positivity for CD56 and CD7. On re-evaluation, a thigh mass was present, metastatic small round blue cell tumour was favoured over acute leukaemia.
Results: Bone marrow analysis revealed CD45-negative popoulation with CD56 and CD7 expression,strong PAS positivity; subsequent evaluation confirmed metastatic small round blue cell tumour.
Conclusions: Here, complete CD45 negativity on flow cytometry was a critical discriminator, prompting evaluation for non-hematopoietic malignancy.The diagnostic overlap between Acute Megakaryoblastic Leukaemia and Metastatic Small Round Blue Cell Tumours poses a significant challenge in paediatric cases. Both can exhibit blast-like clusters with cytoplasmic blebbing, morphologically mimicking each other. Integration of morphology, immunophenotyping, and histology confirmed a metastatic small round blue cell tumour, emphasising the importance of reassessing CD45-negative populations in bone marrow to avoid misdiagnosis.
Key words: CD45 Negative, atypical population, Bone Marrow examination, Non-hematopoetic malignancy, Metastatic Small round blue-cell tumor, Acute leukemia, Megakryoblasts, Flowcytometry, Immunophenotyping |
| 248 |
Exploring hemoglobinopathies in southern Odisha, India: A hospital based study |
1986-06-14 |
Male |
Yes |
L-1412 | pay_R |
Benign |
Anemia |
Laboratory |
Dr Samira Kumar Behera: Professor, Department of Pathology, MKCG Medical College, Berhampur; Dr. Manoj Kumar Patro: Professor, Department of Pathology, MKCG Medical College, Berhampur |
Dr Prasanta Purohit |
MKCG Medical College, Berhampur, Odisha |
Berhampur |
9778118055 |
prasanta.biochem@gmail.com |
Oral |
Title: Exploring hemoglobinopathies in southern Odisha, India: A hospital based study Introduction: Hemoglobinopathies is the major public health burden in India with significant morbidity and mortality. Though, the spectrum of hemoglobinopathies is available, still a large number of geographical region in India remain unexplored. This study was undertaken to analyze the spectrum of hemoglobinopathies in a hospital based set-up catering the population of Southern Odisha, India. Methods: This observational study was carried out in individuals attending to the MKCG Medical College, Berhampur, Odisha for screening of hemoglobinopathies for various clinical purposes. All the cases were investigated for slide test, hemoglobin (Hb) variant analysis by Variant-II (Bio-Rad) followed by molecular analysis when required. Parents and family screening also carried out in some suspected cases. Results: A total of 12,561 cases were analyzed including 6,982 (55.6%) females and 7,858 (62.6%) children. On analysis, 6,757 (53.8%) cases had abnormal Hb chromatograms. Among these, sickle Hb was present in 5,336 (78.9%) cases in heterozygous, homozygous and double-heterozygous states. Similarly, β-thalassemia was present in 1,565 (23.2%) cases followed by many rare variants including Hb-Lepore, HbE, HbD-Punjab, Hb-J variants etc. A total of 691 antenatal cases were also analyzed and resulted with around one-third of women with hemoglobinopathies including sickle-cell in majority cases. The mutation spectrum of β-thalassemia cases (n=400) revealed with IVS 1-5 (G→C) in around 95% of cases. All the three Hblepore variants (HbLepore-Hollandia, HbLepore-Boston and HbLepore-Baltimore) were observed on molecular characterization. Alpha-thalassemia (3.7 and 4.2 kb deletion) were reported in around 45% of study cases (n=400). Conclusions: The huge spectrum of various hemoglobinopathies in southern Odisha resulted in this study warning for the screening of hemoglobinopathies where there is paucity of information as well as for commencement of community based confirmatory screening tests in different geographical regions. Key words: Hemoglobinopathies, Spectrum, Southern Odisha. |
| 249 |
Investigating the Role of T-Regulatory Cells in Inhibitor Formation Among Hemophilia A Patients: A study from tertiary care centre |
1995-01-31 |
Female |
Yes |
LAM-081 | 52439 |
Benign |
Hemeostasis |
Laboratory |
Prof Rashmi Kushwaha1, Prof Suresh Babu1, Dr Mili Jain1, Dr Sanjay Mishra1, Dr S.P. Verma2, Dr Nishant Verma2 1-Department of Pathology, King George’s Medical University, Lucknow, Uttar Pradesh 2-Department of Clinical Hematology & Department of Pediatric |
Dr Shada Bari |
KGMU |
KGMU |
7355107400 |
barishada@gmail.com |
Poster |
Title: Investigating the Role of T-Regulatory Cells in Inhibitor Formation Among Hemophilia A Patients: A study from tertiary care centre
Authors: Dr Shada Bari1, Prof Rashmi Kushwaha1, Prof Suresh Babu1, Dr Mili Jain1, Dr Sanjay Mishra1, Dr S.P. Verma2, Dr Nishant Verma2
Introduction: Development of inhibitors against factor VIII (FVIII) is a major complication in hemophilia A, limiting the efficacy of replacement therapy. Genetic predisposition, treatment-related factors, and immune regulatory mechanisms are implicated, but remain incompletely understood in the Indian population
Methods: A total of 55 patients with hemophilia A were studied and categorized into two groups: Group I (n=27) with inhibitors and Group II (n=28) without inhibitors. Clinical history, bleeding profile, family history, and treatment details were collected. Laboratory investigations included CBC, coagulation assays, mixing studies, and FVIII activity. Immunophenotyping was performed to assess T cell subsets, including regulatory T-cells (Tregs). Statistical significance was determined by Student’s t test, chi-square test, and ANOVA where appropriate.
Results: Inhibitor-positive patients presented at a younger age (14.7±9.8 vs. 22.5±10.3 years; p=0.009) and developed symptoms earlier (3.4±4.3 vs. 8.3±11.3 years; p=0.040). A positive family history was significantly associated with inhibitor development (81.5% vs. 50.0%; p=0.049). Use of recombinant FVIII was more frequent in Group I (59.3% vs. 32.1%). Mixing studies showed prolonged PT (p=0.034), prolonged APTT (p=0.042), and lack of correction in immediate and incubated mixes (p<0.001). Immunophenotyping demonstrated reduced CD4/CD25 ratio (p=0.001). High Bethesda titers correlated with significantly reduced Tregs (p=0.014). Except for lower MCHC (p=0.017), other hematological parameters were comparable.
Conclusions: Inhibitor development in hemophilia A is associated with younger age at presentation, positive family history, and recombinant FVIII exposure. Altered immune regulatory balance, reflected by reduced Treg, appears to play a key role. These findings highlight the need for early immune monitoring and personalized therapeutic strategies in high-risk patients. |
| 250 |
ESTIMATE THE LEVELS OF SELENOPROTEIN P AND GPX3 IN THALASSEMIA MAJOR AND INTERMEDIA PATIENTS |
1995-07-12 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Dr Sanjay Mishra, Prof Rashmi Kushwaha, Dr Mili Jain, Dr S.P.Verma, Dr. Nishant Verma , King Georges Medical University, Lucknow |
Dr Aashi Singhal |
King George's Medical University |
Lucknow |
8126480205 |
aashisinghal12jan@gmail.com |
Poster |
Title: ESTIMATE THE LEVELS OF SELENOPROTEIN P AND GPX3 IN THALASSEMIA MAJOR AND INTERMEDIA PATIENTS
Introduction: Thalassemia major is a chronic, transfusion-dependent hemoglobinopathy associated with progressive iron overload, oxidative stress, and endocrine dysfunction. Among the oxidative biomarkers, Selenoprotein P (SePP), a selenium-transporting glycoprotein- has gained attention for its role in redox regulation and thyroid hormone metabolism.
Methods: This study was conducted over 1.5 years at a tertiary care center in North India, involving 82 participants—53 β-thalassemia patients and 29 healthy controls. Hematological indices were assessed using an automated counter; TSH, ferritin were measured; and SePP, GPX3 levels were quantified via ELISA. Clinical data such as age, transfusion history, and chelation therapy status were also collected.
Results: Results revealed significantly elevated mean SePP levels in thalassemia patients compared to controls (p = 0.028). GPX3 levels were also markedly higher in patients (p < 0.001), reflecting a systemic oxidative stress response. TSH levels were comparable between groups (p = 0.756), although select cases showed borderline elevation.
Conclusions: The study demonstrates that Selenoprotein P and GPX3 are significantly elevated in thalassemia patients, indicative of persistent oxidative stress irrespective of the transfusion load or disease severity. The findings support the utility of incorporating selenium-dependent biomarkers into the clinical monitoring of thalassemia, alongside traditional iron indices, to improve early detection of redox and endocrine complications.
Key words: Thalassemia, oxidative, endocrine, GPX3, transfusion |
| 251 |
A Rare cause of Pyrexia of unknown origin(PUO) : Splenic Sarcoidosis An Enigma |
1997-11-15 |
Male |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Dr. Velu Nair , Haematologist |
Dr. Raj Gabani |
Apollo hospital |
Gandhinagar |
8000707850 |
rajgabani97@gmail.com |
Oral |
Title: A Rare cause of Pyrexia of unknown origin(PUO) : Splenic Sarcoidosis An Enigma
Presenting Author: Dr. Raj Gabani
Introduction:
Sarcoidosis is a chronic systemic granulomatous disease, most commonly involving the lungs and mediastinal lymph nodes. Splenic involvement without pulmonary manifestations is particularly rare. Findings of massive splenomegaly & cytopenias at presentation is atypical and poses a significant diagnostic challenge.
Methods:
We present two rare cases of splenic sarcoidosis.
Case 1: A 48 years female presented with B symptoms (significant weight loss, fever), left side abdominal pain and grossly enlarged spleen (22.5 cm) and liver (18.5 cm). Laboratory evaluation revealed bicytopenia (thrombocytopenia, leukopenia), PET-CT showed diffuse FDG uptake in spleen with reactive changes in marrow, IHC studies on bone marrow showed reactive lymphoid cells in clusters. Evaluation for chronic liver disease, MPN, infectious diseases was negative. Her ACE level was raised (89).
Case 2: A 72 years female presented with low grade fever since 1 year with persistence polymorphonuclear leukocytosis. Examination was normal. Evaluation revealed USG and PET scan showed multiple hypoechoic nodules with increase metabolic activity with axillary and mediastinal lymphadenopathy. LFT and infective workup, MPN panel was negative. Her ACE level was raised(93).
Both patient remains undiagnosed. Then both patients underwent USG guided splenic biopsy for histopathological evaluation
Results:
A definitive diagnosis in both cases was achieved through image-guided splenic biopsy which was uneventful. Histopathological examination revealed non-caseating granulomatous inflammation consistent with sarcoidosis. No evidence of malignancy. Gram, Fungal and AFB stain was negative. We started steroid in both patient and both show good response.
Conclusion:
Though rare, sarcoidosis should be considered in the differential diagnosis while evaluating patients with splenomegaly, cytopenia particularly when systemic evaluation is nondiagnostic. Splenic biopsy plays a crucial role in establishing the diagnosis.
Keywords: Sarcoidosis, Splenomegaly, Splenic Biopsy, Non-Caseating Granuloma, Peripheral Smear, cytopenia |
| 252 |
Clinico-Pathological Profile and Response Assessment of Chronic Myeloid Leukemia Patients Treated with Second-Generation Tyrosine Kinase Inhibitors in a Tertiary Care Hospital |
1993-11-06 |
Male |
No |
- | Regis |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Debmalya Bhattacharyya, Dr. Anupam Chakrapani, Dr. Soumya Bhattacharya, Dr. Chirashree Sanyal, Dr. Abhishek Das, Dr. Arjin Philips, Dr. Ashwini Narayankar, Department of Clinical Hematology and Bone marrow Transplant, Apollo Multispeciality Hospitals, |
Dr. Sayan Sarkar |
Apollo Multispeciality Hospitals, Kolkata |
Kolkata |
9007569514 |
sayan355364@gmail.com |
Oral |
Title: Clinico-Pathological Profile and Response Assessment of Chronic Myeloid Leukemia Patients Treated with Second-Generation Tyrosine Kinase Inhibitors in a Tertiary Care Hospital
Presenting Author: Dr Sayan Sarkar
Introduction: The advent of tyrosine kinase inhibitors (TKIs) has transformed the prognosis of chronic myeloid leukemia (CML), providing patients with near-normal life expectancy. Current therapeutic goals emphasize achieving deeper molecular responses to enable treatment-free remission (TFR). Frontline treatment with second-generation TKIs (2GTKIs) has been shown to induce faster and deeper responses, thereby improving the likelihood of TFR. This study explores the clinico-pathological characteristics and treatment responses of CML patients receiving 2GTKIs at a tertiary care hospital in East India.
Methods: This observational ambispective study included CML patients treated with 2GTKIs at Apollo Multispeciality Hospital, Kolkata over a 3-year period. Data regarding demographics, clinical features, complete hematologic response (CHR), molecular responses, treatment tolerability, and adverse events were collected. Responses were assessed according to European Leukemia Net (ELN) 2020 guidelines.
Results: A total of 53 patients were evaluated. CHR was achieved in 73.7% at 3 months. At 12 months, 41.5 % of patients achieved major molecular response (MMR) and 16.6% achieved deep molecular response (DMR). Early molecular response (BCR-ABL1 ≤10% at 3 months) showed a strong correlation with subsequent achievement of MMR and DMR. Patients with prior imatinib resistance demonstrated slower response kinetics compared to those receiving 2GTKIs as frontline therapy. The most common adverse events included fatigue, headache, diarrhea, and myelosuppression.
Conclusions: 2GTKIs demonstrated high efficacy and favorable response rates in this group of CML patients. Early molecular response emerged as a reliable predictor of long-term outcomes. Regular milestone-based monitoring is essential to identify suboptimal responders and guide timely therapeutic interventions, thereby optimizing the potential for long-term disease control and TFR.
Key words: Chronic Myeloid Leukemia, Tyrosine Kinase Inhibitors, Complete Hematologic Response, Major Molecular Response, |
| 253 |
Nostradamus Meets Haematology: Can Markers of Angiogenesis Predict MRD in Paediatric Acute Lymphoblastic Leukaemia? |
1996-07-20 |
Female |
No |
- | H_LK |
Malignant |
Leukemia & lymphoma |
Laboratory |
Kaninika Sanyal, Pooja Dewan, Anju Khairwa, Richa Gupta, Mrinalini Kotru |
LUBNA SIDDIQUI |
UNIVERSITY COLLEGE OF MEDICAL SCIENCES AND GTB HOS |
DELHI |
7678483165 |
lubna2096@gmail.com |
Oral |
Title: Nostradamus Meets Haematology: Can Markers of Angiogenesis Predict MRD in Paediatric Acute Lymphoblastic Leukaemia?
Introduction: The current risk stratification models of Paediatric ALL rely on clinical and biological parameters such as age, total leukocyte count, and cytogenetic abnormalities to classify patients into high- or low-risk categories. However, these factors do not accurately predict MRD status at diagnosis, as MRD assessment is typically performed after induction therapy. Currently, no validated biomarker exists that can reliably predict MRD status in the pre-induction phase, highlighting the need for novel predictive tools that enable earlier risk-adapted treatment strategies.
Methods: A retrospective study was conducted on 46 bone marrow biopsy specimens. Immunohistochemistry was performed using vascular endothelial growth factor A (VEGF-A) and vascular endothelial growth factor receptor 2 (VEGFR-2) antibodies. The expression of these markers on leukemic blasts, microvascular density (MVD), and relation with megakaryocyte counts was statistically analysed.
Results: The VEGF-A IHC score was significantly higher in patients with MRD-positive status compared to those who were MRD-negative. The mean IHC score in the MRD-positive group was 10.00, whereas in the MRD-negative group it was 4.40. The scores ranged from 2 to 12 in the MRD-positive group and from 0 to 12 in the MRD-negative group. This difference was statistically significant (W = 479.500, p < 0.001), with a large effect size as indicated by the point-biserial correlation coefficient (r = 0.73). However, no association was observed between the expression of VEGF-R2 IHC, MVD and Megakaryocyte count.
Conclusions: Pre-induction MRD prediction with VEGF-A immunoexpression, a marker of angiogenesis, offers potential for enhanced early risk stratification and flagging in pediatric ALL, facilitating timely therapeutic modifications to lower relapse risk. While promising, these approaches require confirmation through large-scale, prospective clinical studies
Key words: MRD, Predict MRD, pediatric ALL, Pre-induction phase, Angiogenesis, VEGF-A, IHC, risk-stratification |
| 254 |
AML-M4E0 with inv(16) (p13q22) /t (16;16)(p13.1q22 ) gene rearrangement: A report of two cases. |
1996-04-24 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Tejaswini Waghmare Professor (Addln.) Seth G.S. Medical college and K.E.M. Hospital |
Komal Badhe |
Seth G.S. Medical college and K.E.M. Hospital |
Mumbai |
8308650516 |
komalbadhe24@gmail.com |
Poster |
Title: AML-M4E0 with inv(16) (p13q22) /t(16;16)(p13.1q22 ) gene rearrangement: A report of two cases.
Introduction: AML-M4E0 is a rare subtype of acute myeloid leukemia characterized by additional presence of eosinophils in a background of myelomonocytic leukemia. It accounts for approximately 5-8% of all AML cases and is relatively more common in younger patients. It is associated with the inv (16)(p13q22) /t(16;16)(p13q22) and classified as acute myeloid leukemia with CBFB::MYH11 fusion in the WHO classification of 2022.
Methods: We present 2 cases of AML-M4E0 diagnosed at our institute. Detailed clinical history including clinical examination and other investigations was retrieved and analyzed.
Results:
Case 1: A 14-year-old female presented with generalized weakness, headache, and abdominal pain. CBC showed Hb 4.6 g/dl, Platelets 19,000/cmm and TLC 12,750/cmm (Myeloblasts 47% Eosinophils 3%). Bone marrow examination revealed increased blasts , monocytes and eosinophils . Flow cytometry revealed acute myeloid leukemia with monocytic differentiation and eosinophilia. Cytogenetics by RT-PCR revealed inv(16)(p13q22)/t(16;16)(p13q22). The patient underwent bone marrow transplant and is clinically stable for the past two years and three months.
Case 2: A 25-year-old male presented with fever, generalized weakness, and ecchymotic patches. CBC showed Hb 7.7 g/dl, Platelets 35,000/cmm, TLC 9,590/cmm (31% myeloblasts, 4% monocytes, 2% eosinophils). On bone marrow aspiration, marrow was hypercellular with 61% blasts, 8% monocytoid cells, 10% eosinophils. Biopsy revealed blasts with monocytoid cells and increased eosinophils. Cytogenetics by RT-PCR showed inv(16)(p13q22)/t(16;16)(p13q22) and molecular analysis revealed CBFB::MYH11 fusion. Patient at present is clinically stable and receiving tablet Azacitidine in cycles of 14 days on treatment followed by 14 days off, in an alternate cycle.
Conclusions: The overall prognosis of AMLM4E0 is good compared to the other subtypes. Therefore, early and accurate recognition through morphology, cytogenetics and immunophenotyping is crucial for favorable outcomes.
Key words: AML-M4E0; myelomonocytic leukemia; CBFB::MYH11 fusion. |
| 255 |
Micro RNA326 : Can this act as surrogate marker to asesss response to therapy In Acute lymphoblastic Leukemia |
1995-03-30 |
Male |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Sarika Singh (Professor, Department of Pathology, Maulana Azad Medical College), Dr Binita Goswami (Professor, Department of Biochemistry, Maulana Azad Medical College), Dr. Khuraijam Bembem (Professor, Department of Pathology, ABVIMS and Dr RML hospi |
Dr. Robin |
Maulana Azad Medical College |
New Delhi |
9654238026 |
robinyadav2009@gmail.com |
Poster |
Title: Micro RNA326 : Can this act as surrogate marker to asesss response to therapy In Acute lymphoblastic Leukemia .
Authors: Dr. Robin, Dr Sarika Singh, Dr Khuraijam Bembem, Dr Binita Goswami, Dr Puneet Kaur Sahi
Introduction: ALL is the most common malignancy of childhood accounting for 25-30% of all paediatric neoplasms worldwide. MRD based risk stratification is considered the standard of care for B ALL patients.
Methods: 20 newly diagnosed cases of B ALL in paediatric population, diagnosed on CBC, PS examination, bone marrow examination and Flow cytometry. microRNA 326 levels were measured at the time of diagnosis and post induction during MRD assessment. 5 age matched healthy controls were taken for reference.
Results: This study analyzed 20 pediatric B-ALL patients, mainly aged 0–12 years (mean 4.6), with slight male predominance (M:F = 1.22:1). Fever (100%), weight loss (90%), and abdominal pain (60%) were common symptoms, while splenomegaly (95%) and hepatomegaly (80%) were frequent signs. Hematology showed anemia in 95% and thrombocytopenia in 75%. Bone marrow blasts averaged 75%, with flow cytometry confirming B-cell lineage (CD19+) and variable CD10, CD22, CD34, CD58, and HLA-DR. MRD follow-up (n=16) found 18.7% positivity. miRNA-326 was significantly downregulated at diagnosis as compared to controls (p=0.024), negatively correlating with blast count (p=0.032) and CD34. At MRD, 2/3 positive patients also showed downregulation compared to healthy controls, though sample size limited significance.
Conclusion: microRNA 326 was significantly downregulated in newly diagnosed ALL cases as compared to controls with a p value of 0.024 making it a potential biomarker for detection of B cell ALL and also as a prognostic marker for MRD detection.
Keywords: B ALL, MRD, microRNA 326, Acute Leukemia, Flow Cytometry |
| 256 |
Evaluation of TRIS-Glucose Buffer for Short-Term Preservation of Semen Parameters: An Experimental Study Using SQA-Vision Automated Analyzer |
2000-01-03 |
Male |
No |
- | pay_R |
Benign |
Miscellaneous |
Laboratory |
Dr Sammar Thakur¹, Dr Tanvi Jha², Dr Umesh Tiwari³, Dr Garima Rakheja⁴, Dr Vijay Kumar⁵ ¹Post Graduate Student, Department of Pathology, ABVIMS & Dr RML Hospital, New Delhi -110001 ²Senior Resident, Department of Pathology, ABVIMS & Dr RML Hospital, New D |
Dr Sammar Thakur |
ABVIMS & Dr Ram Manohar Lohia Hospital |
New Delhi 110001 |
9805625359 |
sammarthakur96@gmail.com |
Oral |
Title: Evaluation of TRIS-Glucose Buffer for Short-Term Preservation of Semen Parameters: An Experimental Study Using SQA-Vision Automated Analyser
Introduction: Accurate semen analysis remains a cornerstone in the evaluation of male fertility; however, delays in sample processing and inappropriate storage conditions can significantly impair sperm quality, particularly in field or resource-limited settings. Buffering agents such as TRIS-glucose buffers have been shown to preserve motility and membrane integrity in semen samples. The SQA-Vision system provides standardized, objective assessment of semen parameters, enabling reliable monitoring of temporal changes under defined storage conditions. This study is designed to evaluate the efficacy of TRIS-glucose buffer in maintaining semen quality during short-term storage at room temperature (~22°C) and refrigeration (4°C), with the overarching aim of identifying optimal strategies for sample preservation when immediate analysis is not feasible.
Methods: A TRIS-glucose buffer was prepared by dissolving TRIS, citric acid and D-glucose in double-distilled water, adjusting the pH to 7.2 ± 0.1, and making the final volume to 100 mL; the solution was stored at 4°C for up to one week. Semen samples were collected from participants after 2–5 days of abstinence, allowed to liquefy, and divided into equal samples. Experimental groups included untreated and TRIS-buffered samples stored at either room temperature (~22°C) or refrigeration (4°C), evaluated at defined time points. For buffered groups, semen was diluted 1:1 with TRIS-glucose solution and stored in labelled microcentrifuge tubes. At each time point, samples were resuspended and analysed using SQA-Vision for sperm concentration, motility, vitality, and morphology under standardised conditions.
Results:
Conclusions: The TRIS glucose buffer has shown improved preservation in various animal studies. The effect of this buffer in preservation of human semen samples will be studied and the final results will be presented during the conference.
Key words: Semen, TRIS glucose buffer, SQA- Vision automated analyzer. |
| 257 |
Blinatumomab as a Bridge to Hematopoietic Stem Cell Transplant in Pediatric Relapsed B-cell Acute Lymphoblastic Leukaemia: A Single-Centre Case Series |
1994-03-30 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Nita Radhakrishnan, Anuj Singh, Sudipto Bhattacharya, Hari Gaire |
Aditi Tulsiyan |
PGICH |
Noida |
8081013856 |
tulsiyanaditi6@gmail.com |
Oral |
Title:
Blinatumomab as a Bridge to Hematopoietic Stem Cell Transplant in Pediatric Relapsed B-cell Acute Lymphoblastic Leukaemia: A Single-Centre Case Series
Background:
Relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL) continues to have poor outcomes, particularly in low- and middle-income countries (LMICs),where chemotherapy has significant toxicity. Achieving measurable residual disease (MRD)-negative status before hematopoietic stem cell transplant (HSCT) is critical for long-term survival. Blinatumomab, a bispecific T-cell engager (BiTE®), offers effective MRD clearance with reduced toxicity compared to conventional chemotherapy. However, data on HSCT-related complications following blinatumomab exposure remain limited in LMIC settings.
Objectives:
To describe our institutional experience of blinatumomab as a bridge to HSCT in pediatric R/R B-ALL, focusing on post-transplant complications.
Methods:
We retrospectively reviewed five pediatric patients with R/R B-ALL treated with blinatumomab prior to HSCT (2020– June 2025). Clinical details collected included stem cell dose, neutrophil/platelet engraftment, donor chimerism and peri trasnplant complications.
Results:
All five patients tolerated blinatumomab and achieved sufficient disease control to proceed to HSCT. 1-2 cycles of Blinatumomab was administered after prior dexamethasone or modified chemotherapy. Engraftment was achieved in all, with >95% donor chimerism documented by day +30. Post-HSCT complications included:engraftment syndrome (n=3) cytomegalovirus (CMV) reactivation (n=4), EBV reactivation (n=1), Clostridium difficle Enterocolitis (n=1), febrile neutropenia (n=1) , and steroid-refractory graft-versus-host disease (GVHD) (n=2). No transplant-related mortality occurred during follow-up.
Conclusion:
Blinatumomab was an effective and safe bridge to HSCT in this pediatric R/R B-ALL cohort. While acute toxicities of blinatumomab were minimal, HSCT was associated with significant immune and infectious complications. Vigilant supportive care, infection surveillance, and tailored GVHD management remain critical in LMIC settings. Larger multi-centric studies are warranted to further define outcomes.
Keywords: Blinatumomab, Pediatric ALL, HSCT, GVHD, CMV, Immunotherapy: |
| 258 |
Assessment of Neutrophil CD64 Expression in Sepsis Patients: Diagnostic and Prognostic Implications |
1996-10-25 |
Female |
No |
- | pay_R |
Benign |
Infection & supportive care |
Laboratory |
Dr. Vinita Paswan, Dr.Vikrant Singh Bhar, Dr. Pankaj Kumar, Assistant Professor, Department of Pathology & Lab Medicine, Dr. Kali Charan Das, Assistant Professor, Department of Anesthesia and Critical care, Dr. Mir Altaf Ahmed, Assistant Professor, Depart |
Dr. Vutla Saisree |
AIIMS Raebareli |
Raebareli |
9963416861 |
saisreevutla9963@gmail.com |
Poster |
Title: Assessment of Neutrophil CD64 Expression in Sepsis Patients: Diagnostic and Prognostic Implications
Introduction: Sepsis is a leading cause of morbidity and mortality in critically ill patients and its early diagnosis remains challenging. Traditional methods, such as blood cultures, though considered the gold standard, are time-consuming and may yield false-negative results. Hence, rapid biomarkers such as CD64 expression on neutrophils are being explored for early sepsis detection.
Methods: The present study included forty clinically diagnosed cases of sepsis, aged over 18 years, admitted to the Intensive Care Unit (March-August 2025) and twenty healthy controls. EDTA blood samples were collected for complete blood counts (Sysmex XN-1000) and CD64 expression on neutrophils by flowcytometry (Beckman Coulter DxFLEX cytometer). The lyse–stain–wash method was used to process samples for flowcytometry. Cases were followed up for 28 days to assess clinical outcome and categorized as survivors and non-survivors for prognostic evaluation. Statistical analysis was done using SPSS software and p<0.05 is considered significant.
Results: The mean fluorescence intensity (MFI) of CD64 was significantly higher in sepsis patients as compared to healthy controls (23,450 ± 3,118 for sepsis vs. 11,656 ± 1,613 for controls; p value = 0.02). Out of forty cases, twenty-six were categorized as survivors and fourteen as non survivors. The MFI of CD64 did not differ significantly between the two groups (26,490 ± 4,195 for survivors vs. 22,319 ± 3,351 for non-survivors; p value= 0.5082).
Conclusions: Neutrophil CD64 is a sensitive marker for early sepsis diagnosis. A larger sample size is needed to more accurately assess the prognostic significance of CD64 in sepsis outcomes.
Key words: Sepsis, Neutrophil CD64 expression, Flowcytometry, Survivors, Non-survivors. |
| 259 |
Unmasking the JAK2 Mutation Spectrum: Insights from Institutional Data |
1997-11-10 |
Male |
No |
- | pay_R |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Dr. Eveeta1, Dr. Abhishek Purohit1, Dr. Poonam Elhence1, Dr. Satyendra Khichar2, Dr. Gopal Krishana Bohra2, Dr. Parmod Kumar3 Department of Pathology & Lab Medicine1, General Medicine2, Medical Oncology3 |
Dr. Sachin |
All India Institute of Medical Sciences, Jodhpur |
Johhpur |
9620260370 |
adns5876@gmail.com |
Poster |
Title: Unmasking the JAK2 Mutation Spectrum: Insights from Institutional Data
Authors: Dr. Sachin1 , Dr. Eveeta1, Dr. Abhishek Purohit1, Dr. Poonam Elhence1, Dr. Satyendra Khichar2, Dr. Gopal Krishana Bohra2, Dr. Parmod Kumar3
Department of Pathology & Lab Medicine1, General Medicine2, Medical Oncology3
Introduction: Since their discovery in 2005, JAK2 mutations have been integrated into WHO’s diagnostic guidelines, enhancing myeloproliferative neoplasms (MPN) classification accuracy and patient management. The JAK2 V617F mutation is present in over 95% of polycythemia(PV) cases, about 50-60% of (Essential thrombocythemia)ET and (Primary myelofibrosis)PMF cases, emphasizing its role in detecting clonal haematopoiesis and distinguishing MPNs from reactive conditions.
Methods: We recently started molecular haematology testing facility at our institute. Suspected MPN cases are referred from Haematolgy clinic. The JAK2 V617F mutation was detected using a qualitative reverse transcriptase polymerase chain reaction (RT-PCR) assay. This method amplifies mutant and wild-type alleles from extracted genomic DNA obtained from EDTA-anticoagulated whole blood. Using mutation-specific primers and fluorescent probes, the assay selectively identifies the presence of the V617F point mutation.
Results: A total of 52 samples were analysed, including 11 females and 41 males. JAK2 mutation was detected in 9 cases, comprising 5 females aged 45 to 72 years and 4 males aged 35 to 69 years. Haematological parameters among mutation-positive cases showed haemoglobin levels ranging from 11.6 to 19.3 g/dL, haematocrit values between 35.71% and 60.5%, total leukocyte counts from 7,640 to 37,700 cells/mm³, and platelet counts ranging from 2.1 to 18.97 lakhs/mm³.
Conclusion: Detection of the JAK2 mutation improves diagnostic accuracy and classification of MPNs according to WHO guidelines. Routine molecular testing enables early diagnosis, guides patient management, and aids prognostic assessment in PV, ET, and PMF. Our institutional results emphasize the critical role of JAK2 testing in haematological evaluations, supporting its inclusion as a key WHO diagnostic criterion.
|
| 260 |
Fixed Dose RA inspired regimen of Rituximab in Adults with Immune Thrombocytopenia |
1990-06-26 |
Female |
No |
- | pay_R |
Benign |
Platelet disorders |
Clinical |
Dr. Nitin Gupta, Dr. Priyamvadha, Dr. Meena Verma |
Shruti Sinha |
Sir Ganga Ram Hospital, New Delhi |
NEW DELHI |
9740838575 |
sinhashruti06@gmail.com |
Oral |
Title: Fixed Dose RA inspired regimen of Rituximab in Adults with Immune Thrombocytopenia
Introduction: There is limited real world data (and none from India) indicating that the fixed dose rituximab regimen of 1g- 2 weeks apart, is an equally efficacious and cost effective alternative to the traditional regimen (375 mg/m2 weekly for 4 weeks), used as second-line therapy in ITP. We aimed to study the efficacy of this regimen in ITP.
Methods: A single-center observational cohort of adult ITP patients, relapsed, or refractory to first line treatment (steroids and/or IVIG), who received rituximab 1g- 2 weeks apart, from January 2021 to July 2025 at Sir Ganga Ram Hospital, New Delhi, was analysed.
Results: Among 36 included patients (median age 43 years; 72% female), baseline median platelets were 7×10^9/L; 69% (25/36) had grade ≥2 bleeding; 64% (23/36) were steroid-dependent and 44% (16/36) were steroid-refractory. ORR was 89% (32/36) with CRR of 78% (28/36). Durable (≥ 6 months) ORR was 58% (14/24) in those with a follow -up duration of at least 6 months. Median TTR was 3.5 weeks; median DOR was 14 weeks (maximum 116 weeks and minimum 4 weeks). Autoantibodies were positive in 50% (16/32) of the responsive cases. Response was attained in most patients with additional first or second line therapy. Those who required additional therapy to maintain response were not considered rituximab responsive. 2 patients who received rituximab fixed dose post relapse, with prior durable response with the traditional regimen, had similar DOR and TTR. Only 1 patient had recurrent respiratory tract infections and hypogammaglobulinemia and none had infusion reactions beyond grade 1-2.
Conclusions: In this real-world cohort, fixed-dose rituximab achieved clinically meaningful steroid and splenectomy sparing responses with acceptable safety and outcomes at least comparable to the 4-dose rituximab regimen.
Key words: Immune thrombocytopenia, rituximab, 1g
|
| 261 |
Neonatal Screening for Hemoglobinopathies: The time is now |
1975-10-11 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Shikha Maljk, Pooja Soni |
Bhavna Dhingra |
AIIMS BHOPAL |
AIIMS/BHOPAL/MP |
7773012600 |
bhavna.pediatrics@aiimsbhopal.edu.in |
Oral |
Title:
Introduction: Haemoglobinopathies are common monogenic disorders and impose a significant health burden in India. Early identification through newborn screening (NBS) facilitates timely intervention, genetic counselling, and option of informed reproductive choices. Madhya Pradesh - with 21% population being tribal - the burden of hemoglobinopathies is huge.
Methods: Prospective observational study at Tertiary care facility in Central India. With funding from State, a laboratory was set up for newborn screening for Hemoglobinopathies. After ethics clearance, and parental informed consent -Samples were collected on DBS Filter papers by heel-prick from newborns between 48-72 hours of life (> 37 weeks' gestation) delivered at the institute. 2893 neonates were screened between July 2022 to June 2025. newborns with a history of packed red cell transfusion on first two days of life were excluded. Samples were analyzed using capillary electrophoresis (Neonatfast from Sebia). Abnormal results were repunched and positives were classified as Screen positive- who underwent cascade screening for parents and molecular confirmation was advised.
Results: From July 2022 to June 2025,2893 newborns were screened. 158 (5.4%) were identified with abnormal hemoglobin patterns - sickle cell heterozygous, HbD trait and HbE trait. One case was identified as beta thalassemia carrier on mutation analysis. Parental screening was available for 98 cases.
Conclusions: Burden of hemoglobinopathies can be offset by prevention and newborn screening can guide for informed reproductive choices in subsequent pregnancy. Early intervention can reduce morbidity.
Key words: Hemoglobinopathy, neonatal screening, prenatal diagnosis, genetic counselling |
| 262 |
POEMS–Castleman Mixed Variant with Peculiar CNS and Multisystemic Features Masquerading as Disseminated Tuberculosis: A Case Report |
1992-05-05 |
Female |
No |
- | H_LKO |
Malignant |
Plasma cell disorders |
Clinical |
Ashima Mishra¹, Satyendra Khichar², Rakesh Kumar³, Niharika Singh⁴ ¹Senior Resident, Department of Internal Medicine, AIIMS Jodhpur ²Associate Professor, Department of Internal Medicine, AIIMS Jodhpur ³Hematology Fellow, AIIMS Jodhpur ⁴Hematology Fellow, |
Ashima Mishra |
AIIMS Jodhpur |
Jodhpur |
8895724532 |
ashimamishra64@gmail.com |
Poster |
POEMS–Castleman Mixed Variant with Peculiar CNS and Multisystemic Features Masquerading as Disseminated Tuberculosis: A Case Report
Introduction-
Central nervous system (CNS) involvement is rare in POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) syndrome and Castleman disease. Reported features include cerebral infarcts, CNS angiitis, enhancing mass lesions, and pachymeningeal enhancement. Cranial vault erosion is uncommonly linked to plasmacytomas or sclerotic lesions. Ocular findings usually involve papilledema; optic nerve sheath enhancement is exceptionally rare. Partial empty sella, possibly endocrinopathy-related, is seldom described. We report a young male with POEMS–Castleman mixed variant with gastrointestinal, pulmonary, and neurological features misdiagnosed as disseminated tuberculosis (TB).
Case Summary-
A 28-year-old male presented with fever, anasarca, cough, and diarrhea for three months. Imaging showed ascites, hepatosplenomegaly, abdominal and retroperitoneal lymphadenopathy, mesenteric fat stranding, centrilobular nodules with tree-in-bud pattern, and pleuropericardial effusion. Despite nine months of antitubercular therapy, symptoms persisted. He developed hypothyroidism, demyelinating polyneuropathy, and visual blurring with grade 3 disc edema. Neuroimaging revealed gliosis from prior infarcts, pachymeningeal enhancement, bilateral optic nerve sheath enhancement, papillitis, partial empty sella, and occipital–clival erosions. Further scans showed bulky kidneys, perinephric fat stranding, and vertebral sclerotic-lytic lesions. PET-CT revealed metabolically inactive nodes; biopsy confirmed mixed-variant Castleman disease. Serum protein electrophoresis detected IgG-lambda monoclonal spike with elevated IgG, while hormonal profile showed hypocortisolism and hypogonadism. Bone marrow cytogenetics revealed anomalies involving chromosome 14q. Additional findings included clubbing, edema, Raynaud’s phenomenon, hyperpigmentation, and elevated IL-6. A diagnosis of POEMS syndrome was made, and bortezomib, lenalidomide, and dexamethasone therapy led to marked improvement.
Conclusion-
In TB-endemic regions, POEMS and Castleman disease should be considered as differentials of TB in refractory cases even among young patients. This case highlights rare CNS manifestations, enriching the literature on these uncommon disorders.
Keywords-POEMS,Castleman,Optic nerve sheath,cranial nerves and Pachymeningeal enhancement,skull vault erosion,partial empty sella,glioencephalomalacic changes
|
| 263 |
Extranodal NK/T-cell Lymphoma with Bone Marrow Relapse: Diagnostic Utility of Flow Cytometry and Biopsy |
1996-05-25 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
1.Dr Pronati Gupta, Specialist Hematopathologist,CNCI. 2.Dr Debdeep Biswas,Post Graduate,CNCI.3.Dr Subhajit Hajra Specialist Hematopathologist,CNCI. |
Dr Sada Mounika |
Chittaranjan National Cancer Institute |
Kolkata |
9052912668 |
dr.sadamounika25@gmail.com |
Poster |
Title:Extranodal NK/T-cell Lymphoma with Bone Marrow Relapse: Diagnostic Utility of Flow Cytometry and Biopsy
Introduction:Extranodal NK/T-cell lymphoma (ENKTL), is a rare and aggressive non-Hodgkin lymphoma strongly associated with Epstein–Barr virus. Although it typically presents in the nasal cavity and upper aerodigestive tract, advanced disease with bone marrow involvement is uncommon and carries a poor prognosis
Methods:48-year-old male, presented with bilateral nasal mass since 6 months, underwent submucous resection and left sided nasal mass excision. After one month he developed a right sided facial swelling, on examination of the right side nasal cavity there is a globular mass and diagnosed as extranodal NK/T-cell lymphoma on histopathological examination and received chemotherapy. Following therapy he presented with persistent anemia and bone marrow examination was done to rule out bone marrow infiltration.
Complete blood counts revealed anemia (Hb 8.5 g/dL), normal WBC count with neutrophilic predominance. Bone marrow aspiration demonstrated mild hypercellularity with infiltration by 29% atypical lymphoid cells of medium-to-large size, coarse chromatin, and prominent nucleoli.
Trephine biopsy showed hypercellular marrow (80–85%) with interstitial infiltration by atypical lymphoid cells, positive for CD3 and CD56, and negative for CD5, consistent with marrow infiltration by lymphoma.
Flow cytometry demonstrated an abnormal lymphoid population (12% of events) with CD56 positivity and cytoplasmic CD3 expression, but negative for CD5, CD7, CD4, and CD8, confirming NK/T-cell lineage.
Results:Both biopsy and flow cytometry confirmed marrow infiltration.
Flow cytometry provided rapid and specific immunophenotypic characterization, complementing histopathology
Conclusions:This case highlights the importance of integrating morphology, immunohistochemistry, and flow cytometry in detecting bone marrow involvement in ENKTL. Bone marrow infiltration, though uncommon, signifies advanced disease with prognostic implications and should be carefully evaluated
Key words: Extranodal NK/T cell lymphoma, Flow cytometry, Biopsy, HPE |
| 264 |
A Rare Presentation of Evans Syndrome in a Young Female |
1984-02-07 |
Female |
No |
- | 56095 |
Benign |
Transfusion medicine |
Clinical |
Prof. Prashant Agarwal , Prof. Priti Elhence |
Dr. Jyoti Bharti |
Sanjay Gandhi Post Graduation Institute of Medical |
Lucknow |
9305240130 |
jyoti73890@gmail.com |
Oral |
Title: A Rare Presentation of Evans Syndrome in a Young Female
Introduction: Evans syndrome (ES) was first described in 1951 by Robert Evans. It is an autoimmune condition that presents two or more cytopenias, which commonly include autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP), with or without immune neutropenia. The type of AIHA that presents in Evans syndrome is warm AIHA, in which IgG antibodies react with red blood cell (RBC) surface antigens at body temperature, as opposed to cold AIHA. In ITP, the immune system is directed against GPIIb/IIIa on the platelets.
Methods: Here is a case report of a 29-year-old female admitted in April 2025 to the department of emergency medicine at our hospital, with chief complaints of gingival bleeding, petechiae, and rashes. On hematological investigations, she had low Hb- 2.8 gm/dl with very low platelet counts of 3000X10³ mm³ and absolute neutrophil count ranging from a low of 2,070 cells/µL to a high of 6,956 cells/µL after treatment.
Results: During the cross-matching, we did not get any compatible PRBC units. After the serological evaluation of autoimmune haemolytic anemia (AIHA), it was found to be a case of warm AIHA with clinical signs of hemolysis. The best-matched packed red blood cell transfusion (PRBC) was done, and her condition improved. Over time, her clinical condition significantly improved, indicating the effectiveness of the combined therapeutic approach.
Conclusions: This observation suggests that corticosteroids, when administered in conjunction with transfusions, may play a crucial role in enhancing hemoglobin levels and improving overall clinical status, even in patients with ITP. The prognosis for patients with Evans syndrome is uncertain; those who react well to treatment see favorable outcomes.
Key words: Autoimmune hemolytic anemia, Evans Syndrome, immune thrombocytopenia, Low Platelet Counts, Autoimmune disorder
|
| 265 |
Effectiveness of Romiplostim and Eltrombopag as a Dual Agent in the Treatment of
Aplastic Anemia: A Prospective Study”( an interrim analysis) |
1992-01-13 |
Male |
Yes |
L-2191 | pay_R |
Benign |
Marrow failure |
Clinical |
Dr Tuphan kanti Dolai,Dr Subham Bhattacharya |
Dr Subhra Kamal Saha |
Nil Ratan Sircar Medical College and Hospital |
Kolkata |
09476359941 |
subhrakamal.saha12@gmail.com |
Oral |
Title:Effectiveness of Romiplostim and Eltrombopag as a Dual Agent in the Treatment of Aplastic Anemia: A Prospective Study
Introduction: Aplastic anemia ,type of bone marrow failure syndrome characterized by pancytopenia and hypocellular marrow. Immunosuppressive therapy (IST) remains the standard of care.Thrombopoietin receptor agonists (TPO-RAs)like Eltrombopag and Romiplostim, have individually demonstrated multilineage hematopoietic recovery. Data on their combined use are scarce.
Methods: Diagnosis and classification of aplastic anemia is done by published criteria. Patients attending at OPD, IPD and General Day Care will be studied. The clinical history, transfusion dependency history taken and hematological, biochemical, bone marrow examination will be done. After that Inj Romiplostim subcutaneously dose 15 mcg /kg weekly and Tab Eltrombopag 100 mg are given simultaneously for a period of 6 month. Primarily to assess the effectiveness of combination of Romiplostim and Eltrombopag as a dual agent and specifically to assess the overall response transfusio dependency,estimate the 6-month overall survival,ECOG performance status at 3 month and 6 month interval. Adverse effect monitored.
Results: At 6 months, hematologic response was achieved in 44 patients (66.6%), with complete response in 25 (37.8%). Erythroid, platelet, and neutrophil responses were observed in 68%, 64%, and 53% of patients respectively. Transfusion independence was attained in 64%. Median time to response was 18 weeks. The estimated 1-year overall survival was 86%. Adverse events included mild hepatotoxicity (10%).No clonal evaluation noted.
Conclusion: Dual therapy with Romiplostim and Eltrombopag is effective and safe in aplastic anemia, with encouraging response rates and manageable toxicity.These results highlight its potential as a novel therapeutic strategy, though long-term follow-up is warranted to confirm durability of response and evaluate risk of clonal evolution.
Key word: (AA )Aplastic Anemia, (TPO RA) Thrombopoetin receptor agonist,(IST)immuno supressive therapy |
| 266 |
“FLAER-Based Multiparameter Flow Cytometry:
A Sensitive Tool for Detecting and Characterizing PNH Clones”
|
1991-08-14 |
Female |
No |
- | T2508 |
Benign |
Marrow failure |
Laboratory |
Dr. Rashmi Kushwaha |
Dr. Anjali Rachna |
King George's Medical University |
Lucknow |
9532956932 |
anjalirachna27@gmail.com |
Poster |
Title: “FLAER-Based Multiparameter Flow Cytometry:
A Sensitive Tool for Detecting and Characterizing PNH Clones”
Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disorder characterized by intravascular hemolysis, thrombosis, and bone marrow failure. The advent of flow cytometry using fluorescent aerolysin (FLAER) in combination with lineage-specific markers has revolutionized PNH diagnosis, enabling highly sensitive detection of glycosylphosphatidylinositol (GPI) anchor–deficient cells.
Aim: To evaluate the diagnostic utility of FLAER in combination with CD157, CD45, CD15, and CD64 multiparameter flow cytometry for the detection and characterization of PNH clones in patients with suspected PNH or related bone marrow failure syndromes.
Methods: A total of 70 patients with clinical suspicion of PNH or marrow failure syndromes were evaluated. Peripheral blood samples were analyzed by multiparameter flow cytometry using FLAER in combination with CD157, CD45, CD15, and CD64 to assess granulocyte and monocyte lineages. PNH clone sizes were categorized as small (<10%), intermediate (10–50%), and large (>50%).
Results: Out of the 70 cases, 20 (28.6%) demonstrated detectable PNH clones, while 50 (71.4%) tested negative. Among the positive cases, clone sizes varied: • Small clones (<10%) were observed predominantly in patients with bone marrow failure syndromes. • Larger clones (>50%) were strongly associated with clinical hemolysis.
Conclusions: FLAER-based flow cytometry combined with lineage-specific markers provides a highly sensitive and reliable diagnostic tool for detecting and monitoring PNH clones. The early detection of even small clones is clinically significant, facilitating timely diagnosis, risk stratification, and optimal patient management.
Key words: Paroxysmal nocturnal hemoglobinuria, FLAER, flow cytometry, GPI anchor deficiency, bone marrow failure, hemolysis |
| 267 |
Efficacy and Safety of Eltrombopag in Increasing Platelet Counts in Patients with Aplastic Anemia: Multicentre retrospective study |
1984-08-03 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
1. A Harshavardhan,MD Oncologist, American Oncology Institute in Lingampally, Hyderabad, 2. B Pawan Kumar, MD Oncologist, Indo American hospital, Hyderabad,3.Mitesh Kumar Dilip Kumar Halvawala, MD Oncologist, Sanguine Hemato-oncology Clinic, Surat.4.Richa |
Suyash Bharat Sharma |
Zydus Lifesciences Ltd |
Ahmedabad |
9760267848 |
Suyash.Bharat@zyduslife.com |
Poster |
Title: Efficacy and Safety of Eltrombopag in Increasing Platelet Counts in Patients with Aplastic Anemia: Multicenter retrospective study Introduction: Eltrombopag, an oral thrombopoietin receptor agonist, has shown potential in the management of aplastic anemia (AA)-related thrombocytopenia. This study evaluated its short-term efficacy and safety in patients with varying severities of AA. Methods: Data of fifty-nine patients with AA were retrospectively analyzed (mean age: 50.90±13.33 years; mean weight: 59.24±9.04kg) who received Eltrombopag with Standard Treatment. Disease severity included non-severe AA (n=14), severe AA (n=36), very severe AA (n=6), and data unavailable (n=3). Platelet counts were recorded at baseline and after 3 months. Safety was assessed through adverse event monitoring.
Results: The median starting dose of Eltrombopag (Elromo) was 75 mg daily. And majority of SAA and Very SAA received 150 mg eltrombopag along with standard treatment. In patients with aplastic anemia, platelet counts showed improvement across all subgroups at 3 months. Severe aplastic anemia patients had the highest rise, increasing from 35,222 ± 33,499/µl at baseline to 151,528 ± 198,923/µl (mean gain 116,306 ± 165,424/µl). Non-severe cases improved from 32,964 ± 26,373/µl to 94,457 ± 42,772/µl (gain 61,493 ± 16,398/µl), while very severe cases rose from 25,667 ± 28,724/µl to 69,667 ± 50,875/µl (gain 44,000 ± 22,151/µl). Adverse events were rare, reported in only 2 patients (fatigue and headache, both grade 1), with no dose modifications or treatment discontinuations required.
Conclusions: Eltrombopag was effective in significantly increasing platelet counts in both severe and non-severe AA, with excellent tolerability. The minimal incidence of mild adverse events highlights its safety and clinical applicability. These findings support the role of eltrombopag as a valuable therapeutic option in AA. Key words :Eltrombopag, aplastic anemia, |
| 268 |
BCMA- Directed Bispecific Antibody Therapy achieving Durable Remission in Plasma Cell Leukemia: A Real World Case Experience |
1989-04-10 |
Female |
No |
- | H_LKO |
Malignant |
Plasma cell disorders |
Clinical |
Dr Rahul Bhargava Department of Hematology and Bone Marrow Transplantation, International Oncology Cancer Insitute Fortis Hospital Noida |
Dr Priyanshi Pachauri |
International Oncology Cancer Institute, Fortis Ho |
Noida |
08860850080 |
priyanshipachauri@gmail.com |
Oral |
Title: BCMA- Directed Bispecific Antibody Therapy achieving Durable Remission in Plasma Cell Leukemia: A Real World Case Experience
Introduction: Plasma cell leukemia is a rare and aggressive plasma cell dyscrasia with dismal outcomes, even in era of novel agents and bone marrow transplantation. Emerging BCMA directed bispecific antibodies offer a new therapeutic avenue in this high risk disease
Methods:: We report a clinical course of 59 years old female with Primary Plasma cell leukemia (13 q deletion). She received four cycles of Daratumumab based induction (Dara-VRd), achieving complete remission. She underwent autologous stem cell transplantation followed by Dara VRd consolidation; Day+100 marrow confirmed MRD negativity
Results: At six months post-transplant the patient developed disease relapse. She was initiated on Teclistamab; a BCMA directed bispecific antibody; in November 2024 . The patient achieved complete remission which has been sustained for 9 months at the time of reporting.
Conclusions: This case demonstrates the potential role of teclistamab in relapsed PCL even after autologous transplant and exposure to multiple novel agents The durable remission achieved highlights the promise of BCMA directed bispecific antibodies as an effective treatment strategy in this high risk population.
Key words: Plasma cell leukemia, 13 q deletion, autologous stem cell transplantation, BCMA bispecific antibody, Teclistamab, Complete remission |
| 269 |
Blood Group and Vascular Access as Determinants of Complications in Therapeutic Plasma Exchange |
1984-07-02 |
Female |
No |
- | 56095 |
Benign |
Transfusion medicine |
Clinical |
Tulika Chandra, Archana Solanki, Ashutosh Singh |
Dr. Jyoti Bharti |
King George Medical University, Lucknow |
Lucknow |
9305240130 |
jyoti73890@gmail.com |
Oral |
Title: Blood Group and Vascular Access as Determinants of Complications in Therapeutic Plasma Exchange
Introduction: Apheresis (plural aphereses; from the ancient Greek aphaire-sis, “a taking away”) is a procedure in which whole blood is removed from the body and passed through an apparatus that separates one (or more) particular blood constituent. This study observes the correlation between complications due to the Therapeutic plasma exchange (TPE) and the patient’s blood group.
Methods: This is a one-year (01/09/2020 to 31/08/2021) prospective observational study conducted by the Tertiary Care Center in northern India. In this, included all the patients, who required TPE, as a part of their management. For inclusion criteria, plasma exchange is done on who fulfilled the criteria for TPE as per the guidelines laid down by the Directorate General Health Services (DGHS). (3) Exclusion criteria included patients who were not given informed consent for TPE.
Results: Total of 150 cycles of TPE were done on 60 cases. The mean age of total patients was 31.95±11.66 and the most prevalent age group was 30-49 years with the maximum number of patients [78(52%)] followed by 10-29 years [66(44%)]. Female dominance was observed [78(52%)] over males [72(48%)] and majority of patients reported to have BMI>30 [126(84%)], followed by 25.00-29.99 [22(14.67%)].
Conclusions: Patients with the O-positive blood group showed maximum complications while patients with the A-positive had maximum allergic complications. By this, we could be prepared for any kind of complications before the procedure started.
Key words: Times New Roman |
| 270 |
Management of Intracranial Haemorrhage in Children and Adolescents with Hemophilia: A Single-Center Experience |
1994-03-20 |
Female |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
Nita Radhakrishnan, Anuj Singh, Sudipto Bhattarcharya, Hari Gaire |
Aditi Tulsiyan |
PGICH |
Noida |
8081013856 |
Tulsiyanaditi6@gmail.com |
Poster |
Title:
Management of Intracranial Haemorrhage in Children and Adolescents with Hemophilia: A Single-Center Experience
Background:
Intracranial haemorrhage (ICH) is a rare but life-threatening complication in hemophilia, often associated with poor outcomes. Data on pediatric ICH from India remain limited.
Methods:
We retrospectively analysed children and adolescents (≤18 years) with hemophilia presenting with ICH between July 2024 and June 2025 at our center. Demographic data, clinical presentation, neuroimaging findings, factor replacement, inhibitor status, and outcomes were reviewed.
Results:
Seventeen patients were included (hemophilia A: 15, hemophilia B: 1, factor VII deficiency: 1). All patients had baseline factor level <1%. The median age was 9 years (range 3–20). Fourteen bleeds were spontaneous and three were trauma-related. Common presentations were headache (76%), vomiting (59%), altered sensorium (29%), seizures (29%), and focal deficits (18%). Haemorrhage sites included subdural, intraparenchymal, subarachnoid, and extradural locations. Inhibitor screening was positive in 6/17 (35%). Management included factor VIII/IX replacement (12), FEIBA (2), Emicizumab (3), and FVII concentrate/FFP (1). Three patients (17.6%) succumbed to the bleed. Of the survivors, 7 recovered without sequelae, 3 with neurological deficits, and 2 required neurosurgical referral. Secondary prophylaxis was initiated in all patients following recovery.
Conclusion:
ICH in hemophilia carries significant mortality (17.6%) and morbidity. Early recognition, urgent neuroimaging, and prompt factor replacement are critical for survival. Availability of bypassing agents and prophylaxis improve outcomes, highlighting the need for comprehensive hemophilia care in resource-limited settings.
Keywords: Hemophilia, Intracranial haemorrhage, Inhibitors, Factor replacement therapy,Emicizumab,Prophylaxis
|
| 271 |
EVALUATION OF IMMUNOPHENOTYPIC ABERRANCIES IN CASES OF B-ACUTE LYMPHOBLASTIC LEUKEMIA BY FLOW CYTOMETRY AND THEIR UTILITY IN MINIMAL RESIDUAL DISEASE ESTIMATION |
1998-03-14 |
Female |
No |
- | Payme |
Malignant |
Leukemia & lymphoma |
Laboratory |
Authors: Sharumathi E1, Tejasvi S1, Siyaram Didel2, Abhishek Purohit1, Poonam Elhence1 Department of Pathology & Lab Medicine1, Paediatrics2 |
Sharumathi E |
All India Institute of Medical Sciences |
Jodhpur, Rajasthan |
8300046976 |
esharumathi@gmail.com |
Poster |
EVALUATION OF IMMUNOPHENOTYPIC ABERRANCIES IN CASES OF B-ACUTE LYMPHOBLASTIC LEUKEMIA BY FLOW CYTOMETRY AND THEIR UTILITY IN MINIMAL RESIDUAL DISEASE ESTIMATION
Authors: Sharumathi E1, Tejasvi S1, Siyaram Didel2, Abhishek Purohit1, Poonam Elhence1
Department of Pathology & Lab Medicine1, Paediatrics2
Introduction:
B-cell acute lymphoblastic leukemia(B-ALL), the most common childhood malignancy, arises from immature B-cell precursors. Flow cytometry is an effective tool for diagnosis and for the identification of leukemia-associated immunophenotypes (LAIPs). These immunophenotypic aberrancies serve as distinct markers for monitoring leukemic cells during measurable residual disease (MRD) assessment, which is considered the strongest independent prognostic factor in ALL.
Material and methods:
This prospective observational study enrolled 33 newly diagnosed B-ALL patients at AIIMS, Jodhpur, between October 2023 and February 2025. Bone marrow aspirate and peripheral blood samples were processed using a ten-color antibody panel at diagnosis, with day30 post-induction samples analyzed for MRD in 26 patients. Two tubes were added to the routine diagnostic panel containing six backbone markers (CD45-KRO/CD34-ECD/CD38-PB/CD19-PC7/CD10-PC5.5/CD20-APC700) and seven LAIP markers (CD58-FITC/CD73-PE/CD123-APC/CD86-APC750 in tube1 and CD81-FITC/CD66c-PE CD200-APC750 in tube2). Samples were acquired on the Beckman Coulter DxFLEX analyser and were analysed using CytExpert.
Results:
The most common aberrancies detected at baseline were CD58(100%), CD73(87.9%), CD123(66.7%), and CD200(60.6%). Cytogenetic abnormalities were identified in 30.8% of evaluable cases, including TCF3-PBX1, ETV6-RUNX1, and BCR-ABL1. MRD positivity was observed in 7.7%(2/26) of cases, one with BCR::ABL1 fusion and another with CD10 negativity and leukocytosis. No significant association was found between MRD status and baseline parameters; however, loss of CD10 and CD20 expression appeared to be associated with persistent disease.
Conclusion:
Early recognition of immunophenotypic aberrancies enables effective monitoring of MRD, providing critical guidance for risk-adapted therapy. This approach is particularly valuable in resource-limited healthcare settings where standardized, cost-effective protocols can substantially improve patient outcomes.
|
| 272 |
Unshattered: The Breakage of the Fusion and a Bridge to Hope with Successful Haplo-identical Stem Cell Transplantation in a Child with iAMP21 Acute Lymphoblastic Leukaemia |
1990-06-02 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Bharath Vikram, SGPGI; Dr Manisha Netam, SGPGI; Dr Sanjeev, SGPGI; Dr Sayan Sinha Roya, SGPGI; Dr Souvik Saha, SGPGI; Dr Rajesh Kashyap, SGPGI; Dr Manish K Singh, SGPGI; Dr DInesh Chandra, SGPGI; Dr Ruchi Gupta, SGPGI; Dr Khaliqur Rahman, SGPGI |
Dr Poorvi Kapoor |
Dr Ram Manohar Lohia Institute of Medical Sciences |
Lucknow |
9739237617 |
doctorpoorvikapoor@gmail.com |
Poster |
Title: Unshattered: The Breakage of the Fusion and a Bridge to Hope with Successful Haplo-identical Stem Cell Transplantation in a Child with iAMP21 Acute Lymphoblastic Leukaemia Authors: Dr Poorvi Kapoor, Dr Mona Viajayaran Introduction: Intrachromosomal amplification of chromosome 21 (iAMP21) is observed in only 2% of pediatric B-cell acute lymphoblastic leukemia (B-ALL) cases and is considered a high-risk cytogenetic abnormality arising from a breakage-fusion-bridge mechanism. Current evidence lacks consensus on the role of allogeneic stem cell transplantation (allo-SCT) in first remission, particularly in resource-constrained settings Methods: We report the case of an 8-year-old male who presented with a pea-sized cervical swelling and diffuse bony pains for one month. Peripheral smear revealed 70% atypical lymphoid cells, and flow cytometry confirmed B-ALL. CSF was positive for blasts. FISH demonstrated RUNX1 amplification and CRLF2 rearrangement in 71% and 69% of cells, respectively. The patient was initiated on BFM95 protocol and achieved measurable residual disease (MRD) negativity post-induction and consolidation. High-dose methotrexate (four cycles) was administered, followed by an allo-SCT from his haploidentical sibling donor (6/12 HLA match). Conditioning comprised fludarabine and total body irradiation (12 Gy). GVHD prophylaxis included post-transplant cyclophosphamide, cyclosporine, mycophenolate mofetil and abatacept Results: The patient experienced grade 1 cytokine release syndrome and mucositis, with neutrophil and platelet engraftment on day +12. Day +30 MRD was negative with 100% donor chimerism. Day +35, he developed fever and rash; biopsy excluded GVHD or infection, and symptoms resolved with topical steroids. Subsequently, he developed grade 1 acute cutaneous GVHD, managed with topical therapy. At day +135 post-transplant, the patient remains MRD-negative, GVHD-free, and in complete donor chimerism Conclusions: In resource-limited settings, where relapse therapy is costlier and riskier than upfront transplantation, iAMP21-positive B-ALL patients may be considered for allo-SCT in first remission as a viable strategy Key Words: iAMP21, B-ALL, haplo-SCT, PTCy |
| 273 |
Bone marrow cytomorphological changes in pure red cell aplasia (PRCA): a retrospective review of 14 cases |
1998-11-26 |
Female |
No |
- | pay_R |
Benign |
Marrow failure |
Laboratory |
1Tapaskanti Parida,1 Somanath Padhi,1 Sarojini Raman,1 Sonali Mohapatra,2 Debashis Sahoo,2 Ashutosh Panigrahi,2 Sandip Kumar Panda3.Departments of 1Pathology and Laboratory Medicine, 2Medical Oncology/Hematology, and 3Nephrology, All India Institute of M |
Vishnupriya Gopalakrishnan |
AIIMS Bhubaneswar |
Bhubaneswar |
8072022750 |
vishnupriya2611g@gmail.com |
Oral |
Title: Bone marrow cytomorphological changes in pure red cell aplasia (PRCA): a retrospective review of 14 cases
Introduction: Pure red cell aplasia (PRCA) is an uncommon cause of unexplained anemia characterized by erythroid maturation arrest (EMA) with adequate myeloid and megakaryocytic lineages in the bone marrow (BM).
Aim: To describe the clinicohematological profile of subjects with PRCA evaluated at a tertiary care center.
Methods:: BM cytohistomorphological changes in PRCA were retrospectively reviewed in respect to erythroid morphology supplemented with E-Cadherin and Glycophorin immunohistochemistry (IHC), and associated cellular changes. These changes were correlated with clinico-biochemical parameters and underlying etiology.
Results: The age group ranged from 3 to 69 years (median; 32 years) with equal gender predilection. Anemia (median Hb;77 g/L, range; 50 to 90 g/L) and reticulocytopenia was consistent. The underlying etiologies were Parvo-B19 (6, post induction ALL-2, renal transplant-1), autoimmune disease (1), chronic liver disease (2, one with HBS+), bacterial sepsis (4). Parvo-B19 related changes (giant proerythroblast, cytoplasmic blebs, glassy intra-nuclear inclusions, and bare gigantic nuclei) were noted in all, confirmed by IgM Parvo-B19 and/or PCR. Myeloid dysgranulopoiesis, bare megakaryocytic nuclei and dyspoiesis, plasmacytosis, and increased histiocytic iron was common in all cases. HLH occurred in two subjects (one post renal transplant, one with chronic liver disease). E-cadherin IHC demonstrated scattered early erythroid progenitors (5 to 30%) with dot like nuclear inclusions and markedly depleted glycophorin positive intermediate and late erythroid in all.
Conclusions: : PRCA may have a diverse etiology and careful recognition of cytomorphological changes in the BM is crucial for early recognition, ordering appropriate investigations, and guiding therapy.
Key words: M:E ratio, reticulocyte, serology, immunosuppressive therapy
|
| 274 |
“Clinical Profile and Treatment Outcomes of Aplastic Anemia: A Retrospective Analysis from a Single-Center Cohort” |
1996-06-22 |
Female |
No |
- | pay_R |
Benign |
Marrow failure |
Clinical |
Dr Monisha Harimadhavan and Dr Neeraj -DM Clinical Hematology |
Dr Prathipati Kowsalya |
Amrita Institute of medical science |
Kochi |
8921364751 |
kowssalyaa2@gmail.com |
Oral |
Title: “Clinical Profile and Treatment Outcomes of Aplastic Anemia: A Retrospective Analysis from a Single-Center Cohort”
Introduction: Aplastic anemia (AA) is a rare, life-threatening bone marrow failure disorder characterized by pancytopenia and hypocellular marrow. The disease ranges from non-severe to very severe forms, and treatment strategies include SCT(Stem cell transplant),ACE therapy (Anti-Thymocyte Globulin/Cyclosporine (CsA) /Eltrombopag) ,androgens(Danazol/Stanozolol).
Objective:
To analyze baseline clinical and hematological characteristics of acquired AA patients and to assess outcomes with ACE-based , Cyclosporine based and Androgens
Methods:
A retrospective observational study was conducted in 88 patients diagnosed with acquired AA. Demographic, clinical, and hematological parameters including age, gender, presenting features, severity, and laboratory indices were recorded. Treatment regimens included ACE-based, CsA–based (with or without Eltrombopag/Danozol), and Androgens based. Statistical analysis was performed using IBM SPSS version 20.0. Categorical variables were expressed as frequency and percentage. Comparisons of categorical variables were assessed with the Chi-square test. Overall survival (OS) was estimated using Kaplan–Meier analysis and compared with the log-rank test.
Results:
Out of 88 patients, 55% were female; mean age was 55 years (range 31–67). Fever (33%) and bleeding (30%) were common presenting features, where the 19% had PNH positivity. Severe and very severe AA accounted for 55% and 31%. ACE based was administered in 20.4%, CsA based in 59.1%, and Androgens alone in 20.4%. At 3 months, overall response was 61% with ACE, 42% with CsA, and 44% with Androgens (p=0.6). At 6 months, CR (Complete response) was higher with ACE (28%) than CsA based (12%) and Androgens (17%).OS was comparable (ATG 83%, CsA 85%, Androgen 89%; p=0.9).
Conclusions:
ATG-based therapy showed better hematologic responses at 3 months and CR at 6 months compared to other regimens, although not statistically significant. In resource-limited settings CsA-based regimens and androgens remain reasonable alternatives, offering acceptable survival outcomes.
Keyword: Anti-thymoglobulin |
| 275 |
Flow Cytometric Ploidy analysis using FXCycle™ Violet dye, A rapid alternative to Cytogenetics in Acute leukaemia: An initial experience at AIIMS Jodhpur. |
1991-12-05 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Abhishek Purohit 1, Dr. Poonam Elhence 1, Dr Gopal Krishana Bohra 2, Dr Siyaram Diedel 3, Dr Parmod Kumar 4 1 Department of Pathology & Lab Medicine, AIIMS Jodhpur 2 Department of General Medicine, AIIMS Jodhpur 3 Department of Paediatric, AIIMS |
EVEETA BARUAH |
AIIMS Jodhpur |
AIIMS Jodhpur |
07576024091 |
eveetabaruah@gmail.com |
Poster |
Title:Flow Cytometric Ploidy analysis using FXCycle™ Violet dye, A rapid alternative to Cytogenetics in Acute leukaemia: An initial experience at AIIMS Jodhpur.
Introduction:Ploidy status is critical for diagnosing, prognosticating, and guiding therapy in acute leukaemia. While conventional cytogenetics (karyotyping) is the gold standard, it is often hampered by long turnaround times, culture failure, and low metaphase yield. Flow cytometry using FXCycle™ Violet dye provides a rapid, cost-effective alternative for DNA content and ploidy assessment. This study presents our initial experience using FXCycle™ Violet-based ploidy analysis and comparing with conventional cytogenetics in Acute leukaemia cases.
Methods:In this prospective study at AIIMS Jodhpur, newly diagnosed acute leukaemia cases underwent in-house ploidy analysis using FXCycle™ Violet dye on a Beckman Coulter DxFLEX flow cytometer. The DNA index is calculated to identify aneuploidy. Parallel samples are sent to external laboratory for G-banding cytogenetic analysis. Results from both methods are compared for concordance.
Results:To date among 35 cases (16 AML, 18 ALL, 1 MPAL), FXCycle™ Violet flow cytometry detected abnormal ploidy (hyperdiploidy/hypodiploidy) in 13 cases. Importantly, metaphase failure occurred in 7 cases externally, making flow cytometry the sole source of ploidy data. Four cases with abnormal ploidy are confirmed by available karyotype reports. Analysis is ongoing for pending cytogenetic results.
Conclusions:FXCycle™ Violet-based flow cytometric ploidy analysis is a rapid, reliable in-house adjunct to external cytogenetics. It is particularly valuable for initial risk stratification in cases with culture failure. While it cannot replace conventional cytogenetics for detecting structural abnormalities, this combined approach ensures a more comprehensive and timely evaluation, better informing critical early treatment decisions.
Key words:Acute leukaemia, ploidy analysis, FXCycle™ Violet dye, flow cytometry, cytogenetics, aneuploidy, DNA index. |
| 276 |
Expression of mutated NPM1 and FLT3 in adult acute myeloid leukemia by immunohistochemistry |
1999-07-22 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Tapaskanti Parida,1 Somanath Padhi,1 Ashutosh Panigrahi,2 Gaurav Chhabra,1 Prabodha Kumar Das2 Departments of 1Pathology and Laboratory Medicine, and 2Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India |
S R Deepa |
AIIMS bhubaneswar |
AIIMS bhubaneswar |
8248984203 |
deeparamulu22@gmail.com |
Oral |
Title:Expression of mutated NPM1 and FLT3 in adult acute myeloid leukemia by immunohistochemistry
Introduction:Acute myeloid leukemia (AML) is a genetically heterogeneous neoplasm and the risk stratification is determined by presence, absence, or co-occurrence of specific driver mutations that govern AML directed therapy and outcome.
Methods:FAB phenotype, nuclear cupping, and pattern of immunoexpression of NPM1 (nucleolar; wNPM1, cytoplasmic; mNPM1) and FLT3 (cytoplasmic) in the myeloid blasts on trephine biopsy were retrospectively reviewed, and correlated with molecular data.
Results:Forty adult AMLs [M/F=25/15, median; 45 years (18 to 75)] comprised of M0/M1(n = 9), M2 (n = 8), APML (n = 3) and M4/M5 (n = 20). The median blast count was 85% (50-95%) and nuclear cupping in ≥10% myeloid blasts was noted in 15 cases (Gr A). On IHC, 5/15 had mNPM1-FLT3, and isolated mNPM1 and FLT3 were seen in 3 and 1 case, respectively. Similarly, among Gr B (cupping in < 10% of blasts, n = 25), 7/25 had mNPM1-FLT3, 7 had isolated mNPM1, and only 1 had FLT3 only. One of three cases of APML had isolated FLT3 positivity by both IHC and molecular tools. IHC and molecular data on NPM1 (all except 1, 93.3%) and FLT3 (100%) were concordant in Gr A, and 17/25 (68%) and 6/8 (75%) had concordance for both the markers, respectively in Gr B. Only six of 40 cases had CD34-/HLA-DR- by flowcytometry.
Conclusions:Our observations suggest that bone marrow IHC can be useful tool to assess mutant NPM1 and FLT3 in AMLs for risk stratification in situations where molecular testing facility is not available or not feasible.
Key words:Risk stratification, AML, molecular testing, immunophenotyping |
| 277 |
Clinicopathological Profile of two Cases of Peripheral T-Cell Lymphoma |
1996-01-13 |
Male |
No |
- | CICAg |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Raj Gabani (DrNB Resident) |
Dr Yoshaan Amit Joshi |
Apollo Hospitals International |
Ahmedabad |
7069994847 |
joshiyoshaan@gmail,com |
Oral |
Title: Clinicopathological Profile of two Cases of Peripheral T-Cell Lymphoma
Introduction: Peripheral T-cell lymphoma (PTCL) is a rare group of aggressive non-Hodgkin’s lymphomas derived from mature T lymphocytes. We report two cases highlighting distinct clinical presentations, therapeutic approaches, and outcomes.
Authors: Gabani Raj, Kheni Sandip, Shah Dhara, Shirure Vijaykumar, Nair Velu
Methods: Two patients with PTCL were evaluated for their clinicopathological features, treatment responses, and disease progression.
Case-1:
A 69-year-old female presented with erythematous scaly lesions involving head, neck, torso, buttocks, perinium, all four limbs, palmoplantar hyperkeratosis, nail dystrophy, lymphadenopathy and lymphocytosis. Flow cytometry and skin biopsy confirmed CD4+ T-cell lymphoma, consistent with Sezary Syndrome stage IVA1 (T4N0M0B2). Initial treatment with methotrexate, prednisolone, acitretin and PUVA therapy normalized the counts, but disease progression (lymphocytic leucocytosis and TLS) required CHOEP.
Case-2:
A 55-year-old female presented with generalized lymphadenopathy and skin nodules. Lymph node biopsy confirmed PTCL-NOS, Stage IV, R-IPI high risk. She achieved CMR after 6 cycles of CHOEP on PET-CT but relapsed, requiring salvage chemotherapy (2 cycles of GDP) and autologous stem cell transplant. Subsequently, she developed extensive mycosis fungoides–like lesions. Despite multiple therapeutic modalities (methotrexate, steroids, PUVA, CEOP, Brentuximab), she progressed with CNS disease (confirmed with CSF flowcytometry). She also developed PML and succumbed to her illness.
Results:Case-1: Achieved partial response with initial therapy, relapsed with systemic disease, and required CHOEP.
Case-2: Achieved initial complete remission post-CHOEP and autologous transplant but relapsed multiple times with cutaneous and CNS involvement, eventually leading to death.
Conclusions:These cases illustrate the heterogeneity and aggressiveness of PTCL, with presentations ranging from cutaneous mycosis fungoides to systemic PTCL-NOS. Despite initial responses to chemotherapy, both cases highlight the high relapse rates and poor long-term outcomes, underscoring the need for novel therapies and early transplant in eligible patients.
Key words: PTCL, Mycosis Fungoides, Sezary Syndrome, T-cell lymphoma. |
| 278 |
First Indian Case Series of VEXAS Syndrome: Integrating Clinical and Laboratory Insights for Improved Recognition of a Rare, Underdiagnosed Condition |
1998-11-05 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Arushi Sharma — Ph.D. Scholar, Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh Aadya Kerkar — Senior Resident, Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh D |
Arushi Sharma |
Post Graduate Institute of Medical Education and R |
Chandigarh |
09501735622 |
arushi115sharma@gmail.com |
Oral |
Title: First Indian Case Series of VEXAS Syndrome: Integrating Clinical and Laboratory Insights for Improved Recognition of a Rare, Underdiagnosed Condition.
Introduction: VEXAS syndrome is a recently identified, adult-onset haemato-inflammatory disorder caused by somatic UBA1 mutations. Characterized by cytoplasmic vacuoles in myeloid precursors, X-linked status, autoinflammatory features, and overlapping hematologic and rheumatologic manifestations, VEXAS presents as a severe and progressive condition. We report the first Indian case series of this syndrome.
Methods: We comprehensively analyzed patients diagnosed with VEXAS syndrome between December 2020 and June 2024. Clinical, pathological, genetic, and outcome data were collected and reviewed. UBA1 gene mutations were identified through Sanger sequencing of Exons 2 and 3.
Results: Out of 53 suspected cases, nine male patients (16.9%) aged 42–77 years were confirmed to have VEXAS syndrome. Common features included recurrent fever (100%), arthritis/arthralgia (89%), inflammatory skin lesions (56%), ocular inflammation (56%), relapsing polychondritis (56%), vasculitis (44%), unprovoked venous thrombosis (33%), and ear chondritis (33%). All had persistent unexplained cytopenias—primarily anemia (89%), thrombocytopenia (33%), and neutropenia (22%). Bone marrow examination (n=7) showed dyshemopoiesis and characteristic cytoplasmic vacuolations. UBA1 mutations included p.Met41Thr (67%), p.Met41Val (22%), and a novel splice-site variant (11%). Patients with p.Met41Val mutation had significantly worse survival outcomes. Despite treatment with glucocorticoids and DMARDs, five patients had refractory disease and succumbed within one year.
Conclusions: This case series highlights the diverse clinical and laboratory features of VEXAS syndrome in the Indian population. Early recognition of this underdiagnosed condition is crucial, particularly among hematologists, rheumatologists, and dermatologists, to improve diagnostic accuracy and clinical outcomes.
Key words: VEXAS syndrome, UBA1 mutation, cytopenia, vacuoles, autoinflammatory disorder, Indian cohort, myelodysplasia, relapsing polychondritis, vasculitis |
| 279 |
Unusual Presentation of Sitosterolemia in Children: A Case Report of Affected Siblings
|
1992-01-13 |
Male |
Yes |
L-2191 | pay_R |
Benign |
Miscellaneous |
Clinical |
Prof.(Dr )Tuphan kanti Dolai Proffesor and Head of Dept of Haematology, Dr Kaustav Ghosh Post DM Senior Resident |
Subhra Kamal Saha |
Nil Ratan Sircar Medical College and Hospital |
Kolkata |
09476359941 |
subhrakamal.saha12@gmail.com |
Poster |
Title: Unusual Presentation of Sitosterolemia in Children: A Case Report of Affected Siblings
Introduction: Sitosterolemia is a rare, autosomal‑recessive disorder of sterol trafficking attributable to pathogenic variants in ABCG5 or ABCG8. Pathophysiology entails intestinal hyperabsorption and impaired biliary excretion of plant sterols, culminating in markedly elevated plasma sitosterol concentrations. Clinically, the phenotype ranges from tendon xanthomas and accelerated atherosclerosis to diverse hematologic derangements. Among these, hemolytic anemia associated with or without macrothrombocytopenia is exceptionally uncommon and may masquerade as congenital hemolytic syndromes
Case presentation :Two affected sisters, aged 12 and 10 years, who exhibited laboratory evidence of chronic hemolysis. The elder sibling experienced pallor with episodic jaundice, pallor, and mild splenomegaly. Peripheral blood smear demonstrated prominent stomatocytes; investigations revealed hemoglobin 7.6 g/dL, reticulocytosis, and mild thrombocytopenia. The younger sibling, evaluated during family screening, was clinically well but had mild anemia (hemoglobin 9.9 g/dL) with occasional stomatocytes and analogous hematologic indices. Lipid profile was within reference limits, and direct antiglobulin tests were negative. Bone‑marrow aspirates disclosed erythroid hyperplasia. Next‑generation sequencing detected a homozygous missense variant in ABCG8 (c.691C>A; p.Pro231Thr, exon 5) in both the siblings, concordant with the clinical suspicion of sitosterolemia. Nutritional counselling to restrict dietary plant sterols along with oral ezetimibe (10mg/day) and periodic monitoring were instituted with resolution of symptoms.
Conclusions: Sitosterolemia should be incorporated into the differential diagnosis of stomatocytic hemolytic anemia, particularly in pediatric patients with suggestive familial patterns and autosomal‑recessive inheritance. Prompt molecular confirmation is pivotal to avert diagnostic delay and to implement targeted interventions such as dietary sterol restriction and sterol absorption inhibiton therapy.
Key words: Sitosterolemia; ABCG8; Hemolytic anemia; Stomatocytosis; Siblings
|
| 280 |
Clinical Experience with Acalabrutinib in Mantle Cell Lymphoma: A Real-World Study |
1984-08-03 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
1. Kandem Sanath, Medical Oncologist, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad. 2. Ankit D Raiyani, Clinical Hematologist & Bone Marrow Transplant Consultant, Qure Clinic, Ahmedabad. 3. Kaushik Paul, Clinical Hematolog |
Suyash Bharat Sharma |
Zydus Lifesciences Ltd |
Ahmedabad |
9760267848 |
Suyash.Bharat@zyduslife.com |
Poster |
Title: Clinical Experience with Acalabrutinib in Mantle Cell Lymphoma: A Real-World Study
Introduction: Acalabrutinib, a next-generation Bruton's tyrosine kinase (BTK) inhibitor, has expanded therapeutic options for B-cell malignancies through improved efficacy and safety profiles. While large clinical trials have assessed its use internationally, real-world data from Indian practice settings, specifically in Mantle Cell Lymphoma (MCL) are scarce. This is a multicenter retrospective study evaluating acalabrutinib-based treatments, risk factor profiles, and clinical outcomes in this population.
Methods: This multicenter retrospective study included data of 22 consecutive adult patients diagnosed MCL treated from 2023–2025 at Indian oncology centers. Patient demographics, prior therapies, cardiovascular risk factors, acalabrutinib dosing schedules, combination regimens, and hematologic response were extracted from clinical records. Therapy was administered as Acalabrutinib (ACAYA) 100mg orally once or twice daily, either as single-agent or combined with anti-CD20 antibodies (Obinutuzumab, Rituximab), Venetoclax, or standard chemoimmunotherapy backbones (R-DHAP, R-CHOP, BR).
Results: In this study of 22 patients with MCL (Mean±SD age 61.79±10.41 years, Mean±SD weight 63.38±9.74 kg), the ORR was 95.2% (CR 13, CRi 2, PR 6). All 3 patients with prior ibrutinib achieved CR, while ibrutinib-naïve patients (n=19) had an ORR of 94.7%. Acalabrutinib was given as first-line in 12, second-line in 6, and third-line or beyond in 4. Combination regimens included acalabrutinib with Obinutuzumab ± Venetoclax (n=7) and chemoimmunotherapy (n=2). Despite frequent comorbidities, treatment was well tolerated with high efficacy.
Conclusion: This real-world multicenter analysis demonstrates that acalabrutinib provides high response rates and a favorable tolerability profile in Indian patients with MCL, even in the presence of significant cardiovascular comorbidities. Importantly, both ibrutinib-pretreated and ibrutinib-naïve patients derived clinical benefit. These findings reinforce the utility of acalabrutinib, both as monotherapy and in rational combinations, and support its integration into routine practice in India.
Keywords: Acalabrutinib, Mantle Cell Lymphoma, Real-world data, BTK inhibitor |
| 281 |
PROGNOSTIC VALUE OF HIGH-RISK CYTOGENETICS AND REVISED ISS & R2-ISS IN MULTIPLE MYELOMA: REAL-WORLD INSIGHTS FROM AN INDIAN COHORT” |
1986-11-19 |
Male |
No |
- | 11052 |
Malignant |
Plasma cell disorders |
Clinical |
Bibhant Shah1, Ronanaki Kavya1, Prisla Dalton1, Arjun kachhwaha1, Reshma Benson1, Nikhil Nagpal1, Uttam kumar Nath1 Department of Medical Oncology Haematology, All India Institute of Medical Sciences, Rishikesh1 |
Bibhant Shah |
All India Institute Of Medical Science , Rishikesh |
rishikesh |
08114552353 |
bivant2000@gmail.com |
Oral |
Title:PROGNOSTIC VALUE OF HIGH-RISK CYTOGENETICS AND REVISED ISS & R2-ISS IN MULTIPLE MYELOMA: REAL-WORLD INSIGHTS FROM AN INDIAN COHORT Introduction:Multiple myeloma is a genetically diverse malignancy where cytogenetic abnormalities strongly impact outcomes. Prognosis is more accurately assessed by R2-ISS, which integrates genetic and clinical variables. In India, VRd and VCD are standard regimens, while access to daratumumab-based and other novel therapies is limited by financial constraints.Methods:We retroprospectively analyzed 70 newly diagnosed MM patients treated between July 2021 and January 2025 at AIIMS Rishikesh. Patients received VRd (n=52), VCD (n=13), KRd (n=3), or DVrd (n=2). High-risk cytogenetics were defined by FISH abnormalities [del(17p), t(4;14), t(14;16), t(14;20), or 1q21 gain]. Patients were staged by both R-ISS and R2-ISS. Survival outcomes were estimated using the Kaplan–Meier method, and predictors were identified through Cox regression analysis. Results:The median age was 54 years (range 31–71); with 46 male. High-risk cytogenetics were present in 20 patients (28.6%). According to R2-ISS, 9 (12.9%) were stage I, 17 (24.3%) stage II, 40 (57.1%) stage III, and 4 (5.7%) stage IV. on median follow-up of 16 months, median PFS and OS were 12.0 and 14.1 months, respectively. Patients with high-risk cytogenetics had inferior PFS (8.8 vs. 13.3 months) and OS (14.5 vs. 14.1 months). By R2-ISS, advanced stages predicted inferior outcomes, with stage IV showing the shortest PFS (6.9 months). On multivariate analysis, high-risk cytogenetics independently predicted progression (HR 2.03; p=0.031) and death (HR 2.28; p=0.027). Each increment in R2-ISS stage conferred a higher risk of progression (HR 1.48; p=0.045) and death (HR 1.56; p=0.038). Conclusions:In this Indian cohort, high-risk cytogenetics and advanced R2-ISS predicted worse outcomes, with R2-ISS superior to R-ISS. VRd and VCD had similar efficacy,Krd showed promising result.Financial constraints limit access to daratumumab-based regimens, underscoring the importance of cytogenetic profiling and optimising available therapies. keywords:Cytogenetics, R2-ISS. |
| 282 |
Myeloperoxidase to the Rescue: Solving a Gastric ‘Lymphoma |
1987-01-29 |
Female |
No |
- | H_LKO |
Malignant |
MPN & MDS/ MPN |
Clinical |
Dr Bandana Mehrotra, Dr Sanjay Mehrotra |
Supriya mehrotra |
RML pathology, Lucknow |
Lucknow |
9838099887 |
mehrotra.supriya@gmail.com |
Oral |
Title- Myeloperoxidase to the Rescue: Solving a Gastric ‘Lymphoma
Background: Myeloid sarcoma (MS) is an extramedullary proliferation of immature myeloid cells that can precede, accompany, or follow acute myeloid leukaemia. Primary gastric involvement is exceptional and often mimics lymphoid or poorly differentiated epithelial neoplasms, leading to diagnostic delay.
Case: An 18-year-old male presented with epigastric discomfort. Complete blood counts were within normal limits. Upper GI endoscopy showed an infiltrative proximal gastric lesion; contrast-enhanced CT demonstrated an ill-defined soft-tissue mass in the hepatogastric and peripancreatic regions, initially raising concern for a lymphoproliferative process.
Histopathology: Gastric biopsies showed mucosa with focal necrosis and a diffuse infiltrate of monomorphic small-to-medium cells arranged in clusters, sheets, and single-file patterns within the lamina propria. Cells had a high N:C ratio, fine chromatin, prominent nucleoli, scant cytoplasm, and brisk mitoses—features of a small round blue cell tumour. Differential diagnoses included non-Hodgkin lymphoma, myeloid sarcoma, and poorly differentiated carcinoma.
Immunophenotype: Tumour cells were positive for CD45, myeloperoxidase, CD117, CD68, and CD43, and negative for lineage-defining B-cell, T-cell, and epithelial markers. The Ki-67 index was ~80%. Peripheral smear was unremarkable, with no evidence of systemic leukaemia at presentation.
Conclusion: This case highlights a critical gastrointestinal diagnostic pitfall—primary gastric myeloid sarcoma masquerading as lymphoma in a young patient with normal counts. A focused IHC panel including myeloid markers (MPO, CD117, CD68) is essential to avoid misclassification and to trigger appropriate hematologic staging and therapy. Early recognition can prevent delays in initiating AML-directed management pathways.
Keywords: myeloid sarcoma, granulocytic sarcoma, stomach, lymphoma mimic, MPO, CD117
|
| 283 |
Incidental Mediastinal Mass in a child: Thymic Fibroadenoma Masquerading as T cell Lymphoblastic Lymphoma |
1989-04-10 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Rahul Bhargava Department of Hematology and Bone Marrow Transplant, International Oncology Cancer Institute, Fortis Hospital, Noida, India |
Dr Priyanshi Pachauri |
International Oncology Cancer Institute Fortis Hos |
Noida |
08860850080 |
priyanshipachauri@gmail.com |
Oral |
Title: Incidental Mediastinal Mass in a child: Thymic Fibroadenoma Masquerading as T cell Lymphoblastic Lymphoma
Introduction:: Mediastinal masses in children often pose a diagnostic challenge due to overlapping clinical, radiological and histopathological features. We present an unusual case of mediastinal mass in a child, initially suspected to be T cell lymphoblastic lymphoma, later confirmed as thymic Lipofibrodenoma – a rare benign entity as well as the youngest reported case of thymic lipofibrodenoma
Methods:A 3 years old female presented with an incidental right clavicle fracture. Chest X ray revealed a mediastinal opacity. Whole body PET CT demonstrated a large left hemithoracic mass. The initial biopsy was suggestive of T cell lymphoblastic lymphoma. In the absence of bone marrow involvement, B symptoms as well as diagnostic dilemma a repeat biopsy was planned after discussing with parents and multidisciplinary team, which suggested sclerosing thymoma. Surgical excision of mediatinal mass was subsequently performed.
Results: Intraoperatively, a well encapsulated mass measuring 10x9x5 cm was found in superior mediastinum, displacing the heart posteriorly. Histopathology of the resected specimen revealed features consistent with thymic lipofibroaadenoma. The postoperative course was uneventful and the patient remains under follow up
Conclusions: This case highlights the diagnostic complexity of pediatric mediastinal masses, where overlapping histological features can mimic aggressive malignancies. Multidisciplinary evaluation and surgical excision proved crucial for establishing the final diagnosis of thymic lpofibroadenoma, a rare benign thymic tumor in children
Key words: Pediatric mediastinal mass, thymic lipofibroadenoma, thymoma, T cell lymphoblastic lymphoma, diagnostic dilemma, case report |
| 284 |
FISH-Net: Creating an Open-Source Deep Learning Framework for Automated Analysis of FISH signals in Hematological disorders. |
1994-09-19 |
Male |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Laboratory |
Satyender Dharamdasani1, Niti Shyamsukha2, Vipul Patil2, Adiya Pandey2,Praveen Sharma1, Sreejesh Sreedharanunni1, Pankaj Malhotra3, Sukrit Gupta4,5 1.Department of Hematology, PGIMER, Chandigarh. 2.Department of Computer Science and Engineering, IIT Ropa |
Satyender Dharamdasani |
Post-graduate Institute of Medical Education and R |
Chandigarh |
8605802224 |
drsatyenderpgi@gmail.com |
Oral |
Title: FISH-Net: Creating an Open-Source Deep Learning Framework for Automated Analysis of FISH signals in Hematological disorders.
Introduction: Fluorescence in situ hybridization (FISH) is integral to the diagnosis and prognostication of hematological malignancies. Despite its clinical importance, FISH interpretation is largely manual, requiring expert cytogeneticists to examine large numbers of cells under the microscope. This process is time-intensive, subject to inter-observer variability, and limits scalability in busy diagnostic laboratories. Commercial automation systems are available but remain expensive and inaccessible in many settings.
Methods: We developed FISH-Net, a home-grown deep learning framework to automate FISH analysis. Bone marrow and peripheral blood samples from 136 patients (acute leukemias, chronic lymphoproliferative disorders, plasma cell myeloma) were processed using standard protocols. The dataset included 209 curated FISH images, split into two sets: 167 for training of the model and 42 for testing/validation. Annotation was carried out using the Computer Vision Annotation Tool (CVAT), with detailed pixel-wise labeling of nuclei, probe signals (red, green, aqua), and fusion signals by three expert hematopathologists—creating the largest curated and openly available FISH dataset to date.
Results: The cell segmentation model achieved IoU and Dice scores >0.8, ensuring robust delineation of overlapping nuclei. The gene signal detection module achieved >85% accuracy across probe classes, including fusion signals. Importantly, the outputs are presented in a user-friendly interface, providing cell-wise statistics and visual overlays that can be rapidly verified by hematopathologists, minimizing the risk of AI-related errors.
Conclusions: FISH-Net is the first in-house instance-segmentation–based AI framework for automated FISH interpretation in hematological malignancies. By reducing manual workload, shortening turnaround time, and improving reproducibility, it has the potential to directly enhance patient care in high-volume and resource-limited diagnostic laboratories, while also contributing a unique open-source dataset for further research.
Key words: FISH, Artificial intelligence, Digital Pathology. |
| 285 |
Genomic integration of FVIII transgene in hepatocytes restores durable FVIII activity in vivo |
1987-06-26 |
Male |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
Jacob Lund2, John Moore3, Carsten Dan Ley2, Karl Agger3, Christopher William Smith2, Jesper Tranekær Jørgensen2, Michelle Scalley Kim3, Jazz Hallinan3, Kendall Sanson3, Rikke Hvid Lindecrona2, Lene Diness Jensen2, Nadin Jahnke3, Gert Bolt4, Erin Louise Br |
Muzammil Khan A Pathan |
Novo Nordisk India Pvt Ltd |
Bengaluru |
9167202176 |
phmk@novonordisk.com |
Oral |
Introduction: First generation AAV-based gene therapies are approved for treatment of congenital hemophilia A (HA), however in most instances FVIII plasma levels have been observed to decline over time. Reasons from loss or silencing of vector to endoplasmic reticulum stress have been proposed to explain declining expression levels. Genomic integration of FVIII transgene into a safe harbor locus, facilitated by a site-specific nuclease, may improve durability of FVIII expression potentially curing patients with HA. The aim was to develop a durable, in vivo genome editing treatment for patients with HA.
Methods: A site-specific megaTAL endonuclease was engineered to target the first intron of the albumin gene and delivered to hepatocytes as lipid nanoparticle (LNP)-encapsulated mRNA. An AAV vector donor encoding a promoter-less, B-domain truncated FVIII transgene was optimized to enable FVIII expression following targeted integration. In vivo efficacy and tolerability were evaluated in F8-/-/Rag2-/- mice and cynomolgus monkeys following simultaneous treatment with both components.
Results: Following simultaneous administration of AAV donor vector and LNP-encapsulated, murine specific megaTAL mRNA in a F8-/-/Rag2-/- HA mouse model, hepatic expression of human FVIII was induced within days of treatment rescuing the bleeding phenotype following tail vein transection. The specific activity was comparable to recombinant FVIII and the plasma level was proportional to the level of genomic integration which was in turn directly dependent on nuclease-mediated cutting activity at the target locus. In cynomolgus monkey, treatment with surrogate AAV encoding a cynomolgus FVIII B-domain truncated transgene and an optimized megaTAL nuclease resulted in genomic integration in single digit percent of the liver cells and a fast onset of FVIII expression durable for at least 12 weeks averaging 104 IU/dL (n=4).
Conclusions: Targeted genomic integration of FVIII transgene has shown promise in pre-clinical models with the potential to become a durable cure for the disease |
| 286 |
Natural Anticoagulants (Protein C, Protein S & Antithrombin III) and APOE gene polymorphism in Stroke: Why and How are they important? |
1981-12-31 |
Male |
No |
- | RBzI4 |
Benign |
Hemeostasis |
Clinical |
DR PUSHPANJALI, ASSOCIATE PROFESSOR, DEPT OF PATHOLOGY |
DR KUNAL RAJ |
RAJENDRA INSTITUTE OF MEDICAL SCIENCES |
RANCHI JHARKHAND |
7546013274 |
kunalranjanpmch@gmail.com |
Oral |
Title: Natural Anticoagulants (Protein C, Protein S & Antithrombin III) and APOE gene polymorphism in Stroke: Why and How are they important?
Authors: Dr Kunal Raj, Dr Pushpanjali R. Ojha, Dr Pradip K. Bhattacharya, Dr Anupa Prasad
Institute: Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
Corresponding Author: Dr Kunal Raj, Email Address: kunalranjanpmch@gmail.com, Contact No.:7546013274
Introduction: Coagulation dysregulation influences stroke pathogenesis and outcomes. Natural anticoagulants (Protein C, Protein S, Antithrombin III) and apolipoprotein E (APOE) gene polymorphisms may impact stroke type, severity, and prognosis. This study evaluated their association in stroke patients.
Methods: A prospective cross-sectional study was conducted (July 2023–June 2025) on 100 adult stroke patients admitted to ICU. Patients with confounding conditions (malignancy, liver disease, vitamin deficiencies, chemotherapy, etc.) were excluded. Protein C, Protein S, and Antithrombin III levels were measured using standardized functional and chromogenic assays. APOE genotyping was performed using PCR, RFLP, and Sanger sequencing. Demographic, clinical, radiological, and biochemical data were statistically analysed (JASP software).
Results: Among 100 patients, 71% had haemorrhagic and 29% ischemic stroke. Mean age was 50–69 years; male: female ratio was 1:0.28. Hypertension (65%) and diabetes (26%) were common comorbidities. Natural anticoagulant levels were higher in haemorrhagic compared to ischemic stroke (Protein C: 99.9% vs 91.1%; Protein S: 98.1% vs 90.3%; Antithrombin III: 110.3% vs 106.1%). The ε3/ε3 genotype (74%) was most prevalent overall, while ε3/ε4 (15%) was significantly associated with higher mortality (p = 0.024). Anticoagulant levels remained within reference ranges across genotypes, though ε2/ε3 carriers showed lower Protein S levels.
Conclusions: APOE polymorphisms influence stroke outcomes. The ε3/ε3 genotype predominates, while ε4 carriers have higher mortality. Natural anticoagulant levels differ between stroke types, suggesting interplay between coagulation and genetic factors in stroke pathophysiology.
Key words: Protein C, Protein S, Antithrombin III, Apolipoprotein E, Polymorphism, Stroke |
| 287 |
TITLE: ACUTE MEGAKARYOCYTIC LEUKEMIA: ADDRESSING THE DILEMMA: AML-M7 IN A NEONATE AND A 6-MONTH-OLD CHILD. |
1998-03-29 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Sarika Singh (Professor, Department of Pathology, Maulana Azad Medical College, New Delhi); Dr. Neha Pandey (Senior Resident, Department of Pathology, Maulana Azad Medical College, New Delhi); Dr. Ashish Jain (Professor & Head, Department of Neonatolo |
Dr. Daksha Suthar |
Maulana Azad Medical College |
New Delhi |
9602964970 |
dakshme13@gmail.com |
Poster |
Introduction:
Congenital leukemia (CL) accounts for < 1% of all the reported cases of pediatric leukemia and often manifests during the first 28 days of life.Trisomy-21 increases risk of developing such neoplasms and manifests as myeloid leukemia of Down syndrome (ML-DS), almost always Megakaryocytic (FAB-M7) subtype of acute myeloid leukemia. These leukemias show spectrum of Transient abnormal myelopoiesis followed by Myelodysplastic phase eventually leading to Acute Myeloid Leukemia. Here,we describe two cases of ML-DS in a newborn and infant.
Case Report:
Case-1: A 29-year-old booked primigravida underwent emergency LSCS at 36+6 weeks gestation due to fetal distress and delivered a baby boy.Baby did not cry immediately after birth.On physical examination,child had Down’s Phenotype and hepatomegaly.Peripheral smear showed TLC-2,69,800/mm3,Hb-14.5g/dL & Platelets-2.57L with presence of 88% blasts,circulating micromegakaryocytes and megakaryoblasts.On cytochemistry,blasts were positive for PAS, NSE.Immunophenotyping showed positivity for CD61,CD71,CD42a,CD42b,CD56,CD34.A diagnosis of Acute Megakaryocytic leukemia–M7(AML-M7) was rendered.Baby was started on low-dose Cytarabine at 1.5mg/kg/day. Gradually TLC decreased with 2% blasts after 7-days-course. Clinically,child showed signs of improvement and started accepting feeds.
Case-2: A 6-month-old male presented with recurrent pyrexia, cough, generalized weakness, and signs of severe respiratory distress.Clinical examination revealed hepatomegaly.P.S showed Hb-7.5 g/dL, TLC-5,990/mm³, and platelet-36,000/mm³ with 14% circulating blasts.Bone marrow aspiration was hemodiluted but showed 22% blasts.On immunophenotyping,the blasts were positive for CD34, CD41, CD42a, CD42b, and CD61,consistent with AML-M7.Bone marrow biopsy showed near-total replacement of hematopoietic tissue by blasts with strong CD34 and CD41 positivity on immunohistochemistry- consistent with AML-M7
Conclusion:
ML-DS is a rare type of AML seen in children with DS.It poses unique difficulties in diagnosis especially in newborns.Our cases highlight the importance of a comprehensive step based diagnostic approach to the disease.Continuous follow-up is vital to ensure long disease free survival and to address potential complications associated with treatment and biological behaviour of disease. |
| 288 |
The Spectrum of Compensated Inherited Hemolytic Anemias: A 15-Year Genomic Study from a Tertiary Referral Center in North India |
1984-04-04 |
Female |
Yes |
L1411 | pay_R |
Benign |
Anemia |
Laboratory |
|
Sonal Seth |
PGIMER |
Chandigarh |
09532226514 |
dr.sonalvij@gmail.com |
Oral |
Title: The Spectrum of Compensated Inherited Hemolytic Anemias: A 15-Year Genomic Study from a Tertiary Referral Center in North India Introduction: Inherited hemolytic anemias (IHAs) are a heterogeneous group of genetic disorders characterized by premature erythrocyte destruction due to mostly intrinsic red cell abnormalities, including defects in membrane proteins, enzymes, or hemoglobin (Hb). While most cases present with anemia of variable severity, a minority present with fully or partially compensated hemolysis and near-normal Hb levels. These cases often pose diagnostic challenges, delaying diagnosis and treatment. We investigated the clinico-hematologic features and mutational landscape of compensated IHA patients from North India. Methods: We retro-prospectively enrolled patients evaluated at a hematology referral center between January 2010 and December 2024. Inclusion criteria were clinical or laboratory evidence of hemolysis with either normal Hb or mild anemia (Hb ≥10 g/dL), no RBC transfusions in the prior year, and ≤2 lifetime transfusions. Investigations included complete hemogram with reticulocyte count, peripheral smear, methemoglobin reduction test for G6PD deficiency, direct antiglobulin test, incubated osmotic fragility test, flow cytometric eosin-5’-maleimide binding assay, high-performance liquid chromatography, and biochemical markers (bilirubin, LDH, haptoglobin). Targeted next-generation sequencing (NGS) was performed using a customized AmpliSeq™ panel (Illumina) covering coding exons, splice junctions, and UTRs of 70 genes related to red cell disorders. Results: Of 61 compensated HA cases over 15 years, NGS identified pathogenic mutations in 31 patients (22 males; age 10–60 years, median 22). HS was the predominant diagnosis (25/31, 80.6%). Among these, ANK1 mutations were most frequent (56%), followed by SPTB, SLC4A1, and SPTA1 mutations. Two patients each had Mediterranean stomatocytosis with macrothrombocytopenia or sitosterolemia (ABCG5) and dehydrated hereditary stomatocytosis (PIEZO1), while one had overhydrated stomatocytosis (RHAG). All mutations were heterozygous except the two sitosterolemia cases, who had homozygous ABCG5 mutations. |
| 289 |
FRONTIER5 direct switch study: Safety of initiating Mim8 prophylaxis without washout of emicizumab |
1987-06-26 |
Male |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
Johannes Oldenburg,2 Gary Benson,3 Pratima Chowdary,4 Robert Klamroth,5,6 Anne Lienhart,7 Davide Matino,8 Camila Martins Mazini Tavares,9 Keiji Nogami,10 Flora Peyvandi,11,12 Amalie Rhode Høgh Nielsen,9 Guy Young,13 Allison P Wheeler14 2. Institute of E |
Muzammil Khan A Pathan |
Novo Nordisk India Pvt Ltd |
Bengaluru |
9167202176 |
phmk@novonordisk.com |
Oral |
Aim: To evaluate the safety of Mim8 prophylaxis in adults and adolescents with HA with/without inhibitors following a direct switch from emicizumab treatment without a washout period nor Mim8 loading dose.
Methods: Mim8 was administered subcutaneously by a pen injector QW, Q2W, or QM for 26 weeks via a weight-based tiered-dosing approach; no Mim8 loading dose was administered. Mim8 treatment frequency was chosen based on patient preference and discussion with the investigator, which may have varied from the patient’s previous emicizumab dosing frequency (QW, Q2W, or once-every-four-weeks [Q4W]). The first Mim8 maintenance dose was administered on the planned emicizumab dosing day. Males/females aged ≥12 years with HA (any severity) who previously received emicizumab prophylaxis for ≥8 weeks prior to screening were included. The primary endpoint was to evaluate the number of treatment-emergent adverse events (TEAEs).
Results: Sixty-one patients were exposed to Mim8 and completed 26 weeks of treatment. Total exposure time: 30.8 years; 107 TEAEs were observed in 43 (70.5%) patients (3.5 TEAEs/patient-years of exposure); most were mild/moderate (88.6%). Four serious TEAEs were reported in 4 (6.6%) patients, all unlikely to be related to Mim8. Eighteen (29.5%) patients reported 24 TEAEs that were possibly/probably related to Mim8. Injection site reactions were reported by 12 (19.7%) patients in 15/990 (1.5%) total injections (most transient; all mild). No thromboembolic events, hypersensitivity reactions, or TEAEs leading to discontinuation were observed. There was no measured clinical evidence of neutralizing anti-Mim8 antibodies. Steady-state Mim8 concentration was achieved by Week 16; emicizumab elimination was completed by Week 26. No exaggerated thrombin peak height response was observed.
Conclusions: A direct switch from emicizumab to Mim8 prophylaxis treatment, without a washout period, in adolescents and adults with HA with/without inhibitors was well tolerated, and no safety concerns were observed. |
| 290 |
ANALYSIS OF NEUTROPHIL-LYMPHOCYTE RATIO AND PLATELET-LYMPHOCYTE RATIO VARIATION IN SICKLE CELL DISEASE PATIENTS ON HYDROXYUREA IN STEADY STATE AND VASO-OCCLUSIVE CRISIS |
1996-09-22 |
Female |
No |
- | pay_Q |
Benign |
Anemia |
Laboratory |
Dr Ripunjaya Mohanty, Associate professor, department of pathology, Dr Sarita Pradhan, professor, department of pathology, Dr Prateek Das, assistant professor, department of pathology, Dr Debahuti Mohapatra, professor and HOD, department of pathology, Dr |
Dr Shristi Anand |
IMS and SUM hospital, bhubaneswar |
Bhubaneswar |
7977075250 |
shristianand2209@gmail.com |
Oral |
ANALYSIS OF NEUTROPHIL-LYMPHOCYTE RATIO AND PLATELET-LYMPHOCYTE RATIO VARIATION IN SICKLE CELL DISEASE PATIENTS ON HYDROXYUREA IN STEADY STATE AND VASO-OCCLUSIVE CRISIS
Authors: Dr Shristi Anand1, Dr Ripunjaya Mohanty1, Dr Sarita Pradhan1, Dr Prateek Das1, Dr Debahuti Mohapatra1, Dr Priyanka Samal2
1Department of Pathology, IMS and SUM Hospital, Bhubaneswar, 2Department of Clinical Hematology, IMS and SUM Hospital, Bhubaneswar
Background: Sickle cell anaemia (SCA) is characterised by recurrent vaso-occlusive crises (VOC) and chronic inflammation. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inexpensive, readily available inflammatory markers with potential prognostic value in SCA.
Aim: To evaluate the variation of NLR and PLR in SCA patients on hydroxyurea during steady state and VOC.
Materials & Methods: A retrospective, record-based study was conducted over one year, including 96 SCA patients (54 males, 42 females) attending a tertiary care hospital. Patients were categorised into steady state (n=56) and VOC (n=40) groups. NLR and PLR values were retrieved from electronic medical records. Data were analysed using SPSS v22, applying chi-square tests for categorical variables, independent t-tests for continuous variables, and Pearson’s correlation for associations.
Results: The mean NLR was significantly higher in VOC patients (4.62 ± 4.12) compared to steady state (2.50 ± 1.85; p=0.001). PLR values were higher in VOC (113.37 ± 76.45) than steady state (86.99 ± 66.48), but the difference was not statistically significant (p=0.075). NLR group distribution showed a significant association with disease state (p=0.020), and PLR group distribution also demonstrated significance (p=0.026). A moderate positive correlation was observed between NLR and PLR (r=0.454, p<0.001). Mean NLR and PLR was higher in patients using HU than HU naïve with a p value of 0.01 and 0.295 respectively.
Conclusion: NLR showed a significant rise during VOC, indicating its potential role as an inflammatory marker in SCA. PLR also tended to increase but did not reach statistical significance. The correlation between NLR and PLR suggests they may reflect overlapping inflammatory pathways. Hydroxyurea is known to induce a decrease in NLR and PLR, which represent a biomarker of inflammation in SCD, however there may be inter-individual variability. NLR and PLR could be incorporated into routine monitoring to aid in early identification of VOC risk in SCA patients on hydroxyurea.
Keywords: Sickle cell anaemia, Vaso-occlusive crisis, Hydroxyurea, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio.
|
| 291 |
ROLE OF CD177 IN FLOW CYTOMETRIC ASSESSMENT OF MYELODYSPLASTIC NEOPLASMS |
0097-09-06 |
Female |
No |
- | T2508 |
Malignant |
Myelodysplastic syndrome |
Laboratory |
Rakshita Acharya,1 Nabhajit Mallik1, Parveen Bose1, Arun Kumar1, Bhavishan Lal1, Sreejesh Sreedharanunni1, Praveen Sharma1, Arihant Jain2, Man Updesh Singh Sachdeva1 1. Department of Hematology, Postgraduate Institute of Medical Education and Research, Ch |
Rakshita Acharya |
Postgraduate Institute of Medical Education and Re |
Chandigarh |
8500920462 |
rakshitaacharyak@gmail.com |
Oral |
Title:ROLE OF CD177 IN FLOW CYTOMETRIC ASSESSMENT OF MYELODYSPLASTIC NEOPLASMS
Introduction:Myelodysplastic neoplasms (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis, peripheral cytopenias, and risk of progression to acute leukemia. Distinguishing MDS from other causes of cytopenias remains challenging. CD177, a glycoprotein expressed on neutrophils, has emerged as a potential marker for assessing clonality in myeloid neoplasms. This study evaluates the utility of CD177 expression in differentiating MDS from other conditions causing cytopenia.
Methods:A total of 143 subjects were enrolled over 1.5 years, including 121 patients and 22 healthy controls. Among patients, 100 presented with unexplained cytopenias, and 21 were diagnosed with a myeloproliferative neoplasms (MPN) or an MDS/MPN. Clinical, hematological, and cytogenetic evaluation was performed. Flow cytometry was used to assess CD177 expression in neutrophils from both bone marrow (BM) and peripheral blood (PB).
Results:Of the 100 cytopenic patients, 48 were diagnosed with MDS. CD177 expression was significantly reduced in MDS patients (median CD177%: BM – 36.1%, PB – 40.5%) compared to the 52 non-MDS cytopenia patients (median CD177%: BM – 78.2%, PB – 80%) (p < 0.0001) and normal controls (median CD177% - 70.6%; p=0.0038). A strong correlation was observed between PB and BM CD177 expression (r² = 0.985) across groups. ROC curve analysis identified CD177% cut-offs of 38.5% in BM and 37.7% in PB, with specificities of 96.1% and 96.2% respectively. The addition of CD177 scoring to Ogata score increased diagnostic sensitivity from 84.1% to 90.9%. The MPN group did not show any significantly reduced CD177 expression.
Conclusions:CD177 is a promising marker for distinguishing MDS from other causes of cytopenia. Its values correlate strongly in PB and BM samples. Integrating CD177 into existing diagnostic algorithms can enhance accuracy, being particularly helpful in elderly patients where invasive procedures may be difficult.
Key words:MDS, CD177, Flowcytometry |
| 292 |
Kimura disease |
1996-05-27 |
Female |
No |
- | RBz3f |
Benign |
Miscellaneous |
Clinical |
Omkar Chaudhari |
Vaishali sharai |
Mahatma Gandhi medical college jaipur |
Jaipur |
8373907907 |
vaishalisharai@gmail.com |
Poster |
Title: kimura disease
Authors: Vaishali sharai, omkar chaudhari
A forty seven years old female,no known comorbidities,no addiction presented with complaints of generalised lymphadenopathy,low grade evening rise of temperature and fatigue.
Weight loss of 5 kg in one month.
Whole body PET Scan- FDG avid intraparotid,bilateral cervical,supraclavicular,bilateral axillary,anterior diaphragmatic,bilateral chest nodes
LDH- 364
Hgm-10.3/7.23/1.40 lakh
N41L19E36
Absolute Eosinophil Count- 2600
Review of slide suggestive of benign chronic inflammatory disorder with eosinophilic microabscesses in background of polymorphous inflammatory cells suggestive of Kimura disease.
IHC-CD 3 and cd 20 positive in reactive T and B cells
BCL2,CD15,CD30 + in immunoblasts
CRP less than 5
ESR- 60
Biopsy from cervical lymph node suggestive of lymphoproliferative disorder.
IHC of the cervical lymph node shows- Acute on chronic suppurative inflammation with florid reactive lymphadenitis.
wall,mediastinal,abdominal,pelvic,bilateral inguinal and bilateral femoral lymph nodes
She was given a Trial of steroids-Pred 1mg/kg/day with weekly CBC monitoring. She responded to steroids.
|
| 293 |
Clinical profile and response to TKI in paediatric chronic myeloid leukemia: an experience from a tertiary care hospital, India |
1996-02-14 |
Male |
No |
- | UPI R |
Malignant |
Leukemia & lymphoma |
Clinical |
Kavya Ronanki, Prisla Dalton, Bibhant Shah, Arjun Kachhwaha, Reshma Benson, Uttam Kumar Nath & Affiliated to All India Institute of Medical Sciences, Rishikesh |
Nikhil Nagpal |
All India Institute of Medical Sciences, Rishikesh |
Rishikesh |
7030990959 |
nikhilnagpal2011@gmail.com |
Oral |
Title: Clinical profile and response to TKI in paediatric chronic myeloid leukemia: an experience from a tertiary care hospital, India
Introduction: Chronic myeloid leukemia (CML) in children and adolescents is rare, constituting less than 3% of pediatric leukemias. Data from India remain scarce, with limited information on clinical spectrum and treatment outcomes.
Methods: We retrospectively analyzed medical records of 32 children (<18 years) diagnosed with CML over 8 -year period. Demographics, presenting features, baseline hematological parameters, spleen size, risk scores (Sokal, Hasford, EUTOS), tyrosine kinase inhibitor (TKI) therapy, and response milestones were reviewed
Results: The cohort included 32 patients (median age 14 years, range 3–18) with a male predominance (69%). The most common presenting complaints were abdominal fullness (75%), fatigue (56%), and fever (44%). Splenomegaly was present in 91% (median size 17 cm), and hepatomegaly in 31%. Laboratory findings showed anemia in 72% (median hemoglobin 8.6 g/dL), leukocytosis in all patients (median WBC 210 ×10⁹/L), and thrombocytosis in 47%.
Risk stratification revealed high-risk disease in 62% (Sokal), 58% (Hasford), and 55% (EUTOS). All patients received TKIs, predominantly imatinib (88%), while 12% required nilotinib or dasatinib due to intolerance or resistance. At three months, complete hematologic remission was achieved in 81%, and early molecular response (BCR-ABL1 ≤10%) in 68%. Treatment switch was required in 12%, mainly due to resistance mutations (including T315I) or poor adherence.
Conclusions: Pediatric CML in our cohort frequently presented with advanced disease and bulky splenomegaly, with a predominance of high-risk scores. Imatinib achieved satisfactory hematologic and molecular responses in most patients; however, resistance and adherence remain significant challenges, underscoring the need for vigilant monitoring and timely access to second-generation TKIs
Key words: Chronic Myeloid Leukemia, Children, Tyrosine kinase inhibitors, India, Pediatric Chronic Myeloid Leukemia |
| 294 |
AML with eosinophilia- A rare case entity. |
1992-12-21 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Ruchi Agarwal, Dr Parveen Rana Kundu, Dr Nitika Chawla, Dr Sunaina Hooda, Dr Monika B Gathwal, Dr Swaran Kaur |
Dr. Shrishti |
BPS GMC Khanpur Kalan, Sonepat, Haryana |
Sonepat |
9518639945 |
Shrishtikhatri21@gmail.com |
Poster |
Title: Acute Myeloid Leukaemia (AML) with eosinophilia- A rare case entity
Introduction: Acute Myeloid Leukemia (AML) with eosinophilia is a distinct morphological subtype characterized by abnormal eosinophilic precursors in addition to myeloblast proliferation. In most cases, eosinophilia reflects underlying core-binding factor (CBF) translocations, which are observed in up to 20% of cases and carry important prognostic and therapeutic implications.
Case report- We report a case of a 40-year-old male who presented with complaints of easy fatigability and difficulty breathing. He had a past history of pulmonary tuberculosis. Clinical examination revealed no significant findings. Complete blood counts showed anemia (Hb 9.0 g/dL), leukocytosis (TLC 27.5 × 10³/µL), and normal platelet count. Peripheral blood smear demonstrated anemia, leukocytosis with circulating myeloblasts, monoblasts, and abnormal eosinophils, with blasts comprising more than 40% and eosinophils around 32%.
Results: In the presence of blasts >40% with eosinophilia, the differential diagnoses include AML with inv(16) (M4Eo), AML with t(8;21), myeloid/lymphoid neoplasms with eosinophilia and PDGFRA/PDGFRB/FGFR1 rearrangements, B-ALL with eosinophilia [t(5;14)], and chronic eosinophilic leukemia in blastic phase.
Conclusions: While eosinophilia in general may be reactive due to cytokine-driven mechanisms in conditions such as allergies, infections, autoimmune diseases, and rarely solid or hematologic malignancies, in AML its presence is usually clonal and genetically driven. Identification of the underlying cytogenetic abnormality not only establishes the diagnosis but also significantly influences prognosis and treatment decisions.
Overall, AML with eosinophilia represents an important clinicopathological entity. Timely recognition of this variant, followed by cytogenetic and molecular confirmation, can dramatically alter patient management, highlighting the need for its consideration in cases presenting with blasts and marked eosinophilia.
Key words: Acute Myeloid Leukaemia, Eosinophilia, Peripheral blood smear |
| 295 |
Nodal T Follicular Helper Cell Lymphoma, Angioimmunoblastic Type with Bone Marrow Plasmacytosis: Identifying Secondary Myeloma vs Reactive Plasmacytosis – An Analysis of 11 Patients at a Tertiary Cancer Care Institute |
1987-04-19 |
Female |
No |
- | 52429 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Authors: Ann Thomas¹, Neshahel O K¹, Prasanth Parameshwaran¹, Binshad Ameer K¹, Vijayalalakshmi Nair¹ Affiliation: MVR Cancer Centre and Research Institute, Kozhikode, Kerala, India |
Sajna P V |
MVR Cancer Centre and Research Institute |
Kozhikode, Kerala |
9496348528 |
drpvsajna@mvrccri.co |
Poster |
Nodal T follicular helper cell lymphoma, angioimmunoblastic type (AITL), is a distinct subtype of peripheral T-cell lymphoma derived from T follicular helper (TFH) cells. It commonly manifests with generalized lymphadenopathy, systemic immune dysregulation, hypergammaglobulinemia, and bone marrow plasmacytosis. In most cases, plasmacytosis is reactive and polyclonal; however, the occurrence of clonal plasma cell proliferation or secondary plasma cell myeloma is exceedingly rare. Differentiating these conditions is critical, as it influences both prognosis and management strategies, and requires integration of clinical features, serum studies, and immunophenotyping.
We retrospectively analyzed 11 patients with AITL diagnosed between 2018 and 2025 at our tertiary cancer care institute. Clinical records, histopathology of lymph nodes and bone marrow, and flow cytometry findings were systematically reviewed. Immunophenotyping was performed using 10-colour single-tube flow cytometry with markers capable of detecting abnormal clonal plasma cells.
The study cohort comprised 9 males and 2 females, with a mean age of 62 years. All patients presented with advanced-stage disease (Stage III: 7/11; Stage IV: 4/11). Cutaneous lesions were seen in 54.5% (6/11), autoimmune hemolytic anemia with positive Coombs test in 18.2% (2/11), and hypergammaglobulinemia in 45.5% (5/11). Bone marrow showed an average plasma cell percentage of 5.5%, with two patients exhibiting markedly elevated plasmacytosis (18% and 30%).
In one patient, 18% plasma cells were identified at diagnosis, but serum electrophoresis showed no monoclonal spike, and flow cytometry confirmed polyclonality. Conversely, another patient developed pancytopenia eight months post-therapy, with 30% plasma cells showing kappa light chain restriction, diagnostic of secondary myeloma.
Although clonal plasma cells have been reported within lymph nodes in AITL, true progression to secondary myeloma is exceptionally rare. Larger multicenter studies with molecular profiling are essential to clarify whether these clonal plasma cells represent a continuum of AITL-related immune dysregulation or an independent secondary malignancy.
Keywords : Nodal T follicular helper cell lymphoma, Angioimmunoblastic T-cell lymphoma (AITL), Peripheral T-cell lymphoma (PTCL), T follicular helper (TFH) cells, Reactive polyclonal plasmacytosis, Clonal plasma cell proliferation, Secondary plasma cell myeloma
|
| 296 |
Spectrum of Bone marrow metastasis in adults in tertiary care cancer centre in Eastern India-A Retrospective Observational Study |
1993-10-22 |
Female |
No |
- | UPI t |
Malignant |
Rare hematological malignancies |
Laboratory |
Dr Pronati Gupta,Dr Subhajit Hajra, Dr Sankar Sengupta. Affiliation: Lab Haematology, Department of Laboratory Medicine,Chittaranjan National Cancer Institute,Newtown,Kolkata |
Dr.Manjari Bhattacharyya |
Chittaranjan National Cancer Institute,Newtown,Kol |
KOLKATA |
9593580368 |
bhattacharyya.manjari@gmail.com |
Poster |
Title:: Spectrum of Bone marrow metastasis in adults in tertiary care cancer centre in Eastern India-A Retrospective Observational Study
Introduction: Bone marrow (BM) metastasis (BMM) occurs when malignant tumor cells originating in the non-hematopoietic system invade the BM through blood or lymphatic circulation. BM forms a "pre-metastatic niche" before the arrival of tumor cells, secreting a variety of cytokines and chemokines to attract primary tumor cells to reach the BM and colonize here .Tumor cells adapt to the BM microenvironment and may enter a dormant state, or proliferate to form clinically identifiable metastases. Most of the patients were diagnosed through BM examination due to persistent or progressive hemocytopenia (commonly seen in hemoglobin and platelets), bone pain, and fever of unknown reason.
Aims and Objectives: A retrospective study of bone marrow metastasis in adults in tertiary care cancer centre in Eastern India.
Methods: In a retrospective study for 2 years we evaluated 30 patients of various histopathologically diagnosed solid malignancies suspected of bone marrow infiltration.Bilateral aspirates and biopsies were collected and smears along with trephine biopsy were processed and stained using routine method..
Results: In our study of 30 patients 20 (66.6%) were males and 10 (33.3%) were females. We evaluated 60 aspirates from 30 patients. Based on clinical and laboratory findings primary malignancies were those of carcinoma breast,carcinoma prostate, carcinoma lung, gastric carcinoma ,carcinoma of rectum, Ewing’s sarcoma and osteosarcoma.Bone marrow metastasis was found in 8 out of 30 cases accounting to (26%) malignant solid tumors.
Conclusions: Bone marrow examination has always been a definitive modality for staging and monitoring the prognosis and treatment in such cases. These corroborative finding such as persistent leucoerythroblastic blood picture prompt an awareness and early detection thus helping these patients in treatment and survival.
Key words: Bone marrow, metastasis. |
| 297 |
THE CRYSTAL CLUE : UNMASKING PRIMARY BONE MARROW OXALOSIS IN YOUNG MALE PATIENTS |
1996-09-22 |
Female |
No |
- | pay_Q |
Benign |
Marrow failure |
Laboratory |
Dr Keshari Rajmohan Pattayat, 2nd year resident, department of pathology, Dr Sarita Pradhan, professor, department of pathology, Dr Shivangi Harankhedekar, HOD, Department of Clinical Hematology and Molecular Lab, Dr Prateek Das, assistant professor, depa |
Dr Shristi Anand |
IMS and SUM hospital, Bhubaneswar |
Bhubaneswar |
7977075250 |
shristianand2209@gmail.com |
Poster |
Introduction: Bone marrow oxalosis is a rare condition characterized by deposition of calcium oxalate crystals within the bone marrow, usually as a part of systemic oxalosis . It has an estimated global prevalence of 1-3 cases per million population. It is characterized by cytopenias, leukoerythroblastosis, hepato-splenomegaly and renal disease. Primary hyperoxaluria is a rare inborn error of metabolism affecting the glyoxylate pathway, in children and adolescents and between 1st to third decade, often mimicking hematologic malignancies or marrow infiltrative disorders, leading to diagnostic delays . The genes most commonly affected are AGXT, GRHPR, and HOGA1. Whereas secondary hyperoxaluria is due to acquired causes like chronic kidney disease, IBD, Celiac disease, dietary excess, drug induced , ethylene glycol poisoning, etc.
Methods : Institutional, retrospective record-based case study done on bone marrow tissue and bone marrow aspiration slides from 2 patients which were stained with hematoxylin and eosin, reticulin and pas stains and was studied under light and polarized microscopy.
Results : Both patients were young males of age 28 and 29 years and presented with unexplained pancytopenia and renal failure. Bone marrow biopsy was done which revealed needle-shaped calcium oxalate crystals in radial patterns surrounded by foreign body-type giant cell reaction, without evidence of hematologic malignancy or metastasis. Later under polarized microscopy the crystals displayed strong birefringence. These findings confirmed bone marrow oxalosis.
Conclusion: Bone marrow oxalosis, though rare, should be considered in patients presenting with pancytopenias with renal dysfunction. Timely diagnosis via bone marrow biopsy provides critical histologic clues and can guide fast interventions, thereby improving outcomes .
Keywords: Bone marrow oxalosis, Renal failure, Cytopenias, Calcium oxalate crystals
|
| 298 |
EFFECT OF PLATELET-RICH PLASMA THERAPY ON MENSTRUAL RESTORATION IN UTERINE CAUSES OF SECONDARY AMENORRHEA – A PILOT STUDY |
1998-04-03 |
Female |
No |
- | pay_R |
Benign |
Transfusion medicine |
Clinical |
DR. KAVERI GUPTA(PG RESIDENT), DR. ANSHUJA SINGLA(PROFESSOR), DR. RICHA GUPTA (PROFESSOR), DR. RACHNA AGARWAL(PROFESSOR AND HEAD) |
KAVERI GUPTA |
UCMS AND GTBH |
New Delhi |
9468946779 |
SWEETKAVERI150@GMAIL.COM |
Oral |
Title:
Effect of Platelet-Rich Plasma Therapy on Menstrual Restoration in Uterine Causes of Secondary Amenorrhea – A Pilot Study
Introduction:
Secondary amenorrhea due to uterine factors such as intrauterine adhesions, thin endometrium, or post-infective scarring compromises reproductive health. Conventional therapies including hormonal regimens and surgical adhesiolysis often yield suboptimal results. Platelet-rich plasma (PRP), an autologous concentrate of platelets rich in growth factors, has emerged as a promising regenerative therapy. This pilot study was designed to evaluate the role of intrauterine PRP infusion in restoring menstruation and improving endometrial thickness.
Methods:
A pilot study was conducted from April 2024 to August 2025. Thirty-five women (18–40 years) with secondary amenorrhea, normal FSH were enrolled. PRP was prepared standard hospital protocol and 3–5 ml instilled intrauterine through a Tomcat catheter. Endometrial scratch or hysteroscopic adhesiolysis was performed when indicated. Sequential PRP cycles (maximum three) were given with endometrial thickness (ET) monitored weekly. Progesterone challenge was administered if ET ≥6 mm. Non-responders received estrogen–progesterone therapy. Primary outcome was resumption of menstruation.
Results:
Periods restored in 14% after the first PRP, 31% after the second, and 60% after three cycles. At three months, nearly half continued to menstruate regularly. The uterine lining became thicker with each cycle (from 2.9 mm to 5.8 mm, p<0.001). Women who also had adhesions removed did much better (92% success) compared to those who did not (43%). Of 16 women who didn’t respond to PRP, 7 began menstruating with hormonal therapy. One woman conceived and delivered a baby at 35 weeks.
Conclusion:
Intrauterine PRP is a safe, minimally invasive, and effective option for menstrual restoration in uterine-cause secondary amenorrhea. Its synergistic use with hysteroscopic adhesiolysis and adjunctive hormonal therapy may further improve outcomes. Larger controlled trials are needed for validation.
Keywords:
PRP, secondary amenorrhea, menstrual restoration, endometrial thickness
|
| 299 |
Nasal versus parenteral vitamin B 12 in macrocytic anemia: A Randomised clinical trial |
1995-01-02 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
Dr Kuldeep Kumar Aastha and Dr Kundan Mishra |
Dr Sarvesh Kumar |
Command hospital, Central command |
Lucknow |
7276651492 |
kumarsarvesh646@gmail.com |
Oral |
Title
Nasal Versus Parenteral Vitamin B12 in Macrocytic Anaemia: A Randomized Clinical Trial
Introduction
Vitamin B12 deficiency is a major cause of macrocytic anaemia, leading to impaired hematopoiesis and systemic complications. While parenteral vitamin B12 remains the standard therapy, intranasal administration offers a non-invasive alternative that may enhance compliance. This study aimed to compare the efficacy and safety of nasal versus parenteral vitamin B12 in patients with macrocytic anaemia.
Method
A prospective, randomized, comparative study was conducted on 60 patients with confirmed macrocytic anaemia and vitamin B12 deficiency. Participants were allocated into two groups: Group A received intranasal vitamin B12 and Group B received intramuscular vitamin B12 for six weeks. Weekly monitoring included hematologic parameters (haemoglobin, MCV, reticulocyte count, WBC, platelet count), serum LDH, body weight, and clinical symptoms. Safety and tolerability were assessed throughout the study.
Results:
Both groups showed significant improvement in haemoglobin (p<0.001), MCV, and clinical status over six weeks. Parenteral B12 produced a faster rise in haemoglobin from weeks 5–6 (p<0.05), while nasal B12 demonstrated an earlier and higher reticulocyte response at weeks 1, 2, 5, and 6. WBC and platelet counts improved significantly in both groups; nasal B12 showed higher WBC at week 4, and the parenteral group had a transient platelet surge at week 2. Serum LDH levels declined significantly, indicating reduced hemolysis. No adverse events occurred in either group, confirming safety and tolerability.
Conclusion:
Both nasal and parenteral vitamin B12 are effective and safe for treating macrocytic anaemia. Intramuscular B12 offers a slightly faster haemoglobin response, whereas nasal administration provides earlier marrow response and a patient-friendly, non-invasive option for long-term therapy.
Keywords:
Vitamin B12, Macrocytic anaemia, Intranasal therapy, Parenteral therapy, Haematologic response. |
| 300 |
Clinico-Pathological Profile of Hereditary Spherocytosis in a Tertiary Care Centre in Eastern India |
1988-07-29 |
Male |
Yes |
L-2190 | pay_R |
Benign |
Anemia |
Clinical |
Subhra Kamal Saha (Senior Resident), Pratibha Singh (Senior Resident), Mayank Pandey(Senior Resident), Prakas Kumar Mandal(Professor), Rajib De (Professor), Tuphan Kanti Dolai (Professor) |
Suprotim Ghosh |
Nil Ratan Sircar Medical College & Hospital |
Kolkata |
9477736822 |
suprotim_ghosh@rediffmail.com |
Oral |
Title: Clinico-Pathological Profile of Hereditary Spherocytosis in a Tertiary Care Centre in Eastern India
Introduction:
Hereditary spherocytosis (HS) ,though constitutes the majority of all inherited hemolytic anemias , is often under-recognized in the Indian subcontinent. The disease demonstrates heterogeneous clinical entity. This study aimed to evaluate the clinical profile, hematological spectrum, diagnostic yield as well as treatment outcome of HS in a Tertiary care centre.
Methods:
We conducted an observational study on patients presenting with features of chronic hemolytic anemia at our centre over a 10-year period. HS diagnosis was based on clinical features, peripheral blood smear, osmotic fragility testing, and confirmatory eosin-5’-maleimide (EMA) binding assay/Next Generation sequencing (NGS) wherever feasible. Data collected included demographic details,family history, clinical presentation, hematological & biochemical parameters and long term treatment outcomes.
Results:
Total 62 patients were diagnosed with HS. The median age at diagnosis was 11 years (range 3 months to 41 years) with a female preponderance. Anemia (93%)was the most common presenting features followed by splenomegaly (74%) & jaundice (68%). Family history of HS was present in 30% of cases. The mean hemoglobin at presentation was 7.6 gm%, with reticulocytosis in 62% of patients. Peripheral smear showed spherocytes in 88% of cases. H/O blood transfusion were present in 72% of patients while 22% were transfusion dependant.11 patients with severe disease underwent splenectomy, resulting in improvement in clinical parameters.
Conclusions:
Hereditary spherocytosis ,often under-diagnosed,constitutes a significant proportion of chronic hemolytic anemia ,especially in children and adolescents. High index of suspicion,early diagnosis using peripheral smear ,OFT/ confirmatory EMA testing enables timely clinical intervention. Disease severity varies, with a subset requiring splenectomy for definitive management. Wider access to diagnostic assays is essential in resource-constraint settings to hasten detection and optimise clinical outcomes.
Key words: Congenital Anemia, Hereditary Spherocytosis, Hemolytic Anemia, Jaundice, Splenomegaly |
| 301 |
Excellent outcomes of pediatric haploidentical HSCT: a single-center experience over three years. |
1985-08-06 |
Male |
Yes |
186 | FACUL |
Benign |
Miscellaneous |
Clinical |
CHINTAN VYAS, SENIOR CONSULTANT, SRCC CHILDREN'S HOSPITAL MUMBAI |
KRITI TRIPATHI |
SRCC CHILDREN'S HOSPITAL MUMBAI |
MUMBAI |
9920801985 |
dr.chintanvyas@gmail.com |
Oral |
Title:Excellent outcomes of pediatric haploidentical HSCT: a single-center experience over three years. Introduction:Expanding donor availability through haploidentical allogeneic hematopoietic stem cell transplantation (HSCT) is critical for children with malignant and nonmalignant disorders, particularly in resource-limited settings. We report outcomes from a single center over three years to evaluate feasibility, safety, and efficacy. Methods:In this retrospective cohort (June 2022–June 2025), 52 pediatric patients (34 male; mean age 84.5 months, range 5.5 months–17 years) underwent haploidentical HSCT for benign (n=30) and malignant (n=22) indications. All grafts were peripheral blood; conditioning was predominantly myeloablative (n=46). Thirty received T cell–depleted (Tαβ depleted) grafts and 23 received T cell–replete grafts. Median CD34+ dose was 10 × 10^6/kg (range 6–30). Tαβ depletion targeted <25 × 10^3/kg αβ cells; a CD45RO add back schedule (day 0 and repeated doses from day +28 to +120) was employed to balance immune reconstitution and graft versus disease control. Results:Neutrophil engraftment occurred in 51/52 patients at a median of 13 days (range 8–26); full donor chimerism median 14 days (8–39). Graft failure occurred in two patients (one primary, one secondary). Acute GVHD occurred in 40% (grade III–IV 18%); chronic GVHD in 10%. Invasive fungal infections included aspergillosis (12%) and candidiasis (6%); no deaths attributable to CMV, BK, EBV, or adenovirus. Day 100 transplant related mortality (TRM) was 2%; overall TRM 11%; relapse rate 11%. Median follow up was 480 days (range 100–1,132). Overall survival was 78% (benign disease 97%; malignant disease 61%). Deaths were due to infections (n=4), GVHD (n=2), and relapse (n=6). Conclusions:Peripheral blood haploidentical HSCT with Tαβ depletion and CD45RO add back or post-transplant cyclophosphamide produced successful and sustainable engraftment, low early TRM, and encouraging survival, demonstrating a scalable, effective strategy for pediatric transplant programs in developing world settings. Rapid access to a family donor no longer needs to |
| 302 |
Clinical Outcomes and Safety Profile of Eltrombopag in Patients with Immune Thrombocytopenia (ITP): A Multicenter Experience |
1991-04-03 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
1.Sirisharani Siddaiahgari, Medical Oncologist, Rainbow children hospital, Hyderabad.2.Sridhar G, Haematologist, Sri Ramakrishna Hospital, Coimbatore. 3.Vyas Chintan T, Paediatric hematologist, SRCC hospital, Mumbai.4. Amarnadh Polisetty, Medical Oncologi |
Richa Tripathi |
Zydus Lifesciences Ltd |
Ahmedabad |
09687419996 |
Richa.Tripathi@ZydusLife.com |
Poster |
Title: Clinical Outcomes and Safety Profile of Eltrombopag in Patients with Immune Thrombocytopenia (ITP): A Multicentre Experience
Introduction: Eltrombopag, an oral thrombopoietin receptor agonist, is widely used for immune thrombocytopenia (ITP). However, real-world evidence from Indian cohorts is limited. This study evaluated the short-term efficacy and safety of eltrombopag in ITP patients.
Methods: A total of 158 patients’ data with ITP were retrospectively analysed (mean age ± SD: 46 ± 16.37 years; mean weight ± SD: 58.33±12.73 kg). Disease subtypes included acute ITP (n=83), chronic ITP (n=59), persistent ITP (n=12), and 4 patients with unavailable subtype data. The median starting dose of eltrombopag (Elromo) was 50 mg daily. Platelet counts were recorded at baseline and at 3 months. Adverse events and treatment modifications were documented.
Results: The mean baseline platelet count was 38,026.58±32500.03/µL, which increased significantly to 176,414.56±164504.06/µL at 3 months, representing an average rise of 138,387.97±161990.22/µL. A sustained platelet response was observed across all ITP subtypes. Adverse events were reported in 5 patients (3.1%), including myalgia, transaminitis, fatigue, and nausea, all grade 1 in severity. Eltrombopag was not discontinued in any patient due to toxicity. Dose modification was required in 1 patient, while 4 continued without changes.
Conclusions: Eltrombopag demonstrated substantial efficacy in improving platelet counts in ITP patients with a favourable safety profile. The low incidence of only mild adverse events and absence of treatment discontinuation highlight its tolerability. These findings reinforce eltrombopag as an effective therapeutic option for ITP in the Indian clinical setting.
Keywords: Eltrombopag, immune thrombocytopenia, platelet count, safety, efficacy
|
| 303 |
Good, Better And Best: A Twenty Year Follow Up Study Of Children With Severe Aplastic Anemia From A Single Centre In India. |
1993-09-18 |
Female |
No |
- | pay_R |
Benign |
Marrow failure |
Clinical |
Anuraag Reddy Nalla, Kavitha Ganesan, Nithya S, Minakshi P, Ramya Uppuluri, Revathi Raj Department of paediatric hematology, oncology and BMT, Apollo cancer centres, Chennai India |
Vijayshree Muthukumar |
Apollo Cancer Centre, Chennai |
Chennai |
8904181283 |
vijayshree.kumar@yahoo.com |
Oral |
Good, Better And Best: A Twenty Year Follow Up Study Of Children With Severe Aplastic Anemia From A Single Centre In India.
Severe aplastic anemia (SAA) in children is a life-threatening disorder associated with infections, bleeding, and early mortality. Matched sibling donor hematopoietic stem cell transplantation (HSCT) is the treatment of choice, while matched unrelated donor HSCT and immunosuppressive therapy (IST) serve as alternatives. The introduction of haploidentical HSCT has broadened treatment options. This study reviews 20 years of institutional experience in pediatric SAA.
Methods: A retrospective review was conducted of children aged 0–18 years with SAA treated between January 2004 and December 2024. Before 2015, treatment included IST or matched donor HSCT; thereafter, haploidentical HSCT was offered for life-threatening cases. Data were collected from medical records and analyzed with standard statistical methods.
Results: Ninety children were treated: 27 with matched donor HSCT (including 3 unrelated), 28 with haploidentical HSCT, and 35 with IST. Compared with matched donor HSCT, haploidentical HSCT recipients had older donors (median 38 vs. 13 years), higher graft rejection (21.4% vs. 0%), and more CMV reactivation (28% vs. 0%) (p<0.05). Five-year overall survival was 92.4% for matched donor HSCT, 62% for haploidentical HSCT, and 82.4% for IST (p=0.04). In the haploidentical cohort, rabbit ATG conditioning achieved 92.8% survival, comparable to matched donor HSCT, while absence of r-ATG was linked to 50% graft rejection. IST with eltrombopag improved survival compared with IST alone (94% vs. 68.7%; p=0.07). Event-free survival was 92.5% for matched donor HSCT, 62.5% for haploidentical HSCT, and 44% for IST.
Conclusion: Matched donor HSCT remains the preferred therapy for pediatric SAA. Haploidentical HSCT with r-ATG conditioning is a valid alternative when no matched donor is available. IST outcomes improve with eltrombopag but remain inferior for long-term disease control.
Keywords: Severe aplastic anemia, IST, HSCT |
| 304 |
Prognostic significance of Normoblasts to assess Feto-Maternal outcome among pregnancies requiring Intensive care: An Observational Study |
1980-07-29 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Dr Archana Kumari, Prof and HOD, Dept of OBGY, Dr Zeba Parween, Junior Resident, Dept of OBGY |
Dr Pushpanjali R. Ojha, Associate Professor, Trauma Pathology |
Rajendra Institute of Medical Sciences |
Ranchi |
9650374095 |
drprojha@gmail.com |
Oral |
Title: Prognostic significance of Normoblasts to assess Feto-Maternal outcome among pregnancies requiring Intensive care: An Observational Study
Introduction: Normoblasts (NRBCs) are erythrocytic precursors physiologically seen in neonates however pathologically in maternal blood. We aimed to assess the prognostic significance of NRBCs in evaluating feto-maternal outcomes in high-risk pregnancies requiring intensive care.
Methods: A prospective cross-sectional study was conducted between January 2024-June 2025. Pregnant women with singleton pregnancy and > 20 weeks gestation with obstetric complications admitted in Obstetric department ICU of RIMS, Ranchi were recruited. All data (socio-demographic, clinical and hematological) were collected at day 1 and 3, entered in Microsoft Excel sheet and analyzed using SPSS version 23.0 statistical software.
Results: Out of 104 cases, 53.8% had NRBCs with mean age of 26.87±6.30 years and gestational age of 35.87±4.18 weeks. 62.5% maternal mortality which increases with NRBC rise was observed. Higher severity of illness, temperature, blood pressure, pH, sodium and total bilirubin levels were observed in these cases. Prevalence of severe preeclampsia (21.4%), antepartum eclampsia (30.4%), cardiac diseases, pulmonary edema, sepsis and disseminated intravascular coagulation (DIC) were higher. Higher incidence of fetal death and respiratory distress and inverse association with gestational age was observed. Day 1 and 3 observations reveal strong correlation with temperature, total bilirubin, creatinine, APACHEII and SOFA score revealing relevant association between NRBC counts and disease severity, organ dysfunction and poor neurological function. Day 1 and 3 NRBC counts show moderate-to-high sensitivity (68.9-77.8%) and accuracy (78.9-84.9%). Persistently high NRBC levels and an abrupt rise during hospitalization was a strong predictor for in-hospital ICU mortality. Conclusions:This was first of its kind study to correlate baseline and two point time NRBC estimation with feto-maternal outcome and observed this estimation as an important indicator. NRBC trend as prognostic marker for disease severity and mortality risk.
Keywords: Normoblasts, Feto-maternal outcome |
| 305 |
Impact of Pre HSCT Immunotherapy on Outcomes in Childhood Leukaemia – A Retrospective Study from Tertiary Care Centre from Southern India |
1993-09-18 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Anuraag Reddy Nalla, Kavitha Ganesan, Nithya S, Minakshi P, Ramya Uppuluri, Revathi Raj Department of paediatric hematology, oncology and BMT, Apollo cancer centres, Chennai India |
Vijayshree Muthukumar |
Apollo Cancer Centre, Chennai |
Chennai |
8904181283 |
vijayshree.kumar@yahoo.com |
Oral |
Title:
Impact of Pre HSCT Immunotherapy on Outcomes in Childhood Leukaemia – A Retrospective Study from Tertiary Care Centre from Southern India
Introduction:
Survival in childhood acute lymphoblastic leukaemia (ALL) has improved, yet relapsed/refractory (R/R) cases remain a major challenge. Novel immunotherapies such as blinatumomab and inotuzumab with ponatinib are increasingly used before hematopoietic stem cell transplantation (HSCT). This study evaluates HSCT outcomes following immunotherapy in children with R/R ALL.
Methods:
We retrospectively reviewed children ≤18 years with R/R ALL who underwent HSCT after immunotherapy between December 2018 and December 2024. Blinatumomab was used in non-Ph/Ph-like ALL, while inotuzumab with ponatinib was used in Ph/Ph-like disease. Clinical features, transplant complications, and survival outcomes were analyzed from medical records.
Results:
Twenty-five children were included: 16 received blinatumomab and 9 inotuzumab/ponatinib. Median age at HSCT was 10 years; all achieved remission prior to transplant. Post-HSCT, 70% of blinatumomab recipients developed cytokine release syndrome (CRS), with 50% requiring tocilizumab or anakinra, significantly higher than historical CRS rates (13%). In the inotuzumab group, all patients developed grade 1 sinusoidal obstruction syndrome (SOS), managed with diuretics and prophylactic N-acetyl cysteine. Viral reactivation occurred in 56% of blinatumomab and 33% of inotuzumab recipients. No transplant-related mortality was observed. Overall survival was 68%, with all eight deaths (32%) due to relapse. Survival was higher with inotuzumab (77%) compared to blinatumomab (57%). Median time to relapse was 9 months for blinatumomab and 12 months for inotuzumab.
Conclusion:
Pre-HSCT immunotherapy effectively achieved remission in R/R ALL and enabled transplantation without regimen-related mortality. Blinatumomab increased CRS risk, while inotuzumab predisposed to SOS, both manageable with supportive measures. Longer follow-up is required to assess durability of remission and long-term survival.
Keywords:
Acute lymphoblastic leukaemia, pediatric, immunotherapy, blinatumomab, inotuzumab, HSCT, cytokine release syndrome, sinusoidal obstruction syndrome |
| 306 |
Estimation of Myeloid derived Suppressor cells in Pediatric B cell Acute Lymphoblastic Leukemia patients and correlation with post-induction measurable residual disease responseEstimation of Myeloid derived Suppressor cells in Pediatric B cell Acute Lymph |
1994-10-10 |
Female |
Yes |
L-2234 | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr.Kavya Ronanki senior resident department of Medical Oncology Hematology, AIIMS Rishikesh,Dr.Bivant Shah senior resident department of Medical Oncology Hematology,Dr.Nikhil Nagpal senior resident department of Medical Oncology Hematology,Dr.Eswar senior |
Dr.Prisla Maria Dalton senior resident department of Medical Oncology Hematology AIIMS Rishikesh |
AIIMS Rishikesh |
Rishikesh |
9894218524 |
prisladalton@gmail.com |
Oral |
Title:Estimation of Myeloid derived Suppressor cells in Pediatric B cell Acute Lymphoblastic Leukemia patients and correlation with post-induction measurable residual disease response Introduction:Myeloid-derived suppressor cells (MDSCs) are immature myeloid cells that are immunosuppressive and can impair anti-leukemic immune responses in acute lymphoblastic leukemia (ALL).This study analyzed total MDSCs and subsets—polymorphonuclear (PMN-MDSCs), monocytic (M-MDSCs), and early-derived MDSCs during induction therapy and correlated them with measurable residual disease (MRD) and clinical risk . Methods:Thirty three newly diagnosed pediatric B cell ALL patients were included in the study after consent.After baseline risk stratification, induction was initiated using Berlin-frankfurt-Munrich (BFM) regimen and ICICLE-ALL-14 regimen .MDSCs and its subsets were detected and quantified by Flowcytometry.Statistical Analysis was done using SPSS software. Results:This study included 33 patients with mean age of 7 years.The mean total MDSC proportion (as % of non-debris cellular events) decreased significantly from 1.31% ± 2.26% pre-treatment to 0.34% ± 0.44% post-treatment (p =0.0069).MRD negativity and positivity was seen in 75.7% and 24.2% of patients. PMN-MDSCs expressed as percentage of total Non-debris cellular events(NDCE) reduced from 0.613% ± 0.82% to 0.105% ± 0.23% (p < 0.001), while M-MDSC level reduction remained statistically unchanged. PMN-MDSCs declined in MRD-positive patients from 0.782% ± 0.9% pretreatment to 0.115% ± 0.28% post treatment (p = 0.043) and in MRD-negative patients from pretreatment value of 0.55% ± 0.8% to post treatment value of 0.098% ± 0.212% (p = 0.00066). Early-derived MDSCs were higher pre-treatment in MRD-positive patients (0.37% ± 0.51%) than in MRD-negative patients (0.046% ± 0.109%) (p < 0.0001).Risk-stratified analysis showed a gradient of early MDSC burden at baseline: high-risk (0.157%± 0.2%) intermediate-risk (0.068%± 0.14%), and standard-risk (0.017%± 0.02%)(p < 0.0001). Conclusion:Elevated early-derived MDSCs at diagnosis correlate with MRD positivity and risk status and are potential future therapeutic targets. Keywords: Myeloid Derived Suppressor Cell.B-cell Acute Lymphoblatic Leukemia. |
| 307 |
Oral Mucositis in the Transplant Journey: Real-World Data from a Single-Centre Prospective Study |
1983-10-02 |
Female |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Kaushik N, Veronica Lobo, Sushma B, Chaitanya H Balakrishnan, Seetharam Anandram, Cecil Ross |
Sanjukta Rao |
St John's Medical College Hospital |
Bangalore |
9886508910 |
drsanjuktasrao@gmail.com |
Poster |
Title: Oral Mucositis in the Transplant Journey: Real-World Data from a Single-Centre Prospective Study Background : Oral mucositis (OM) is a frequent and debilitating complication of hematopoietic stem cell transplantation (SCT), impacting nutrition, infection risk, and quality of life. This study aimed to describe risk factors, severity, and management strategies for OM in a cohort of transplant recipients at our centre. Methods: Eighteen consecutive SCT patients were prospectively evaluated for OM, graded per WHO toxicity scale. Data on demographics, transplant type, conditioning regimen, BMI, prophylaxis, and management were analyzed. Statistical tests included Mann-Whitney U, Kruskal-Wallis, and Spearman’s correlation. Results: Of 18 patients, 7 (38.9%) were female; mean age was 37 years (21–63). Ten underwent autologous SCT (7 myeloma, 2 lymphoma, 1 MIDD) and 8 allogeneic SCT (1 matched sibling, 7 haploidentical). Conditioning regimens included myeloablative (37.5%) and reduced intensity (62.5%). Mean onset of OM was day +3.5 (range −1 to +7). OM grades 1–2 occurred in 11 patients (61.1%), grade 3 in 6 (33.3%), and grade 4 in 1 (post-TBI). All received chlorhexidine rinses; high-dose melphalan patients received cryotherapy prophylactically. Management included bland rinses, anti-inflammatory mixtures, and opioid analgesia (morphine in 33%, fentanyl boluses in 33%; continuous IV fentanyl in 1 patient). Mean resolution time was 10.3 days (range 8–18). Severity was not associated with sex (p=0.81) or age (r=0.22, p=0.39). A weak negative, non-significant correlation was seen with BMI (r=−0.31, p=0.21). Severity did not differ significantly between autologous and allogeneic SCT (mean grade 2.4 vs 2.0, p=0.32). Reduced intensity conditioning was associated with lower OM severity (p=0.014). Conclusion: OM remains a significant complication of SCT. In this small cohort, no association with gender, age, or BMI was observed. Conditioning regimen strongly influenced severity, with TBI linked to grade 4 mucositis. These findings contribute to limited Indian data and underscore |
| 308 |
Real-World Experience with Acalabrutinib in Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL): A Multicentre retrospective analysis from India |
1991-04-03 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
1. Revanth B,Haematologist, Sparsh Hospital, Bengaluru.2 Chandrasekhar B,Haematologist, MGCH, Vizag 3. Dadhich HK,Medical Oncologist, Kinkar Nursing Home, Kota.4. Gupta SK,Haemato Medical Oncology & Bone Marrow Transplant, Venkateshwara Hospital, Delhi.5. |
Richa Tripathi |
Zydus Lifesciences Ltd |
Ahmedabad |
09687419996 |
Richa.Tripathi@ZydusLife.com |
Oral |
Title: Real-World Experience with Acalabrutinib in Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL): A Multicentre retrospective analysis from India Introduction: Acalabrutinib, a second-generation BTK inhibitor, has demonstrated efficacy and tolerability in CLL and SLL. However, real-world data from Indian clinical practice is limited. This study aims to evaluate treatment patterns, prior therapy exposure, cardiovascular comorbidities, and hematologic responses in patients treated with acalabrutinib. Methods: A retrospective analysis was performed on 130 patients diagnosed with CLL (n=122) and SLL (n=8) treated from 2023–2025 at Indian oncology centres. Baseline demographics, lines of therapy, dosing regimens, drug combinations, prior ibrutinib exposure, cardiovascular risk factors, and hematologic responses were evaluated. Result: In this study, 130 patients were evaluated, including 122 with CLL and 8 with SLL, with mean ages of 61.6± 10.45 years and 62.2± 9.82 years, respectively, and a mean weight of 63.3± 9.72 kg. Hematologic responses in CLL were 76 CR, 12 CRi, and 33 PR; in SLL, 3 CR, 3 CRi, and 2 PR. Of 22 patients previously treated with Ibrutinib, 9 achieved CR, 8 CRi, and 5 PR, while among 108 Ibrutinib-naïve patients, 70 had CR, 28 CRi, and 9 PR. Acalabrutinib was administered as first-line in 13, second-line in 8, and third-line in 4 patients. ORR were 100% in CLL and 99.2% in SLL, consistent across Ibrutinib-pretreated (100%) and naïve (99.1%) patients. Treatment was given as monotherapy (n=106) or in combination with obinutuzumab and/or venetoclax, showing good efficacy and tolerability. Common comorbidities included hypertension (65%), diabetes (25%), and hypercholesterolemia (5%), while atrial fibrillation (3%), cerebrovascular disease (2%), and peripheral arterial disease (1%) were less frequent; acalabrutinib remained well tolerated despite these conditions. Conclusion: This real-world analysis confirms acalabrutinib (Acaya) as an effective treatment option for both frontline and R/R CLL & SLL. Keywords: Acalabrutinib, Chronic Lymphocytic Leukemia |
| 309 |
Retrospective Study on Dasatinib 50mg for Chronic Myeloid Leukemia in the Chronic Phase: A Look at Newly Diagnosed and Previously Treated Cases |
1985-12-23 |
Male |
No |
- | H_LKO |
Malignant |
MPN & MDS/ MPN |
Clinical |
|
Dr. Surendra Prasad Shah |
Sir Ganga Ram Hospital |
New Delhi |
9693253214 |
spshahbtr@gmail.com |
Oral |
Title-Retrospective Study on Dasatinib 50mg for Chronic Myeloid Leukemia in the Chronic Phase: A Look at Newly Diagnosed and Previously Treated Cases
Authors-Surendra Prasad Shah, Nitin Gupta ,Naman Bansal ,Navneet Mishra, Priyamvadha R, Shruti Sinha, Sir Ganga Ram Hospital, New Delhi, India
Introduction-Worldwide, the literature on low-dose Dasatinib (50 mg) in CML-CP shows comparable efficacy with enhanced tolerance and fewer treatment interruptions due to reduced toxicity compared to the standard dose (100 mg). In India, CML onset occurs at a younger age than in Western countries, with many patients discontinuing treatment early due to financial constraints or respiratory toxicity, primarily pleural effusion. Our study aimed to evaluate the efficacy, tolerability, and toxicity profile of low-dose Dasatinib in CML-CP patients in India.
Methods-A retrospective study was conducted from existing data of CML-CP patients in the Department of Hematology, Sir Ganga Ram Hospital, New Delhi from Jan 2020 to July 2025.Patients who received dasatinib 50 mg daily as first line TKI or previously treated with another TKI or higher dose of dasatinib were taken in study. Quantitative BCR-ABL1 PCR assessments were conducted at 3, 6, and 12 months following the initiation of dasatinib treatment.
Results-Total of 33 patients were included in the study . At 3 months, 31(93.94%) out of 33 patients achieved EMR. Out of the 33 patients recruited, only 26 were evaluable for response at 12 months. MMR at the end of 1 year was achieved in 24 (92.31%) out of 26 patients on Dasatinib 50mg daily.
Conclusions-Although limited by its small sample size, our study contributes to the existing body of evidence of low-dose Dasatinib . Notably, no cases of cardiac ,pulmonary or hematologiocal toxicities were observed in our study.
Keywords: Chronic myeloid leukemia,BCR-ABL1, dasatinib, tyrosine kinase inhibitor,50mg
|
| 310 |
Polatuzumab Based Regimens in B-cell NHL: Early Real-World Outcomes and Bridging to Cellular Therapy — Single-Center Indian Experience |
1989-04-24 |
Female |
Yes |
L-2026 | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Sayan Sarkar, Dr. Debmalya Bhattacharyya, Anupam Chakrapani, Soumya Bhattacharya, Department of Clinical Hematology, Apollo Multispeciality Hospitals, Kolkata, India |
Ashwini Narayankar |
Apollo multi-speciality hospitals, Kolkata |
Kolkata |
9867395032 |
ashwininarayankar@yahoo.com |
Poster |
Title:
Polatuzumab-Based Regimens in B-cell NHL: Early Real-World Outcomes and Bridging to Cellular Therapy - Single-Center Indian Experience
Background:
Polatuzumab vedotin (Pola), an anti-CD79b antibody–drug conjugate, is effective in relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) and improves frontline outcomes (POLARIX trial). In India, where CAR-T access is limited, Pola provides a key therapeutic option, however, real-world data are scarce.
Methods:
We retrospectively reviewed adult B-cell NHL patients receiving Pola-based therapy at our center (Aug 2024–Aug 2025). Clinical characteristics, treatment setting (frontline vs R/R), regimen, response, and adverse events were analyzed. The primary endpoint was overall response rate (ORR). Secondary endpoints were safety, feasibility, progression-free survival (PFS), overall survival (OS), and post-Pola consolidation.
Results:
Ten patients received Pola-based therapy (median age 61 years, range 27–77; M:F 7:3); 70% had stage III–IV disease (median R-IPI 3). Pola was used frontline in 3 patients (Pola-R-CHP) and in the R/R setting in 7 (Pola-BR, Pola-RICE, Pola-RGDP), with a median of 1 prior line (range 1–3). Six patients were response-evaluable: ORR 100% (6/6; complete metabolic response 67%, partial response 33%). At cutoff, ORR was 60% (6/10) with non-assessed patients counted as non-responders. Grade ≥3 hematologic toxicity occurred in 2 patients; one LRTI was associated with cytopenia. Other events (folliculitis, typhoid, suspected RCC) were unrelated. No treatment-related deaths occurred. Consolidation included autologous SCT (n=1). Importantly, 3 patients were bridged to CAR-T therapy. Median follow-up was short, precluding mature PFS/OS.
Conclusion:
This early single-center Indian experience shows that Pola-based regimens are feasible and effective in both frontline and R/R B-NHL, achieving high early response rates with manageable toxicity. Pola also enabled bridging to SCT and CAR-T, a critical advantage in the Indian context. This highlights the need for larger multicenter studies with long-term outcomes.
Key words: Polatuzumab, DLBCL, real-world
|
| 311 |
The Day Blood Froze: Unraveling a Rare IgG-Driven Agglutination at Room Temperature |
2000-01-07 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
Dr Ritika Sud, Professor of Medicine |
Dr Nilayan Sarkar |
Lady Hardinge Medical College |
Delhi |
8076560082 |
nilayansarkar@gmail.com |
Poster |
Title: The Day Blood Froze: Unraveling a Rare IgG-Driven Agglutination
Introduction: Room temperature agglutination significantly complicates diagnostics and poses a challenge in resource constraint settings. Usually IgM mediated, IgG mediated cases are extremely rare in literature. Herein, we report a case of a 19-year female, who initially presented with complains of fever, fatigue and jaundice for 1 month.
Methods: Observation; case report
Results: Her examination revealed severe pallor, icterus and splenomegaly. Her evaluation started with blood draw which immediately agglutinated within the syringe. Repeated attempts yielded similar results. A hematology consultation was taken which recommended the use of a water-bath. Subsequently, her blood analysis revealed Hemoglobin of 4.3 gm/dl, TLC of 7600/uL, Platelets of 73,000/uL, total/direct bilirubin of 3.11/0.40, INR 1.3, LDH of 311 and absent schistocytes. Coombs panel revealed warm autoantibodies positive for IgG, C3c, C3d and insignificant titers of Cold agglutinin with no detectable IgM. A diagnosis of warm autoimmune hemolytic anemia with thrombocytopenia was made. For this, pulse steroid therapy was started. On day two of therapy, she developed severe vomiting, loose stools, with subsequent acute kidney injury, anuria, metabolic acidosis and shock. Dialysis was initiated under broad spectrum antibiotic cover. The patient improved and stabilized.
A workup for Auto-Immune hemolytic anemia revealed ANA, dsDNA, SS-A positivity with low C3 and C4 levels. Retrospective review of history revealed history of dry eyes with confirmatory positive Schirmer’s test. Her course of hospital stay was complicated by catheter site thrombosis in left femoral vein with subsequent tests for antiphospholipid syndrome being positive.
Conclusions: She was ultimately diagnosed with Evans syndrome secondary to Systemic Lupus Erythematosus with overlap (Secondary Sjogren and Antiphospholipid syndrome). Evans syndrome carries a worse prognosis compared to autoimmune hemolytic anemias with lower remission and higher relapse rates.
Key words: AIHA, Evans syndrome, Cold Agglutinins, SLE. |
| 312 |
Anaplastic diffuse large B-cell lymphoma: An Enigmatic morphological mimicker |
1997-12-14 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Rachana Meena1 , Shivangi Dagar1,Ajay Gogia2 ,Sameer Bhakshi2 Deepam Pushpam 2, Saumyaranjan Mallick1 Affiliation) Department of Pathology, All India Institute of Medical Sciences, New Delhi 2) Department of Medical Oncology, Dr BRAIRCH, All India Inst |
Ramya RB |
AIIMS- New delhi |
New Delhi |
9003688526 |
ramyarbalakrishnan@gmail.com |
Poster |
Anaplastic diffuse large B-cell lymphoma: An Enigmatic morphological mimicker
Authors: Ramya RB1, Rachana Meena1 , Shivangi Dagar1,Ajay Gogia2 ,Sameer Bhakshi2 Deepam Pushpam 2, Saumyaranjan Mallick1
Affiliation: 1) Department of Pathology, All India Institute of Medical Sciences, New Delhi
2) Department of Medical Oncology, Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi
Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common adult non-Hodgkin lymphoma, representing 30–40% of cases. The anaplastic variant, though rare (~3%), is highly aggressive and mimics entities such as classic Hodgkin lymphoma, ALCL, ALK-positive LBCL, melanoma, and undifferentiated carcinoma, leading to diagnostic difficulties. Accurate recognition is critical for guiding appropriate therapy and prognostication.
Aims & Objectives: To document and analyse two cases of anaplastic DLBCL, highlighting their clinical diversity and diagnostic challenges
Methods: Here, we report two cases with distinct clinical presentations
Results: These include a 73-year-old female with cervical and axillary lymphadenopathy with Ann Arbor stage II (Case 1), and a 25-year-old male with a paravertebral mass and hypercalcemia (Case 2). Routine hematological investigations were unremarkable. Histopathological examination of excision biopsies from cervical lymph node as well as the paravertebral mass showed diffuse sheets of highly pleomorphic tumour cells with sinusoidal infiltration and frequent atypical mitoses, closely simulating undifferentiated carcinoma, ALCL, classic Hodgkin lymphoma, and malignant melanoma. Immunohistochemistry showed CD20 and CD30 positivity. MUM1 and c-MYC were expressed in the female patient but absent in the male. Other markers (CD3, CD10, BCL2, BCL6, ALK, CD15, EBV-LMP1) were negative. Both cases were diagnosed as anaplastic DLBCL and treated with R-CHOP, with marked clinical improvement on follow-up
Conclusion: The anaplastic variant of diffuse large B-cell lymphoma is morphologically distinct yet clinically enigmatic. Although linked to aggressive features, it remains underexplored in our population, and its accurate recognition relies on careful assessment of morphology and immunohistochemical profile. |
| 313 |
Burkitt Lymphoma/Leukemia- A retrospective study of survival outcomes in a tertiary care center. |
1989-03-06 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
|
Dr Himadri Sonowal |
Tat Medical Center |
Kolkata |
9163550068 |
himadrisonowal@gmail.com |
Poster |
Title:
Introduction:
Methods:
Results:
Conclusions:
Key words: |
| 314 |
Early Results of comparison of low-dose generic dasatinib (50 MG/Day) versus imatinib (400 MG/Day) in newly diagnosed chronic Phase chronic myeloid leukemia:Single centre Randomised control study |
1991-04-15 |
Female |
Yes |
L-2210 | pay_R |
Malignant |
MPN & MDS/ MPN |
Clinical |
Priyadarshini Peram1, S Venkata Kiran1, Aditya Tayde1, Baishnav Suresh1, Pratibha Yonzone1, Thomas Kuncheria1, S Karthick Velavan1, Nakul Tikare1, Ashutosh Panigrahi1, Somanath Padhi1, Prabodha Das1 1 All India Institute of Medical Sciences, Bhubaneswar, |
Shivangi Sharma |
All India Institute of Medical Sciences |
Bhubaneswar |
9399677980 |
drsharmashivangi@gmail.com |
Oral |
Title: Early Results of comparison of low-dose generic dasatinib (50 MG/Day) versus imatinib (400 MG/Day) in newly diagnosed chronic Phase chronic myeloid leukemia:Single centre Randomised control study
Introduction: Chronic myeloid leukemia (CML) is common in Indian adults. Imatinib is preferred due to affordability and safety, while dasatinib offers superior early and deep responses but with more side effects. Anecdotal evidence suggests low-dose dasatinib (50 mg) may reduce toxicity without losing efficacy.
Methods: The present study enrolled newly diagnosed CML-CP patients of ≥ 18 years of age between February 2024 & March 2025. Eligible subjects were randomized to receive either dasatinib at 50 mg/day or imatinib at 400 mg/day & molecular response was assessed.
Results:Out of 67 newly diagnosed chronic myeloid leukemia (CML) patients, 58 completed at least 6 months of therapy and were analyzed—29 received dasatinib (50mg) and 29 imatinib (400mg). The median age was 44 years, with a male-to-female ratio of 1.8:1. The risk categories included 22% low, 45% intermediate, and 33% high. At 3 months, 93% achieved complete hematologic response. Early molecular response (EMR) rates were 86% with dasatinib and 82% with imatinib. At 6 months, dasatinib showed higher rates of EMR (86%), CCyR (65%), and MMR (38%) compared to imatinib (82%, 52%, and 24%). The responses were better in higher-risk groups with dasatinib. Both drugs were generally well-tolerated, though side effects varied; gastrointestinal and blood toxicities were more common with dasatinib, while musculoskeletal symptoms were higher with imatinib. Notably, dose reductions due to adverse events occurred less often with dasatinib (7%) versus imatinib (28%). One dasatinib patient progressed to blast phase, and another died from febrile neutropenia.
Conclusion : Low-dose dasatinib is well tolerated and yields better early and deeper molecular responses, especially in higher-risk patients. It also offers cost and compliance advantages in resource-limited settings. |
| 315 |
Decoding TAM in Down Syndrome: Distinct Haematological and Immunophenotypic Landscape
|
1999-06-17 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Man Updesh Singh Sachdeva |
Dr Shimreeth Hannah S |
PGIMER |
Chandigarh |
8220105573 |
shimreethhannahs@gmail.com |
Oral |
Decoding TAM in Down Syndrome: Distinct Haematological and Immunophenotypic Landscape
Author: Dr Shimreeth Hannah S, Dr Man Updesh Singh Sachdeva
Introduction: Leukemias in Down syndrome form a distinct subgroup with characteristic genetic and immunophenotypic features. Limited data from Indian cohorts prompted this study to analyse antigen expression patterns in TAM, AML, and B-ALL associated with Down syndrome.
Methods: This was a retrospective observational study conducted in the Department of Pathology, PGIMER, including 33 paediatric patients with Down syndrome diagnosed with TAM, AML, and B-ALL. Clinical and haematological data were retrieved from medical records, and immunophenotyping was performed by multiparametric flow cytometry.
Results: In 33 Down syndrome cases, TAM presented at the youngest age( median age =12months) with higher TLC and low platelet count. In our study, TAM and ML-DS cases demonstrated a characteristic megakaryocytic immunophenotype with strong expression of CD61, CD41a, and CD42b, in line with previously reported literature on Down syndrome–associated leukemias. Interestingly, we observed a relatively high frequency of CD13 expression in TAM (45%), which is higher than that emphasized in prior studies, where myeloid markers such as CD33 and CD38 are more commonly highlighted. This suggests that myeloid antigen expression in TAM may be broader in spectrum in our cohort.
Another distinctive finding was the statistically significant expression of HLA-DR (61.5% in TAM, p = 0.022), which contrasts with some reports that describe HLA-DR as variably expressed. Similarly, CD123 was consistently negative in TAM while positive in a subset of AML and B-ALL (p = 0.004), providing an additional discriminator not widely emphasized in earlier series.
Conclusion: Taken together, while our observations broadly confirm the established immunophenotypic profile of TAM and ML-DS, certain differences, such as the higher rate of CD13 positivity and the discriminatory value of HLA-DR and CD123 in TAM, represent novel contributions. |
| 316 |
Stratifying Pediatric ITP Outcomes Using Cytometric and Clinical Data: A Predictive Modeling Approach at Diagnosis |
1994-05-25 |
Female |
No |
- | pay_R |
Benign |
Platelet disorders |
Laboratory |
Purva Kanvinde2, Amrutha Jose1, Ritika Khurana2, Umair Ahmed Bargir1, Reetika Malik Yadav1, Chandrakala Shanmukhaiah3, Amit Jain4, Ratna Sharma4, Pranoti Kini4, Omkar Khandkar5, Sujata Sharma6, Priyanka Setia1, Nidhi Desai1, Maya Gupta1, Aparna Dalvi1, Sh |
Neha Jodhawat |
ICMR-NIIH |
Mumbai |
8097429573 |
nehajodhawat7@gmail.com |
Oral |
Title: Pediatric immune thrombocytopenia (ITP) is a heterogeneous autoimmune disorder with variable clinical outcomes. While most children experience spontaneous remission, 10 to 20% progress to chronic ITP. Early prediction to chronicity remains a clinical challenge. This study aimed to develop and validate a logistic regression-based model integrating immune features to predict chronicity ITP among children. Methods: In this prospective cohort study, 108 pediatric ITP patients were stratified into: newly diagnosed with remission (n = 48), progressors (n = 13), and chronic ITP (n = 47). Peripheral blood was analysed by multicolor flow cytometry to for 79 immune subsets. Clinical variables including bleeding symptoms, platelet count, and recent infections/vaccinations were recorded. Multivariable logistic regression was performed using immune parameters alone and in combination with clinical features. Model performance was assessed via 5-fold cross-validation and validated on the progressor cohort. Results: Patients with chronic ITP had a distinct immunological feature characterized by reduced CD4/CD8 ratio, naïve Th and naïve Tc cell and increased effector memory, Tc cell percent, senescent T cell(CD57+, PD1+), B memory and class switched memory B cells. The immune-only model identified reduced naïve cytotoxic T cells[CD8⁺CD27⁺CD45RA⁺] and increased double-negative B cells [CD19⁺CD27⁻IgD⁻] as key predictors (accuracy 71.6%, AUC 0.761, p<0.001), correctly classifying 8/13(61.5%) progressors. Increased frequencies of class-switched memory (CSW) B cells [CD19+CD27+IgM-IgD-], terminally differentiated effector cytotoxic [CD8⁺CD28⁻] T cells, more specific double negative (DN)B cells population of CD21-/lowCD38-cells[CD19+CD21-/low CD38-CD27-IgD-] and clinically, epistaxis and absence of abrupt onset were associated with chronicity in combined model improving overall accuracy 82.8%, (AUC 0.905, p < 0.001) correctly classifying 10/13(76.92%) progressors. Conclusions: Integration of clinical features with detailed immune profiling enables early and accurate prediction of chronic ITP in children. These findings support its potential in selecting appropriate management strategies warranting validation in larger multicentric cohorts.
Keywords: chronic ITP, flowcytometry, predictor, pediatric,immunophenotyping |
| 317 |
A rare case of Glanzmann thrombasthenia presenting with spontaneous intraperitoneal bleed |
1998-11-07 |
Female |
No |
- | H_LKO |
Benign |
Platelet disorders |
Clinical |
Dr. RASHMI RANJAN MOHANTY, Dr. ANUPAMA BEHERA, Dr. DHRITI SUNDAR DAS, Dr. SRIKANT BEHERA; DEPT OF GENERAL MEDICINE AIIMS BHUBANESWAR |
Dr. APARNA PSS |
AIIMS BHUBANESWAR |
BHUBANESWAR |
09182122526 |
pssaparna.kkd@gmail.com |
Poster |
Title: A rare case of Glanzmann thrombasthenia presenting with spontaneous intraperitoneal bleed
PRESENTING AUTHOR: Dr. APARNA PSS
COAUTHORS: Dr. RASHMIRANJAN MOHANTY, Dr. ANUPAMA BEHERA, Dr. D.S. DAS, Dr. SRIKANT BEHERA
INSTITUTION: DEPT OF GENERAL MEDICINE, AIIMS BHUBANESWAR
Introduction: Glanzmann thrombasthenia is an inherited platelet function disorder caused by deficiency of platelet integrin alpha IIb beta III. It usually presents with familial history and mucocutaneous bleeding.
Methods: A 16-year-old female born out of non-consanguineous marriage, with history of mucocutaneous bleeding from 1 year of age, without similar history in family came to the emergency with chief complaints of abdominal pain for 10 days and abdominal distension for 7 days, without history of trauma or intervention. She had no history of hemarthrosis. E-FAST was positive. Emergency CECT abdomen with CT angiography was done which showed free fluid in perihepatic, perisplenic, hepatorenal pouch, paracolic gutters and pelvic regions with no active bleeding. Routine evaluation showed Platelet count was normal (1.7 lakh/mcL, normal range 1.5-4.5 lakh/mcL); Coagulation profile was normal- APTT- 26 seconds (normal range 21.3-30.3); PT-13 seconds (normal range 11-14); INR 1.1. Bleeding time was increased (> 6 minutes; normal range 2-6 minutes); Clotting time was normal. Hence the patient was evaluated in the line of platelet function disorders. Platelet aggregation study showed absent aggregation with ADP, epinephrine, collagen; aggregation with ristocetin. There was absent CD 61 expression on flow cytometry.
Results: Patient diagnosed to be a case of Glanzmann thrombasthenia. Patient was managed conservatively with observation and monitoring of vitals.
Conclusions: On reviewing the literature, the incidence of intraperitoneal bleed is very rare with isolated case reports. Glanzmann thrombasthenia is in itself rare with an incidence of one in a million. The sporadic nature and the spontaneous intra peritoneal bleed make this atypical and distinct presentation
Key words: Glanzmann thrombasthenia, mucocutaneous, intraperitoneal |
| 318 |
Central nervous system involvement in patients with Acute Myeloid Leukemia at AIIMS Rishikesh: An observational study.
|
1994-10-10 |
Female |
Yes |
L-2234 | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr.Kavya Ronanki senior resident department of Medical Oncology Hematology, AIIMS Rishikesh,Dr.Bivant Shah senior resident department of Medical Oncology Hematology,Dr.Nikhil Nagpal senior resident department of Medical Oncology Hematology,Dr.Eswar senior |
Prisla Maria Dalton |
AIIMS Rishikesh |
Rishikesh |
9894218524 |
prisladalton@gmail.com |
Poster |
Title:Central nervous system involvement in patients with Acute Myeloid Leukemia at AIIMS Rishikesh: An observational study.
Introduction:CNS involvement in Acute myeloid leukemia(AML) is rare.This study evaluates the clinical features,outcome and median survival of AML patients with CNS involvement.
Methods:All AML patients admitted between 2023 and 2025 were evaluated.
Results:CNS involvement was seen in 9 patients with Acute myekoid leukemia.The median age of AML patients with CNS involvement was 26 years( IQR :29.5).Male: Female ratio was 1.2: 1.Out of the 9 patients 22.2% patients had optic nerve involvement,22.2% patients had parenchymal involvement,22.2% patients had spinal involvement ,11% patient had orbital chloroma with facial nerve involvement,11% had both spinal and parenchymal involvement and 11% had nomal MRI finding.Baseline fundus involvement was seen in 55.55% patients.CSF leukemic involvement was seen in 33.3% patients. The mean total leukocyte count of these patients at prsentation was 85525 cells per cumm.Molecular studies revealed t(8:21) in 2 patients, t(9:22) in 2 patients (one of which is Chronic myeloid leukemia with myeloid blast crisis), 2 patients with NPM mutation,1 patient with FLT3 mutation ,1 patient with t(1:17)-Acute Promyelocytic Leukemia variant and rest with negative molecular study. Among these patients 33.3% were treated with Intrathecal cytarabine, 55.5% were treated with triple Intrathecal therapy(TIT) and 11% was treated with TIT and cranial irradiation.Treatment outcome: Out of 9 patients, 44.4% succumbed,33.3% are in remission,11 % succumbed during transplant and 11% didnot achieve remission at all.Median overall survival of these patients was 6.5 months(IQR:3-16)
Conclusions:Acute myeloid leukemia patients with CNS involvement didnot have a good overall outcome.Younger age at presentation is one of the risk factor for CNS involvement.
Keywords: Acute myeloid leukemia,Central nervous system,Intrathecal therapy.
|
| 319 |
Beyond Primary Chronic Kidney Disease (CKD) : Flow Cytometric Detection of Clonal Plasma Cells Heralds Advent of Better Outcomes in a Case Series from Eastern India |
1989-11-02 |
Male |
No |
- | pay_R |
Malignant |
Plasma cell disorders |
Clinical |
Dr Krishna Kumari (KIMS), Dr Biswajit Bhuyan (KIMS), Dr Jogamaya (KIMS) |
Dr Sandeep Abhijit Pattnaik |
Kalinga Institute of Medical Sciences, Bhubaneswar |
Bhubaneswar |
09439494913 |
sandeep.abhijit89@gmail.com |
Oral |
Title: Beyond Primary Chronic Kidney Disease : Flowcytometric Detection of Clonal Plasma Cells Heralds Advent of Better Outcomes in a Case Series from Eastern India Introduction: Along the eastern coast of India, the prevalence of CKD reaches as high as 14.5%. Whereas many cases become transfusion and dialysis dependant, the etiology of disease refractoriness remains largely unknown. We, at our tertiary level cancer centre, have initiated flowcytometry based plasma cell dyscrasia (PCD) workup for all such cases with early data suggesting the higher prevalence of plasma cell clonality and better treatment outcomes of antimyeloma therapy. Methods: An ambispective analysis of 12 patients (till date) included cases diagnosed and treated as primary CKD for at least 3 months with referral to hematology for either refractory anemia or pancytopenia. Comprehensive paraproteinemia evaluation included biochemical and bone marrow flowcytometry for PCD. Flowcytometry panels included CD38, CD138, CD19, CD56, and light chain restriction analysis. Patients were reclassified based on IMWG criteria and treated with appropriate antimyeloma regimens Results: Among 12 patients (median age 58 years, male:female ratio 2:1), flow cytometry revealed clonal plasma cell populations in all cases. Seven patients were reclassified as multiple myeloma, 4 as MGRS, and 1 as symptomatic MGUS. All patients had abnormal free light chain ratios (median κ/λ ratio 0.15, range 0.02-45.8). Following antimyeloma therapy initiation, for atleast 1 month, 7/12 patients (58.3%) achieved transfusion independence, with median hemoglobin improvement from 7.8 to 10.2 g/dL. Creatinine stabilization occurred in 8/12 patients (66.7%), with mean creatinine reduction of 1.2 mg/dL. Serum FLC showed significant reduction in 9/12 patients (75%). Conclusions: Flowcytometric analysis of plasma cell clonality should be considered in CKD patients presenting with unexplained cytopenias. Early detection of monoclonal gammopathy-related disorders enables timely antimyeloma therapy, potentially preventing progression to refractory anemia and kidney disease.
Key words: CKD, flowcytometry, PCD |
| 320 |
Targeting JAK2V617F Mutant Clone and Fibrosis in Myelofibrosi |
1999-09-21 |
Female |
No |
- | pay_R |
Malignant |
|
Laboratory |
Dr. Hamenth Kumar Palani, Arvind Venkatraman, Dr. Uday Prakash Kulkarni, Dr. Sushil Selvarajan, Dr. Anu Korula, Dr. Biju George, Dr. Aby Abraham, Dr. Sujith Karumathil, Dr. Vikram Mathews |
Abirami Rajasekaran |
Christian Medical College |
vellore |
8870879401 |
abirami.r@cmcvellore.ac.in |
Poster |
Title: Targeting JAK2V617F Mutant Clone and Fibrosis in Myelofibrosis
Introduction:
Primary myelofibrosis is a chronic Myeloproliferative neoplasm characterised by clonal hematopoietic stem cell proliferation, progressive bone marrow fibrosis, and debilitating clinical manifestations. Current therapies, including JAK inhibitors, provide symptomatic relief but fail to reverse fibrosis significantly. Thus, there is a pressing need for novel anti-fibrotic approaches.
Methods:
Stable JAK2V617F Ba/F3 cells were generated using lentiviral transduction and validated for JAK2V617F expression. Drug screening was performed on these cells to identify compounds with selective activity against the mutant clone, including glycolytic inhibitors, JAK inhibitors, BH3 mimetics, and other classes of drugs. The potential candidate was further evaluated for anti-fibrotic effects. Patient-derived MSCs from myelofibrosis patients were treated with the potential drug for 72 hours. Western blot and immunofluorescence were used to assess the expression of fibrosis-associated markers, including α-SMA and fibronectin. Quantitative analysis was performed using ImageJ, normalizing to loading controls.
Results:
From the initial screening using Ba/F3 WT and JAK2V617F cell lines, Arsenic trioxide(ATO) exhibited selective inhibitory effects on JAK2V617F mutant cells compared to wild-type controls. Since bone marrow fibrosis is a key pathological feature of myelofibrosis, the impact of ATO on bone marrow fibrosis was evaluated. Treatment of PMF-Patient-derived MSC with ATO significantly reduced the expression of fibrotic markers such as α-SMA and FN1, indicating a potential antifibrotic effect.
Conclusions:
Our findings suggest that ATO selectively targets JAK2V617F mutant cells and reduces the expression of fibrotic markers in patient-derived MSCs, indicating its potential as an anti-fibrotic agent in primary myelofibrosis. However, further experiments are required to confirm these effects and to elucidate the underlying molecular targets and mechanisms.
Key words: PMF, mutant clone, Mesenchymal Stromal cells, fibrosis |
| 321 |
Low frequency Iron supplementation in regular repeat whole blood donors with Latent Iron Deficiency |
1998-12-14 |
Female |
No |
- | pay_R |
Benign |
Transfusion medicine |
Clinical |
DR RICHA GUPTA, PROFESSOR DEPT. OF PATHOLOGY |
DR HARAMOL KAUR |
UCMS & GTB HOSPITAL, DELHI |
UCMS & GTB HOSPITAL, DELHI |
9910790101 |
dr.haramolkaur09@gmail.com |
Oral |
TITLE: Low-Frequency Iron Supplementation in Regular Repeat Whole Blood Donors with Latent Iron Deficiency
INTRODUCTION: Blood donation is a generous act that saves lives—but for regular repeat whole blood donors (those who donate at least thrice, with the last donation within a year), it can come at a hidden cost. Each donation results in a loss of approximately 230 mg of iron. In India, donor eligibility is assessed using hemoglobin (Hb) levels alone (cut-off: 12.5 g%), which often misses latent iron deficiency (LID)—a condition where iron stores are depleted despite normal Hb. LID can quietly affect energy levels and increase the risk of developing iron deficiency anemia. Addressing this through iron supplementation not only protects donor health but helps retain committed donors in the pool.
METHODS:The study was conducted at blood donation camps organized by GTB Hospital. Blood samples (EDTA and plain) were collected from the tubing of donated bags for CBC (via 5-part hematology analyzer) and serum ferritin (via chemiluminescence immunoassay). After 90 days of supplementation, follow-up samples were collected from the antecubital vein under aseptic precautions. A total of 23 subjects were included for paired analysis.
RESULTS: Of 400 donors screened, 27.5% had LID. Sixty initiated low-frequency iron supplementation; 26 completed follow-up. Among them, 92.3% showed ferritin normalization. Despite moderate adherence, the intervention proved highly effective.
CONCLUSION: Low-frequency iron supplementation emerged as a well-tolerated and impactful strategy to correct LID in regular donors. Its simplicity and success suggest it could be seamlessly integrated into donor care protocols—supporting both donor health and long-term retention.
KEY WORDS: LATENT IRON DEFICIENCY, IRON SUPPLEMENTATION, REGULAR REPEAT BLOOD DONORS |
| 322 |
Unmasking Isolated CNS Relapse in a Child with Acute Promyelocytic Leukemia: The Pivotal Role of CSF Cytology” |
1999-03-14 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Kaninika Sanyal*, Mrinalini Kotru*, Sonal Sharma*, Pooja Dewan**, Preeti Diwaker*; : Department of Pathology* and Department of Paediatrics**, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi-110095 |
Dr. SWETA MATHAPATI |
UCMS and GTBH |
Delhi |
9742525426 |
swetam6474@gmail.com |
Poster |
Unmasking Isolated CNS Relapse in a Child with Acute Promyelocytic Leukemia: The Pivotal Role of CSF Cytology”
Authors: Sweta Mathapati*, Kaninika Sanyal*, Mrinalini Kotru*, Sonal Sharma*, Pooja Dewan**, Preeti Diwaker*
Affiliation: Department of Pathology* and Department of Paediatrics**, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi-110095
Introduction: Isolated CNS relapse in acute promyelocytic leukemia (APML) is a rare but clinically significant event, requiring timely management. Here we present a case highlighting the utility of CSF cytology in APML patients presenting with CNS symptoms even in the absence of marrow involvement.
Case summary: A 12-year-old boy with APML (PML-RARA–positive), achieved complete hematologic and molecular remission with therapy and was on regular follow-up. After 8th cycle of maintenance therapy, the patient presented with severe headache and vomiting. CSF was sent for cytology and smears revealed 80% atypical cells, morphologically consistent with promyelocytes; suggestive of CNS relapse. Concurrent bone marrow examination and molecular studies were also done and turned out to be negative. Intrathecal treatment was given which resulted in significant clinical improvement.
Discussion: APML relapse in CNS is a rare event, and mostly presents with extramedullary symptoms as observed in this case. Isolated CNS relapse with negative bone marrow findings is even more rare, with less than 15 cases reported till date according to literature.
Conclusion:
This case underscores the diagnostic value of CSF cytology in detecting isolated CNS relapse, even when molecular findings remain negative. This case reinforces the importance of CSF examination and the need for clinicians to maintain a high index of suspicion, in patients of APML with unexplained neurological symptoms, regardless of remission status.
Presenter: Dr. Sweta Mathapati
Post graduate, Second year
Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi-110095
Phone: 9742525426
Email: swetam6474@gmail.com
|
| 323 |
Role of Inflammatory Marker gene (NKG2D) Polymorphism in Complicated homozygous SCD of western Odisha, India |
1982-08-23 |
Female |
No |
- | pay_R |
Benign |
Infection & supportive care |
Laboratory |
+Dr. Sarita Behera , Professor, Dept. of Medicine. MKCGMCH, ++Dr. Chhotray Marandi, Associate Professor, Dept. of Medicine, BBMCH, +++Dr. Sucharita Mohanty, Professor, Dept of Biochemistry, BBMCH, ++++Ms. Pragalbha Jaysingh, Scientist-B, MRU,BBMCH |
Dr. Preetinanda M. Dash |
Bhima Bhoi Medical College & Hospital |
Balangir |
09923137539 |
preeti.n.dash@gmail.com |
Oral |
Title: Role of Inflammatory Marker gene (NKG2D) Polymorphism in Complicated homozygous SCD of western Odisha, India Introduction: Natural Killer Group 2, Member D (NKG2D) is an immune-activating receptor found on the surface of NK cells and certain T cells, which plays a crucial role in the body's response to cellular stress. Micro thrombi and episodes of vaso-occlusion resulting in a chronic inflammatory state are the hallmark of Patients with Sickle Cell Disease (SCD). This chronic inflammatory state is responsible for subsequent infection, hemolysis and Multi organ dysfunction. However, no data is yet available on this field from Odisha being the area of more SCD patients. Objective of this study is to decipher the Single Nucleotide Polymorphism of Inflammatory Marker gene NKG2D if it has any association with SCD complications in the sample population of western Odisha, India. Methods: Current study is carried out at Dept. of General Medicine and Multidisciplinary Research Unit (sponsored by Dept. of Health Research, Govt. of India) Bhima Bhoi Medical College & Hospital, Balangir. One Hundred cases (M/F=50/50) of complicated SCD patients with history of painful crisis, blood transfusion, infection, organ dysfunctions attending to Dept of General Medicine & Surgery (OPD/IPD) are selected for this study along with healthy control (AA, N=30) to evaluate the SNPs (NKG2D-Chromosome-12) using TaqMan assay (Thermo Fisher Scientific, India). Results: SNP of NKG2D (rs 2617171 C/G, VIC/FAM) was observed to be highly polymorphic (G/G) in SCDs in comparison to the control group. (47% vs 23.3%). The said polymorphism was found to be associated with occurrence of more Organ dysfunction i.e. Cholelithiasis, AVN, Cardiomegaly, autospelenctomy both in C/G and G/G with 8.5% and 12.7% respectively. Conclusions: This may help to predict disease severity at an early stage that helps in prevention of SCD complications. Key Words: Inflammatory Marker genes, NKG2D, SNP, SCD |
| 324 |
Comprehensive Analysis of Pseudotumor in Coagulation Disorders: Insights from a Retrospective-Prospective Cohort |
1999-11-20 |
Female |
No |
- | pay_R |
Benign |
Hemeostasis |
Laboratory |
Sandeep Albert, Department of Orthopaedics; Abraham Sunder Singh, Anbu Jeba, Sharon Lionel, Uday Kulkarni, Anu Korula, Biju George, Vikram Mathews, Eunice Sindhuvi Edison, Aby Abraham, Department of Hematology, Christian Medical College Vellore |
Mariya Tomy |
Christian Medical College, Vellore |
Vellore |
7306918532 |
mariya.tomy@cmcvellore.ac.in |
Poster |
Title: Comprehensive Analysis of Pseudotumor in Coagulation Disorders: Insights from a Retrospective-Prospective Cohort
Introduction: Pseudotumors are rare, characterized by the gradual growth of blood-filled masses with capsule in soft tissues, muscles, or bones affecting less than 2% of the coagulation disorder patients. In India, majority of the coagulation impaired patients receive episodic therapy, only a small number develop pseudotumor for an unknown cause. The goal was to describe pseudotumor by clinical characteristics, imaging locations, histopathology, and genetic analysis.
Methods: This study involved a retrospective group of 28 patients and a prospective group of 18 patients with coagulation disorders who developed pseudotumors. Their coagulation profiles, biochemical parameters, clinical, radiological, and biopsy findings were recorded from their medical records. Molecular analysis was done to characterize genetic defects.
Results: Among 46 patients, 38 (83%) had Hemophilia A (HA) and 6 (13%) had Hemophilia B (HB), with severe HA in 84% of which 45% were inhibitor positive and 16% were moderate HA. Pseudotumors were also observed in one patient with VWD type III and FXIII deficiency. The average age at diagnosis was 33.7 years (15 to 69). Swelling and impaired mobility were commonly reported. The most common locations for pseudotumors were the femur (51%), soft tissue (20%), peritoneum (11%), pelvis (10%), and tibia (8%). All patients were on episodic replacement therapy and underwent excision surgeries of which 3 patients required amputation, and 2 deceased. Histology showed signs of chronic inflammation, fibrosis, fibrocollagenous tissue, hemorrhage, and macrophages filled with hemosiderin. This reflects a combination of inflammatory, fibrotic, and bleeding issues related to pseudotumor pathology. The biochemical and mutation analysis was done.
Conclusion: Pseudotumors in patients with coagulation disorders require careful evaluation and tailored management.
Keywords: Pseudotumors, Hemophilia, Coagulation Disorders, Radiology, Histopathology, Genetic Variants |
| 325 |
ROLE OF RABBIT ANTI-T LYMPHOCYTE GLOBULIN (rATLG) AS A SECOND-LINE THERAPY IN TRANSPLANT INELIGIBLE SEVERE APLASTIC ANEMIA PATIENTS. |
1995-06-15 |
Male |
Yes |
L-2182 | H_LKO |
Benign |
Marrow failure |
Clinical |
Dr Shailendra Prasad Verma, Additional Professor and Head, Department of Clinical Hematology; Dr Swasti Sinha, Assistant Professor, Department of Clinical Hematology; Dr P Raghuveer, Senior Resident, Department of Clinical Hematology; Dr Gaurav Datta, Sen |
Dr Aritra Saha |
King George's Medical University |
Lucknow |
9401650438 |
aritraofficial@gmail.com |
Oral |
Title: ROLE OF RABBIT ANTI-T LYMPHOCYTE GLOBULIN (rATLG) AS A SECOND-LINE THERAPY IN TRANSPLANT INELIGIBLE SEVERE APLASTIC ANEMIA PATIENTS.
Introduction:
Aplastic anaemia (AA) is an uncommon haematopoietic failure syndrome, distinguished by pancytopenia and a hypoplastic bone marrow, and is associated with considerable mortality risk. Haematopoietic stem cell transplantation (HSCT) remains the preferred option for suitable candidates; however, immunosuppressive therapy (IST)—particularly horse anti-thymocyte globulin (hATG) in combination with ciclosporin—continues to be first-line, especially for older individuals or those unsuitable for transplant. Failure or relapse following initial IST presents significant therapeutic difficulties, with HSCT regarded as the treatment of choice. In developing countries, HSCT is frequently not feasible, largely due to financial constraints, and in such circumstances, rabbit anti-T-lymphocyte globulin (rATLG) may be considered a viable alternative.
Methods:
This retrospective, single-centre study enrolled 10 transplant-ineligible severe or very severe AA patients who had failed or relapsed after hATG between 2020 and 2024. All received rATLG (4 mg/kg/day, 5 days) with standard cyclosporine, eltrombopag, and supportive care. Responses were evaluated at 3, 6, and 12 months. Results: Partial responses were observed in 20%, 30%, and 40% of patients at 3, 6, and 12 months, respectively; no patient achieved a complete response. All responses were partial and occurred predominantly between 6 and 12 months. The overall two-year survival rate was 78%. Major adverse effects were fever (100%), pruritus and hepatic dysfunction (70% each), and febrile neutropenia or steroid-induced hyperglycemia (40% each).
Conclusions:
Rabbit ATLG offers modest efficacy as salvage in severe/very severe AA after IST failure and transplant ineligibility. Guidelines continue to emphasize HSCT, restricting rATG to second-line use in the relapsed/refractory setting, but socio-economic constraints common in low-resource settings strongly influence treatment decisions and outcomes, allowing HSCT in only a handful of cases.
Key words: Rabbit ATG, Relapsed/Refractory Severe Aplastic Anemia. |
| 326 |
Impact of Androgen Therapy on Telomere Length, T Cell Subsets, and miRNA Expression in Aplastic Anemia Patients |
1990-02-11 |
Female |
No |
- | pay_R |
Benign |
Marrow failure |
Laboratory |
Rosy Mary Marandi, Aruna Barade, Nutan Damodar Joshi, Sharon Lionel, Uday P Kulkarni, Aby Abraham, Vikram Mathews, Biju George, Eunice Sindhuvi E, Christian Medical College Vellore |
Rosy Mary Marandi |
Christian Medical College |
Vellore |
9110918157 |
rosy.mary@cmcvellore.ac.in |
Poster |
Title: Impact of Androgen Therapy on Telomere Length, T Cell Subsets, and miRNA Expression in Aplastic Anemia Patients. Introduction: Aplastic anemia (AA) is a bone marrow failure syndrome mainly caused by T cell–mediated immune destruction. Androgens are used as immunomodulatory/hematopoiesis-stimulating treatments, especially in resource-limited settings. Response to androgen therapy varies, influenced by unknown factors. miRNAs serve as biomarkers for immune response prediction, and telomere shortening is linked to AA prognosis and treatment response. This study explores T cell profiles, miRNA expression, and relative telomere length (rTL) in androgen-treated AA patients. Methods: This study includes 30 AA (from 2020 to date) patients who opted for androgen therapy and were followed up. Blood samples were collected at baseline and 3 months. CD3, CD4, CD8, and regulatory T cells were analysed, and CD4:CD8 ratios were calculated. rTL was measured from peripheral blood DNA using quantitative real-time PCR, plasma miRNA was profiled, and results were statistically analysed. Results: Of the 30 AA patients, median age 35 (3-60) years, 16 were non-responders (NR) and 14 responders (R). There was no significant difference in the baseline rTL between NR and R. Of the 30 AA, 17 patients had miRNA data (median age 38 (12-59) years; 9 males and 8 females), and were classified as non-severe AA (N=8) or severe AA (N=9). Median rTL increased from 0.57 pre-treatment to 0.86 at 3 months post-treatment. Ten patients responded, while seven did not. Response rates were not affected by gender or disease severity. Responders showed a significant increase in rTL (p=0.015), but had no correlation between rTL and CD4:CD8 ratio. miRNA profiling revealed significant downregulation of miR-146b-5p (fc=2.24; p=0.04) in responders. Conclusions: Androgen therapy in AA patients induces significant telomere lengthening and downregulation of miR-146b-5p in responders, highlighting potential molecular markers of treatment response. Keywords: Aplastic Anemia, miRNA, telomere. |
| 327 |
Correlation of Extended Neutrophil and Monocyte Activation Parameters and sepsis score in Paediatric Patients with Sepsis |
1994-07-12 |
Female |
No |
- | 56091 |
Benign |
Infection & supportive care |
Clinical |
2.Dr. Taruna Rajpal ,3.Dr. Neha Mehra ,4.Dr Vijay Kumar 2. Senior Medical Officer, Hematology and Clinical Pathology Unit, ABVIMS, Dr RML Hospital, New Delhi-110001 3 Professor, Department of Paediatrics, Pathology, ABVIMS, Dr RML Hospital, New Delhi- |
Dr.Deepshikha |
ABVIMS and Dr. RML Hospital |
New Delhi |
8278481823 |
shikhadeep.1207@gmail.com |
Oral |
Title: Correlation of Extended Neutrophil and Monocyte Activation Parameters and sepsis score in Paediatric Patients with Sepsis
Authors: Dr Deepshikha 1, Dr. Taruna Rajpal 2,Dr. Neha Mehra 3 ,Dr Vijay Kumar4
¹Senior Resident, Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi-110001
2 Senior Medical Officer, Hematology and Clinical Pathology Unit, ABVIMS, Dr RML Hospital, New Delhi-110001
3 Professor, Department of Paediatrics, Pathology, ABVIMS, Dr RML Hospital, New Delhi-110001
4Professor and Head, Hematology and Clinical Pathology Unit, Department of Pathology, ABVIMS and Dr RML Hospital, New Delhi-110001
Introduction
Sepsis in pediatric intensive care units (PICU) is a major cause of morbidity and mortality. Early detection and ongoing monitoring are essential to improve outcomes. The modern hematological analyser Sysmex XN1000 series provides cell population data (CPD) by using fluorescence flow cytometry to evaluate leukocyte volume (FSC), granularity (SSC), and nucleic acid/protein content (SFL). Extended activation parameters such as NE‑SFL, SSC, FSC, NE-WX, NE-WY, NE-WZ, MO‑WX, MO-WY and MO‑WZ reliably indicate neutrophil and monocyte activation. These CPDs have shown promise in differentiating septic from non-septic pediatric patients.
Materials & Methods:
This cross-sectional observational study is being conducted over one year in the Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi in children (0–12 years) admitted with suspected or confirmed sepsis. Unconfirmed sepsis, missing CPD data, underlying hematological or oncological disease, age > 12 years are excluded from the study. 2 mL venous blood in K₃EDTA tubes is collected and processed within 2 hours to minimize pre-analytical variation using the Sysmex XN‑1000. The activation parameters: NE‑SFL, NE-SSC, NE-FSC, NE‑WX, NE‑WY, NE‑WZ, MO‑WX, MO‑WY, MO‑WZ would be noted would be noted and correlation
between activation parameters and sepsis score would be undertaken. Appropriate statistical analysis would be performed.
Results:
Data collection and analysis are ongoing, and the complete results with final statistical outcomes will be presented at the conference. However previous studies have shown that the median values of NEU-X, NEU-Y, MON-X, MON-Y, and CRP (C-Reactive Protein ) in the sepsis group were significantly higher than those in the control group.
Conclusion: The activation parameters may be used as indicators for the differential diagnosis of sepsis with comparable diagnostic efficacy to CRP. These activation parameters are easier and quicker to obtain, so may be crucial for early diagnosis of sepsis.
Keywords: Sepsis, activation parameters, CPD
|
| 328 |
Clinical Profile and Treatment Outcomes of Polycythemia Vera: A Single-Center Retrospective Study from North India |
1989-05-04 |
Male |
Yes |
L-2250 | pay_Q |
Malignant |
MPN & MDS/ MPN |
Clinical |
Verma S P², Sinha S³, Raghuveer P¹, Middinti A¹, Datta G¹, Saha A¹, Shukla A¹, Kumar M¹, Sharma S¹, Kumari K¹ Affiliations: 1. Senior Resident, Department of Hematology, King George’s Medical University, Lucknow, Uttar Pradesh, India 2. Associate Professo |
RAJ KUMAR MAURYA |
King George’s Medical University, Lucknow, Uttar P |
Lucknow |
08317048394 |
RAJMYA09@GMAIL.COM |
Oral |
Background: Polycythemia vera (PV) is a chronic myeloproliferative neoplasm characterized by erythrocytosis, bone marrow trilineage proliferation, and JAK2 mutations.[1] It poses risks of thrombosis, bleeding, and disease progression. Current risk-adapted management targets hematocrit (HCT) <45% to reduce thrombotic events, with hydroxyurea (HU) as the standard cytoreductive agent for high-risk patients.[2] HU resistance/intolerance necessitates alternatives such as ruxolitinib.
Objective: To describe the clinical profile, treatment patterns, hematologic responses, and outcomes of PV patients in a real-world single-center cohort.
Methods: This retrospective study included 40 adults diagnosed with PV between 2018 and mid-2024, with ≥1-year follow-up. Risk stratification was based on age (>60 years) and prior thrombosis. Treatment, HCT response, and overall survival (OS) were analyzed descriptively.
Results: The median age was 52.2 years; females comprised 57.5%. Low-risk patients accounted for 60%. At baseline, 90% had HCT >45%, 75% leukocytosis, and 47.5% thrombocytosis. First-line therapy included HU plus phlebotomy (60%) or phlebotomy alone (27.5%); ruxolitinib was used second-line (17.5%). Despite therapy, >40% had suboptimal HCT control at 2 years. Indications for cytoreduction were age >60 (32.5%), inadequate HCT control (30%), thrombocytosis (22.5%), or thrombosis history (20%). During a median follow-up of 28.5 months, thrombotic/bleeding events were infrequent, and no cases of leukemic transformation or myelofibrosis progression occurred. Five-year OS remained high: 95.8% in low-risk and 93.8% in high-risk groups.
Conclusions: Compared to larger registries, this cohort showed a younger median age and female predominance.[3] Many low-risk patients required HU, reflecting persistent hematologic abnormalities or symptoms. While survival was excellent and consistent with prior reports, [4,5] hematocrit control was suboptimal in a notable proportion. Study limitations include small sample size, short follow-up, and limited long-term event capture.
Keywords:
Polycythemia vera, Myeloproliferative neoplasm, JAK2 mutation, Hydroxyurea, Ruxolitinib, Hematocrit control, Cytoreduction, Thrombosis, Bleeding.
|
| 329 |
Circulating CD26⁺ Leukemic Stem Cells as a Novel Diagnostic Marker for Chronic Myeloid Leukemia |
1995-02-28 |
Female |
No |
- | pay_R |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Gaurav Chhabra, Somanath Padhi, Ashutosh Panigrahi, Prabodha Kumar Das, Debasis Jash - Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar & Department of Hematology, All India Institute of Medical Sciences, |
Shirin Sultana |
All India Institute of Medical Sciences, Bhubanesw |
Bhubaneswar |
9992274094 |
sk.shirinsultana@gmail.com |
Oral |
Title: Circulating CD26⁺ Leukemic Stem Cells as a Novel Diagnostic Marker for Chronic Myeloid Leukemia
Authors: Shirin Sultana1, Gaurav Chhabra1, Somanath Padhi1, Ashutosh Panigrahi2, Prabodha Kumar Das2, Debasis Jash1
1 Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar
2 Department of Hematology, All India Institute of Medical Sciences, Bhubaneswar
Introduction: Leukemic stem cells (LSCs) are a small subset of leukemia cells with self-renewal, proliferative and differentiative capacities resembling hematopoietic stem cells. They are central to disease initiation, persistence and relapse due to resistance to chemotherapy. Chronic myeloid leukemia (CML) is a hematopoietic stem cell neoplasm defined by t(9;22) fusion gene. This study evaluated flow cytometric detection of CD26⁺ LSCs as a potential standalone diagnostic marker for CML.
Methods: This prospective study included 41 suspected CML cases presenting with leucocytosis and 10 controls with other hematolymphoid neoplasms, irrespective of disease phase. Peripheral blood samples were analysed using multiparametric flow cytometry with a four-color antibody panel for expression of CD 26 on LSC. CML diagnosis was confirmed by BCR- ABL transcript detection through RT-PCR.
Results: CD26 expression was observed in all CML cases, independent of disease phase or transcript type, while no control sample showed positivity. At diagnosis, the median percentage of CD26⁺ CML LSCs in peripheral blood was 0.7% (range: 0.1–38.5). Within CD34⁺/CD38⁻ fraction, the median proportion of CD26⁺ cells were 25.6% (range: 3.2–100). The expression of CD 26+ LSC did not differ with transcript type on RT-PCR examination.
Conclusion: Circulating CD26⁺ LSCs represent a specific marker for CML across all disease stages. Flow cytometric assessment of CD26 on CD34⁺/CD38⁻ population offers a cost-effective, rapid & robust diagnostic strategy & holds promise as a practical alternative to conventional molecular & cytogenetic methods.
Keywords: CML, Leukemic Stem Cells, Flowcytometry, CD26 |
| 330 |
“Screening for CCR5Δ 32 variant mutation in exposed uninfected spouse of HIV-1 patients: a potential target of hematopoietic stem cell transplantation in HIV” |
1997-06-07 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
|
Shivangi Nayak |
KING GEORGE MEDICAL UNIVERSITY |
Lucknow |
9161127069 |
shivangi.nayak97@gmail.com |
Poster |
Title: “Screening for CCR5Δ 32 variant mutation in exposed uninfected spouse of HIV-1 patients: a potential target of hematopoietic stem cell transplantation in HIV” Authors: Dr. Shivangi Nayak , Dr. Geeta Yadav , Dr Himanshu Dandu, Dr Vimala Venkatesh Dr. Suruchi Shukla , Dr. Neetu Gupta Department of Pathology; Department of Medicine; Department of Microbiology; ART Center ; King George’s Medical University, Lucknow
Introduction :HIV uses the CCR5 co-receptor to infect CD4+ T cells. The CCR5-Δ32 mutation disrupts receptor function, offering resistance in homozygotes and partial protection in heterozygotes. Common in Northern Europe but rare in South Asia, this study evaluated its prevalence among North Indian HESN spouses.
Methods :After informed consent and ethical approval, 517 participants were enrolled: 267 HIV-negative spouses of HIV-positive partners and 250 healthy controls. Blood samples were collected in EDTA tubes, stored at -80°C, and DNA extracted using Qiagen and DTI Fab Spin kits. DNA quality was confirmed spectrophotometrically. CCR5-Δ32 polymorphism was analyzed by PCR, with agarose gel electrophoresis identifying homozygous, heterozygous, or wild-type alleles based on band size.
Results: Participants’ mean age was lower in cases (38.47 ± 9.52) than controls (45.14 ± 15.22; p<0.001). Males predominated (59.4% overall; 67.4% cases). Most cases were from central Uttar Pradesh (67%), with 15.25 ± 11.40 years of exposure. CCR5-Δ32 mutation was rare: heterozygous 3.4%, homozygous 0.19%, with regional variation highest in Unnao (33.3%) and Hardoi (14.3%; p=0.014) .
Conclusions: The prevalence of the CCR5-Δ32 mutation was extremely rare in the studied Indian population. Homozygous Δ32/Δ32 deletion was noted in only 0.19% (1/517), and heterozygous deletion was reported in 3.4% (18/517) of individuals. Most spouses remained HIV-negative despite prolonged exposure, with CCR5-Δ32 mutation rare (1.3% cases, 2.6% controls). Resistance likely involves additional genetic, behavioural, and virological factors beyond CCR5-Δ32 in Indian populations. Consistent with previous Indian |
| 331 |
Learning Curve For Pathologists: Lineage Promiscuity Model In Hypogranular Variant Of Acute Promyelocytic Leukemia |
1986-01-30 |
Male |
Yes |
L-1962 | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
|
Dr Avinash Singh |
All India Institute of Medical Sciences- Patna |
Patna |
8789481771 |
avinashsingh02186@gmail.com |
Poster |
Title: Learning Curve For Pathologists: Lineage Promiscuity Model In Hypogranular Variant Of Acute Promyelocytic Leukemia.
Introduction: Acute promyelocytic leukemia (APL) has an annual incidence rate of 0.08 cases per 100000 population. APL is of two cytomorphological variants: Hypergranular (classic, M3) and hypogranular (microgranular, M3v). On immunophenotyping M3v-APL, the promyelocytes are frequently located in the traditional blast gate on CD 45 vs side scatter plots and they are positive for CD 2, CD 13, CD 33, CD 34, CD 64, CD 117 and negative for HLA-DR.
Case Presentation: A 10 year old boy presented with complaints of fever and body-ache for three months. No other significant past or present surgical and medical history was noted. The peripheral blood smears showed atypical promyelocytes. There was apparent paucity of granules with many bilobed or butterfly shaped nuclei. No auer rods were present. Myeloperoxidase was strongly positive. Flowcytometry showed high side scatter as seen in classical APL. CD 34 and CD 38 was positive along with CD 33, CD 13, CD 117 and HLADR. CD 4 (T helper cell marker) was also expressed in moderate intensity. The cells were dimly positive for CD 25 and moderate expression of CD 123 was seen as well. FISH showed PML-RARA t(15;17)(q24;q21).
Discussion: According to WHO, HLA-DR is usually absent in M3v-APL, implicating the rather exceptional characteristic of the case. The expression of HLA-DR is a consequence of deregulation of lineage affiliated genes occurring during the process of leukemic transformation. Presence of markers which are characteristic of blasts indicates a deviation from the lineage specific markers (i.e. lineage promiscuity or infidelity).
Conclusion: This case proves that APL can originate from progenitors that did not or only partially encounter lineage restriction. Expression of these markers along with atypical morphology are associated with a poor clinical outcome. |
| 332 |
Automated Analyser with High Fluorescence Parameters for Malignant Effusion Triage in Body Fluids |
2000-03-27 |
Male |
Yes |
L2248 | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
1. Dr. Ginni Bharti- Senior Resident Department of Laboratory Medicine, AIIMS, New Delhi. 2. Dr. Tushar Sehgal- Associate Professor Department of Laboratory Medicine AIIMS, New delhi. 3. Dr. Deepali Jain-Professor Department of Pathology AIIMS, New delhi. |
Anshul Jangra |
AIIMS New Delhi |
New Delhi |
9899967276 |
anshul27jangra@gmail.com |
Poster |
Title: Automated Analyser with High Fluorescence Parameters for Malignant Effusion Triage in Body Fluids
Introduction: Automated cytometric analysis of body fluids (BF) offers a rapid adjunct to conventional cytology. The Sysmex XN-series analyser generates high-fluorescence body fluid (HF-BF) parameters that may serve as biomarkers for malignancy. This study evaluated the diagnostic performance of HF-BF% and HF-BF# across different BF types, using cytopathology as the gold standard.
Methods: A total of 412 BF samples (pleural, ascitic, and bronchoalveolar lavage [BAL]) were prospectively analyzed in the Department of Laboratory Medicine, AIIMS, New Delhi. Each specimen underwent automated cytometric evaluation on the Sysmex XN-series analyser in BF mode to obtain nucleated cell counts, differential counts, and HF-BF indices, alongside cytopathological examination. Diagnostic accuracy was assessed by sensitivity, specificity, and receiver operating characteristic (ROC) curve analysis to establish optimal cutoffs.
Results: Among ascitic fluid samples (benign n=137, malignant n=27), malignant effusions showed significantly higher total WBC counts (median 393/µL vs. 118/µL, p<0.001) and absolute HF-BF counts (median 12/µL vs. 3/µL, p<0.001). ROC analysis identified an HF-BF cutoff of 6.5/µL, yielding 70% sensitivity and 74% specificity (AUC=0.72). HF-BF% was also elevated in malignant effusions (median 4.5% vs. 1.8%, p=0.023) but demonstrated only moderate diagnostic accuracy (AUC=0.65). Mononuclear and polymorphonuclear cell distributions did not significantly differentiate malignant from benign cases. Comparable trends in HF-BF indices and diagnostic performance were observed in pleural and BAL fluids.
Conclusions: HF-BF parameters generated by the Sysmex XN-series analyser correlate with cytology in distinguishing malignant from benign effusions, particularly in ascitic and pleural samples. Absolute HF-BF count is the most reliable marker, offering moderate diagnostic utility. Automated fluorescence cytometry can serve as an effective screening tool to prioritize cytology review, but cytopathological confirmation remains essential for definitive diagnosis.
Key words: Sysmex XN-series analyser, body fluid cytometry, HF-BF, malignant effusion, automated diagnostics |
| 333 |
Massive Transfusion in Paediatric Patients: Experience from an Apex Institute |
2000-03-27 |
Male |
Yes |
L2248 | H_LKO |
Benign |
Transfusion medicine |
Clinical |
1. Radheshyam Meher- Senior Resident Department of Transfusion Medicine, AIIMS, New Delhi. 2. Arulselvi Subramanian-Professor, Department of Laboratory Medicine, AIIMS, New Delhi. |
Anshul Jangra |
AIIMS New Delhi |
New Delhi |
9899967276 |
anshul27jangra@gmail.com |
Poster |
Title: Massive Transfusion in Paediatric Patients: Experience from an Apex Institute
Introduction: Trauma is a leading cause of childhood mortality, where early activation of massive transfusion protocols (MTPs) can be lifesaving. However, data on paediatric MTP use in low- and middle-income countries (LMICs) remain scarce. This study evaluated transfusion practices, component ratios, and outcomes in paediatric trauma patients receiving MTP.
Methods: A retrospective observational study was conducted at AIIMS Trauma Centre, New Delhi. Children ≤12 years requiring MTP activation between May 2024–April 2025 were included. Clinical data were retrieved from patient records, laboratory values from institutional databases, and transfusion details from blood bank software. Outcomes assessed were transfusion volumes, blood component ratios, and in-hospital mortality.
Results: Of 383 MTP activations, 25 (6.5%) involved paediatric patients (mean age 4.5 ± 3.3 years, weight 16.5 ± 7.2 kg; 56% male). Falls (64%) and road traffic accidents (24%) were leading causes. Initial vitals revealed hypotension (80/50 mmHg), tachycardia (PR 140), and low GCS (8). Median 24-hour transfusion volume was 100 mL/kg, with massive transfusion (≥70 mL/kg) achieved in 76%. A balanced PRBC:FFP ratio was consistently maintained during the first hour (100%) but declined to 64% at 24 hours. Tranexamic acid use was limited (8%). FAST was positive in 36%. Overall mortality was 40%, with median hospital stay of 10 days.
Conclusions: Paediatric massive transfusion is associated with high mortality despite early protocol activation. While balanced component ratios were feasible initially, their sustainability declined over time. Limited antifibrinolytic use and variable adherence underscore the need for improved paediatric-specific protocols. Prospective multicentre studies are essential to optimize MTP strategies in LMICs.
Key words: Paediatric trauma, massive transfusion protocol, blood product ratio, transfusion practices, LMIC, survival outcomes |
| 334 |
Double Jeopardy: Concomitant Papillary Renal Cell Carcinoma and Chronic Lymphocytic Leukemia - A rare co-occurrence of Solid and Hematological Malignancies |
1993-09-21 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Nil Ratan Sircar Medical College and Hospital |
Pratibha Singh |
Nil Ratan Sircar Medical College and Hospital |
Kolkata |
9712527759 |
drpratibhasingh21@gmail.com |
Poster |
Title: Double Jeopardy: Concomitant Papillary Renal Cell Carcinoma and Chronic Lymphocytic Leukemia - A rare co-occurrence of Solid and Hematological Malignancies Background: Papillary renal cell carcinoma (PRCC) is the second-most common subtype of kidney cancer, accounting for about 10–15% of all renal cell carcinomas. Many cases are detected incidentally, but classic symptoms can include blood in the urine, flank pain, and a lump in the abdomen. Chronic Lymphocytic Leukemia (CLL), on the other hand, is a chronic leukemia involving dysfunctional B lymphocytes, mainly affecting older adults. Patients having CLL have an increased risk of developing secondary primary malignancy; in this case, the diagnosis of PRCC preceded CLL. Hypotheses involve shared cytogenetic abnormalities and microenvironmental factors permitting the development of dual malignancies, but it is rare for a solid malignancy to precede a B-cell malignancy We present a case of 55 year 55-year-old male, who was initially diagnosed to be a case of PRCC and subsequently developed CLL Case: A 55-year-old male presented with an asymptomatic SOL in the left kidney, underwent radical nephrectomy for the same, and histological examination was suggestive of PRCC(Type 1), pathological stage – pT1bNxMx. Patient underwent treatment and was asymptomatic for 1 year, this was followed by intermittent abdominal pain for 1 year. On evaluation, he had generalized lymphadenopathy and hepatosplenomegaly. Pet CT showed multiple FDG-avid supra and infradiaphragmatic lymphadenopathy with a bulky mesenteric mass. Patient underwent BMA examination, which was suggestive of Chronic Lymphoproliferative Disorder. Further Immunophenotyping was done, which was consistent with findings of Chronic Lymphocytic Leukemia. Patient started on Acalabrutinib-based therapy and on regular follow-up. Conclusions: The co-occurrence of PRCC and CLL is a rare, documented entity. Dual malignancies are not just rare occurrences, but a diagnostic and therapeutic challenge. It is pertinent to be vigilant and plan management accordingly for such clinical |
| 335 |
Etavopivat Reduces Incidence of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: HIBISCUS Trial Phase 2 Results through 52 Weeks |
1991-07-19 |
Male |
No |
- | H_LKO |
Benign |
Anemia |
Clinical |
Amit Y Jadhav, Novo Nordisk India Pvt Ltd, Bengaluru; Julie Kanter, University of Alabama at Birmingham, Birmingham, AL, USA; Sophia Delicou, Hippokrateio General Hospital, Athens, Greece; Fuad El Rassi, Emory University School of Medicine, Atlanta, GA, U |
Amit Y Jadhav |
Novo Nordisk India Pvt Ltd |
Bengaluru, India |
7795802171 |
aiyj@novonordisk.com |
Oral |
Introduction: Etavopivat is potent, selective, once-daily, orally bioavailable activator of red blood cell (RBC) pyruvate kinase isozyme, decreasing 2,3-DPG levels and increasing ATP levels in RBCs. Here we report 52-week data from HIBISCUS (NCT04624659) phase 2 trial.
Methods: Participants were aged 12–65 years, randomised 1:1:1 to oral etavopivat 200 mg, etavopivat 400 mg or PBO, once daily for 52 weeks. Primary endpoints: annualised, independently adjudicated VOC rate over 52 weeks and Hb response (>1 g/dL increase from baseline [BL]) at Week 24.
Results: 60 participants were randomised to receive etavopivat 200 mg (n=21), 400 mg (n=20) or PBO (n=19). In intent to treat population, annualised VOC rates were 1.07 for 200 mg group, 1.06 for 400 mg group and 1.97 for PBO. VOC rate ratios for etavopivat:PBO (95% CI; % reduction) were 0.55 (0.24, 1.26; 45.7%) for 200 mg group and 0.54 (0.23, 1.26; 46.2%) for 400 mg group. Median time to first VOC: 33.6 weeks for each etavopivat group, 16.9 weeks for PBO. Hb response at Week 24: 38% (n=8/21) in 200 mg group, 25% (n=5/20) in 400 mg group and 11% (n=2/19) in PBO group. PROMIS Fatigue Scale showed improvements for those receiving etavopivat. In Per Protocol population, annualised VOC rates were 0.66 (n=13) for 200 mg group, 0.7 (n=12) for 400 mg group and 1.77 (n=15) for PBO. VOC rate ratios (95% CI; % reduction) were 0.37 (0.16, 0.85; 62.7%) for 200 mg group and 0.39 (0.17, 0.90; 60.5%) for 400 mg group. Most reported AEs in any group were mild to moderate and resolved without action. Serious AEs, all of which were resolved.
Conclusions: Etavopivat reduced annualised VOC rate through Week 52, increased Hb levels at Week 24, and improved haemolysis markers and patient-reported fatigue vs PBO, consistent with potential clinical benefit. Etavopivat was well tolerated. |
| 336 |
EFFECTS OF THERAPEUTIC PLASMA EXCHANGE IN PATIENTS WITH HEAVY METAL POISONING |
1995-10-19 |
Male |
No |
- | pay_R |
Benign |
Transfusion medicine |
Clinical |
Prof Tulika Chandra, Dr. Archana Solanki, Dr. Ashutosh Singh: |
Kislay Mishra |
King George's Medical University |
Lucknow |
7004668242 |
kislaythecooldude@gmail.com |
Oral |
Title: EFFECTS OF THERAPEUTIC PLASMA EXCHANGE IN PATIENTS WITH HEAVY METAL POISONING
Introduction: Heavy metals are defined as naturally occurring elements that have a high atomic weight and a density 5 times greater than that of water. Heavy metal poisoning is the accumulation of heavy metals in toxic amounts in the soft tissues of the body. TPE has been emerging as a promising treatment modality for such cases.
Aims: 1. To analyze the effect of therapeutic plasma exchange in patients presenting with heavy metal poisoning with respect to the concentration of metal in blood.
2. To assess the efficacy of therapeutic plasma exchange in patient presenting with heavy metal poisoning with respect to their outcomes.
3. To assess the hematological and serological parameters pre and post therapeutic plasma exchange.
Methods: 10 patients diagnosed with heavy metal poisoning showing no improvement on chelation and consenting for undergoing TPE were included in this study. Based on their laboratory and clinical assessment, they underwent 1-1.5 volume plasma exchange on COM.TEC. The patients underwent 1-3 TPE cycles. Hematological and clinical parameters before and after each cycle were assessed.
Results: Of the 10 cases,4 presented with acute poisoning while 6 presented with chronic poisoning. Significant decrease in hemoglobin, hematocrit, TLC and platelet count was observed in all cases. Significant changes were also observed in LFT and KFT. Serum metal concentration also showed significant change after TPE (p-value=0.026). 8 patients were discharged in stable condition while 2 patients expired.
Conclusions: TPE when employed early with or without chelating agents aids in clearing out the heavy metals and their metabolites thus offsetting their adverse effects on various organ systems. Also, TPE may show added benefits when organ dysfunction like liver failure has already set in.
Key Words: TPE, Heavy metal, poisoning |
| 337 |
KMT2A Rearrangements as a Driver of Aggressive Haematological Malignancies: Clinical and Prognostic Insights from a Tertiary Care Center in North India. |
1995-04-22 |
Male |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
|
Dr. Harshal Mamlekar |
Sanjay Gandhi Post graduate institute of medical s |
Lucknow |
9588491906 |
harshalmamlekar6@gmail.com |
Oral |
Title: KMT2A Rearrangements as a Driver of Aggressive Haematological Malignancies: Clinical and Prognostic Insights from a Tertiary Care Center in North India. Introduction:KMT2A (lysine methyltransferase 2A, formerly MLL) rearrangements (KMT2Ar) define a high-risk molecular subset of acute leukemias characterized by aggressive clinical behavior, poor response to conventional therapies, and high relapse rates. Methods:We retrospectively analyzed 36 patients with cytogenetically or molecularly confirmed KMT2Ar acute leukemias diagnosed between January 2020 and January 2024 at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow. Diagnostic workup included bone marrow morphology, flow cytometry, karyotyping, and FISH. Patients were treated with standard AML (7+3) or ALL (BFM-95/HyperCVAD) protocols; select patients received venetoclax-based regimens. Outcomes assessed included induction response, measurable residual disease (MRD), overall survival (OS), and progression-free survival (PFS). Results:KMT2Ar accounted for 4% of 902 acute leukemia cases. The median age was 17 years, with a slight female predominance (52.7%). KMT2Ar was more frequent in ALL (55.5%) than AML (39%), with a minority presenting as mixed-phenotype acute leukemia (MPAL) or acute undifferentiated leukemia (AUL). Extramedullary involvement was seen in 33.3%, and cerebrospinal fluid (CSF) positivity in 14.3% of evaluated patients. Of the 36 patients, only 23 (63.9%) could initiate definitive therapy; 13 (36.1%) died early due to severe infections, hemorrhage, or leukostasis-related complications. MRD assessment post-induction revealed negativity in 88% of evaluable ALL patients and 67% of AML patients. However, relapse occurred in 33.3% of patients within 3 months of remission. Survival analysis demonstrated a median OS of 12.5 months with a 2-year OS of 20%. T-ALL patients had superior outcomes, with OS and PFS. Conclusion: KMT2Ar leukemias constitute an aggressive and clinically heterogeneous group associated with high early mortality and relapse, particularly in AML and B-ALL. Subtype-specific outcomes suggest relatively favorable prognosis in T-ALL patients. The inability to initiate therapy in one-third of patients. |
| 338 |
The effect of concizumab on thrombin generation in FVII deficient plasma |
1996-04-03 |
Female |
No |
- | H_LKO |
Benign |
Hemeostasis |
Laboratory |
Marianne Kjalke, Rare Blood Disorders, Research and early development, Novo Nordisk, Denmark |
Preeti Navik |
Novo Nordisk India |
Bengaluru |
9727887305 |
IPNV@novonordisk.com |
Poster |
Title: The effect of concizumab on thrombin generation in FVII deficient plasma Introduction: Concizumab is a humanized monoclonal antibody neutralizing tissue factor pathway inhibitor (TFPI) and is approved for subcutaneous prophylaxis in adults and adolescents with hemophilia A or B with inhibitors in the US, EU and Japan. Inhibition of TFPI results in enhanced thrombin generation in haemophilia plasma. Factor VII (FVII) deficiency is a rare bleeding disorder characterized by impaired thrombin generation. To evaluate the in vitro effect of concizumab in thrombin generation assays in FVII deficient plasma. Methods: Concizumab (250 - 4000 ng/mL) was added to congenital FVII deficient plasma with <1% FVII or to normal human plasma containing either a monoclonal or a polyclonal neutralizing antibody to FVII. Thrombin generation was measured after adding a fluorogenic thrombin substrate and calcium (FluCa, Thrombinoscope, Stago) together with 1 pM tissue factor and phospholipids (PPP-Low, Thrombinoscope, Stago). Results: A delayed thrombin peak was observed in congenital FVII deficient plasma (lag time 68.9 ± 29.6 min, mean and SD of n=5) compared to normal human plasma (lag time of 5.7 ± 0.4 min, Fig 1). Concizumab at 4000 ng/mL shortened the lag time in FVII deficient plasma to 37.1 ± 10.6 min. The thrombin peak was lower in FVII deficient plasma (12.5 ± 18.7 nM), compared to normal plasma (58.9 ± 12.9 nM). Concizumab enhanced the thrombin peak in FVII deficient plasma to 49.0 ± 17.5 nM. Similar data were obtained in normal human plasma where FVII activity was neutralized with antibodies. Conclusions: A delayed thrombin peak was observed in the absence of FVII. Concizumab shortened the lag time of thrombin generation and enhanced the thrombin peak in FVII-deficient plasma. Whether this effect translates to a bleed preventing effect in congenital FVII-deficient patients would need to be evaluated in clinical studies |
| 339 |
Real-World Outcomes with Low-Dose Dasatinib (50 mg) in Imatinib-Resistant Chronic Myeloid Leukemia in Chronic Phase: A Retrospective Analysis of Efficacy and Safety. |
1995-04-22 |
Male |
No |
- | H_LKO |
Malignant |
MPN & MDS/ MPN |
Clinical |
Dr. Nandhini Gangadaran, Senior Resident |
Dr. Harshal Mamlekar |
Sanjay Gandhi Post graduate institute of medical s |
Lucknow |
9588491906 |
harshalmamlekar6@gmail.com |
Oral |
Title: Real-World Outcomes with Low-Dose Dasatinib (50 mg) in Imatinib-Resistant Chronic Myeloid Leukemia in Chronic Phase: A Retrospective Analysis of Efficacy and Safety Introduction:Imatinib resistance poses a major therapeutic challenge in chronic myeloid leukemia in chronic phase (CML-CP). While dasatinib 100 mg daily is effective, toxicity limits its use. Evidence suggests dasatinib 50 mg daily may retain efficacy with fewer adverse events, but data in imatinib-resistant settings remain scarce. This study aimed to evaluate the efficacy, safety, and survival outcomes of low-dose dasatinib in imatinib-resistant CML-CP and to identify predictors of response and progression. Methods:We retrospectively analyzed 53 adults with imatinib-resistant CML-CP treated with low-dose dasatinib at a tertiary center (2002–2025). Molecular responses [early molecular response (EMR), major molecular response (MMR), deep molecular response (DMR: MR4.0/MR4.5)], progression-free survival (PFS), overall survival (OS), and adverse events were assessed. Predictors of response and progression were evaluated using multivariate Cox regression. Results: Median age was 50 years; 41.5% were high ELTS risk. At median follow-up of 93 months, 62.3% achieved DMR, and 15.1% attained durable MMR. Patients with prior MMR loss on imatinib showed superior outcomes (61.8% achieved MR4.5; p=0.002). In contrast, primary resistance and concomitant EMR/MMR loss correlated with poor response. TKD mutations were detected in 32.1%; T315I mutation, high ELTS risk, and baseline BCR-ABL1 >100% independently predicted inferior outcomes. Five patients (9.4%) progressed to blast crisis. Ten-year PFS and OS were 85% and 100%, respectively. Adverse events occurred in 49.1%, predominantly cytopenias and pleural effusion, yet only 7.5% required drug discontinuation. Conclusions: Low-dose dasatinib is effective and well tolerated in imatinib-resistant CML-CP, achieving deep molecular responses with durable survival outcomes. Molecular predictors such as T315I mutation, ELTS risk, and high baseline BCR-ABL1 can guide risk-adapted therapy. These real-world results support dose-optimized strategies for improving long-term disease control while minimizing toxicity. |
| 340 |
More Than Joint Disease: Understanding Anemia in Juvenile Idiopathic Arthritis |
1996-07-17 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
|
DR. APOORVA PRAKASH |
LADY HARDINGE MEDICAL COLLEGE |
NEW DELHI |
8171960865 |
apoorva17prakash@gmail.com |
Oral |
Title: More Than Joint Disease: Understanding Anemia in Juvenile Idiopathic Arthritis
Introduction: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of chronic inflammatory arthritis in children under 16 years of age, often accompanied by extra-articular manifestations. Anemia is the most frequent hematological abnormality, arising from chronic inflammation, iron deficiency, or a combination of both, which can complicate diagnosis. Its severity often parallels disease activity and contributes to morbidity and adverse outcomes. This study aims to evaluate the prevalence, types, and underlying mechanisms of anemia in JIA and to assess its association with disease activity and clinical outcomes.
Methods: A cohort of 50 children diagnosed with JIA was studied. Hematological evaluation was performed using the Sysmex XN1000 automated analyzer. Peripheral blood smears were prepared and stained with Wright–Giemsa for morphological assessment. Anemia was defined according to WHO hemoglobin cut-offs for age and corroborated with peripheral smear findings. Iron studies were undertaken to classify anemia into anemia of chronic disease (ACD), iron deficiency anemia (IDA), or a combination of both (ACD+IDA).
Results: Among 50 patients, 36 (72%) were anemic and 14 (28%) had normal hemoglobin levels. Mild anemia was observed in 26 cases, moderate anemia in 10 cases, while no severe anemia was detected. All anemic patients had microcytic anemia. Anemia did not show a significant association with JIA subtype or disease activity. Of the anemic cases, 18 (50%) were classified as ACD, 16 (44.4%) as IDA, and 2 (5.6%) as ACD+IDA.
Conclusions: Anemia is a frequent and clinically relevant complication in JIA. Although not correlated with disease subtype or activity in this study, anemia significantly impacts quality of life. Its prompt identification and classification are vital, as early treatment can mitigate morbidity and improve outcomes.
Key words: anemia, anemia of chronic disease, iron deficiency anemia, Juvenile Idiopathic Arthritis |
| 341 |
Modulating Hypoxia-Induced Prothrombotic Responses with Hydrogen Sulfide Donors: Insights from In Vitro and In Vivo Models. |
1994-12-11 |
Female |
No |
- | H_LKO |
Benign |
Miscellaneous |
Laboratory |
: Vaishnavi Gupta1,3, Arushi Bhutani1, Ram Niwas Meena1, Bhanu Prakash2, Sanjay Batra2, Farman Abbasi2, Smriti Moi2, Manish Sharma1,4, 1Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO, Delhi-110054, India 2Medicinal and Process Chemistry |
Vaishnavi Gupta |
Defence Institute of Physiology and Allied Science |
New delhi |
7303966508 |
vaishnavi.g615@gmail.com |
Poster |
Title:Modulating Hypoxia-Induced Prothrombotic Responses with Hydrogen Sulfide Donors: Insights from In Vitro and In Vivo Models Introduction:Venous thromboembolism (VTE) is a silent yet life-threatening condition that poses a serious risk to lowlanders ascending to high altitudes (HA). Hypobaric hypoxia, a hallmark of HA, contributes to endothelial dysfunction and promotes a prothrombotic state. Given the emerging therapeutic potential of H₂S in counteracting oxidative stress, inflammation, and vascular injury. Our study investigates its protective effects using two distinct models: a hypoxia exposure model to simulate HA conditions, and a thrombosis model involving IVC ligation to mimic venous clot formation. Methods:In vitro and in vivo models were used to evaluate the efficacy of H₂S donors under hypoxic conditions. HUVECs were pre-treated with H₂S donors and exposed to 0.5% O₂ for up to 72 hours; intracellular H₂S levels were quantified using SF7-AM staining. In vivo, animals received H₂S donors for seven days prior to hypobaric hypoxia exposure (25,000 ft, 24 h), with plasma H₂S levels measured via amperometric probe. A separate thrombosis model was established through IVC ligation, with recovery assessed six hours post-surgery. Thrombotic parameters and screening markers were analyzed across both in vivo models. Results:Our observation showed that pre-treatment with H₂S donors restored and sustained H₂S levels under both in vitro and in vivo hypoxic conditions. In the hypobaric hypoxia model, HH reduced PT and aPTT, while increasing PF1+2 and D-dimer levels, indicating a procoagulant shift. H₂S donor administration attenuated these effects, normalizing coagulation parameters. In the IVC ligation model, H₂S treatment significantly reduced thrombus length and weight, along with decreased PF1+2 and D-dimer levels, confirming its anti-thrombotic efficacy. Conclusions:H2S donors counteract the hypoxia-induced pro-coagulation state and thrombosis by restoring coagulation balance and reducing thrombus formation. These findings highlight H₂S as promising therapeutic strategy to mitigate thrombotic risk associated with HA exposure. |
| 342 |
AI Augmented Classification of ADVIA WBC Scattergrams Classification for Early Detection of Hematological Malignancies |
1986-09-21 |
Female |
Yes |
L-1734 | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Smeeta Gajendra, Dr Ritu Gupta & Laboratory Oncology, AIIMS, Delhi |
Dr.Tanima Dwivedi |
All India Institute of Medical Sciences |
New delhi |
7406741788 |
tanimadwivedi@gmail.com |
Oral |
Introduction: Early detection of hematological malignancies is vital for prompt treatment. Manual review of WBC scattergrams is labor-intensive and prone to observer variability, while automated analyzers, despite producing cellular morphology based scattergrams remain underutilized. This study applies artificial intelligence (AI) to classify scattergrams, aiming to improve diagnostic speed, accuracy, and reproducibility.
Methods: In this retrospective, single-center study, WBC scattergrams (Peroxidase and Basophil channels) from patients with TLC of >40,000/µL on the ADVIA-2120i analyzer were analyzed. Diagnoses were confirmed by bone marrow, flow-cytometry and molecular/cytogenetics. Images were processed in a machine learning tool, with automatic 85% training and 15% testing split. Results: Among 386 total cases, 326 were used for training (AML: 71, ALL: 67, CML: 80, CLL: 43, Non-hematological malignancy/controls: 65 cases) and 60 cases for testing. On the independent test set, all controls were correctly identified, achieving 100% sensitivity. The model achieved an overall test accuracy of 70%, high sensitivities for CML(94.4%), ALL(91.7%), and CLL(84.6%) indicating strong classification performance. AML(75.0%) showed comparatively lower sensitivities. Overall, the model demonstrated strong detection performance for most categories, with further optimization needed for AML classification.
Conclusion: AI model demonstrated strong performance in distinguishing hematological malignancies from non-malignant cases, accurately classifying 100% of control samples as non-malignant and reliably identifying all malignancy cases. However, precise subtype classification particularly in AML was limited, likely due to morphological variability and insufficient subtype-specific training. These findings highlight the potential of AI-based scattergram analysis as an effective screening tool to flag suspected hematological malignancies, reduce the need for manual peripheral smear reviews, and optimize laboratory workflows. This approach can enhance diagnostic efficiency in high-throughput settings, support timely follow-up testing, and contribute to the evolution of automated hematology diagnostics.
Key Words: Artificial intelligence, Hematological malignancies, WBC scattergram |
| 343 |
Autologous Peripheral Blood Stem Cell Transplant in cases of Multiple Myeloma – a Case Series |
1995-10-19 |
Male |
No |
- | H_LKO |
Malignant |
Plasma cell disorders |
Clinical |
Prof Tulika Chandra, Dr Archana Solanki, Dr. Ashutosh Singh |
Dr. Kislay Mishra |
King George’s Medical University |
Lucknow |
7004668242 |
kislaythecooldude@gmail.com |
Oral |
Title: Autologous hematopoietic stem-cell transplantation is the standard treatment of MM in transplantation-eligible patients. HSC are found primarily in the bone marrow, with extremely low frequencies (0.01-0.5% of nucleated cells) in peripheral blood. Mobilization of cells into the peripheral blood using growth factors which are then collected by apheresis. Successful engraftment has been observed with counts ranging from 2 to 5 × 106 CD34+ cells/kg. Various factors may affect the yield of the product and therefore the successful engraftment, which are observed in this study.
Methods: This is a retrospective analysis of patients diagnosed with MM-ISS3. 5 such patients were treated at our centre and were followed up on a weekly basis initially and then monthly. Participants were initially kept on chemotherapy for 12 months (8-18 months) and were then admitted for stem cell harvest in ECOG performance status-1. 2 participants received G-CSF only as stem cell mobilizing agent while 3 received both G-CSF and plerixafor. After chemoablation by high dose melphalan, the collected product was transfused. The patients’ response was gauged by assessing the engraftment by measuring 1) Hb 2) TLC 3) ANC 4) Platelet Count.
Result: All 5 participants were transfused adequate amount of CD34+ cells i.e., 14.8×106 cells/kg (11-28×106 cells/kg). 4 participants required 1 apheresis procedure each while 1 participant required 2 cycles. The average time for the harvesting procedure was 246 min (220-280 min) Engraftment occurred at around 11-12 days. All 5 participants were discharged in CR-1 stage and ECOG performance status-1. All the follow-ups thereafter were uneventful.
Conclusion: The study showed favourable outcome for all the participants. Autologous PBSC transplant for MM is a standard therapy. Mobilizing agents like G-CSF and Plerixafor should be advocated for all eligible candidates.
Key words: MM, PBSC, Autologous transplant |
| 344 |
Malignancy associated haemophagocytic lymphohistiocytosis: a battle within a war |
1987-08-10 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Hema NS, Gnanamani S, Rikki Rorima John, Leni Grace Mathew; Christian Medical College, Vellore |
Dr. Leenu Lizbeth Joseph |
Christian Medical College, Vellore |
Vellore |
9486809752 |
leenujoseph@gmail.com |
Oral |
Title: Malignancy associated haemophagocytic lymphohistiocytosis: a battle within a war
Introduction: Malignancy associated HLH (M-HLH) is a rare but potentially life-threatening type of secondary hemophagocytic lymphohistiocytosis (sHLH) in children. It is more common in haematolymphoid malignancies among paediatric cancers. We present the spectrum of M-HLH diagnosed and treated over a 12-year period in our department.
Methods: Children diagnosed to have M-HLH associated with leukaemia and lymphoma from 2012- 2024 at PHO Unit at Christian Medical College, Vellore. Data was collected from electronic medical records.
Results:19 children with M-HLH were included in this study. Mean age at diagnosis was 8.7 years. The spectrum of haematolymphoid malignancies included Hodgkin lymphoma [HL] (4), ALCL (4), SPTCL (4), PTCL- NOS (2) extra nodal NK- T cell lymphoma (2) and cutaneous T cell lymphoma [CTCL], B cell ALL and JMML (1 each). Average interval from symptom onset to diagnosis was 4.7 months. All children fulfilled HLH diagnostic criteria. EBV serology was positive in 2/8.
17/19(89%) opted for treatment. Those who opted for treatment received dexamethasone as per HLH 2004 protocol along with definitive treatment for the underlying malignancies. Cyclosporin (1 each with PTCL, HL) and etoposide (2 with ENKTCL, 1 each with PTCL, SPTCL and HL) were added as response to steroids plus treatment of underlying disease was inadequate. With a median followup of 25 months, at the time of analysis, 7 (37 %) have completed treatment and are in CR1, 3 are currently on treatment. 9(47%) died, including 2 children who had refused treatment (JMML-1, ALCL-1).
Conclusions: Hematolymphoid malignancy associated with HLH in the paediatric population is associated with adverse outcomes, with 47 % mortality in our cohort. ENKTCL and ALCL especially, when associated with HLH were associated with poor prognosis.
Key words: M-HLH, haematolymphoid malignancies |
| 345 |
Bone Marrow ‘Bombshells’: Incidental and Primary Diagnosis of Solid Tumors in Bone Marrow Aspirates and Biopsies – A 26-Case Study from a Tertiary Care Centre |
1986-05-01 |
Female |
No |
- | H_LKO |
Benign |
Marrow failure |
Laboratory |
Khaliqur Rahman, Ruchi Gupta, Dinesh Chandra, Rajesh Kashyap, Manish Kumar Singh. Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow. |
IPRA SINGH |
Sanjay Gandhi Post Graduate Institute of Medical S |
LUCKNOW |
9415958181 |
ipra86@gmail.com |
Poster |
Title: Bone Marrow ‘Bombshells’: Incidental and Primary Diagnosis of Solid Tumors in Bone Marrow Aspirates and Biopsies–A 26-Case Study from a Tertiary Care Centre
Introduction: The incidental discovery of a metastatic deposit in bone-marrow during morphological examination is uncommon.It provides a vital clue for the clinician to search for an unknown primary, determine the stage,and manage these unsuspected cases appropriately. This study aimed to analyze incidence,clinical presentation,and morphological patterns of infiltration by solid tumors detected mainly through bone-marrow examination,without any prior history of a known malignancy.
Methods: This was retrospective study conducted over 5-years (January-2019 to December-2023) in the Department of Hematology.Patient data diagnosed with metastatic neoplasm via bone-marrow aspiration or biopsy,without a prior history of known malignancy, were collected from the hospital information system.Analysis was performed on bone-marrow aspirate and imprint smears stained with MGG,as-well-as on H&E-stained sections from bone-marrow biopsy.Immunohistochemistry was used to identify primary malignancy when necessary.
Results: Over five-years,a total of 11,783bone-marrow samples were submitted for morphological examination.Of these,26 samples(0.22%)showed presence of metastatic deposits,which were unsuspected and had no known primary.The patients' ages ranged from 6 to80 years(mean age 48.92 years),with male-to-female ratio 2.2.The most common symptom in adults was lower backache,followed by pancytopenia,PUO,or bone pain in children.Anemia was the most frequent hematological finding.A leucoerythroblastic blood picture was observed in 12patients.In children,most common diagnosis of incidental bone marrow metastasis was small blue round cell tumor(n=5), including neuroblastoma or Ewing’s sarcoma.In adults, the most common primary was prostatic adenocarcinoma(n=9),followed by infiltrating duct carcinoma of breast(n=2),colonic adenocarcinoma(n=1),lung adenocarcinoma(n=1),adenocarcinomaNOS(n=4),and unclassified metastatic carcinoma(n=4).
Conclusions: Bone-marrow examination may have an unsuspected finding of metastatic deposit from an unknown primary.A diligent morphological and immunohistochemical examination is helpful in correctly identifying metastatic deposit and suggesting primary. It helps in timely appropriate management.
Key words: Metastatic deposit,Bone-marrow,Unsuspected,Incidental detection |
| 346 |
Clinical Characteristics of Isolated Trisomy 11 verse KMT2A-Rearranged Acute Myeloid Leukemia: A retrospective Comparative Study |
1994-06-21 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Alpeshkumar Bipinbhai Kapadia1, Madhavi Maddali1, Phaneendra Datari1, Mithun Abraham Prakash1, Sujith Karumathil1, Uday Prakash Kulkarni1, Sushil Selvarajan1, Sharon Anbumalar Lionel1, N. A. Fouzia1, Anu Korula1, Biju George1, Aby Abraham1, Poonkuzhali B |
Y. Farheen1 |
christian medical college vellore-ranipet campus |
vellore |
8220673343 |
farheen.y94@gmail.com |
Poster |
Title:Clinical Characteristics of Isolated Trisomy 11 verse KMT2A-Rearranged Acute Myeloid Leukemia: A retrospective Comparative Study Introduction:Isolated trisomy 11 is an rare cytogenetic abnormality occurring in less than 1% of acute myeloid leukemia (AML) cases and is reported to be associated with poor prognosis. KMT2A-rearranged (KMT2Ar) AML is adverse-risk cytogenetic group and is characterized by distinct clinical features including increased early mortality and resistance to conventional chemotherapy. The clinical characteristics distinguishing isolated trisomy 11 from KMT2Ar AML have not been well characterized Methods:Aim: To analyse the baseline demographic, clinical and hematologic characteristics of AML cases with isolated trisomy 11 and systematically compare their profiles with KMT2Ar AML cases, and determine whether these represent distinct biological entities. Methodology: We conducted a retrospective analysis of 26 cases with isolated trisomy 11 diagnosed between January 2007 and December 2024, and compared with 58 KMT2Ar AML cases. Clinical parameters, including patient demographics, diagnostic categories, complete blood count parameters, blast percentages in peripheral blood and bone marrow, were evaluated and appropriate statistical test were performed. Results:The Isolated trisomy 11 subjects (n=26) showed a male predominance (69.2%) with median age of 50.5 years (range: 10-75). The isolated trisomy 11 was identified across myeloid neoplasms, most frequently in: AML (n=19, 73.1%), followed by MDS (n=6, 23.1%) and CMML-2 (n=1, 3.8%). Hematologic parameters revealed cytopenia’s with median haemoglobin of 7.8 g/dL, median total leukocyte count of 4.1×10⁹/L, and median platelet count of 71.5×10⁹/L. The median blast count was 11% in peripheral blood and 68% in bone marrow. Comparative analysis with KMT2Ar cases revealed trisomy 11 patients were significantly older (p<0.001), and had significantly lower haemoglobin levels (p=0.012). No statistically significant differences were observed in gender distribution (p=0.242). Conclusions:Isolated trisomy 11 represents a distinct cytogenetic entity in myeloid neoplasms, characterized by older age at presentation and more pronounced anemia compared |
| 347 |
Laboratory monitoring of Extended Half- Life (EHL) factor VIII with APTT based one- stage assay. |
1988-12-23 |
Female |
No |
- | 52495 |
Benign |
Hemeostasis |
Laboratory |
Dr.Bipin Kulkarni1(Scientist E,Head, Department of Haemostasis and Thrombosis)ICMR-NIIH,Dr.Chandrakala Shanmukhaiah2(HOD and professor,Dept.of hematology,Seth GS Medical College and KEM hospital, Mumbai), Akshata Rahate2(Staff Nurse-KEM Hospital), Prachi |
KIRTI BEELAGI |
ICMR-NIIH |
Mumbai |
09844190378 |
kirtighargi@gmail.com |
Poster |
Title: Laboratory monitoring of Extended Half- Life (EHL) factor VIII with APTT based one- stage assay.
Introduction: Extended half-life (EHL) factor replacement products have transformed hemophilia treatment, allowing for better trough levels and less frequent infusions. But this progress comes with a challenge: conventional lab monitoring methods, like the one-stage clotting assay (OSA), are often not up to the task of accurately measuring them. EHL products often display significant inter-assay and inter- reagent variability in OSAs, potentially leading to misinterpretation and suboptimal dosing.
Methods: Post EHL FVIII transfused patient plasma samples and different concentrations of commercial plasma were evaluated using conventional and modified OSA calibrated with EHL-rFVIII and compared with chromogenic assays. Four commonly used APTT reagents with varying activators and phospholipid compositions were tested to assess their impact on assay sensitivity and precision.
Results:The modified OSA using EHL-rFVIII as calibrator and selected APTT reagents demonstrated improved concordance with chromogenic assays, enhancing reliability in clinical monitoring. Certain APTT reagents (e.g., Triniclot and Actin FS) showed better compatibility with EHL products than others.
Conclusions: Calibration of OSA with EHL-specific standards, combined with appropriate APTT reagent selection, significantly enhances the accuracy of FVIII activity estimation in patients on EHL therapy. Adoption of this approach can aid personalized treatment decisions and improve patient outcomes.
Key words: Hemophilia A, Extended Half-Life Factor VIII, One-Stage Assay, Chromogenic Assay, Laboratory Monitoring, Afstyla. |
| 348 |
Quantitative Detection of Deletional Alpha Thalassemia by Fragment Length Analysis: A Cost-Effective MLPA and NGS Alternative. |
1995-10-28 |
Female |
No |
- | REB87 |
Benign |
Anemia |
Laboratory |
Soma Pradhan, Jesina Samuel, Neelagandan Kamala Nathan, Rakshini, Eunice Sindhuvi, Shaji R Velayudhan, Department of Clinical Haematology |
Sweety Priyanka |
Christian Medical College, Vellore |
Vellore |
+919080118512 |
sweety.priyanka@cmcvellore.ac.in |
Poster |
Title: Quantitative Detection of Deletional Alpha Thalassemia by Fragment Length Analysis: A Cost-Effective MLPA and NGS Alternative.
Introduction: Deletional alpha thalassemia results from loss of one or more alpha-globin genes, leading to reduced globin synthesis and variable anaemia. Gene dosage analysis is essential for accurate diagnosis and genetic counselling. Among the available techniques, multiplex PCR with capillary electrophoresis fragment length analysis provides a rapid, reproducible, and cost-effective method. It offers a practical alternative to MLPA and NGS, which are more resource-intensive.
Methods: Between January 2024 and July 2025, peripheral blood samples from suspected thalassemia cases were analysed. Genomic DNA was subjected to multiplex PCR-capillary electrophoresis for initial screening of alpha-globin gene deletions or duplications. Selected samples underwent MLPA for gene dosage confirmation, while exome sequencing by NGS was performed in a subset for evaluation of copy number changes and additional genetic contributors to haemolytic anaemia. Results: Among 1230 samples analysed for thalassemia genotyping, 185 were tested specifically for alpha-globin gene dosage. Copy number changes were identified in 59%. Among 12 cases evaluated by MLPA, nine showed concordance with dosage results, one CNV was uniquely detected by MLPA, and two with multiple polymorphisms were unresolved by dosage analysis. In 27 cases analysed by NGS, 21 matched the dosage findings. Discordances occurred in six cases: three false HBA2 deletions identified by NGS and three true CNVs (two deletions and one duplication) missed by NGS but detected by dosage analysis.
Conclusions: Multiplex PCR-capillary electrophoresis fragment analysis offers a rapid, sensitive, and highly specific first-line approach for alpha-globin gene dosage determination. It demonstrates reliability compared with NGS by minimizing false positives, while complementing MLPA in complex cases. Its cost-effectiveness, reproducibility, and diagnostic accuracy establish it as a robust method for routine alpha thalassemia genotyping in clinical laboratories.
Keywords: alpha thalassemia, gene dosage, MLPA, NGS. |
| 349 |
Cytogenetic Characteristics and Clinical Outcomes of Hematological Malignancies with Double Minutes: A Comprehensive Analysis of 22 Cases |
1984-09-22 |
Female |
No |
- | Payme |
Malignant |
Leukemia & lymphoma |
Laboratory |
Alpeshkumar Bipinbhai Kapadia1, Madhavi Maddali1, Phaneendra Datari1, Mithun Abraham Prakash1, Sujith Karumathil1, Uday Prakash Kulkarni1, Sushil Selvarajan1, Sharon Anbumalar Lionel1, N. A. Fouzia1, Anu Korula1, Biju George1, Aby Abraham1, Poonkuzhali Ba |
J. Meena |
CHRISTIAN MEDICAL COLLEGE VELLORE-RANIPET CAMPUS |
vellore |
09894189001 |
meenubhavsar@yahoo.in |
Poster |
Title: Cytogenetic Characteristics and Clinical Outcomes of Hematological Malignancies with Double Minutes: A Comprehensive Analysis of 22 Cases
Introduction: Double minutes (dmin) are rare, small, acentric DNA fragments visible in the karyograms that represent oncogene amplification commonly involving genes like CMYC and KMT2A, in hematological malignancies. Double minutes are usually associated with aggressive disease behaviour, genomic instability, and poor prognosis.
Methods: We retrospectively analyzed clinical and laboratory data of 22 patients with hematological malignancies harbouring double minutes diagnosed between July 2006 and April 2025. Fluorescence in situ hybridization (FISH) was performed for CMYC and KMT2A amplification detection in selected cases while next-generation sequencing (NGS) was utilized for mutation analysis.
Results:The double minutes cohort comprised 22 subjects with a median age of 45 years (range 2-75) and male predominance (59.1%). The dmin was identified across multiple haematologic disorders, most frequently in acute myeloid leukemia (n=10, 45.5%), secondary AML (n=4, 18.2%), acute lymphoblastic leukemia (n=3, 13.6%), myelodysplastic syndrome (n=2, 9.1%), and one case each of aplastic anemia, pancytopenia, and plasmablastic myeloma (4.5% each). The complete blood counts revealed severe cytopenia: median haemoglobin 7.7 g/dL (range 3.3-12.8), platelet count 29.5×10⁹/L (range 3-272), and total leukocyte count 3.85×10⁹/L (range 0.3-129.5). Bone marrow blast percentage showed wide variation with a median of 49% (range 0-100), while LDH levels were elevated with a median of 1098 U/L (range 236-8577). Among patients tested, CMYC amplification by FISH was positive in 75% of cases (6/8), while NGS revealed additional mutations in 80% of tested cases (4/5), indicating genomic complexity. Clinical outcomes revealed 50% mortality at last contact.
Conclusions: Hematological malignancies with double minutes is characterized by myeloid predominance, severe cytopenia, CMYC amplification, and poor clinical outcomes, highlighting the urgent need for personalized treatments
Key words: |
| 350 |
ABO Compatibility in Platelet Transfusions: Necessary or Negotiable? |
1995-08-07 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
TULIKA CHANDRA,S.P VERMA,ARCHANA SOLANKI,ASHUTOSH SINGH, KGMU LUCKNOW |
SOMYA CHAHAR |
SAROJINI NAIDU MEDICAL COLLEGE |
AGRA |
9410085911 |
somyachahar11@gmail.com |
Oral |
Title : ABO Compatibility in Platelet Transfusions: Necessary or Negotiable?
Introduction: In everyday transfusion practice, limited inventory coupled with the limited 5-day storage period for platelets necessitates provision of many ABO-mismatched Platelet transfusions. But the question remains – is giving ABO mismatched or matched platelets equally effective in all patients.
Methods: To compare the corrected count increment (CCI) after transfusion of ABO matched and mismatched platelets in newly diagnosed patients of acute Leukemia.
Results: In 32 patients receiving total 384 RDPs, platelet count after 1 hour and 24 hour of two transfusion showed that the ABO matched group exhibited a significant higher mean platelet count increment than ABO mismatched group (p value = .031). While calculating the CCI of matched and mismatched groups in both transfusions it was observed that at 1 hour and 24 hour CCI was higher in ABO matched group as compared to mismatched but this was not clinically significant ( p value = .088).
Conclusions: Supply of ABO compatible platelets is not possible as inventory does not allow owing to the short shelf life of platelets . This study was conducted with the aim of providing documentary evidence regarding platelet increment in a patient after transfusion of ABO matched and mismatched RDPs. Absolute platelet count increment was more in ABO matched transfusions as compared to mismatched transfusions but there was no significant difference in the CCI during initial transfusions on giving ABO matched or mismatched RDPs. Therefore we conclude that patient benefit is same in both ABO matched and mismatched RDPs so we should not restrict our supply to ABO matched platelets only as the needy patients might not be able to get the required platelets.
Key words: CCI, leukemia, ABO matched, mismatched, RDP. |
| 351 |
Diagnostic Yield of Fluorescence In Situ Hybridization (FISH) Testing in Eosinophilia: A Five-Year Retrospective Analysis |
1980-06-24 |
Male |
No |
- | pay_R |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Alpeshkumar Bipinbhai Kapadia1, Madhavi Maddali1, Phaneendra Datari1, Mithun Abraham Prakash1, Sujith Karumathil1, Uday Prakash Kulkarni1, Sushil Selvarajan1, Sharon Anbumalar Lionel1, N. A. Fouzia1, Anu Korula1, Biju George1, Aby Abraham1, Poonkuzhali Ba |
Manoj Moni V T |
CHRISTIAN MEDICAL COLLEGE VELLORE-RANIPET CAMPUS |
RANIPET |
9994254389 |
manoj.moni@cmcvellore.ac.in |
Poster |
Title: Diagnostic Yield of Fluorescence In Situ Hybridization (FISH) Testing in Eosinophilia: A Five-Year Retrospective Analysis
Introduction: The eosinophilic disorders include reactive conditions and hematological malignancies resulting from tyrosine kinase gene rearrangements and somatic mutations. Most rearrangements are cryptic and missed by karyotyping. FISH and molecular-based testing can detect cryptic rearrangements, but comprehensive molecular screening becomes challenging in resource-poor settings.
Methods: We retrospectively analyzed clinical and laboratory data of 214 consecutive subjects with eosinophilia who underwent FISH testing between January 2020 and June 2025. FISH probe testing included BCR::ABL1, PDGFRA, PDGFRB, FGFR1, and JAK2. Positivity rates were calculated for individual probes and stratified by the number of probes tested per patient (1-5 probes)
Results: Median age was 36.5 years (range 0-77) with male predominance (64.5%). All cases were BCR::ABL1 negative. Positivity rates were: PDGFRA (n=11, 5.1%), PDGFRB (n=3, 1.4%), FGFR1 (n=1, 0.5%), JAK2 (n=1, 0.5%). Overall FISH analysis revealed positive results in 16 subjects (7.5%), with all positive cases classified as myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions (MLNE-TKGF). One case was of chronic eosinophilic leukemia (CEL, 0.5%). The majority remained uncategorized as idiopathic hyper eosinophilia (n=137, 64%) and non-specific causes (n=56, 26%). When analyzed by testing strategy, patients tested with all five probes (n=133) showed 6.0% positivity, while those tested with fewer probes demonstrated variable rates (3.7%-28.6%), with higher yields in targeted testing scenarios. Most positive cases were confined to PDGFRA and PDGFRB, with minimal contribution from other probes
Conclusions: Frontline testing with PDGFRA and PDGFRB probes captures the majority of positive cases (6.5% combined). A stepwise algorithm prioritizing high-yield probes followed by next-generation sequencing for negative cases with persistent clinical suspicion can optimize diagnostic accuracy while improving cost-effectiveness over broad FISH panels.
Key words: |
| 352 |
Molecular characterisation of Female Haemophilia A |
1983-04-17 |
Male |
No |
- | H_LKO |
Benign |
Hemeostasis |
Laboratory |
Sankari Devi G, Fouzia.N.A, Aby Abraham, Eunice S. Edison |
Rajkumar.S.V |
Christian Medical College Vellore, Ranipet Campus |
Ranipet-Vellore |
9787579394 |
rajkumar.sv@cmcvellore.ac.in |
Poster |
Title:
Molecular characterisation of Female Haemophilia A
Introduction:
Hemophilia A (HA) is an X-linked recessive bleeding disorder that primarily affects males, while females are usually asymptomatic carriers. Information on female patients with moderate or severe hemophilia is limited, as they rarely exhibit such phenotypes.
In rare cases, non-random or skewed X-Chromosome inactivation (XCI) may silence the normal X chromosome, leading to symptomatic haemophilia.
Aim:
The aim of the study was to investigate XCI patterns in female haemophilia A patient, presenting with moderate to severe HA phenotype.
Methods:
Genomic DNA was extracted from peripheral blood. Intron 1 and intron 22 inversions were analyzed using a PCR based method. Genetic variants in F8 gene were screened by PCR followed by Sanger sequencing. Deletions and duplications were screened by MLPA analysis. X-chromosome inactivation patterns were also analysed.
Results:
Between January 2015 and June 2025, we analyzed 557 hemophilia A cases, among these, there were female patients with a haemophilia A phenotype. Two with severe hemophilia A (FVIII:C <1%), and one with moderate haemophilia A (FVIII: C 3.3%). The molecular defect in these patients were in a heterozygous state, a frameshift mutation (c.1297_1305dupTTTGAACA), a nonsense mutation (c.970C>T) and a gross deletion of exons 8–9 in the F8 gene. Their mothers were also heterozygous for the same mutations but showed no bleeding symptoms and had normal FVIII levels. XCI analysis revealed skewed inactivation in some samples.
Conclusions:
Even though it is rare, there are cases of females with haemophilia A phenotype, which require comprehensive molecular diagnosis.
Key words: Haemophili A (HA), X-chromosome Inactivation (XCI). |
| 353 |
RTEL1 Gene Mutations contribute to Inherited Bone Marrow Failure Syndrome in the Indian Population |
1981-04-10 |
Male |
No |
- | H_LKO |
Benign |
Marrow failure |
Laboratory |
Eswari Sampath, Rosy Mary Marandi, Nutan Joshi, Aby Abraham, Biju George, Eunice S Edison |
Neelagandan Kamalanathan |
Christian Medical College Vellore, Ranipet Campus |
Ranipet-Vellore |
9944024069 |
neelacmc@gmail.com |
Poster |
Title:
RTEL1 Gene Mutations contribute to Inherited Bone Marrow Failure Syndrome in the Indian Population
Introduction:
Inherited Bone Marrow Failure syndromes (IBMFS) are a group of rare disorders where the bone marrow cannot produce sufficient blood cells. Pathogenic genetic variants in genes involved in hematopoiesis, telomere biology, and transcription factor regulation have been identified as key contributors to IBMFS. We focus on clinical features and outcomes in IBMFS patients harboring RTEL1 variants.
Aims & Objectives:
In this study we attempted to identify germline variants in patients with IBMFS.
Methods:
Patients who underwent molecular diagnosis for IBMFS were included in this study. Variants were screened by targeted next generation sequencing (NGS). Sequencing was done on the Illumina platform. Bioinformatics was done following the GATK best practices framework. Telomere length of patients was analyzed by using RQ-PCR.
Results:
Of the patients who underwent molecular diagnosis from 2019 to May 2025 for IBMFS ,we identified RTEL1 variants in 25 patients, 18 males and 7 females. The mean age was 27±16 years. The age of onset varied from 2 to 59 years. Among these 25 patients, 21 patients had heterozygous variants and 4 patients had homozygous variants. Of the 21 patients who had heterozygous variants: 12 were pathogenic variants and 9 were Variants of Uncertain Significance (VUS). Of the 12 pathogenic or likely pathogenic variants, 1 was VSAA and 5 presented with SAA and 6 were NSAA. Two patients with heterozygous RTEL1 variant and SAA underwent allogeneic HSCT.
In 4 patients with homozygous variants: 3 had pathogenic variant associated with NSAA and one had VUS.
Conclusions:
RTEL1 mutations in the Indian population show a predominance of heterozygous autosomal dominant variants.
Key words: IBMFS, Bone marrow failure, RTEL1, Autosomal dominant, Pathogenic variant, Transplant |
| 354 |
Molecular Diagnosis of Iron Related Disorders using NGS |
1981-06-02 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Laboratory |
Neelagandan K, Fouzia.N.A, Sharon Anbumalar Lionel, Sujith, Aby Abraham, Eunice S Edison |
Senthil Kumar Govinda Swamy |
Christian Medical College Vellore, Ranipet Campus |
Ranipet-Vellore |
9790150285 |
sen_cmc@yahoo.co.uk |
Poster |
Title:
Molecular Diagnosis of Iron Related Disorders using NGS
Introduction:
Molecular diagnosis of iron-related disorders involves genetic testing to identify mutations in genes that regulate iron metabolism, such as HFE, HAMP, HJV, TFR2, TMPRSS6 and SLC40A1 (ferroportin), which cause conditions like hereditary hemochromatosis (HH) and iron-refractory iron deficiency anaemia (IRIDA).
Aim & Objectives:
The aim of using NGS in iron disorders is to achieve a definitive genetic diagnosis for patients who present with symptoms of iron dysregulation.
Methods:
Patients who presented with iron disorders to our centre between 2019 and May-2025 were selected for this study. DNA was extracted and variants were screened by targeted next generation sequencing (NGS). Bioinformatics was done following the GATK best practices framework.
Results:
A total of 8 iron disorder patients included in the study. Median age was 22.75 years (6-41).
Of the 8, 4 had primary hemochromatosis (HAMP-3, HJV-1) and 4 had IRIDA (TMPRSS6). The 3 patients with HAMP gene mutations have mean Hb of 12.9±0.5 g/dL, mean MCV of 85.3±7.2 fL and serum ferritin level in the range of 71 - 2591 ng/ml. The 4 patients with TMPRSS6 gene mutations have mean Hb of 7.0±1.3 g/dL, mean MCV of 51.6±3.6 fL and mean serum ferritin level of 19.7±6.4 ng/ml (13.9 - 28.6). In patients with primary HH, 2 were missense and 2 were nonsense variants (stop codon). In patients with IRIDA, 3 were missense and 1 was splice site variant, all of them are likely pathogenic.
Conclusions:
Since iron dysregulation involve numerous genes, NGS offers a superior method for diagnosing iron-related disorders, overcoming limitations of traditional tests and providing crucial genetic information for patient care.
Key words: Haemochromatosis, IRIDA, HAMP, HJV, TMPRSS6, Anaemia, Iron deficiency, NGS |
| 355 |
The Butterfly Impostor: Midline Lesion Unmasked as CNS-DLBCL |
1987-01-29 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr.Sanjay Mehrotra, Dr.Bandana Mehrotra, Dr.Garima Singh |
Dr. Supriya Mehrotra |
RML Pathology, Lucknow |
Lucknow |
9838099887 |
mehrotra.supriya@gmail.com |
Poster |
Title: The Butterfly Impostor: Midline Lesion Unmasked as CNS-DLBCL
Introduction: “Butterfly lesions” spanning the corpus callosum are often presumed glioblastoma. Primary CNS lymphoma (PCNSL) can mimic this radiologic pattern, risking misdiagnosis and treatment delay.
Methods: A 59-year-old male presented with neurological symptoms, and MRI revealed a large, heterogeneously enhancing intra-axial “butterfly-shaped” lesion involving the corpus callosum and adjacent lobes with perilesional edema. Biopsy showed sheets of atypical round-to-ovoid cells with prominent nucleoli, increased mitotic activity, and focal hemorrhage, raising suspicion for a malignant round cell tumor. Differential diagnoses included lymphocytic lymphoma, neurocytoma, and other round cell tumors.
Results: Immunohistochemistry (IHC) confirmed hematolymphoid origin (CD45+), B-cell lineage (PAX5+, CD79a+), germinal center phenotype (CD10+, BCL6+), double-expressor biology (BCL2+, c-MYC+) with very high proliferation index (Ki-67~90%), ruling out glial, neuroendocrine, and metastatic tumors. The integrated findings established a diagnosis of Diffuse Large B-Cell Lymphoma of the CNS, Germinal Center Type.
Conclusions: Midline “butterfly” does not equal glioblastoma. An early, minimal IHC panel (CD45 → PAX5/CD79a → CD10/BCL6 ± BCL2/c-MYC) rapidly establishes PCNSL and guides lymphoma-specific therapy planning. Hence, this case underscores the indispensable role of IHC in navigating such diagnostic grey zone.
Key words: PCNSL, DLBCL, lymphoma, butterfly lesion |
| 356 |
A Rare Case of Myelodysplastic Syndrome developed in HCV infected patient |
1994-03-01 |
Male |
No |
- | T2509 |
Malignant |
Myelodysplastic syndrome |
Laboratory |
Dr Kulwant Singh, Dr Parveen Rana Kundu, Dr. Nitika Chawla, Dr Swaran Kaur Saluja |
Dr. Raj Aravind K |
BHAGAT PHOOL SINGH GOVERNMENT MEDICAL COLLEGE |
KHANPUR KALAN, SONIPAT |
8825626993 |
rajkaravind13@gmail.com |
Poster |
Title:A Rare Case of Myelodysplastic Syndrome developed in HCV infected patient
Introduction:Myelodysplastic syndromes (MDS) refers to a heterogenous group of closely related clonal hematopoietic disorders commonly found in aging population. MDS is observed as one of the significant extrahepatic manisfestations in hepatitis C virus infection. The correlation between HCV infection and myelogenous disorder is still debated.
Methods:A 62 year old male came to emergency with the complaint of generalised body weakness for the past 1 year. There was prior history of blood transfusion twice. He was detected as HCV positive 3years ago. Laboratory testing showed hemoglobin 9.0 gm%, TLC 2000/cumm, platelet count 40,000/cumm, neutrophils 40%, lymphocytes 50%, monocyte 8%, eosinophil 2%, basophil 0%, RBC 3.14 million/cumm, MCV 91.5 fL, MCH 29.3 pg, RDW 25.8%, hematocrit 28.8% and corrected reticulocyte count was 3.2%. Peripheral blood smear showed dimorphic blood picture with anisopoikilocytosis and target cells.
Results:Bone marrow aspiration was done. Smears were hypercellular for age with increased myeloid to erythroid ratio. Myeloid series appeared adequate with occasional giant metamyelocytes. Erythroid series were hyperplastic with micro normoblastic and megaloblastic changes. Megakaryocytes were slightly reduced in number and showed dyspoietic changes. Iron stores were slightly increased (4+). Possibility of Myelodysplastic Syndrome with thrombocytopenia was considered.
Conclusions:The incidence of Myelodysplastic Syndrome during HCV infection is rare. Most common mutation observed in elderly population is in germline DDX41. The correlation between HCV infection and myelodysplastic syndrome is still under research. Aetiologies can be an inflammatory response, an autoimmune response or the virus's direct effect on bone marrow. Therefore, further studies are highly essential to identify the risk factors, to prevent and to effectively manage the myelodysplastic syndrome in HCV infected patients.
Key words:Myelodysplastic, hepatitis C virus, heterogenous, metamyelocytes, dyspoietic. |
| 357 |
Spectrum of Bone Marrow Metastases from Solid Tumors: A Three-Year Case Series from a Tertiary Care Center |
1996-07-05 |
Male |
No |
- | pay_R |
Malignant |
Rare hematological malignancies |
Laboratory |
Dr. Namrata P Awasthi, Dr. Ariba Zaidi, Dr. Pradyumn Singh, Prof. Nuzhat Husain Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow |
Dr. Kaushlendra Kumar |
DR. RMLIMS |
LUCKNOW |
9651356825 |
kaushlendra5796@gmail.com |
Oral |
Title: Spectrum of Bone Marrow Metastases from Solid Tumors: A Three-Year Case Series from a Tertiary Care Center
Introduction: Bone marrow evaluation, performed primarily for hematologic indications, can occasionally uncover metastases from non-hematologic malignancies. Early recognition is clinically consequential, providing the first diagnostic clue to an occult primary in some patients and refining stage and management in others.
Methods: We conducted a retrospective observational analysis of 23 consecutive cases of metastatic bone marrow involvement diagnosed between January 2022 and March 2025 at the Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow. All patients underwent bone marrow aspiration (BMA) with concurrent trephine biopsy in most cases; immunohistochemistry (IHC) was applied as required to suggest site of origin. We summarized demographics, hematologic abnormalities, and tumor spectrum, and quantified upfront diagnoses.
Results: Patients ranged from 17–79 years (mean 51.1, median 55) with a near-equal sex distribution (M:F = 1.1:1). An upfront diagnosis from marrow was made in 18/23 where primary malignancy was not known. Hematologic abnormalities were frequent: anemia in 15/23 (65.2%), thrombocytopenia in 9/23, leukopenia in 1/23, with bicytopenia in 9/23. The common primaries were from prostate adenocarcinoma (5/23), breast carcinoma (4/23) and Ewings/PNET (2/23) and single cases of lung adenocarcinoma, gastrointestinal adenocarcinoma and synovial sarcoma. In several instances, the trephine biopsy was decisive when aspiration was scanty, and IHC (e.g., PSA, CK7/CK20, TTF-1/Napsin A, CDX2) refined site attribution.
Conclusions: In a real-world tertiary care setting, marrow metastases are uncommon but diagnostically pivotal, yielding upfront cancer diagnoses in 78% of affected patients. Cytopenias are the most consistent hematologic flags. A combined BMA–trephine approach with targeted IHC maximizes detection and site prediction, enabling timely staging and management. Routine consideration of marrow evaluation is warranted in patients with unexplained cytopenias or systemic symptoms, even without a prior cancer diagnosis. |
| 358 |
Advancing Accuracy in Non-invasive Hemoglobin Estimation: A Comparative Clinical Study of the Non-invasive Anemia Detection App (NiADA) |
1993-09-21 |
Female |
Yes |
L-2312 | pay_R |
Benign |
Anemia |
Laboratory |
Tuphan Kanti Dolai1, Krishanu Banerjee2, Abhishek Sharma1, Ivan Chernukha2, Debjeet Das3, Vipul Sharma4, Mou Nandi1 1 - Nil Ratan Sircar Medical College and Hospital, 2 – Artificial intelligence, Monere Corporation, Lehi, USA, 3 - Artificial intelligence |
Pratibha Singh |
Nil Ratan Sircar Medical College and Hospital |
Kolkata |
9712527759 |
drpratibhasingh21@gmail.com |
Oral |
Title: Advancing Accuracy in Non-invasive Hemoglobin Estimation: A Comparative Clinical Study of the Non-invasive Anemia Detection App (NiADA)
Introduction: Anemia remains a significant global health burden in low- and middle-income countries. Traditional hemoglobin screening methods are invasive, resource-intensive, and difficult for repeated population-level screening. The Non-invasive Anemia Detection App (NiADA) provides a smartphone-based, AI-powered alternative for estimating hemoglobin levels using images of lower palpebral conjunctiva.
Methods:This study was conducted at NRS Medical College and Hospital, Kolkata, India, from December 2024 to January 2025. Total of 2,476 participants (ages 2-90 years) were enrolled. Partial facial images, focusing on the lower eyelid, using smartphones running NiADA version 3 for automated analysis in real time by the AI model. Venous blood samples were collected immediately after image capture, and hemoglobin levels were measured using an automated hematology analyzer. Regression and classification performance were evaluated using BlandAltman analysis, mean bias, Lin’s concordance correlation coefficient (CCC), and confusion matrices with subgroup analyses.
Results:NiADA exhibited strong agreement with laboratory-measured hemoglobin levels across all demographic subgroups, with Pearson correlation coefficients ranging from 0.81 to 0.86, Lin’s CCC between 0.80 and 0.87, and R² values spanning 0.73 to 0.76. The mean bias remained within ±0.27 g/dL across cohorts. Bland-Altman analysis showed 95% of predictions were within the limits of agreement for children (−2.07 to 2.46 g/dL), females (−2.48 to 2.64 g/dL), and males (−2.51 to 3.05 g/dL).NiADA achieved the highest accuracy in adult females (88.7%) in anemia classification. Sensitivity remained consistently high across all groups (≥88%), while specificity ranged from 71.8% to 76.1%.
Conclusions: NiADA version 3 demonstrates strong accuracy and reliability, is well-suited for large population as a non-invasive tool, with comparable performance to conventional devices and longitudinal monitoring in both clinical and community setting
Key words: anemia, Artificial Intelligence, non-invasive screening, public health screening |
| 359 |
THE STOMACH UNDER SIEGE: AGGRESSIVE COURSE OF GRANULOCYTIC SARCOMA |
1996-02-18 |
Female |
No |
- | 56154 |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Richa Singh, Prof. Rashmi Kushwaha, Prof. SP Verma, Prof. Suresh Babu |
DR JYOTSANA |
KING GEORGE'S MEDICAL UNIVERSITY |
LUCKNOW |
8726257076 |
1jyotsana1@gmail.com |
Poster |
TITLE: THE STOMACH UNDER SIEGE: AGGRESSIVE COURSE OF GRANULOCYTIC SARCOMA
AUTHOR: Dr. Jyotsana, Dr. Richa Singh, Prof. Rashmi Kushwaha, Prof. SP Verma, Prof. Suresh Babu
INTRODUCTION:
Granulocytic sarcoma (GS), also known as myeloid sarcoma or chloroma, is a rare extramedullary tumor composed of immature myeloid cells. While common in skin, bone, and lymph nodes, gastrointestinal involvement is unusual, and gastric localization is exceedingly rare.
METHOD:
An 18-year-old male presented with abdominal pain, vomiting, early satiety, and dizziness. Imaging revealed a bulky gastric mass. Histopathology revealed diffuse infiltration by blasts, which were immunohistochemically positive for CD117, MPO, CD34, and CD68; the bone marrow was uninvolved. The patient received standard AML induction chemotherapy (daunorubicin + cytarabine) but succumbed to progressive disease and complications.
RESULTS:
Diagnosis of gastric GS requires high suspicion, as it mimics lymphoma or other small round cell tumors. IHC confirmation is essential. Cytogenetic abnormalities, such as t(8;21), inv(16), or trisomy 8, may be associated. Management is systemic AML-type chemotherapy; surgery and radiotherapy are adjunctive. Prognosis remains poor, with a high risk of progression to acute leukemia within months.
CONCLUSION:
Primary gastric granulocytic sarcoma is a rare, aggressive malignancy that demands early recognition and prompt AML-based therapy. Awareness among clinicians and pathologists is crucial to avoid misdiagnosis and initiate timely treatment.
|
| 360 |
MYELODYSPLASTIC SYNDROME: A COMPLEX HEMATOLOGIC PUZZLE UNRAVELED |
1998-06-21 |
Female |
No |
- | 24AAN |
Malignant |
Myelodysplastic syndrome |
Laboratory |
|
SANDRA T VIJAY |
KASTURBA MEDICAL COLLEGE |
MANGALORE |
7619476711 |
sandratvijay98@gmail.com |
Poster |
Title: MYELODYSPLASTIC SYNDROME: A COMPLEX HEMATOLOGIC PUZZLE UNRAVELED Introduction: Myelodysplastic syndrome encompasses a heterogeneous group of clonal hematopoietic stem cell disorders characterized by ineffective haematopoiesis, persistent peripheral cytopenia and morphologic dysplasia in one or more myeloid cell lines. Predominantly affecting older adults, MDS manifests with symptoms related to anaemia, bleeding and increased infection risk due to bone marrow failure. Diagnosis relies on detailed morphological evaluation of peripheral blood and bone marrow, supported by cytogenetic and molecular studies when available. The natural course is highly variable with a significant proportion of patients progressing to acute myeloid leukaemia. Early recognition and risk-adapted therapy are essential to improve patient outcomes and quality of life. Methods: The patient underwent comprehensive clinical evaluation with detailed history and physical examination. Laboratory analyses included complete blood count (CBC), peripheral blood smear and routine biochemical testing. Peripheral blood smears were stained with Wright-Giemsa and examined for morphologic abnormalities. Bone marrow aspiration and biopsy were performed to assess cellularity, dysplasia and blast percentage. Cytogenetic and molecular analyses were not conducted due to resource limitations. Results: MDS presents a complex clinical and diagnostic challenge due to its heterogeneity. Morphologic assessment remains fundamental for diagnosis, particularly when advanced molecular diagnostics are unavailable. Risk-adapted management can improve symptom control, reduce transfusion needs and delay leukemic transformation. This case emphasises the importance of evaluating unexplained cytopenia thoroughly and initiating appropriate hematologic workup for timely diagnosis and intervention. Conclusions: This case highlights the insidious and variable clinical course of myelodysplastic syndrome, emphasizing the importance of careful morphologic and clinical assessment in diagnosis, especially in settings with limited access to molecular diagnostics. Clinicians should maintain a high index of suspicion in patients with unexplained anaemia or cytopenia to ensure prompt and appropriate care. Key words: myelodysplastic syndrome, cytopenia, bone marrow failure, morphologic dysplasia, clonal hematopoietic |
| 361 |
UNMASKING A MEDICAL EMERGENCY: APML CASE REPORT |
2001-05-28 |
Male |
No |
- | 24AAN |
Malignant |
Leukemia & lymphoma |
Laboratory |
|
SAI SASHANK KOCHERLAKOTA |
KASTURBA MEDICAL COLLEGE |
MANGALORE |
9381469474 |
saisashank2001@gmail.com |
Poster |
Title: UNMASKING A MEDICAL EMERGENCY: APML CASE REPORT Introduction: Acute promyelocytic leukaemia is a unique and aggressive subtype of acute myeloid leukaemia characterized by the accumulation of abnormal promyelocytes in the bone marrow and peripheral blood due to a specific chromosomal translocation t (15;17) PML-RARA fusion gene. APML is clinically distinguished by a high risk of severe bleeding complications caused by a characteristic coagulopathy resembling disseminated intravascular coagulation. Prompt diagnosis and immediate initiation of targeted therapy with all-trans retinoic acid and arsenic trioxide have revolutionized its prognosis, transforming APML from a fatal to a highly curable leukaemia subtype. Methods: The patient underwent a detailed clinical assessment including history and physical examination. Initial laboratory investigations included complete blood count peripheral blood smear and routine biochemical tests. Peripheral smear examination was performed to identify blast morphology and presence of Auer rods and faggot cells. Bone marrow aspiration and biopsy were conducted to confirm diagnosis and assess cellularity. Due to financial constraints FISH for detection of the PML-RARA fusion gene was not performed. Results: Acute promyelocytic leukaemia is a medical emergency where timely treatment can make a significant difference. With the use of targeted therapies like all-trans retinoic acid and arsenic trioxide most patients today achieve long-term survival. However, complications such as severe bleeding and infections remain major challenges and can lead to sudden deterioration or death especially if diagnosis or treatment is delayed. Conclusions: This case highlights the aggressive and unpredictable nature of acute promyelocytic leukaemia where initial nonspecific symptoms can rapidly progress to life-threatening complications such as disseminated intravascular coagulation. Despite advances in targeted therapies like arsenic trioxide and all-trans retinoic acid early diagnosis and prompt initiation of treatment. Keywords: PML-RARA fusion, t(15;17) translocation, coagulopathy, disseminated intravascular coagulation, all-trans retinoic acid, arsenic trioxide, medical emergency, bone marrow, abnormal promyelocytes. |
| 362 |
THERAPY RELATED AML: CASE SERIES
|
1998-05-28 |
Male |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
DR.SWARNABINDU BANERJEE DM MEDICAL ONCOLOGY MEDICAL COLLEGE KOLKATA |
DR. KUSHAL CHATTERJEE |
Medical College Kolkata |
Kolkata |
8420809438 |
kchatindia@gmail.com |
Oral |
Title:THERAPY RELATED AML: CASE SERIES Introduction:Secondary leukaemia after treatment of Ca Breast is a definite yet rare entity with incidence rates(.41%).Chemotherapy related acute leukaemia is secondary to treatment related translocation errors mainly due to alkylating agents & anthracyclines.
Methods:The data is collected from OPD f/u,electronic medical record & case files & are depicted using descriptive statistics.The patients having abnormalities in CBC & differential were asked to undergo BM aspiration,biopsy.
Results:No. of patients=9,Breast cancer=7,Embryonal Rhabdomyosarcoma of Jaw(ERMS)=1,Ewings Sarcoma vertebrae(EWS)=1 median age of presentation=47yrs,median interval between treatment of primary malignancy& diagnosis of acute leukaemia=17mons.Tumour stage T2 in all of them (100%), lymphnodal status: majority N0(4cases=57%)& N1,N2,N3 1each.None of them were metastatic.ERMS was CGIIIB,EWS was nonmetastatic. As neo-adjuvant /adjuvant all of the ca breast received anthracycline & alkylating agent(100%) while 2of them additionally received taxane(28%).3 of them received radiation.Among the 7patients 4 developed AML (57%),2developed APML(28%),1 MDS(14%).At presentation regarding symptomatology 7 patients(100%) had fatigue ,1 had sore throat( 14%) 6patients(85%) had thrombocytopenia,5patients had leucopenia(72%),2 had leucocytosis(28%),2(28%) had circulating blasts in peripheral blood.Marrow cytogenetics showed t(15,17) in 2cases(28%),1 case(15%) had t(8,21) & del5q,MDS case had del5q &del7q ,1 case(15%) showed complex cytogenetics,2cases (28%) showed indeterminate cytogenetics. 4patients (57%)took treatment ,3patients(42%) was referred for supportive care.The latency of AML in ERMS was 6 yrs & the cytogenetics showed no special features.Non metastatic vertebral EWS presented with preB ALL & hyperleucocytosis.The one with ERMS was given 3+7 f/b by 3x HDAC,counselled for BMT,the party declined & there was relapse within 3mons.subsequently she was given OMCT & had CR in BM post 3 mon ultimakely succumbed to progressive disease.The one with EWS died within 15 days of diagnosis due to cerebral hyperleucocytosis.
Conclusion: Clinicopathologically almost all are secondary to anthracyclines &alkylators & median survival is longer(1yr vs 8mon) compared to other series
Keyword: AML EWS ERMS
|
| 363 |
“When CD56 Shines Too Bright: Unmasking AML with RAM Phenotype in Older Adults.” |
1997-04-03 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Vandana Puri, Dr. Ritika Sud |
Dr. Gunjan Batra |
LADY HARDINGE MEDICAL COLLEGE |
Delhi |
9650690494 |
batra.gunjan97@gmail.com |
Poster |
Title: “When CD56 Shines Too Bright: Unmasking AML with RAM Phenotype in Older Adults.”
Introduction: Acute Myeloid Leukemia (AML) is a clonal hematopoietic malignancy most commonly diagnosed in the elderly. The RAM phenotype of AML, characterised by dim or absent CD45, HLA-DR, and CD38, and frequently strong CD56 expression, is typically described in pediatric populations and is rarely reported in older adults. This variant is associated with an aggressive disease course, diagnostic complexity, and resistance to standard therapy.
Case Description: We report the case of a 75 year old female with history of treated tuberculosis presented with altered sensorium and generalised bone pain. Investigations revealed pancytopenia and 30% blasts on peripheral smear. Bone marrow aspiration yielded a dry tap; imprint smears revealed 46% blasts with trilineage suppression. Biopsy showed 80% cellularity with grade 2 marrow fibrosis. Flow cytometry demonstrated 22% blasts with strong CD56, CD117, CD7, and dim MPO, CD13, CD33, CD34 with negative expression for CD3, CD19, HLA-DR, CD123, CD15, and CD38—supportive of RAM phenotype. Molecular testing for CBFA2T3:GLIS2 was advised. Due to the patient’s frailty and advanced age, a conservative plan focusing on supportive care and hypomethylating agents was started; however, the patient succumbed within 48hours.
Discussion: This case highlights the unusual occurrence of RAM-phenotype AML in elderly, a presentation largely confined to pediatric cohorts and underscores the diagnostic challenge it poses, especially in TB-endemic areas, where symptoms may mimic infections or metastases. Elderly patients with RAM phenotype tend to experience rapid disease progression and high resistance to conventional therapies, often failing to achieve remission. Therefore, flow cytometry has a critical role in avoiding misdiagnosis and timely management.
Conclusions: The AML with RAM phenotype is associated with an inferior survival outcome. Hence, prompt immunophenotyping is essential for early diagnosis and appropriate management.
Keywords: RAM phenotype, immunophenotyping, marrow fibrosis |
| 364 |
"FLAER-Based Multiparameter Flow Cytometry for Sensitive Detection of PNH Clones" |
1991-08-14 |
Female |
No |
- | T2508 |
Benign |
Miscellaneous |
Laboratory |
Dr. Rashmi Kushwaha, Dr. S.P Verma , Dr. Mili Jain, Dr. Dr. Geeta Yadav, Dr. Sanjay Mishra, Dr. Suresh Babu |
Dr. Anjali Rachna |
King George's Medical University |
Lucknow |
9532956932 |
anjalirachna27@gmail.com |
Oral |
Title :"FLAER-Based Multiparameter Flow Cytometry for Sensitive Detection of PNH Clones"
Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disorder
characterized by intravascular hemolysis, thrombosis, and bone marrow failure. The advent of flow cytometry
using fluorescent aerolysin (FLAER) in combination with CD157, CD45, CD15, and CD64c (lineage-specific markers) has revolutionized PNH
diagnosis, enabling highly sensitive detection of glycosylphosphatidylinositol (GPI) anchor–deficient cells
Aim: To evaluate the diagnostic utility of FLAER-based multiparameter flow cytometry for the detection and
characterization of PNH clones in patients with suspected PNH or related bone marrow failure syndromes
Methods: A total of 70 patients with clinical suspicion of PNH or marrow failure syndromes were evaluated. Peripheral
blood samples were analyzed by multiparameter flow cytometry using FLAER in combination with CD157,
CD45, CD15, and CD64 to assess granulocyte and monocyte lineages. PNH clone sizes were categorized as
small (<10%), intermediate (10–50%), and large (>50%)
Results: Out of the 70 cases, 20 (28.6%) demonstrated detectable PNH clones, while 50 (71.4%) tested negative.
Among the positive cases, clone sizes varied: • Small clones (<10%) were observed predominantly in patients
with bone marrow failure syndromes. • Larger clones (>50%) were strongly associated with clinical hemolysis
Conclusions: FLAER-based flow cytometry combined with lineage-specific markers provides a highly sensitive and reliable
diagnostic tool for detecting and monitoring PNH clones. The early detection of even small clones is clinically
significant, facilitating timely diagnosis, risk stratification, and optimal patient management
Key words: Paroxysmal nocturnal hemoglobinuria, FLAER, flow cytometry, GPI anchor deficiency, bone marrow failure,
hemolysis. |
| 365 |
Dose Adjusted (DA) R CHOP – A novel way to treat elderly DLBCL
|
1989-03-12 |
Male |
No |
- | REM2d |
Malignant |
Leukemia & lymphoma |
Clinical |
|
Dr. faran naim |
Max super speciality hospital saket |
Delhi |
8935031630 |
Faran.naim.fn@gmail.com |
Oral |
Title: Dose Adjusted (DA) R CHOP – A novel way to treat elderly DLBCL
Introduction: DLBCL is the most common lymphoma in elderly population in Indian subcontinent. Unfortunately, there is no clear consensus on ideal and uniform way to treat these patients. There is lot of heterogeneity among this group and approach to treatment. Here we present our single center experience of novel way to treat these patients with standard of care R CHOP 21 regimen.
Methods: This is retrospective analysis of elderly DLBCL (65 years or above) patients treated at our center. Elderly patients were treated with R CHOP regimen with gradual dose escalation based on toleration. All patients received 50 percent dose of Adriamycin and Vincristine in cycle 1. Patients having significant infection requiring admission or ANC below 500 on 3 or more occasions continued on same dose of Adriamycin rest escalated to 75% dose in cycle 2 and 100% dose in cycle 3. Patients having ileus or grade 3 or more neurological toxicity continued on same dose of vincristine rest received 75% and 100% dose respectively in cycle 2 and 3.
Results: Total 45 elderly DLBCL patients were analyzed, 51% of patients presented with advanced stage III/IV disease. Out of these 44% (20) received DA R CHOP. Complete remission (CR) was achieved in 90% of cases. At a median follow-up of 16 months, the overall survival rate was 85%.
Conclusions: DLBCL is a curable lymphoma in elderly patients. Standard R CHOP regimen giving best PFS, but this regimen in elderly gives lot of morbidity and mortality in elderly patients. Our novel approach provides us chance to deliver standard of care in tolerating patients with less morbidity.
|
| 366 |
Cytogenetic Subtype-Specific Impact of End-of-Induction MRD on Outcomes in Pediatric B-ALL: Distinct Inferior Prognosis in TCF3::PBX1 Patients. |
1987-01-13 |
Male |
Yes |
L-1523 | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Karthik Bommannan B.K.1, Venkatraman Radhakrishnan2, Balaji Thiruvengadam Kothandan2, Prasanth Srinivasan2, Gargi Das2, Shirley Sundersingh 1. Department of Oncopathology1, Department of Medical Oncology2, Cancer Institute (W.I.A), Adyar, Chennai. |
Karthik Bommannan B.K. |
Cancer Institute (W.I.A) |
Chennai |
8872896711 |
bkkb87@gmail.com |
Oral |
Introduction: End-of-induction measurable residual disease (EOI-MRD) is a key prognostic marker in pediatric B-lineage acute lymphoblastic leukemia (B-ALL), yet its role across cytogenetic subgroups remains incompletely defined. Methods: We retrospectively studied treatment-naïve pediatric B-ALL patients diagnosed between January 2018 and December 2022, with follow-up through December 2024. Clinico-laboratory data, including cytogenetics, interphase-FISH, and EOI-MRD, were reviewed. Patients were stratified as standard risk (SR: hyperdiploidy, ETV6::RUNX1), poor risk (PR: BCR::ABL1, KMT2A rearrangements, hypodiploidy, iAMP21), or intermediate risk (IR: others). Sixty-month overall survival (OS) and relapse-free survival (RFS) were analysed.
Results: Among 244 patients, 232 (95%) had cytogenetic/FISH results, among whom 213 (92%) had EOI-MRD data, with 79 (37%) being EOI-MRD positive. Among SR-patients (n=66), EOI-MRD positivity significantly reduced RFS (67% vs. 89%, p=0.044) but not OS (79% vs. 95%, p=0.096). In IR-patients (n=129), EOI-MRD positivity predicted inferior survival (RFS 50% vs. 72%, p=0.008; OS 52% vs. 74%, p=0.003). Among PR-patients (n=18), EOI-MRD positivity decreased OS (67% vs. 100%, p=0.036), though RFS differences were not significant (67% vs. 92%, p=0.153). On analysing subtype-specific outcomes among EOI-MRD-positive vs negative patients, ETV6::RUNX1 patients (n=20) had the best OS irrespective of EOI-MRD status (100% vs. 80%, p=0.083), while EOI-MRD-positivity predicted universal relapse (RFS 79% vs. 0%, p=0.006). Hyperdiploid patients (n=46) had favourable outcomes when EOI-MRD-negative (RFS 100% vs. 83%, p=0.071; OS 92% vs. 78%, p=0.436). Notably, TCF3::PBX1 patients (n=18) with EOI-MRD-positivity had universally poor outcomes, with both RFS (0% vs. 66%, p=0.002) and OS (0% vs. 85%, p=0.002) being significantly worse. Subtype-specific EOI-MRD outcomes among PR-patients were not compared due to low numbers.
Conclusions: EOI-MRD is a robust prognostic marker across cytogenetic subtypes. EOI-MRD positive PR- patients and TCF3::PBX1 IR-patients require intensified EOI-MRD directed strategies, while EOI-MRD negative SR-patients and non-TCF3::PBX1 IR-patients may benefit from treatment de-escalation.
Keywords: Acute Lymphoblastic leukemia, MRD, Cytogenetics. |
| 367 |
RETICULOCYTE HEMOGLOBIN EQUIVALENT FOR THE DIAGNOSIS OF IRON DEFICIENCY ANEMIA IN UNDER-5 CHILDREN |
1999-01-29 |
Male |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
Dr. Pooja Dewan, Director Professor, Pediatrics; Dr. Mrinalini Kotru, Director Professor, Pathology |
Dr. Rohan Bhatt |
University College of Medical Sciences |
Delhi |
9650773962 |
rohan_bhatt@outlook.com |
Oral |
Title: RETICULOCYTE HEMOGLOBIN EQUIVALENT FOR THE DIAGNOSIS OF IDA IN UNDER-5 CHILDREN
Authors: Dr. Rohan Bhatt, PG Resident, Pediatrics, UCMS & GTBH; Dr. Pooja Dewan, Director Professor, Pediatrics, Dr. Mrinalini Kotru, Director Professor, Pathology
Introduction: Modern automated hematology analysers let us quantify the hemoglobin content of reticulocytes using the same vial of blood used for the estimation of hemoglobin for the diagnosis of anemia. Because of the short life span of reticulocytes, Ret-HE reflects the functionally available iron stores and shows potential as a novel IDA marker.
Methods: We screened children between the ages of 1 & 5 years presenting to the pediatrics OPD of GTB Hospital, Delhi. Based on hemoglobin and ferritin levels, children were divided into IDA (hemoglobin of <11 g/dL and serum ferritin <12 μg/L) & control groups (Hb ≥11g/dL & serum ferritin ≥12 μg/L). Children with latent ID (serum ferritin <12 μg/L but Hb≥ 11g/dL) were classified into a separate group. Iron profile testing (transferrin saturation(TS), TIBC, S. Iron) was performed for IDA and control groups.
Results: Ret-HE had the maximum area under the ROC curve for the diagnosis of IDA at 0.983 which was more than TS (0.931), TIBC (0.899) & serum iron levels (0.894). A Ret-HE cut-off of 21.65 pg was predicted to be optimal by ROC analysis. On testing the said cut-off with ferritin as the gold standard, Ret-HE had the best sensitivity (95.1%) and specificity (95.2%), better than TS <16% (sensitivity 87.3%, specificity 80%) and TS <20% (sensitivity 83.8%, specificity 94.7%).
Conclusions: Ret-HE is a rapid, cost effective diagnostic test for IDA which performed better than traditional iron profile markers in the diagnosis of IDA in our study. Ret-HE at a cut-off of < 21.65 pg can be used for IDA diagnosis.
Keywords: Reticulocyte hemoglobin equivalent, Ret-HE, Iron deficiency anemia, Children |
| 368 |
Utility of T/B/NK Single-Platform Flow Cytometry on BD Lyric for Detecting Inborn Errors of Immunity in Paediatric Patients: A Study from a Large Tertiary Care Hospital in India |
1999-09-23 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Laboratory |
Dr. Vandana Puri, Dr. Gunjan Batra, Dr. Shailaja Shukla, Dr. P.L. Jyotsna |
Dr. Shikha Menon |
Lady Hardinge Medical College |
Delhi |
9909892208 |
shikhashailesh23@gmail.com |
Poster |
Title: Utility of T/B/NK Single-Platform Flow Cytometry on BD Lyric for Detecting Inborn Errors of Immunity in Paediatric Patients: A Study from a Large Tertiary Care Hospital in India.
Introduction: Inborn Errors of Immunity (IEI), are a diverse group of disorders caused by defects in immune system development or function, presenting with recurrent infections, autoimmunity, or allergy. Early diagnosis reduces morbidity, mortality, and guides targeted therapy. Flow cytometry is a rapid and reliable screening tool. This study assesses the diagnostic utility of a T/B/NK single-platform flow cytometry (FCM) assay on BD Lyric in suspected paediatric IEI, emphasizing cost-effectiveness in resource-limited settings.
Methods: This retrospective study included 62 patients (<18 years; 41 males, 21 females) with clinically suspected IEI. The most common presentations were sepsis and recurrent pneumonia. Serum immunoglobulins were reduced in 75% of suspected Agammaglobulinemia cases. FCM used CD3 (T cells), CD19 (B cells), and CD16/CD56 (NK cells) to quantify subsets. Abnormal values were followed by advanced panels for definitive diagnosis and classification of immunodeficiencies. Based on their immunophenotypic profiles, patients were classified into distinct subtypes of IEI.
Results: Of 62 cases, 25% (16/62) showed CD19 underexpression with reduced Serum Immunoglobulins, with or without CD3/CD16/CD56 overexpression, suggesting Agammaglobulinemia. Similarly, 16% (10/62) showed CD3 underexpression, further subtyped as; 30% (3/10) showed CD3 and CD19 underexpression with CD16/CD56 overexpression (T-/B-/NK+), 20% (2/10) showed CD3, CD16/CD56 underexpression with CD19 overexpression (T-/B+/NK-), 40% (4/10) showed CD3 underexpression with CD19, CD16/CD56 overexpression (T-/B+/NK+) and 10% (1/10) showed ) global underexpression of CD3, CD19, CD16, and CD56 (T-/B-/NK-) suggesting SCID.
Conclusions: Single-platform T/B/NK flow cytometry is a rapid, reliable, and cost-effective preliminary diagnostic tool for IEI. It enables early detection and timely management, with particular relevance in resource-constrained healthcare settings like India.
Key words: : Inborn Errors of Immunity, Flow cytometry, BD Lyric system, T/B/NK |
| 369 |
Clinical Outcome of Hydroxyurea with Thalidomide in Patients of Hb E Beta Thalassemia and its Relationship with XmnI Polymorphism- Interim Analysis from a Prospective interventional study |
1989-02-04 |
Male |
Yes |
L-2199 | H_LKO |
Benign |
Anemia |
Clinical |
DR RAJIB DE PROFESSOR DEPARTMENT OF HEMATOLOGY, NRSMCH; DR SHUVRANEEL BAUL , ASSOCIATE PROFESSOR, DEPARTMENT OF HEMATOLOGY, NRSMCH ;DR T.K. DOLAI PROFESSOR AN HEAD DEPARTMENT OF HEMATOLOGY, NRSMCH |
MAYANK PANDEY |
Nil Ratan Sarkar Medical College and Hospital |
KOLKATA |
8910204908 |
vikramadityamp@gmail.com |
Oral |
Title: Clinical Outcome of Hydroxyurea with Thalidomide in Patients of Hb E Beta Thalassemia and its Relationship with XmnI Polymorphism- Interim Analysis from a Prospective interventional study
Authors: Mayank Pandey, Rajib de, Shuvraneel Baul, T.K Dolai
Introduction: Hemoglobin E/β-thalassemia is one of the most prevalent hemoglobinopathies in South and Southeast Asia, with considerable clinical heterogeneity ranging from transfusion dependence to milder phenotypes. Hydroxyurea and thalidomide are established fetal hemoglobin (HbF) inducers with proven benefit in reducing transfusion requirements. Genetic modifiers, particularly the XmnI polymorphism, influence HbF production and disease severity. This study evaluates the clinical outcomes of hydroxyurea plus thalidomide therapy and its correlation with XmnI polymorphism.
Methods: This prospective interventional study has a sample size of 66 patients with Hb E/β-thalassemia aged 18–50 years, who receive hydroxyurea for at least six months prior to inclusion. Patients receive hydroxyurea (10–20 mg/kg/day) plus thalidomide (1–2 mg/kg/day, max 50 mg) and are to be followed for six months. Hemoglobin levels, HbF levels, serum ferritin, transfusion requirements, and adverse effects are monitored at base line , at 3 months and at 6 months. XmnI polymorphism is assessed at baseline using PCR-RFLP. Data are analyzed with SPSS v16, with significance at p<0.05.
Results: 50 patients have been enrolled in the study till date. Preliminary data suggests that addition of thalidomide to hydroxyurea results in a significant decline in transfusions frequency, increment of HbF levels with no major adverse effects. XmnI polymorphism leads to a better response.
Conclusions: interim data from the study provides evidence on the efficacy of hydroxyurea-thalidomide therapy in Hb E/β-thalassemia and establishes the predictive value of XmnI polymorphism, potentially guiding personalized therapy in this population.
Key words: Hb E beta thalassemia, hydroxyurea, thalidomide, fetal hemoglobin, XmnI polymorphism, transfusion |
| 370 |
:Genomic landscape of acute lymphoblastic leukemia- clinical and prognostic correlates. |
1996-10-04 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Ayush Agarwal, Mehak Trehan, Shubham Goswami, Jasmita Dass, Mukul Aggarwal, Manoranjan Mahapatra |
Abhinav Sengupta |
AIIMS |
New Delhi |
9903085044 |
abhinav04101996@gmail.com |
Poster |
Title:Genomic landscape of acute lymphoblastic leukemia- clinical and prognostic correlates.
Introduction: Acute lymphoblastic leukemia harbors diverse genomic alterations, including fusions and mutations, critically shaping clinical behavior and prognostic outcomes.
Methods: We retrospectively analysed 107 patients diagnosed with acute lymphoblastic leukemia in a tertiary care facility over 2 years who had undergone next-generation sequencing to detect DNA mutations and RNA fusions. We described the baseline mutation profile and analysed treatment outcomes in form of induction mortality, complete remission, and measurable residual disease.
Results: There were 107 patients who were diagnosed with ALL, 67.3% were B-ALL. The median age was 20 years (12- 33), and AYA formed the largest cohort (39.4%). 74 (71.2%) were male. Fusions were detected in 48 (44.9%) patients, 21 (43.8%) were Ph-positive ALL, and 4 (8.3%) had Ph-like translocations. PAX5 was the most common translocation partner in Ph-negative ALL (12.5%). Among cytogenetically normal patients, fusions were detected in 23.3%. NGS detected mutations in 76 (71.0%) patients with a median (IQR) of 1 mutation detected. Elderly ALL had significantly higher mutation burden 1.5 (1- 4), and pediatric group the least at 0 (0- 1), p=0.002. The most frequent derangement was seen in tumor suppressor pathway (41%), with the CDKN pathway most commonly affected. The next most common mutations were in the signaling pathways, with RAS pathway most commonly altered. Among the patients, 82 were treated with induction mortality of 34.2%. 25.6% patients were MRD positive at end of induction. Seven TP53-mutated ALL were treated, three died in. The rest except one went into MRD positive CR. One patient developed very early relapse. Ph-like signature had adverse outcomes, with MRD positive at end of consolidation in both treated patients.
Conclusions: NGS identified prognostic fusions and mutations in cytogenetically normal ALL patients helping risk stratification.
Keywords: ALL, NGS, Prognostic biomarkers
|
| 371 |
Paediatric Chronic Myeloid Leukemia, usual haematological cancer presenting at unusual age – series of 8 cases |
1995-01-23 |
Male |
No |
- | pay_R |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Vishvdeep Khushoo2, Richa Juneja1, Akriti Khare1, Santosh Rathod2, Chetana Arunrao Mandaokar , Rasika Gadkari 1. Department of Pathology1, Department of Medical Haematology2, All India Institute of Medical Sciences, Nagpur. |
Syed Taha Hussain |
All India Institute of Medical Sciences, Nagpur |
Nagpur |
9550248164 |
sthussain95@gmail.com |
Poster |
Title: Paediatric Chronic Myeloid Leukemia, usual haematological cancer presenting at unusual age – series of 8 cases.
Authors: Syed Taha Hussain1, Vishvdeep Khushoo2, Richa Juneja1, Akriti Khare1, Santosh Rathod2, Chetana Arunrao Mandaokar , Rasika Gadkari 1
Institute: Department of Pathology1, Department of Medical Haematology2, All India Institute of Medical Sciences, Nagpur
Introduction: Chronic myeloid leukaemia(CML) affecting children and adolescence is relatively rare. Due to lack of robust evidence, CML management in children is not standardized and often follows guidelines developed for adults.
Methods: Out of total 169 CML cases, 8 paediatric CML were diagnosed between september2022 to march2025 at our center. Relevant clinicopathological data and treatment details were retrieved from the hospital information records and studied.
Results: The age ranged from 5 to 18 years with a median age of 16 years. There was male predominance with a male to female ratio of 6:1. The most common presenting symptom was fatigue. One of the cases presented with painful erection. Splenomegaly, lymphadenopathy and hepatomegaly were noted in 5, 2 and 1 case respectively. As per EUTOS score 2 cases were high risk. Peripheral smear was diagnostic of CML in all cases. Bone marrow was done in 6/8 cases. Six cases presented in chronic phase and one case each was detected in accelerated phase and blast crisis. In all cases diagnosis was confirmed with RT PCR and Major BCR ABL transcript was detected. The patient with blast crisis succumbed to disease due to ICH before therapy. Rest 7 cases were started on TKI therapy and we intend to discuss their response and treatment outcome.
Conclusion: We detected 8 paediatric CML over 2.5 years with varied presentation. Differences in disease biology, treatment strategies and its rarity make paediatric CML an important area for collaborative/larger studies in future.
Key words: Paediatric Chronic Myeloid Leukemia |
| 372 |
Unmasking Chronic ITP: Genetic Clues from Next-Generation Sequencing |
1994-05-25 |
Female |
No |
- | pay_R |
Benign |
Platelet disorders |
Laboratory |
Lavina Temkar1,Umair Ahmed Bargir1, Purva Kanvinde2, Ritika Khurana2, Maya Gupta1,Chandrakala Shanmukhaiah3, Amit Jain4, Ratna Sharma4, Pranoti Kini4, Omkar Khandkar5, Sujata Sharma6, Priyanka Setia1, Aparna Dalvi1, Shweta Shinde-Vhatkar1, Sangeeta Mudal |
Neha Jodhawat |
ICMR-NIIH |
Mumbai |
8097429573 |
nehajodhawat7@gmail.com |
Oral |
Title: Unmasking Chronic ITP: Genetic Clues from Next-Generation Sequencing
Introduction: Immune thrombocytopenia(ITP) is the most common acquired thrombocytopenia in children, diagnosed by excluding other conditions. Chronic ITP in children, traditionally viewed as an acquired disorder, may have underlying genetic component especially inherited platelet disorders(IPD) and inborn errors of immunity(IEI) which are often missed. ~40% of inherited thrombocytopenia patients are initially labeled as chronic ITP. This study investigates the use of next generation sequencing(NGS) and specific-specialized assays, to enhance diagnostic accuracy and guide management.
Methods: 56 pediatric patients with chronic ITP(platelet count <100*10⁹/L; ASH-2011 criteria) underwent clinical or whole-exome sequencing using NGS. Variant prioritization and classification were done as per ACMG best practice guidelines. Familial segregation studies and additional specialized assays (eg. lymphocyte subset, immunoglobulin, protein expression (WASP) ,etc) were performed depending on genetic findings.
Results:
he median age at presentation was 5.8 years (range: 3.3–8.5). All presented with thrombocytopenia, mostly petechiae and ecchymoses.
Thirty patients (53.6%) carried 39 variants; 14 were identified in IEI-related genes (IKBKB,WAS,IKZF3,ARHGEF1,IFNGR1, STAT3,STING1,NLRP3,C3,CFH,THBD,TERT), while 25 were in platelet-disorder genes (ANKRD26, GFI1B,HSPA6,F5,ITGA2B,SLFN14,VWF,JAK2,TUBA8,TPM4,MYH9,GP1BB,SERPINE1,GP1BA,PROS1,FLI1,TUBB8,CYCS). Pathogenic/likely-pathogenic variants were identified in VWF, WAS, and TPM4 in six patients(10.7%). Of these,three initially responded to steroids, two to IVIG (later relapsing), and one didn’t respond. Clinically significant variants of uncertain significance (VUS) were found in 24 patients (42.9%), mostly in platelet-associated genes. The remaining 26 (46.4%) had no detectable variants. Clinical responses among VUS carriers were heterogeneous. Importantly, sequencing results guided management: avoidance of immunosuppression in patients with ANKRD26 and GP1BB genes, and HSCT-consideration in WAS patient.
Conclusion: Sequencing identified clinically relevant variants in over half of pediatric chronic ITP patients, aiding differential diagnosis from IPD and IEI. Genetic findings influenced management. High number of VUS underscores the need for further studies to clarify their pathogenicity.
Keywords: Pediatric, chronic-ITP, genetic-sequencing, IPD, IEI
|
| 373 |
"Not All That Jaundice is GVHD: A Liver Biopsy Tale of Late-Onset VOD" |
1994-08-31 |
Male |
No |
- | 56153 |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dr mehak trehan AIIMS New Delhi,dr Manoranjan mahapatra AIIMS New Delhi |
Dr.Shubham Goswami |
All india institute of medical science AIIMS New D |
New delhi |
07725009334 |
shu3108@gmail.com |
Poster |
Title: Not All That Jaundices is GVHD: A Liver Biopsy Tale of Late-Onset VOD Background: Sinusoidal obstruction syndrome (SOS), also known as veno-occlusive disease (VOD), is a potentially life-threatening complication of allogeneic hematopoietic stem cell transplantation (HSCT). While classical SOS/VOD presents within the first 21 days with jaundice, painful hepatomegaly, and weight gain, late-onset forms occurring beyond day +21 are increasingly recognized, particularly following haploidentical HSCT. These atypical cases may lack classical hallmarks, complicating diagnosis and delaying appropriate management. Case Presentation: A 41-year-old female with adverse-risk acute myeloid leukemia achieved complete remission after 3+7 induction and high-dose cytarabine consolidation. She subsequently underwent haploidentical HSCT using a fludarabine–busulfan–cyclophosphamide regimen with post-transplant cyclophosphamide for GVHD prophylaxis. On day +42, she developed progressive abdominal distension and hepatomegaly without jaundice. Ascitic fluid analysis indicated portal hypertension, while liver enzymes were near normal and bilirubin rose modestly to 2.7 mg/dL. Infectious, autoimmune, and drug-induced etiologies were excluded. A diagnostic liver biopsy revealed zone 3 sinusoidal congestion, hepatocyte dropout, and delicate perisinusoidal fibrosis, confirming SOS. Due to financial constraints and absence of multi-organ dysfunction, she was managed conservatively with fluid restriction, diuretics, and avoidance of hepatotoxic medications. Gradual resolution of ascites and normalization of bilirubin ensued, and she was discharged in stable condition. Discussion: This case illustrates the diagnostic challenge of late-onset SOS, which often does not satisfy classical Baltimore or modified Seattle criteria. In such patients, biopsy may be indispensable to distinguish SOS from competing etiologies, particularly GVHD or viral hepatitis. While defibrotide remains the only approved therapy, supportive measures can suffice in milder presentations if recognition is timely. Conclusion: Late-onset SOS post haploidentical HSCT is an underrecognized entity that requires a high index of suspicion. Liver biopsy serves as a crucial diagnostic tool in atypical cases, enabling early institution of supportive care and favorable. |
| 374 |
Epidermal Necrosis with Fungal Hyphae Following L-Asparaginase Therapy in Acute Lymphoblastic Leukaemia with FLT3-ITD Mutation |
1995-08-16 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
|
Dr Prashant Gautam |
Himalayan Institute of Medical Sciences |
Dehradun |
9792877771 |
drprashantmishra1608@gmail.con |
Oral |
Title: Epidermal Necrosis with Fungal Hyphae Following L-Asparaginase Therapy in Acute Lymphoblastic Leukaemia with FLT3-ITD Mutation: A Rare Case Report with review of literature.
Abstract
Authors- Dr Prashant, Dr Avriti, Dr Ankit Batra
Background:
Acute lymphoblastic leukaemia (ALL) is the most common childhood malignancy, and L-asparaginase is a cornerstone of induction therapy. However, its immunosuppressive effects predispose to opportunistic infections. Cutaneous mucormycosis is a rare but life-threatening complication. The presence of FLT3-ITD mutation in ALL, though uncommon, may worsen prognosis and heighten infection risk.
Case Presentation:
We report a 14-year-old female with precursor B-cell ALL, harboring an FLT3-ITD mutation, who developed necrotic skin lesions following L-asparaginase therapy. On day 25 of admission, she presented with gangrene over the thigh. Histopathological examination of debrided tissue revealed full-thickness epidermal necrosis with broad fungal hyphae, confirmed on PAS and GMS staining. Laboratory evaluation showed severe neutropenia and Protein S deficiency. Radiology excluded disseminated infection. L-asparaginase was discontinued, and systemic antifungal therapy with liposomal amphotericin B was initiated along with wound debridement and G-CSF support. The patient showed gradual improvement, with resolution of lesions and recovery of neutrophil counts, allowing cautious resumption of chemotherapy.
Conclusion:
This case highlights a rare presentation of cutaneous mucormycosis with epidermal necrosis following L-asparaginase therapy in ALL with FLT3-ITD mutation. Early recognition, prompt histopathological confirmation, aggressive antifungal therapy, and surgical debridement were pivotal for survival. Clinicians should maintain a high index of suspicion for angioinvasive fungal infections in immunocompromised patients presenting with necrotic skin lesions during induction chemotherapy. |
| 375 |
Title
Parental Knowledge Gaps and Challenges in Childhood Malignancy: A Cross-Sectional Study at a Tertiary Care Centre in North India |
1997-08-22 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
|
Dr Divya Sharma |
Himalayan institute of medical science |
Dehradun |
9354386376 |
divyasharma10f36@gmail.com |
Oral |
Title
Parental Knowledge Gaps and Challenges in Childhood Malignancy: A Cross-Sectional Study at a Tertiary Care Centre in North India
Introduction
Childhood cancers constitute nearly 3% of all newly diagnosed cancers in India and remain a significant cause of mortality. Despite therapeutic advances, outcomes in low- and middle-income countries are hampered by delayed diagnosis, inadequate infrastructure, and limited supportive care. Parents are central to a child’s treatment journey, yet their awareness and the challenges they encounter are not well studied in the Indian setting. This study aims to assess parental knowledge and identify challenges faced during the management of pediatric malignancies.
Methods
This cross-sectional descriptive study will be conducted over 12 months in the Pediatrics and Oncology Departments of Himalayan Institute of Medical Sciences, Dehradun. Parents or caregivers of children under 18 years receiving treatment for newly diagnosed or relapsed malignancy will be recruited using stratified random sampling. Data will be collected using a predesigned, prevalidated semi-structured questionnaire translated into English and Hindi. Sociodemographic data will be recorded using the Modified Kuppuswamy Scale. Analysis will be performed using SPSS version 22 with descriptive and inferential statistics.
Results
The study will evaluate parental knowledge of pediatric malignancies and document key challenges such as financial burden, emotional distress, treatment-related uncertainties, and barriers to accessing care. Associations with socioeconomic and demographic variables will also be analyzed.
Conclusions
Findings are expected to provide evidence for developing structured educational interventions and psychosocial support strategies for families. The results may further inform policy integration of childhood cancer care in India to improve outcomes and quality of life.
Keywords
Childhood malignancy; Pediatric oncology; Parental knowledge; Psychosocial challenges; Supportive care; India |
| 376 |
Cutaneous First, Clonal Next: Morphea Profunda as a Rare Manifestation of Plasma Cell Dyscrasia |
1990-05-03 |
Male |
No |
- | pay_R |
Malignant |
Plasma cell disorders |
Clinical |
Prachi Pratichi Das, Sudha Sethy, Rabindra Kumar Jena, SCB Medical College & hospital |
Vivek Behera |
SCB Medical College & Hospital |
Cuttack |
9437194400 |
drvivekbeherahematology@gmail.com |
Poster |
Title: Cutaneous First, Clonal Next: Morphea Profunda as a Rare Manifestation of Plasma Cell Dyscrasia
Authors: Dr Vivek Behera1, Dr Prachi Pratichi Das2, Dr Sudha Sethy3, Dr Rabindra Kumar Jena4
Affiliation: SCB Medical College & Hospital, Cuttack
Introduction: Cutaneous manifestations in plasma cell dyscrasias are rare and often under-recognized. Morphea profunda, a localized scleroderma variant, has been reported in association with monoclonal gammopathies and multiple myeloma, usually as part of paraprotein-related dermatoses. We report a case of multiple myeloma presenting with morphea profunda as an initial clue to diagnosis.
Case Presentation: A 75-year-old female presented with progressive skin tightening and pigmentation over the dorsum of the right forearm for 2 months, associated with generalized weakness, easy fatigability, and pallor. There was no Raynaud’s phenomenon, dysphagia, respiratory, renal, or other systemic features of connective tissue disease. Examination revealed pallor and localized tightening of skin extending from the metacarpophalangeal joints to the elbow. Laboratory evaluation showed anemia (Hb 7.3 g/dL), normal leukocyte and platelet counts, preserved renal and liver function, and elevated total protein (9.4 g/dL) with low albumin (3.8 g/dL). Serum protein electrophoresis detected an M-protein of 3.06 g/dL, immunofixation identified IgG kappa monoclonal protein, and serum free light chain assay showed an abnormal kappa/lambda ratio (5.34). Bone marrow aspiration revealed 20% clonal plasma cells, confirming multiple myeloma (ISS stage I). ANA and ENA profiles were negative. Skin biopsy demonstrated dense sclerotic collagen bands with lymphoplasmacytic infiltrates in lower dermis and subcutis, consistent with morphea profunda.
Conclusions: This case highlights morphea profunda as an unusual and rare cutaneous manifestation of multiple myeloma, falling under paraprotein-related dermatoses. Recognition of such atypical skin changes is crucial as they may serve as an early diagnostic clue to underlying plasma cell dyscrasia.
Key words: Multiple myeloma, Morphea profunda, Paraprotein-related dermatosis, Plasma cell dyscrasia, Cutaneous manifestation |
| 377 |
Neurological Complications in Sickle Cell Disease: Prevalence and Correlation with Risk Factors in an Eastern India Cohort |
1990-11-28 |
Female |
No |
- | pay_R |
Benign |
Anemia |
Clinical |
Vivek Behera, Sudha Sethy , Rabindra Kumar Jena, SCB Medical College & Hospital |
Prachi Pratichi Das |
SCB Medical College & Hospital |
Cuttack |
9090409417 |
prachipratichidas2811@gmail.com |
Poster |
Title: Neurological Complications in Sickle Cell Disease: Prevalence and Correlation with Risk Factors in an Eastern India Cohort
Authors: Dr Prachi Pratichi Das1, Dr Vivek Behera2, Dr Sudha Sethy3, Dr Rabindra Kumar Jena4
Introduction: Sickle cell disease (SCD) is a common hemoglobinopathy associated with significant neurological complications, including ischemic and hemorrhagic strokes and silent cerebral infarcts. These events contribute substantially to morbidity, but data from Eastern India are scarce.
Methods: This cross-sectional study was conducted in the Department of Clinical Hematology, SCB Medical College, from March 2024 till date. Patients with homozygous SCD (HbSS) were evaluated for clinical profile, transfusion history, VOC, and ACS. Investigations included CBC, Retic, LDH, ferritin, and D-dimer. MRI brain was performed in all patients to identify silent or overt neurological lesions. Statistical analysis was done using SPSS, with p < 0.05 considered significant. Results: Eight patients (n=8) had abnormal MRI findings. Lesions included infarcts (75%) and hemorrhage (25%), with clinically having seizures (25%), headache (25%), and asymptomatic findings (50%). Asymptomatic abnormalities comprised chronic ischemia, small vessel ischemic changes, and subcortical thinning. Patients with abnormal MRI had significantly higher LDH levels (2521 vs. 973.5 U/L, p=0.014) and absolute reticulocyte counts (9.45 vs. 3.85, p=0.034) than those with normal MRI. Other parameters, including hemoglobin, ferritin, and D-dimer, showed no significant association. Hemolytic phenotype predominated in patients with abnormal MRI (75%). Conclusions: Eight patients (n=8) had abnormal MRI findings. Lesions included infarcts (75%) and hemorrhage (25%), with clinically having seizures (25%), headache (25%), and asymptomatic findings (50%). Asymptomatic abnormalities comprised chronic ischemia, small vessel ischemic changes, and subcortical thinning. Patients with abnormal MRI had significantly higher LDH levels (2521 vs. 973.5 U/L, p=0.014) and absolute reticulocyte counts (9.45 vs. 3.85, p=0.034) than those with normal MRI. Hemolytic phenotype predominated in patients with abnormal MRI (75%).
Key words: SCD |
| 378 |
Megakaryocyte abnormalities: from ITP to myeloproliferative neoplasms |
1967-02-22 |
Female |
Yes |
L-1720 | 56166 |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Dr. Anil Irom & Jawaharlal Nehru Institute of medical sciences |
Rajkumari Banashree Devi |
Jawaharlal Nehru Institute of medical sciences |
Imphal East |
9366527125 |
rkbanashree@gmail.com |
Oral |
Title: Megakaryocyte abnormalities: from ITP to myeloproliferative neoplasms
Authors: Prof. Rajkumari Banashree Devi
Introduction:
Megakaryocytes are specialized & largest bone marrow cells which are responsible for the production of platelets. The platelets in turn are integral components in maintaining hemostasis & coagulation integrity. Normal mature megakaryocytes typically measuring 30-100 μm in diameter, have multilobed nuclei resulting from repeated endomitosis and pinkish granules in the cytoplasm. Megakaryocytes are usually located in singles, near vascular sinusoids away from the bony trabeculae. Alterations in morphology of megakaryocyte are the hallmark findings in several disorders, including ITP, myeloproliferative neoplasms, myelodysplastic syndromes etc.
Methods: Retrospective study. All cases ITP, MPNs & MDS (in whom bone marrow examination was available) were included.
Results: In benign condition like ITP, megakaryocytes are usually small immature with blue cytoplasm. Whereas large forms with hyperlobulated nuclei and abundant cytoplasm are seen in polycythemia vera in a background of hypercellular marrow. Similar large form with deeply lobulated nuclei is noted in essential thrombocythemia however the cellularity is either normocellular or hypercellular. In primary myelofibrosis, megakaryocytes are markedly atypical with bulbous and cloud-like nuclei, hyperchromatic disorganized chromatin, and usually show prominent clustering. Megakaryocytes in myelodysplastic syndrome also reveal atypical features such as small forms (slightly larger or similar to a promyelocytes) with single and round nuclei (micromegakaryocytes).
Conclusions:
Recognition of megakaryocyte morphology aids in diagnosis of different benign & malignant hematological disorders. Detailed assessment of megakaryocytes on bone marrow aspiration and biopsy is performed with light microscopy or digital imaging, In difficult cases, immunohistochemical markers such as CD61, CD41 and von Willebrand factor can assist in identification of megakaryocytes and distinguish between benign and neoplastic forms. |
| 379 |
An unusual case of Acute Promyelocytic Leukemia, morphology to the rescue! |
2001-01-10 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Mohammed Bilal Ali, Mohammad Burney, Zakaa Noori, Mouza AlSharhan, Pankhi Dutta. Dubai hospital |
Anwaar Alhadhrami |
Dubai Hospital-Department of Laboratory Medicine a |
Dubai |
00971502194977 |
anwaar_alkalali@hotmail.com |
Poster |
Title:An unusual case of Acute Promyelocytic Leukemia, morphology to the rescue!
Introduction:Acute Promyelocytic Leukemia (APL) is a medical emergency presenting with life-threatening coagulopathy necessitating early diagnosis & therapy. Typically, the patient presents with bleeding while thrombosis is rare (<10% of all APL cases). While morphology is the starting point, negative CD34 & HLADR on flowcytometry plays a critical role in the initial diagnosis (before molecular confirmation).
Method:We present a case of APL with an atypical immunophenotype & unusual clinical features.
Results:A 44 year old female presented with dizziness, petechiae, menorrhagia & visual disturbances. The haemoglobin was 10.1{reference-12-15gm/dl}, white blood cell, 49,000(reference- 3600-11000/ul), platelet count was 29,000 (reference-150000-450000/ul). Blood film showed abnormal hypergranular promyelocytes without classical faggot cells. Bone marrow (aspiration & biopsy) showed sheets of these cells. APML was diagnosed on morphology. Flowcytometry showed positive MPO, CD117, CD13, CD33, CD64, CD2 along with positive CD34 & HLA DR. Prothrombin time was 12.6 sec(reference 9.7-11.8), Activated Partial Thromboplastin Time (APTT) 23.2 sec(reference, 25.1 -37.7) while fibrinogen was 135 mg/dl (reference 200-400). ATRA (40 mg BD was started with dexamethasone(10 mg BD) & 2 gm of hydroxyurea. Within hours, she developed slurred speech and left sided weakness. CT and MRI confirmed a right middle cerebral artery infarct. There was no haemorrhagic conversion. She was started on aspirin with advice to keep platelets > 50,000/ul. PCR after 5 days showed PML::RARA gene of subtype BCR3. Next-generation-sequencing for myeloid markers detected FLT-3 (ITD).
Conclusion:This high risk case of APML is unusual for expression of CD34 & HLADR & also for developing a thrombosis. This case highlights unusual features of APL and also reiterates importance of morphology as ATRA was started based on morphology in spite of the atypical flow cytometry findings which was perhaps lifesaving.
Key words-APL, Acute promyelocytic leukemia, CD34, HLADR, cerebral infarct |
| 380 |
Title: Patterns of the dots: Diagnostic utility of scattergram in haematological malignancies. |
1997-05-28 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr Garima Goel(Professor), Dr Vaishali Walke(Professor & HOD)- Department of pathology& lab medicine. |
Shanmugapriya Arul |
AIIMS- All India Institute of medical sciences. |
Bhopal |
8189985085 |
shanmugapriyaarul7@gmail.com |
Oral |
Title: Patterns of the dots: Diagnostic utility of scattergram in haematological malignancies.
Background: New generation automated hematology analyzers provide numerical (Complete blood count) as well as graphical (scattergrams and histograms) data for predicting several inflammatory, infectious and hematological neoplastic conditions. The present study aimed to analyze the patterns of scattergrams in various hematological malignancies.
Methodology: The present study was an observational cross-sectional study carried out retrospectively for a period of one year including 427 confirmed and diagnosed cases of hematological malignancies. The CBC and scattergrams were analyzed on either Sysmex XN1000 and Mindray BC6800 hematology analyzers. The findings were correlated with peripheral smear and bone marrow findings.
Results: The scattergrams showed unique patterns for different hematological malignancies based on location, shape, size, density of the cells and their clustering. A total of 427 cases were been studied in which 143 cases were of ALL cases, 139 cases of AML cases along with 14 cases of APML and one case of AMML, 120 cases of CML and 10 cases of CLL. Unique scattergrams were observed in different hematological malignancies.
Conclusion: Pattern analysis of scattergram can be used as an effective aid to suspect and triage cases of hematological malignancies. It also helps to prioritize the evaluation of cases which needs further evaluation with molecular and cytogenetic studies.
Key words: Scattergram, Hematological malignancies, Automation, Hematological analyzer, Graphical data
|
| 381 |
CLINICO-ETIOLOGICAL PROFILE AND OUTCOME OF CHILDREN WITH APLASTIC ANAEMIA: THE REAL WORLD DATA FROM A TERTIARY CARE HEALTH CENTRE IN NORTH INDIA
Alka Yadav,1 N D Vaswani,1 Neeraj,2 Deepak3, Kanika3
1 professor, 2 assistant professor, 3 junior resident |
2007-09-13 |
Female |
No |
- | pay_R |
Benign |
Marrow failure |
Clinical |
Alka Yadav,1 N D Vaswani,1 Neeraj,2 Deepak3, Kanika3 1 professor, 2 assistant professor, 3 junior resident Department of Pediatrics , |
Kanika |
Pt. B. D. Sharma Post Graduate Institute of Medic |
Rohtak, Haryana |
09588382795 |
iscallpgimsrohtak@gmail.com |
Poster |
Title: CLINICO-ETIOLOGICAL PROFILE AND OUTCOME OF CHILDREN WITH APLASTIC ANAEMIA: THE REAL WORLD DATA FROM A TERTIARY CARE HEALTH CENTRE IN NORTH INDIA Introduction: Aplastic anaemia (AA) is caused by a variety of drugs, chemicals, toxins, and viruses. A significant number of patients classified as idiopathic has no definite aetiology identified. This study assessed the clinical-etiological profiles and outcome of children with AA in North Indian setting from August 2020 to July 2024 Method: This retrospective observational study included children (aged <14 years) with confirmed AA based on bone marrow examination according to the International Agranulocytosis and Aplastic Anaemia Study guidelines. HSCT was advised to all patients if feasible, and the rest were offered immunosuppressive therapy (IST) as horse ATG (40mg/kg/dose x 4 days) and cyclosporine. The epidemiology, clinical features, etiology, treatment, and outcomes were recorded for all cases. Results: We evaluated 51 cases with median age 10.1 years (range: 2-14 years). The median number of days between the onset of symptoms and diagnosis was 49 days (range: 17-124 days). The most common clinical presentation was fever (62.3%) followed by bleeding manifestations (56.3%) and pallor (50.5%). At presentation, 76.5% had very severe aplastic anaemia (VSAA), 17.6 % had severe aplastic anaemia (SAA), and 5.9% had non-severe aplastic anaemia (NSAA). Regarding etiology, 7.8% of cases had Fanconi's anaemia, 5.9 % PNH clone, 11.8% Parvo B19 infection, and 74.5 % were idiopathic. Only 21 cases received IST, seven patients died before definitive therapy while 14 referred for HSCT. The overall response rate was 52.4 %, with a complete response (CR) in 36.4% and partial response (PR) in 63.6%. Variables such as age, gender, socioeconomic status, duration of illness, duration from diagnosis to IST and type of IST had no correlation with outcome (p>0.05). Conclusions: VSAA is most common form with an 52.4% overall response rate to IST similar to the literature. |
| 382 |
Clinicopathological profile of symptomatic alpha thalassemia: a single centre study of 5 years |
1992-05-22 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
Shivani Kaushal, Ruchi Gupta, Dinesh Chandra, *Kausik Mandal, Manish Kumar Singh, Khaliqur Rahman, Mona Vijayran, Rajesh Kashyap. Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow. |
Laya Thomas |
Sanjay Gandhi Post Graduate Institute of Medical S |
Lucknow |
8129226447 |
layathomas22@gmail.com |
Poster |
Clinicopathological profile of symptomatic alpha thalassemia: a single centre study of 5 years Laya Thomas, Shivani Kaushal, Ruchi Gupta, Dinesh Chandra, *Kausik Mandal, Manish Kumar Singh, Khaliqur Rahman, Mona Vijayran, Rajesh Kashyap Introduction -The study aimed at characterizing the clinic-pathological features of α-thalassemia at a tertiary care center in India. Methods A retrospective study of all suspected alpha thalassemia cases reported over a period of five years June 2020-June 2025. Baseline demographics, laboratory data were extracted from electronic medical records.Anemia was classified as severe,moderate mild. HPLC was performed on Biorad Variant II analyzer, and patients with HbA2 levels less than 2.0%, were screened.Low iron stores and absence of molecular data were excluded from the study. Molecular diagnosis performed by Multiplex Ligation dependent Probe Amplification and sanger sequencing were performed in limited number of samples. Results: A total of 33 patients suspected of having alpha thalassemia were included, accounting for 0.6% of all cases of hemoglobinopathies. Median age at diagnosis 23 years. Distribution by age revealed 25% patients <14 years and 75% in the above 14- year age group. Clinically, patients presented with severe anemia was predominant among children under 12 years (46%), whereas moderate anemia was most common in adults (44%). Hematological profile included microcytic hypochromic indices MCV-66 ± 8 fl, MCH -20 ± 3pg and MCHC - 29 ± 3g/dl) with raised red blood cell count (4.6 ± 0.9), RDW 20 ± 2 and reticulocyte count (median 3.5%). The median HbA2 levels by HPLC was 1.6%(range 1.1-2.0%). Pre-integration peaks were detected in 26 cases. The most common molecular defect was-α³.⁷ deletion noted in 12 cases. Additionally,in three cases point mutations and deletions in HbA2 gene were detected. Conclusion -Microcytic hypochromic indices, pre-integration peaks showed a strong correlation with underlying deletions in MLPA. Sequencing may help in point mutations/small deletions. |
| 383 |
Mixed Phenotypic Acute Leukemia: Series of four cases |
1987-02-09 |
Female |
No |
- | Ref7n |
Malignant |
|
Laboratory |
|
Garima Sharma |
Dr Ram Manohar Lohia Institute of Medical Sciences |
Lucknow |
8756745024 |
drgarima.gsvm@gmail.com |
Poster |
Title:Title: MPAL: Series of four cases
Authors: Sharma G, Awasthi NP, Goswami K, Singh P, Hussain N
Abstract:
Introduction. : Acute leukemia of ambiguous lineage (ALAL) encompasses mixed-phenotype acute leukemia (MPAL), which is immunophenotypically different and co-express more than one cell lineage, and acute undifferentiated leukemia (AUL), which lacks sufficient immunophenotypic differentiation along any cell lineage. MPAL constitutes small fraction of acute leukemias representing less than 5%. It is associated with poor prognosis, early relapse and extramedullary infiltration. Diagnosis of MPAL requires a comprehensive approach taking into account morphological and immunophenotypic characteristics (lineage attributes), cytogenetic and molecular features (biological attributes), and clinical history (clinical attributes). Here we present a series of four cases of MPAL reported at our institute from.
Materials and methods: We present a case series of four patients diagnosed with MPAL over a period of five years from 2020 to 2025 at our institution. All patients underwent detailed clinical evaluation, complete blood counts, peripheral smear examination, bone marrow aspiration and trephine biopsy. Flow cytometry was performed using an extended panel of myeloid, B-lymphoid, and T-lymphoid markers to establish lineage assignment according to WHO 2017 criteria.
Results: All four patients had varied presentation, three had splenomegaly, mucosal bleeding, and one had pancytopenia. Peripheral smear showed blasts with heterogeneous morphology. Bone marrow aspiration and biopsy revealed hypercellular marrow with replacement by blasts. Flow cytometry confirmed the diagnosis of MPAL, T myeloid (2 cases), B Myeloid (1 case) and one case of CML in mixed phenotypic blast crisis-B myeloid by demonstrating co-expression of markers of myeloid and lymphoid lineages in all cases. Patients were initiated on induction chemotherapy; however, outcomes varied due to disease aggressiveness and treatment-related complications.
Conclusion: MPAL is an uncommon but aggressive hematological malignancy with variable clinical outcomes. Splenomegaly, mucosal bleeding, and pancytopenia should raise suspicion for acute leukemia, and comprehensive evaluation including flow cytometry is essential for accurate diagnosis. Early recognition and subtype identification are critical for guiding therapy and prognostication.
Introduction:
Methods:
Results:
Conclusions:
Key words: |
| 384 |
Clinical profile and long-term outcomes of Acquired Pure Red Cell Aplasia in adolescents and adults: A single center retrospective study.
|
1994-07-02 |
Male |
No |
- | 11111 |
Benign |
Marrow failure |
Clinical |
ARIHANT JAIN, ADDITIONAL PROFESSOR |
Paras Gupta |
PGIMER Chandigarh |
PGIMER Chandigarh |
08506879624 |
parasguptaucms@gmail.com |
Poster |
Background: Pure red cell aplasia (PRCA) is a rare hematological disorder characterized by selective suppression of erythropoiesis. Limited data exist regarding the clinical profile and outcomes of PRCA with different treatment strategies. Methods: We conducted a retrospective analysis of patients diagnosed with PRCA at our center from January 2005 to December 2024. Diagnosis was based on standard criteria. Clinical characteristics, time to diagnosis, laboratory findings, bone marrow morphology, underlying etiologies, treatment approaches, and outcomes were evaluated. From 2014 onwards, all patients underwent flow cytometry to detect circulating T-large granular lymphocyte (LGL) clones. Patients with PRCA secondary to hematologic malignancies or post-transplant were excluded. Complete response (CR) was defined as sustained hemoglobin >10 g/dL for ≥8 weeks without transfusion, and partial response (PR) as hemoglobin >8 g/dL for ≥8 weeks without transfusion. Responders included those achieving CR or PR; non-responders remained transfusion-dependent. Event-free survival (EFS) was calculated from relapse or death. Results: The median age was 46.5 years (range, 15–75), with a female predominance (55.3%). The median time from symptom onset to diagnosis was 2 months. Among identified etiologies, a circulating LGL clone was present in 14/18 (77.7%), while parvovirus infection was detected in 3/46 (6.5%). First-line therapy consisted primarily of cyclosporine (5 mg/kg/day for 6–18 months) combined with prednisolone (1 mg/kg/day tapered over 6 weeks) in 78% of patients. Other regimens included calcineurin inhibitor (CNI) with intravenous immunoglobulin (4.3%), mycophenolate mofetil (6.4%), and thymectomy (10.6%). Two or more lines of therapy were required in 19.5% of patients. The response rate was 56% at 3 months, 61% at 6 months, and 82.6% at last follow-up. Among second-line treatments, danazol was most frequently used (53.3%), followed by mycophenolate mofetil (20%). The presence of an LGL clone correlated significantly with treatment response (100% vs. 50%, p = 0.0392). Age, treatment delay, lymphoid aggregates |
| 385 |
Duration of B-cell Aplasia following anti-CD19 CAR-T cell therapy in Relapsed or Refractory Leukemia and Lymphoma: VELCART Trial |
1990-09-11 |
Male |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Arun Kumar Arunachalam, Uday Kulkarni, Mohammed Yasar, Arvind Venkatraman, Swathy Palanikumar, Reeshma Nair Radhakrishnan, Majeela Solomon, Abirami Rajasekaran, Phaneendra Venkateswara Rao Datari, Sushil Selvarajan, Anu Korula, Aby Abraham, Biju George, |
Hamenth Kumar Palani |
Christian Medical College Vellore |
Vellore |
9003562033 |
hamenth@cmcvellore.ac.in |
Poster |
Title: Duration of B-cell Aplasia following anti-CD19 CAR-T cell therapy in Relapsed or Refractory Leukemia and Lymphoma: VELCART Trial
Introduction: Anti-CD19 CAR-T cell therapy is an established treatment modality for relapsed or refractory (r/r) B-cell leukemias and lymphomas. This study investigated the efficacy of point-of-care manufactured CAR-T cells, with B-cell aplasia serving as a surrogate marker of therapeutic activity.
Methods: In this phase 1 dose-escalation study, ten patients with r/r disease, comprising B-ALL (n=6) and B-cell lymphoma (n=4), were enrolled. Autologous anti-CD19 CAR-T cells were manufactured using a second-generation lentiviral vector (LTG1563, Miltenyi Biotec) on the CliniMACS Prodigy platform. B-cell aplasia was assessed by flow cytometric quantification of B cells and evaluation of serum immunoglobulin levels.
Results: All patients received fresh CAR-T infusions with a median transduction rate of 38%. Complete remission (CR) was achieved in 100% of B-ALL cases and 50% of lymphoma cases by 3 months. At a median follow-up of 1.8 years, 8 of 10 patients remained progression-free. B-cell aplasia was sustained in all patients until day 90, with two ALL patients demonstrating B-cell reconstitution at 6 months and 12 months, respectively, while maintaining remission up to the last follow-up (1.5 years). Hypogammaglobulinemia persisted in 8 of 10 patients beyond 2 years, except two patients showed IgG recovery at one year post-infusion.
Conclusions: Data from the phase 1 VELCART trial demonstrate that point-of-care manufactured CAR-T cell therapy is both effective and well-tolerated. The safety profile is consistent with that of other CAR-T products, and high complete remission rates were achieved across dose levels in heavily pretreated patients, supporting its potential as a treatment option for relapsed/refractory B-cell malignancies.
Key words: CAR-T, VELCART, Leukemia, Lymphoma. |
| 386 |
When the Rash Is Missing: CD123⁺/CD56⁻ BPDCN as a Leukemia Mimic |
1998-10-11 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Arunima Gupta¹, Dr. Meghna Tyagi¹, Dr. Mansi Kala¹, Dr. Avriti Baveja Batra², Dr. Smita Chandra¹ ¹Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, India ²Department of Clinical H |
Arunima Gupta |
Swami Rama Himalayan University |
Dehradun |
9996065477 |
arunimagupta1110@gmail.com |
Poster |
Title: When the Rash Is Missing: CD123⁺/CD56⁻ BPDCN as a Leukemia Mimic
Authors: Dr. Arunima Gupta¹, Dr. Meghna Tyagi¹, Dr. Mansi Kala¹, Dr. Avriti Baveja Batra², Dr. Smita Chandra¹
¹Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, India
²Department of Clinical Hematology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, India
Introduction:
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, aggressive hematologic malignancy. Cutaneous lesions are its hallmark, but marrow and nodal involvement are common, and CNS relapse may occur. Diagnosis is difficult as it can mimic acute leukemias, particularly acute megakaryoblastic leukemia (AML-M7)¹,².
Methods:
A pediatric patient suspected of acute leukemia underwent peripheral smear, bone marrow aspirate, and trephine biopsy. Immunophenotyping was performed with flow cytometry including CD123, CD4, CD7, CD33, CD34, TdT, CD117, CD41, CD42, and CD61. Cytogenetic testing and next-generation sequencing (NGS) were undertaken.
Results:
Peripheral smear and aspirate showed 58% blasts with high nuclear-cytoplasmic ratio, fine chromatin, and inconspicuous nucleoli. Trephine biopsy revealed near-complete marrow replacement by blasts with stromal fibrosis. Flow cytometry demonstrated strong CD123 with CD4/CD7 co-expression, dim/negative CD33, and absence of immaturity markers. Aberrant CD41 was present, but CD42/CD61 were absent, ruling out megakaryocytic lineage. Cytogenetics showed a 5q deletion, and NGS detected an MLL rearrangement. Collectively, these findings favored BPDCN over AML-M7.
Conclusions:
This case highlights the diagnostic challenge of BPDCN without cutaneous disease. Distinctive immunophenotyping and molecular studies are essential for distinguishing it from acute leukemia mimics and ensuring timely management of this aggressive neoplasm.
Keywords:
BPDCN, acute leukemia mimic, pediatric, CD123, AML-M7, flow cytometry, MLL rearrangement
|
| 387 |
TTPs Trojan horse : Metastatic Adenocarcinoma mimicking a Hematological emergency |
1998-06-04 |
Male |
No |
- | H_LKO |
Malignant |
Rare hematological malignancies |
Clinical |
Dr sarita ,Dr shivangi ,Dr gayatri ,Dr prateek ,Dr priyanka ,Dr Rajat |
Dr Parthasarathi Parida |
IMS &SUM HOSPITAL ,BHUBANESWAR |
BHUBANESWAR |
8249362561 |
parthaodang@gmail.com |
Poster |
TTPs Trojan horse : Metastatic adenocarcinoma mimicking a hematological emergency
Author: Dr Partha, Dr Sarita, Dr Shivangi, Dr Gayatri, Dr Prateek, Dr Priyanka Samal, Dr Rajat
Affiliation: IMS and SUM Hospital, Bhubaneswar
Background
Thrombotic microangiopathy (TMA) are a group of disorders characterized by microangiopathic hemolytic anemia (MAHA) and severe thrombocytopenia. TTP (thrombotic thrombocytopenic purpura) and HUS (hemolytic uremic syndrome) are the two main subtypes. TMA may be also a presenting feature of an underlying cancer, either occult or in association with metastases.
Case presentation
A 46-year male presented with backpain and breathlessness. On physical examination, he had mild pallor and no significant skin bleeds, organomegaly or lymphadenopathy was detected. Patient was known hypertensive, which was well controlled. Complete blood count showed bicytopenia with a haemoglobin of 7.1 g/dL, and platelet count of 29 x 103/L. The peripheral blood smear showed 12% schistocytes, prompting a diagnosis of microangiopathic hemolytic anemia. LDH elevated at 743 U/L. Coagulation screen including PT, APTT, TT and fibrinogen was within normal range, ruling out DIC. Serum creatinine was 1.0 mg/dl. Coomb’s Test was negative.Initial diagnosis of TTP was done and TPE was initiated.
Diagnosis
After 2 sessions of TPE, there was no significant improvement in platelet count or hemolysis. A bone marrow biopsy was also performed which revealed erythroid and megakaryocytic hyperplasia with focal infiltration by metastatic adenocarcinomatous deposits. This prompted a PET-CT scan which subsequently revealed irregular asymmetric thickening involving the terminal ileum, IC junction and caecum. Colonoscopic guided biopsy was planned.
Treatment
The initial management with TPE was ineffective and ultimately ceased upon confirming the diagnosis of metastatic adenocarcinoma. The treatment strategy was shifted to address underlying malignancy, as chemotherapy is the most effective therapy for CA-TMA.
Conclusion
Cancer associated thrombotic microangiopathy is seen in rare subset of patients with undiagnosed malignancies. This case report underscores the importance of considering metastatic adenocarcinoma in the differential diagnosis of TTP-like syndrome, particularly in patients who do not respond to TPE and have atypical features.
Keywords:TTP.,Adenocarcinoma
|
| 388 |
Study of DNA Ploidy in Childhood Acute Lymphoblastic Leukemia in Flowcytometry |
1996-08-25 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Shailaja Shukla, Director Professor in Department of Pathology, LHMC; Dr. Mukesh Dhankar, Professor in Deparment of Paedieatric, LHMC; Dr. Sunita Sharma, Director General of Health Services, MoHFW., GOI |
Dr. RASHMI KUMARI |
Lady Hardinge Medical College |
New Delhi |
08076510448 |
rashmigautam018@gmail.com |
Oral |
Title: Study of DNA Ploidy in Childhood Acute Lymphoblastic Leukemia by Flowcytometry
Introduction: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy in which the detection of chromosomal abnormalities plays an important diagnostic and prognostic role. Apart from structural chromosomal defects, numerical aberrations or defects in ploidy are present in approximately 30% of childhood B cell ALL serving as a well-established prognostic marker. Ploidy assessment by conventional cytogenetics (CG), including karyotyping and FISH, is laborious and time consuming. Flow cytometric (FCM) DNA analysis may be simpler and faster. In this study, DNA index (DI) derived by FCM DNA analysis was used for ploidy assessment and was correlated with immunophenotyping and other prognostic factors.
Methods: DNA content and laboratory features were evaluated in 45 newly diagnosed, pediatric ALL cases comprising 27 males and 18 females. FxCycle Violet DNA binding dye was used for determining DI by flow cytometry. The FCM DNA data was compared with corresponding conventional karyotyping, wherever available.
Results: In FCM ploidy, DI ranged from 0.64 to 2.12 and S-phase fraction (SPF) from 0.6-21.9%. Diploidy was seen in 23 (51.1%), hyperdiploidy in 12 (26.7%) and hypodiploidy in 10 (22.2%) cases. Aneuploid cases were associated with lower leukocyte counts (p=0.013) and diploid with thrombocytopenia (p=0.048) and elevated peripheral blood blast counts (p=0.026). There was no association of DI with age, gender and other clinico-haematological parameters. Elevated SPF was significantly associated with high-risk ALL category (p=0.047) but not with other clinico-haematological parameters. Karyotyping was performed in 26 cases with FCM DNA analysis showing 92.3% concordance.
Conclusions: FCM DNA ploidy analysis demonstrates high concordance with karyotyping and provides rapid detection of aneuploidy in ALL, thus, allowing early therapeutic intervention and helping in predicting patients outcome.
Key words: Flow cytometry, acute lymphoblastic leukemia, DNA index, aneuploidy, DNA ploidy.
|
| 389 |
Why Did the Clinical Hematologist Venture into Public Health? An Insight into Hybrid Hematology Practice in a City in Eastern India |
1971-01-07 |
Male |
Yes |
L-812 | H_LKO |
Benign |
Miscellaneous |
Clinical |
Abhijit Ghosh, Naren Roy |
Dr Prantar Chakrabarti |
Blood@Prantar.In |
Kolkata |
9433018899 |
prantar@gmail.com |
Oral |
Title: Why Did the Clinical Hematologist Venture into Public Health? An Insight into Hybrid Hematology Practice in a City in Eastern India?
Introduction: Clinical hematology in India is rapidly evolving, yet many conditions encountered in practice have broader public health implications. Hybrid care—balancing in-person visits with virtual consultations—offers a unique vantage point to study patient demographics, disease burden, and system-level gaps. This study examines how a clinical hematologist’s experience led to a natural extension into public health advocacy.
Methods: A retrospective observational analysis was conducted over 12 months (September 2024–August 2025) using three structured datasets: chief complaints, diagnoses, and medications. Patients were seen in person 5 days a month in Kolkata and virtually during the remaining period. Key variables analyzed included age, gender, presenting symptoms, diagnosis prevalence, and trends in drug utilization
Results: Data from 668 patients who consulted for the first time were analyzed. The most typical presenting symptom was weakness, with anemia present in 34% of the patients. 28% of these patients had already received more than two units of blood transfusion before consultation. 39.8% of the patients had iron deficiency anemia. 93 patients with HbE Beta Thalassemia were on follow-up. Several of these conditions—nutritional anemia, thalassemia, and vaccine-preventable infections—represent areas where early detection, genetic counselling, and community-level interventions could reduce burden.
Conclusions: The hybrid model of hematology practice unveiled a dual challenge: addressing complex hematologic diseases while confronting preventable conditions rooted in nutritional, infectious, and genetic backgrounds. This intersection highlights the imperative for hematologists to engage in public health initiatives—spanning awareness campaigns, rational drug use, vaccination, and genetic screening programs. Bridging clinical hematology with public health strategies can reshape outcomes and equity in resource-variable settings, justifying the hematologist’s venture beyond the clinic into the community.
Key words: Telemedicine, Iron-deficiency Anemia, Thalassemia, Public Health |
| 390 |
EFFECT OF HEMATOCRIT AND STORAGE TIME OF RECONSTITUTED BLOOD ON HAEMATOLOGICAL PARAMETERS OF NEONATES UNDERGOING EXCHANGE TRANSFUSION |
1994-12-07 |
Male |
No |
- | pay_R |
Benign |
Transfusion medicine |
Laboratory |
Dr. Tulika Chandra, Dr. Archana Solanki, Dr. Ashutosh Singh, Dr. Mala Kumar |
Dr. Shivam Azad |
King George's Medical University |
Lucknow |
8933956377 |
dr.shivamazad@gmail.com |
Oral |
Title: EFFECT OF HEMATOCRIT AND STORAGE TIME OF RECONSTITUTED BLOOD ON HAEMATOLOGICAL PARAMETERS OF NEONATES UNDERGOING EXCHANGE TRANSFUSION
Introduction: Exchange transfusion is the use of whole blood or equivalent to replace the neonate’s circulating blood and simultaneously removing bilirubin and maternal antibodies. Reconstituted blood for exchange transfusion is prepared by mixing RBCs (compatible with maternal serum or neonates’ serum) and AB plasma.
Methods: On receiving the request for reconstituted whole blood for exchange transfusion, both mother’s and baby’s samples were tested and reconstituted blood was prepared by mixing O negative PRBC with AB plasma. Exchange transfusion was performed by “Manual push and pull technique”. Volume of blood to exchange was calculated on the basis of the weight of the child. Double volume exchange transfusion was performed because it clears out 50% of bilirubin and 90% of neonatal red cells. The hematological parameters of the neonate were evaluated with respect to hematocrit and storage time of the reconstituted whole blood unit.
Results: For bilirubin levels, a significant difference in mean percentage change was observed between Group A and Group B. For sodium and glucose levels, a significant difference in mean percentage change was observed between Group C and Group D.
Conclusions: These findings suggest that in case of hematocrit of the reconstituted whole blood units, higher hematocrit is better as is it associated with better
reduction in serum bilirubin and better maintenance of oxygen saturation. In case of storage time of reconstituted whole blood units, O negative units less than 10 days old should be used, similar to the current standard practice.
Key words: Reconstituted whole blood, Exchange transfusion, Double volume exchange transfusion, Hematocrit, Push and pull technique. |
| 391 |
Frequency and Clinical Correlates of MECOM Rearrangements in Myeloid Neoplasms: An Indian Cohort Study. |
1984-10-29 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Shailja Thakur, Anshu, Vikash Kaushik Praveen Sharma, Pulkit Rastogi, Nabhajit Mallik, Narender Kumar, Prashant Sharma, Shano Naseem, Man Updesh Singh Sachdeva, Jasmina Talreja, Charanpreet Singh, Pankaj Malhotra, Reena Das, Sreejesh Sreedharanunni, PGIME |
Dr Harish Kumar |
PGIMER, Chandigarh |
Chandigarh |
8628052164 |
captharishc@gmail.com |
Poster |
Title: Frequency and Clinical Correlates of MECOM Rearrangements in Myeloid Neoplasms: An Indian Cohort Study. Introduction: MECOM (MDS1 and EVI1 complex locus) gene rearrangements, typically involving 3q26, are uncommon but clinically significant aberrations in myeloid neoplasms including AML, MDS and CML. These rearrangements are associated with adverse prognosis and poor response to therapy. We aim to explore the frequency of MECOM rearrangements and to compare clinico-hematological parameters in indian cohort in which it’s not well defined. Methods: We retrospectively reviewed 528 acute leukemia/ CML/ MDS cases, referred for fluorescence in situ hybridization (FISH) testing. All cases were analyzed using a standardized probe panel including 5q/5p, 7q/CEN7, CEN8, 20q, KMT2A break-apart (BA), NUP98 BA, MECOM BA, and TP53/CEN17 probes. Clinical variables such as age, sex, total leukocyte count (TLC), bone marrow blast percentage, and diagnostic category were correlated with MECOM rearrangement status. Results: MECOM rearrangements were identified in 19 of 528 patients (3.5%). The median age of MECOM-rearrangement cases was 50 years (IQR: 7–66), comparable to 41 years (IQR: 1–99) in the MECOM-r negative group (p = 0.032). Gender distribution was similar between the two cohorts (M:F, 1:1 vs 1.5:1; p = 0.568). Median bone marrow blast percentage did not differ significantly (26%, IQR 0–82 vs 38%, IQR 0–97; p = 0.472). Likewise, TLC was comparable (7.86 ×10⁹/L, IQR 1.35–226.04 vs 8.22 ×10⁹/L, IQR 0.12-49.3; p = 0.975). The majority of MECOM-positive cases were morphologically diagnosed as AML(52%) with 90% of these were AML with maturation. The commonest cytogenetic abnormality was monosomy 7. Conclusions: MECOM rearrangements were detected in 3.5% of patients, distinguished by significantly older age at diagnosis with no significant associations with sex, blasts count or TLC compared to rearrangement negative cases. These findings emphasize the diagnostic and clinical relevance of incorporating MECOM testing.
Keywords-MECOM rearrangement, AML, MDS, FISH. |
| 392 |
Comparative study of maternal soluble fms-like tyrosine kinase-1(sFlt-1)/ Placental Growth Factor (PlGF) ratio & platelet parameters in antenatal women with and without preeclampsia. |
1998-10-17 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
Dr. Geetika Sharma (Assistant Professor, Department of Pathology, Lady Hardinge Medical College), Dr. Sunita Sharma (Director Professor, Department of Pathology, Director General of Health Services, Ministry of Health and Family Welfare, New Delhi), Dr. R |
Dr. Anushka Dhawan |
Lady Hardinge Medical College |
New Delhi |
9983232933 |
anushkadhawan4@gmail.com |
Oral |
Title:Comparative study of maternal soluble Fms-like tyrosine kinase-1(sFlt-1)/ Placental Growth Factor (PlGF) ratio & platelet parameters in antenatal women with and without preeclampsia.
Introduction:Preeclampsia affects 2–8% of pregnancies worldwide, contributing to 46,000 maternal and 500,000 perinatal deaths annually. Angiogenic imbalance (elevated sFlt-1 & reduced PlGF levels) and platelet activation play a key role in the pathogenesis, reflecting endothelial dysfunction and thrombo-inflammatory activity. The study evaluated maternal serum sFlt-1/PlGF ratio and platelet indices in antenatal women with and without preeclampsia (28–37 weeks gestation) and their correlation with adverse outcomes.
Methods:A prospective analytical case-control study was conducted in 54 women with preeclampsia and 54 normotensive gestational age-matched controls. Serum sFlt-1 and PlGF levels were measured using ELISA immunoassay. Platelet indices were evaluated using automated hematology analyzer. All preeclamptic women were followed till delivery.
Results: Median gestational age in preeclamptic women was 35 weeks, IQR=32.0 – 36.0. Mean platelet count and mean PCT were significantly lower while PDW, MPV, P-LCR and IPF were significantly elevated in the preeclampsia group (all p < 0.005). Thrombocytopenia was more common in preeclampsia (p = 0.029). Preeclampsia cases showed elevated mean sFlt-1, sFlt-1/PlGF ratio and reduced PlGF levels than controls (p < 0.001). Higher median PDW, MPV, P-LCR and IPF was associated with adverse perinatal outcomes, however angiogenic biomarkers showed a non-significant trend. PlGF (≤109.3 pg/ml) best predicted adverse outcomes, sFlt-1 (>1876 pg/ml) & P-LCR (>45.9%) helped rule them out. No significant association was seen between platelet parameters and angiogenic markers.
Conclusions:Angiogenic biomarkers and platelet indices may aid risk stratification in preeclampsia. P-LCR emerges as cost-effective predictor of perinatal risk supporting early intervention.
Key words: Preeclampsia, sFlt-1/PlGF ratio, PDW, MPV, P-LCR, PCT, IPF, adverse maternal outcomes, adverse perinatal outcomes.
|
| 393 |
Clinico-hematological and molecular profile of Chronic Myeloid Leukemia : A study from a tertiary care teaching hospital in North India |
1998-11-05 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
P. Lalita Jyotsna, Jyoti Garg, Vandana Puri, Shailaja Shukla, Sunita Sharma, Department of Pathology |
Neha Budania |
Lady Hardinge Medical College, New Delhi |
New Delhi |
7014780961 |
nehabudania34@gmail.com |
Poster |
Title: Clinico-hematological and molecular profile of Chronic Myeloid Leukemia : A study from a tertiary care teaching hospital in North India
Introduction:Chronic myeloid leukemia is a clonal myeloproliferative disorder driven by BCR-ABL fusion oncogene. It can manifest with splenomegaly, cytopenias or constitutional symptoms, though in some cases it is detected incidentally as leukocytosis . While molecular diagnostics confirm the Philadelphia chromosome, clinico-hematological assessment remains central for diagnosis and phase determination.
Methods: A descriptive analysis of 23 CML patients between 2023 to 2025 was undertaken. Records were reviewed for clinical history, complete blood counts, peripheral smears, bone marrow aspirates/biopsies, NAP scores and cytogenetic studies.
Results: Patients ranged in age from 6 to 75 years (mean~36 years). Splenomegaly was the most common clinical feature presented followed by fever and anaemia like symptoms, with one case diagnosed incidentally. Hemoglobin ranged between 5.5-13.2 g/dL. Total leukocyte counts ranged from 62.8-726.92 x103/L, while platelet counts spanned 96-933 x109/L, reflecting both thrombocytopenia and thrombocytosis. Peripheral smears consistently revealed left-shifted granulopoiesis with myeloid precursors at all stages, along with frequent basophilia and eosinophilia. Bone marrow was uniformly hypercellular with granulopoietic predominance, showing myeloid cells in all stages of maturation along with increased eosinophils and basophils. In all cases, NAP score was consistently reduced (0 to 18) compared with controls. All cases were cytogenetically proven to carry Philadelphia chromosome translocation. Phase distribution showed 20 patients (86.95%) presented in chronic phase and 3 (13.05%) in blast crisis.
Conclusions: Most CML patients in our series presented in chronic phase with classical clinico-hematological features. Uniformly reduced NAP scores, together with cytogenetic confirmation, reinforced diagnostic relevance. Furthermore, occurrence of blast crisis cases emphasizes the need for careful phase recognition at presentation, with direct implications for management and prognosis.
Key words: Chronic myeloid leukemia, Myeloproliferative disorder, Clinico-hematological spectrum, Philadelphia chromosome, BCR-ABL, NAP score.
|
| 394 |
Impact of Updated WHO, ICC, and ELN 2022 Classifications on Acute Myeloid Leukemia: Insights from a Single-Centre Study |
1987-07-20 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Alpeshkumar Bipinbhai Kapadia1, Madhavi Maddali1, Phaneendra Datari1, Mithun Abraham Prakash1, Sujith Karumathil1, Uday Prakash Kulkarni1, Sharon Anbumalar Lionel1, Anu Korula1, Biju George1, Aby Abraham1, Poonkuzhali Balasubramanian1, Vikram Mathews1 1D |
Sathya Mani |
Christian Medical College Vellore, Ranipet campus |
Ranipet |
9751391841 |
smileesathya@gmail.com |
Poster |
Title: Impact of Updated WHO, ICC, and ELN 2022 Classifications on Acute Myeloid Leukemia: Insights from a Single-Centre Study.
Introduction: Acute Myeloid Leukemia (AML) classification has undergone substantial revisions with the 2022 updates from the World Health Organization (WHO), International Consensus Classification (ICC), and European LeukemiaNet (ELN). These guidelines emphasize genomic alterations in addition to conventional morphology and cytogenetics, transforming diagnostic and prognostic algorithms. This study aims to classify AML cases using WHO-2017, WHO-HAEM5, and ICC, and to stratify risk using ELN-2022 criteria.
Methods: We retrospectively analyzed all AML cases referred for cytogenetic and molecular testing between 2018 and 2025. Targeted NGS was performed using a customized myeloid gene panel on the Illumina platform with ≥250x coverage, and variants were annotated according to AMP/ACMG/VICC guidelines.
Results: According to WHO-2017, out of 215 AML cases, 108 (50.8%) were AML with recurrent genetic abnormalities (AML-RGA), 36 (16.7%) were AML with myelodysplasia-related changes (AML-MRC), and 71 (33.0%) were AML not otherwise specified (AML-NOS). All AML-RGA cases remained the same under WHO-HAEM5 and ICC 2022. Of the 71 AML-NOS cases, 21 (29.6%) were reclassified as AML-MR under WHO-HAEM5. Using ICC 2022, 107 cases (AML-MRC + AML-NOS) were reclassified as AML-Myelodysplasia related gene mutations in 33 cases (30.8%), AML-MRC in 27 (25.2%), and AML with TP53 mutation in 13 (12.1%), while 34 (31.8%) remained AML-NOS. ELN-2022 risk stratification showed 76 cases (35.3%) as favorable, 62 (28.8%) as intermediate, and 77 (35.8%) as adverse risk.Conclusions: The WHO-HAEM5, ICC, and ELN updates highlight the pivotal role of molecular genetics in AML classification and prognosis. In our study, nearly one-third of cases initially diagnosed as AML-NOS under WHO-2017 were reclassified into clinically meaningful categories, underscoring the importance of comprehensive cytogenetic and molecular testing for accurate AML subtyping and risk assessment. Keywords: Acute Myeloid Leukemia (AML), Next-Generation Sequencing (NGS).
|
| 395 |
Prevalence and effect of MYD88L265P mutation in Diffuse Large B Cell Lymphoma patients |
1994-01-15 |
Male |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Authors: Nauris Quamar*, Bharat Vikram, Shivani Kaushal, Manish Singh, Dinesh Chandra, Ruchi Gupta, Mona Vijayaran, Sayan S Roy, Sanjeev, Rajesh Kashyap, Khaliqur Rahman#. Author Affiliation: Department of Hematology (Lab), Sanjay Gandhi Postgraduate Inst |
NAURIS QUAMAR |
Sanjay Gandhi Postgraduate Institute of Medical Sc |
Lucknow |
08755198823 |
naurisquamar@gmail.com |
Oral |
Title: Prevalence and effect of MYD88L265P mutation in Diffuse Large B Cell Lymphoma patients
Introduction: MYD88 mutations are oncogenic drivers in diffuse large B-cell lymphoma (DLBCL), activating NF-κB signalling. While global prevalence ranges from 10-30%, with higher rates have been noted in extra nodal/immune-privileged site. Their prognostic impact remains variable across studies, often linked to poorer survival and relapse.
Methods: In this retrospective analysis of 45 patients of DLBCL, MYD88L265P mutations were assessed on the FFPE DNA using Allele Specific-PCR based detection. Data included cell-of-origin (COO), anatomical site, and clinical outcomes. Prevalence, subgroup associations, and outcome differences were evaluated using descriptive statistics and Fisher's exact test.
Results: MYD88L265P mutations were identified in 11/45 (24.4%) cases. Mutations showed similar prevalence rates in GCB (4/17, 23.5%) and non-GCB (7/28, 25.0%) subtypes. It was slightly higher in the DLBCL of extra nodal site as compared to the nodal sites (28.6% vs 20.6%). A significantly higher rates of MYD88 mutation was noted in cases with CNS lymphomas (4/8, 50%) versus non-CNS (7/37, 18.9%). Among cases with known outcomes, MYD88 mutated patients had higher mortality (5/8 dead, 62.5%) compared to wild type (11/24 dead, 46.2%), though not statistically significant (Fisher's exact p=0.68).
Conclusions: In this Indian cohort, MYD88L265P mutations were noted in 24.4% of DLBCL cases, with enrichment in CNS sites, supporting their role in aggressive subtypes. While outcome differences were not significant, it was associated with poorer outcome.
Key words: DLBCL, MYD88L265P mutation, CNS involvement, Prognosis |
| 396 |
From Marrow to Mucosa: Rare Extramedullary Manifestation of Multiple Myeloma |
2000-01-26 |
Male |
No |
- | H_LKO |
Malignant |
|
Clinical |
Dr Dinesh Kumar Sinha |
Dr Aman Kumar |
Indira Gandhi Institute Of Medical Sciences |
Patna |
7667204843 |
amankumarroy123@gmail.com |
Oral |
Title: From Marrow to Mucosa: Rare Extramedullary Manifestation of Multiple Myeloma.
Introduction: Multiple myeloma is a malignant plasma cell disorder primarily involving the bone marrow. Extramedullary spread occurs in a small subset of patients, with the gastrointestinal tract rarely affected. Colonic involvement is exceptionally uncommon and may clinically mimic colorectal carcinoma or lymphoma.
Methods: We present the case of a patient who attended our clinic with gastrointestinal complaints. Clinical presentation, diagnostic evaluation, histopathology, and management are detailed to highlight this unusual manifestation.
Results: A 62-year-old male with a 3-year history of multiple myeloma on intermittent therapy presented with progressive abdominal pain, altered bowel habits, and intermittent rectal bleeding. Colonoscopy revealed a friable mass in the sigmoid colon. Biopsy demonstrated dense sheets of atypical plasma cells, positive for CD138 and CD38, with lambda light chain restriction. Laboratory evaluation showed anemia (Hb 8.6 g/dL), elevated creatinine (2.1 mg/dL), and hypercalcemia (11.6 mg/dL). PET-CT revealed widespread disease with colonic involvement. The patient was commenced on systemic therapy with bortezomib, lenalidomide, and dexamethasone (VRd regimen). Supportive surgical consultation was sought for local obstruction risk, but conservative management was initially pursued. Despite therapy, the patient’s disease progressed, reflecting aggressive biology.
Conclusions: Colonic involvement in multiple myeloma is a rare extramedullary manifestation that can closely mimic primary colorectal malignancy. This case emphasizes the importance of histopathological confirmation to avoid misdiagnosis and ensure appropriate treatment. Awareness of such atypical presentations is essential, particularly in relapsed or refractory myeloma, where prognosis remains poor.
Key words: Multiple myeloma; Colon; Extramedullary disease; Case report; Plasma cell neoplasm; Gastrointestinal involvement |
| 397 |
Prognostic role of Hematological Inflammatory Ratios in Acute Ischemic and Haemorrhagic Stroke |
1984-08-20 |
Female |
Yes |
L-2156 | H_LKO |
Benign |
Miscellaneous |
Laboratory |
Dr Archna Verma, Dr Ashutosh Kumar Mishra, Dr Vikrant Singh Bhar, Dr Shradha Krupa Department of Pathology & Lab Medicine, Department of Neurology, AIIMS Raebareli, Uttar Pradesh, India. |
Vinita Paswan |
AIIMS Raebareli |
Raebareli |
9953916062 |
pathvinita20@gmail.com |
Poster |
Title: Prognostic role of Hematological Inflammatory Ratios in Acute Ischemic and Haemorrhagic Stroke
Introduction: Stroke is a leading cause of morbidity and mortality. Hematological inflammatory ratios such as Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Lymphocyte-to-Monocyte Ratio (LMR) have been proposed as prognostic markers. Their role in differentiating outcomes between ischemic and haemorrhagic stroke in elderly patients remains under investigation.
Methods: A cross-sectional study was conducted on 150 elderly stroke patients (≥60 years), including 121 ischemic and 29 haemorrhagic cases. Demographic features, comorbidities, haematological parameters (TLC, NLR, PLR, LMR), and modified Rankin Scale (mRS) scores at discharge were analysed. Independent t-tests and chi-square tests were used to compare stroke subtypes and outcomes
Results: Ischemic stroke predominated (80.7%). Hypertension was the most common risk factor (64%), showing a borderline association with haemorrhagic stroke (p = 0.056). Mean NLR and TLC were significantly higher in haemorrhagic stroke (NLR: 10.1 vs. 4.7, p < 0.001; TLC: 12.2 vs. 10.4, p = 0.042). PLR and LMR showed no significant differences between subtypes. Functional outcomes were poor overall, with 74% of patients having Modified Rankin Scale(mRS) ≥4 at discharge. NLR emerged as the strongest predictor of poor prognosis, whereas PLR and LMR had limited predictive value
Conclusions: Patients with acute stroke, NLR was significantly elevated in haemorrhagic stroke and independently predicted poor functional outcome across subtypes. PLR and LMR were less reliable prognostic markers. Simple hematological indices may provide cost-effective tools for early risk stratification in both ischemic and haemorrhagic stroke.
Key words: Ischemic stroke, Haemorrhagic stroke, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Lymphocyte-to-monocyte ratio, Functional outcome |
| 398 |
Prevalence of BCL2, BCL6, MYC rearrangement in Diffuse Large B Cell Lymphoma and its clinicopathological effect. |
1990-10-02 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Co-Authors: Manish Singh, Bharat Vikram, Shivani Kaushal, , Dinesh Chandra, Ruchi Gupta, Mona Vijayaran, Sayan S Roy, Sanjeev, Rajesh Kashyap, Khaliqur Rahman#. Author Affiliation: Department of Hematology (Lab), Sanjay Gandhi Postgraduate Institute of M |
Dr. Shubhi Pandey Sharma |
Sanjay Gandhi Post Graduate Institute of Medical S |
Lucknow |
9406502868 |
shubhi.pandey210@gmail.com |
Oral |
Title: Prevalence of BCL2, BCL6, MYC rearrangement in Diffuse Large B Cell Lymphoma and its clinicopathological effect.
Introduction: Diffuse large B-cell lymphoma (DLBCL) is a biologically heterogeneous disease with variable clinical outcomes. This study was designed to assess the prevalence of Chromosomal rearrangements involving BCL2, BCL6, and cMYC in patients with DLBCL and evaluate their clinicopathological correlations.
Methods: 50 patients diagnosed with DLBCL were analyzed using fluorescence in situ hybridization (FISH) for BCL2, BCL6, and cMYC rearrangements. Clinical data, including demographic variables, stage, extranodal involvement, serum LDH levels, International Prognostic Index (IPI) score, etc were retrospectively reviewed. Statistical analyses were performed to identify associations between rearrangement status and clinicopathological features.
Results: A total of 50 patients with DLBCL, including 18 GCB and 32 non-GCB cases, were evaluated for gene rearrangements. The overall prevalence of BCL2, BCL6, and cMYC rearrangements was 14%, 20%, and 10%, respectively. Rearrangements involving BCL2 (21% vs. 11%) and cMYC (21% vs. 6%) were more frequent in the GCB subtype, whereas BCL6 rearrangements predominated in non-GCB cases (22% vs. 14%). No double-hit or triple-hit lymphomas were identified in this cohort. On immunohistochemistry (IHC), protein expression was observed in 100% of BCL2, 66% of BCL6, and 33% of cMYC rearranged cases. Conversely, among cases with IHC positivity, the corresponding rearrangement frequencies detected by FISH were 18.8% for BCL2, 18.1% for BCL6, and 16.7% for cMYC. Clinically, rearrangement-positive cases were significantly associated with advanced-stage disease (75% vs. 35% at stage III–IV), higher IPI scores, and elevated serum LDH levels (median 910 IU/L vs. 763 IU/L). However, no significant differences were observed with respect to age or gender distribution.
Conclusions: BCL2, BCL6, and cMYC rearrangements were detectable in a substantial subset of DLBCL patients and carry important clinicopathological implications.
Key words: BCL2, BCL6, MYC, FISH, DLBCL |
| 399 |
Acute leukemia on the cross-roads of lymphoid and myeloid differentiation – A Diagnostic Challenge. |
1995-07-25 |
Male |
Yes |
H-171 | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Prabodha Kumar Das (Professor), Dr. Ashutosh Panigrahi (Additional Professor), Dr. Somnath Padhi (Additional Professor) |
Dr. Aditya Tayade (Senior Resident) |
AIIMS |
Bhubaneswar |
8446001872 |
dr.adityatayade@gmail.com |
Oral |
Title: Acute leukemia on the cross-roads of lymphoid and myeloid differentiation – A Diagnostic Challenge.
Introduction: Classification of acute leukemia involves assigning lineage by resemblance of blast to normal progenitor cells which is helpful in deciding treatment & assessment at follow-up.
Acute leukemia of ambiguous lineage (ALAL) are those leukemia that either fail to show evidence of Myeloid, B-lymphoid or T-lymphoid lineage commitment, or show commitment to more than one lineage (MPAL) posing a diagnostic and therapeutic challenge owing to the different treatment regimens used for AML & ALL.
Case 1 - A 17y/Male with complaints of fever & generalized weakness & bilateral neck swelling for 1 month.
Patient was pale and tachypneic with generalized lymphadenopathy and Splenomegaly (3cm).
CBC showed hyperleukocytosis (3lacs/microL) with severe anemia and thrombocytopenia.
PS revealed 94% blasts.
Flow cytometry ETP ALL v/s MPO negative AML. BM Bx & IHC was s/o MPO negative AML. Started Leuko-pheresis f/b low dose Cytarabine & further managed with 7+3 induction & 3 cycles of high dose Cytarabine after which patient was MRD negative & counselled for Allo-SCT.
Case 2 - A 41y/Male patient with fever & bone pains since 1 month.
Patient was hemodynamically stable, mildly febrile with normal general and systemic examination.
CBC showed leukocytosis with low normal platelet count.
PS identified 77% blasts.
Flow Cytometry Positive for CD 34, 45, 33, 117, nuTdT, HLA-DR, cyCD3 (strong), CD7, CD5 (weak).
BM Bx IHC showed CD3(dim), CD117(strong and diffuse) leading to dilemma.
Careful review of the BM Bx IHC and flow cytometry graphs confirmed ETP-ALL.
Started on hyper-CVAD Regimen.
Conclusions: The two cases show how leukemia arising from very early progenitors may be difficult to differentiate albeit, the diagnostic significance in terms of treatment and follow-up disease monitoring is invaluable.
Key words: ALAL, MPAL, AML, ETP-ALL |
| 400 |
TITLE: REFRACTORY CYTOPENIAS IN PEDIATRIC AGE GROUP: MIRROR TO INBORN ERRORS OF IMMUNITY(IEI) |
1994-06-12 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Clinical |
|
Dr. Prisha Nankana |
SGPGIMS Lucknow UP |
lucknow |
09467195556 |
nankanaprisha@gmail.com |
Oral |
Title: REFRACTORY CYTOPENIAS IN PEDIATRIC AGE GROUP: MIRROR TO INBORN ERRORS OF IMMUNITY(IEI) Introduction: Refractory cytopenias ( Immune thrombocytopenic purpura(ITP)/ Autoimmune Haemolytic anemia(AIHA)/ Pure red cell aplasia (PRCA) / Autoimmune neutropenia (AIN) ) are frequent in pediatric age group, occurring in 30% of the patients. The treatment options available for these patients in second line and third line should be wisely chosen as per the underlying genetic disorder. We present here our data of the past 1 year of managing Refractory autoimmune cytopenias with inborn errors of immunity in the pediatric age group. Methods: Pediatric patients with refractory AIHA, ITP, PRCA and AIN who underwent a whole exome sequencing (WES) and had an Inborn error of immunity (IEI) treated in the past 1 year from July 2023- July 2024 at Sanjay Gandhi Post graduate Instititute of Medical Sciences, Lucknow were included in the study. Results: A total of 10 patients with Refractory Autoimmune cytopenias had a confirmed IEI. Three had PRCA (1 BLNK-, 2 ADA 2 deficiency), 3 had Evans syndrome (1 CBL, 1 ANKRD26 with IRF2BP2, 1STAT3 GOF), 2 had Chronic ITP (RASGRP2-, NCKAP1L), 1 had AIN (ADA2 def) and 1 patient had aplastic anemia (ADA2 deficiency). In our cohort 2 patients succumbed to infective complications, One is planned for Allo HSCT and others are on follow up and close monitoring. Conclusions: In the pediatric age group, refractory AIC are sometimes the sole presenting features of inborn errors of immunity, as reflected in our cohort where none of them had any concomitant immunological manifestation. A genetic diagnosis can predict a more refractory course, but may also help guide specific targeted immunotherapy. Key words: PRCA-Pure Red cell aplasia, AIHA-Autoimmune hemolytic anemia, ITP-Immune thrombocytopenic Purpura, AIN-Autoimmune neutropenia, VUS-Variant of uncertain significance. |
| 401 |
UNMASKING A RARE ETIOLOGY OF FEVER IN AML: A CASE OF SPLENIC ECHINOCOCCOSIS |
1994-01-15 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr S.P VERMA |
DR KHUSBOO KUMARI |
KING GEORGES MEDICAL UNIVERSITY |
LUCKNOW |
9113457039 |
khusbookhushikk22@gmail.com |
Poster |
Title: UNMASKING A RARE ETIOLOGY OF FEVER IN AML: A CASE OF SPLENIC ECHINOCOCCOSIS
Introduction:
Fever in patients with acute myeloid leukemia (AML) can result from infections, disease-related causes, or therapy-related complications. Identifying uncommon infective etiologies is critical, especially in immunocompromised patients who may have atypical presentation.
Case Presentation:
A 50-year-old male with prior history of hemophagocytic lymphohistiocytosis (HLH) following malaria presented with fever, anorexia, generalized weakness, and left upper abdominal discomfort for two months. Examination revealed pallor and splenomegaly (9 cm BCM). Investigations showed Hb 5.9 g/dL, TLC 39,500/cmm, and platelets 8,000/cmm. Peripheral smear demonstrated 55% atypical blasts with Auer rods, and flow cytometry confirmed AML. He was started on Azacytidine with Midostaurin due to poor performance status.
Inspite of being on broad spectrum antibiotics, the patient continued to have persistent high-grade fever .Sputum culture grew Enterococcus avium but appropriate antibiotic modification failed to control fever. Given abdominal pain and massive splenomegaly, contrast-enhanced CT abdomen was performed, which revealed a large walled-off hypodense non-enhancing lesion in the spleen, suggestive of abscess. Splenic aspirate culture was sterile; however, serum IgG for Echinococcus was positive.
Management and Outcome:
The patient was initiated on albendazole 400 mg once daily after infectious disease consultation. He became afebrile within 48 hours. Follow-up imaging at 2 and 4 weeks demonstrated complete resolution of the splenic lesion. He successfully completed four cycles of azacytidine plus midostaurin and achieved remission.
Conclusion:
This case underscores the importance of a broad differential diagnosis for persistent fever in AML patients. Splenic echinococcosis, though rare, should be considered in endemic regions, particularly when fever is unresponsive to broad-spectrum antibiotics and associated with splenic lesions. Early diagnosis and antiparasitic therapy can result in favorable outcomes even in immunocompromised hosts.
Key words: AML, persistent fever, splenic abscess, echinococcosis, albendazole |
| 402 |
COAGULATION DISORDER AS A CAUSE OF INTRACRANIAL HAEMORRHAGE IN TERM NEONATES: A CLINICAL ANALYSIS |
1994-06-12 |
Female |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
|
Dr. Prisha Nankana |
SGPGIMS Lucknow UP |
lucknow |
09467195556 |
nankanaprisha@gmail.com |
Oral |
Title: COAGULATION DISORDER AS A CAUSE OF INTRACRANIAL HAEMORRHAGE IN TERM NEONATES: A CLINICAL ANALYSIS
Introduction: Intracranial haemorrhage (ICH) in term neonates is a critical condition associated with high morbidity and mortality. While prematurity and birth trauma are well-established contributors, congenital and acquired coagulation disorders represent a significant yet under-recognized cause of neonatal ICH. Early identification of these haemostatic defects is essential for timely intervention and improved outcomes.This study aims to evaluate the role of coagulation disorders in the pathogenesis of ICH among term neonates, highlighting diagnostic approaches, therapeutic strategies, and clinical outcomes.
Methods: A retrospective review was conducted of neonates diagnosed with ICH in the Neonatology Department of our institute between January 2020 and January 2025. Inclusion criteria encompassed term neonates with radiologically confirmed ICH and documented coagulation defects, including Factor XIII deficiency, vitamin K deficiency bleeding (VKDB), inherited thrombocytopenia, and other factor deficiencies. Cases with traumatic ICH, unrelated congenital malformations, or incomplete data were excluded. Diagnostic workup included cranial ultrasonography, CT/MRI as indicated, and comprehensive hematologic evaluation (CBC, PT, aPTT, INR, fibrinogen, D-dimer, and specific factor assays). Management involved targeted factor replacement, plasma and platelet transfusions, and supportive neurological care.
Results: The cohort demonstrated a diverse spectrum of coagulation abnormalities contributing to ICH, with Factor XIII deficiency and VKDB being prominent etiologies. Neuroimaging patterns varied by underlying defect. Early therapeutic intervention correlated with improved neurological outcomes, although diagnostic delays were common due to subtle clinical presentations and limited access to specialized assays.
Conclusions: Coagulation disorders are a significant and often overlooked cause of ICH in term neonates. A structured diagnostic algorithm and prompt hematologic evaluation are critical for guiding treatment and preventing recurrence. Enhanced awareness and early intervention can substantially improve neurodevelopmental prognosis in affected neonates.
Key words: - Intracranial hemorrhage, Neonates, Coagulation disorders
|
| 403 |
COMBINATION OF CYCLOSPORINE AND ELTROMBOPAG AS A FIRST-LINE THERAPY IN PATIENTS WITH APLASTIC ANEMIA: A SINGLE CENTER EXPERIENCE. |
1995-06-15 |
Male |
Yes |
L-2182 | pay_Q |
Benign |
Marrow failure |
Clinical |
Dr Shailendra Prasad Verma, Additional Professor and Head, Department of Clinical Hematology; Dr Swasti Sinha, Assistant Professor, Department of Clinical Hematology; Dr P Raghuveer, Senior Resident, Department of Clinical Hematology; Dr Gaurav Datta, Sen |
Dr Aritra Saha |
King George's Medical University |
Lucknow |
9401650438 |
aritraofficial@gmail.com |
Oral |
Title:
COMBINATION OF CYCLOSPORINE AND ELTROMBOPAG AS A FIRST-LINE THERAPY IN PATIENTS WITH APLASTIC ANEMIA: A SINGLE CENTER EXPERIENCE.
Introduction:
Aplastic anemia is a life-threatening disorder characterized by bone marrow failure and a decrease in blood cell production. The standard immunosuppressive therapy (IST) regimen—comprising horse anti-thymocyte globulin (hATG), cyclosporine (CSA), and eltrombopag (EPAG)—may be inaccessible in resource-limited settings due to cost, with upfront omission of hATG sometimes required. This study evaluates the efficacy and safety of first-line dual therapy with CSA and EPAG in patients with severe aplastic anemia (SAA), very severe aplastic anemia (VSAA), and transfusion-dependent non-severe aplastic anemia (TD-NSAA) over 13 years of age.
Methods:
A retrospective, hospital-based observational study was conducted. The primary outcome was response rate at 3 and 6 months; the secondary outcome was assessment of treatment-related adverse effects.
Results:
Of 36 patients (median age 35 years, 18 males/18 females), 13 had TD-NSAA, 21 had SAA, and 2 had VSAA. PNH clones were identified in 14 patients. At 6 months, two SAA patients were lost to follow-up; one VSAA patient died from intracranial haemorrhage and was classified as a non-responder. All the TD-NSAA patients showed a response at 6th month (CR 30.7%, PR 69.3%). While among SAA subjects, 78.9% responded (CR 36.8%, PR 42.1%), 21.05 % did not; no VSAA patient responded. The response rate correlated significantly with disease severity (p 0.001) but not with the presence of a PNH clone. The most common adverse effect was mild liver enzyme derangement (40%), followed by nausea, raised bilirubin, and other mild symptoms.
Conclusions: CSA and EPAG dual therapy can provide a feasible and cost-effective alternative for initial treatment in SAA and NSAA patients in settings where hATG is unavailable or unaffordable. For VSAA, standard IST remains preferable due to poor responses.
Keywords: Aplastic anemia, |
| 404 |
Hidden in the Sinusoids: Diagnostic Journey of αβ Hepatosplenic T-Cell Lymphoma |
1998-02-03 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Nidhi Srivastav¹, Dr. Meghna Tyagi¹, Dr. Sumit Garg¹, Dr. Avriti Baveja Batra², Dr. Mohammad Akram³, Dr. Mansi Kala¹, Dr. Smita Chandra¹ ¹Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, D |
Dr Nidhi Srivastav |
Himalayan Institute of Medical Sciences |
Dehradun |
8980633629 |
nidhi.srivastav8@gmail.com |
Poster |
Title: Hidden in the Sinusoids: Diagnostic Journey of αβ Hepatosplenic T-Cell Lymphoma
Introduction: Hepatosplenic T-cell lymphoma (HSTCL) is an uncommon, aggressive peripheral T-cell lymphoma, representing less than 1% of non-Hodgkin lymphomas [1]. The γδ subtype constitutes most of the cases, while the αβ variant is exceedingly rare, with only isolated reports in the literature [2]. Because of its nonspecific presentation, establishing a diagnosis requires a high index of suspicion and integration of histopathological and immunophenotypic findings.
Case Presentation
A 32-year-old male presented with three months of fever, progressive weakness, and pallor. On examination, he had massive splenomegaly. Laboratory evaluation revealed severe pancytopenia (haemoglobin 7.1 g/dL, total leukocyte count 1.2 × 10³/µL, platelets 21 × 10³/µL). Abdominal ultrasonography confirmed hepatosplenomegaly with features suggestive of splenic infarction. Bone marrow aspiration was paucicellular and contained 31% atypical lymphoid cells.
Methods: Bone marrow biopsy showed sinusoidal infiltration by atypical lymphoid cells. Flow cytometric analysis demonstrated expression of pan–T-cell markers CD2, CD3, and CD7, while markers of B-cell lineage (CD19, CD22), myeloid lineage (MPO), and immaturity were negative. This profile was consistent with an αβ T-cell immunophenotype. Correlation of marrow morphology with flow cytometry was critical in confirming the diagnosis.
Discussion and Conclusion
The αβ subtype of HSTCL is particularly unusual compared to the γδ variant [2]. Its aggressive clinical behaviour and rapid progression result in a median survival of less than one year, even with therapy [1]. Our patient deteriorated rapidly and succumbed shortly after diagnosis, underscoring the grave prognosis. This case highlights the indispensable role of bone marrow histology and flow cytometry in identifying this rare lymphoma subtype and emphasizes the need for awareness among clinicians and pathologists.
Key words: Hepatosplenic T-cell lymphoma, αβ subtype, flow cytometry, bone marrow biopsy, pancytopenia, prognosis
|
| 405 |
Non-joint bleeds in patients with hemophilia A or B with inhibitors: Concizumab explorer7 study |
1990-08-25 |
Male |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
1. Amy Shapiro, 1Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, US 2. Ana Boban, 2Haemophilia Centre, Department of Haematology, University Hospital Centre Zagreb, Zagreb, Croatia and School of Medicine, University of Zagreb, Zagreb, Croatia |
Vetrivel Babu Nagarajan |
Novo Nordisk India |
Bangalore |
7021004389 |
vrbn@novonordisk.com |
Poster |
Title: Non-joint bleeds in patients with hemophilia A or B with inhibitors: Concizumab explorer7 study Introduction: Concizumab is an anti-tissue factor pathway inhibitor monoclonal antibody intended for hemophilia A/B with (HAwI/HBwI) and without inhibitors, approved for once-daily, subcutaneous prophylaxis in HAwI/HBwI. Aim: To assess non-joint bleeds in the prospective, multicenter, open-label phase 3 explorer7 study (NCT04083781) in HAwI/HBwI during concizumab prophylaxis vs on-demand treatment as an exploratory analysis. Methods: Patients were randomized 1:2 to on-demand treatment or concizumab prophylaxis. On-demand patients switched to concizumab after ≥24 weeks. After a 1.0 mg/kg concizumab loading dose (Day 1), patients received a 0.20 mg/kg daily dose (Day 2+), with potential dose adjustment (5–8 weeks) to 0.15/0.25 mg/kg daily based on concizumab plasma concentration measured after week 4. Here we describe the location and number of non-joint bleeds during on-demand or concizumab treatment at the 32- and 56-week cut-offs in explorer7, and annualized bleeding rates (ABRs) for treated spontaneous and traumatic muscle bleeding episodes (includes re-bleeds and bleeds occurring contemporaneously) at the 32-week cut-off. Informed consent/ethics committee approval were obtained. Results: This exploratory analysis included 19 patients on-demand and 33 patients on concizumab. Amongst non-joint bleeds, muscle bleeds were most frequently reported, with 32 treated bleeds (17.6% of all treated bleeds) in 47.4% of on-demand patients and 4 bleeds (6.1% of all treated bleeds) in 12.1% of patients on concizumab. The estimated ABR [95%-confidence interval] for treated spontaneous and traumatic muscle bleeding episodes in patients on-demand was 1.5 [0.78;2.99] vs 0.1 [0.02;0.31] on concizumab (ABR ratio: 0.05 [0.01;0.22]; p<0.001). At the 56-week cut-off, low numbers of non-joint bleeds were maintained with concizumab. Conclusions: Few non-joint bleeds were reported with concizumab prophylaxis in explorer7 at the 32- and 56-week cut-offs. The ABR for muscle bleeding episodes was reduced in patients on concizumab compared with on-demand |
| 406 |
Homozygous Hemoglobin Lepore : Diagnostic challenges and clinical implications.
|
1998-03-21 |
Female |
No |
- | H_LKO |
Benign |
Anemia |
Laboratory |
Dr Sarita Pradhan¹, Dr Shivangi Harankhedkar¹, Dr Gayatri Behera¹, Dr SKC Mishra¹, Dr Prateek Das¹, Dr Priyanka Samal². Department of Pathology, IMS and SUM Hospital, Bhubaneswar, Odisha¹. Department of Clinical Hematology, IMS and SUM Hospital, Bhubanesw |
Dr. Anagha Atul Yenurkar |
IMS and SUM Hospital |
Bhubaneswar |
9890100778 |
ana210398@gmail.com |
Poster |
Title : Homozygous Hemoglobin Lepore : Diagnostic challenges and clinical implications.
Authors : Dr. Anagha Atul Yenurkar¹, Dr Sarita Pradhan¹, Dr Shivangi Harankhedkar¹, Dr Gayatri Behera¹, Dr SKC Mishra¹, Dr Prateek Das¹, Dr Priyanka Samal².
Department of Pathology, IMS and SUM Hospital, Bhubaneswar, Odisha¹.
Department of Clinical Hematology, IMS and SUM Hospital, Bhubaneswar, Odisha².
Background : Hemoglobin Lepore is a rare beta-globin gene disorder from delta-beta gene fusion. It appears in heterozygous or homozygous forms, the latter resembling beta-thalassemia major. Its diagnosis is supported by capillary zone electrophoresis (CZE) migration pattern analysis.
Case presentation : A 3-year-old child presented with anemia, icterus, and yellow urine. Examination showed hemolytic facies and splenomegaly (5 cm below the left costal margin). History revealed consanguinity. CBC and hemoglobin electrophoresis were advised for further evaluation.
Diagnosis : CBC showed hemoglobin of 6.4 g/dl, RBC count 3.44×10⁶/µl, and MCV 62.8 fl. Peripheral smear revealed anisopoikilocytosis, target cells, teardrop cells, and basophilic stippling. Hemoglobin electrophoresis (CZE) (SEBIA FP) was performed, revealing the following zones - Hb F ( 92.1%) and a peak in the zone D ( 7.9%), with no detectable Hb A or Hb A2. The patient's father and mother’s electrophoresis showed a similar peak in D zone of 11.5% and 11.3% respectively. HbA2 was within normal range. Considering the unusual peak percentages in the parents’ CZE and the absence of A and A2 in the index case, we reviewed abnormal hemoglobins co-migrating in the D zone and concluded the variant to be Hb Lepore, pending molecular confirmation.
Treatment : The patient was advised 250 ml blood transfusion and iron, folic acid supplements. Hb Lepore treatment depends on severity: mild cases need monitoring and folic acid; severe cases require regular transfusions, iron chelation, possible splenectomy and rarely, stem cell transplantation.
Follow up : Hb Lepore follow-up varies by genotype: heterozygous cases need symptom monitoring and genetic testing; homozygous or compound forms require anemia management, transfusions, monitoring for related complications.
Conclusion : This case underscores the need to consider rare hemoglobinopathies like homozygous Hb Lepore in consanguineous families, emphasizing careful interpretation of CZE findings in thalassemia-prevalent regions for accurate diagnosis.
Keywords : Hb lepore, homozygous, anemia, hemoglobinopathy, consanguinity, thalassemia mimic.
|
| 407 |
Concizumab Use in India: Initial Clinical Experience and Outcomes |
1980-12-05 |
Male |
Yes |
L-2237 | NA |
Benign |
Hemeostasis |
Clinical |
Dr Subash Chandra Jha, Haematology, New Gardiner Superspeciality Hospital, Patna, 2. Dr Karthik. K, Clinical Hematology, Dr Mehta's Hospitals, Chennai. |
Dr Vishnu Sharma |
Clinical Hematology, SMS Medical College |
Jaipur |
9828535706 |
visunita@ymail.com |
Oral |
Title: Concizumab Use in India: Initial Clinical Experience and Outcomes Introduction: Concizumab is a humanised monoclonal IgG4 antibody that acts as a haemostatic rebalancing agent. It acts by inhibition of Tissue Factor Pathway Inhibitor (TFPI) enhances FXa production via the extrinsic pathway, a mechanism expected to be effective in haemophilia A and B, regardless of inhibitor status, without interfering with downstream coagulation regulation. Concizumab is approved for Haemophilia A or B with or without inhibitors by USFDA and EMA and in India it is approved for Haemophilia A or B with inhibitors (HAwI or HBwI). Methods: This case report presents data from patients with haemophilia who were administered concizumab. Concizumab was imported for personal use in limited quantity using form 12B after securing permission from CDSCO. Patients received an initial loading dose of concizumab at 1.0 mg/kg, followed by a starting daily dose of 0.20 mg/kg, with subsequent dose adjustments determined by centralised concizumab ELISA results at four weeks. Effectiveness was assessed by documenting the number of bleeding episodes, while safety was evaluated based on observed adverse reactions. Results: Three patients (2 with HBwI aged 12 & 19, 1 with HB aged 19) started Concizumab after being on episodic therapy with rFVIIa or FIX. Their prior ABRs were 30, 50, and 24, respectively with frequent hospital visits. The median duration of 2 months 15 days. One patient aged 12 had 2 bleeds initially which was managed with rFVIIa, after 4 weeks, the patient had low drug levels (<200 ng/mL) and was up titrated. Post-adjustment, no further bleeds occurred in this patient. Another patient had a traumatic bleed managed with one FIX dose. No adverse events were reported during the treatment period. Conclusions: Early real-world experience with Concizumab in India demonstrates promising outcomes in patients with Haemophilia B and inhibitors |
| 408 |
Randomised Controlled Trial of High Dose Dexamethasone and Methylprednisolone in Immune Thrombocytopenia (HDMI Trial) |
1978-09-22 |
Male |
Yes |
L-1568 | H_LKO |
Benign |
Platelet disorders |
Clinical |
Kanwaljeet Singh, Preeti Tripathi, Rajan Kapoor, Suman Kumar |
Kundan Mishra |
Army Hospital (Research & Referral) |
Delhi, India |
9871323179 |
mishrak20@gmail.com |
Oral |
Title: Randomised Controlled Trial of High Dose Dexamethasone and Methylprednisolone in Immune Thrombocytopenia (HDMI Trial)
Introduction: The first line of therapy of Immune Thrombocytopenia (ITP) is corticosteroids. Most guidelines recommend corticosteroids as the first-line therapy but don’t recommend any specific corticosteroids for use in ITP. Therefore, we aimed to compare dexamethasone with methylprednisolone.
Methods: ITP patients of any gender and age 18 years or more requiring corticosteroids were included. Group-1 (intervention arm) received intravenous methylprednisolone (MP) pulse followed by oral prednisolone (1 mg/kg/day) (maximum- six weeks). Group 2 (comparator arm) received oral dexamethasone (Dexa) 40 mg/day once daily for four days (up to three cycles at a gap of 14 days).
Results: 127 patients with ITP were randomized in two arms (63 in Group-1 and 64 in Group-2). The median age was 34 years and 33% were males. The initial peak of platelet (after one week of therapy) in group-1 was one lac while it was 60x109/L in group-2 (p<0.001). On day eight, the overall response was 55% and 50.2% in two arms arms. The day seven platelets were a strong determinant for the later kinetics of platelets. So, a separate analysis was done to assess the difference in early platelet response (D7 platelets) and late platelet kinetics (post D7 platelets) between the two groups. After six weeks, both MP and Dexa were almost equal in efficacy. At day 43, the overall response was 63% and 60.6% in MP and dexa arms respectively. The complete response was 29.4% and 26.6% respectively. Adverse events were mild (grade1 and 2) and equal proportion in both arms.
Conclusions: Though dexamethasone and methylprednisolone showed comparable long-term efficacy and adverse events, considering a statistically significant better early platelet response with methylprednisolone, we concluded that methylprednisolone is better than dexamethasone in treating ITP.
Key words: ITP |
| 409 |
Joint bleed diagnosis and treatment delays in people with hemophilia: Global real-world data |
1994-12-18 |
Male |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
Flora Peyvandi,1 Neil Reynolds,2 Olivera Rajkovic-Hooley,2 Cléa Percier,3 Leonardo Gottlob,3 Roberta Gualtierotti1 - 1Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; 2Adelphi Real World, Bollington, Chesh |
Dr Kishan Patel, MD |
Novo Nordisk India Private Limited |
Bangalore |
9909063922 |
ksip@novonordisk.com |
Poster |
Title: Joint bleed diagnosis and treatment delays in people with hemophilia: Global real-world data
Introduction: Joint bleeding is common in PwH. Guidelines recommend treatment within 2 hours, but detection and treatment are often delayed. We undertook a multi-national, quantitative RWE study of PwH and their caregivers to explore the burdens of hemophilia through PROs and experiences. Aim is to Characterize patterns in joint bleed diagnosis and treatment.
Methods: Participants were recruited through physicians, patient groups, and online; and were eligible if diagnosed with hemophilia and receiving prophylaxis or episodic treatment. All ages were included. Participants were ineligible if in a clinical trial or receiving an investigative treatment. Key outcomes included the number of suspected joint bleeds; bleeds treated at home versus HTC; suspected bleeds confirmed by ultrasound; time between suspicion and treatment of joint bleeds; and hours spent travelling to an HTC. All participants provided informed consent.
Results: 495 responses were captured from 8 countries (Dec2023 to Mar2024). Mean (SD) rate of joint bleeds suspected by respondents was 2.5 (3.9) bleeds/pt/yr. Mean (SD) delays between joint bleed suspicion and treatment at home or an HTC were 5.0 (8.0) and 5.4 (9.7) hours, respectively. >60% of respondents reported ≥2 hours from suspicion to treatment of bleeds at home or an HTC. 56% of respondents go to their HTC whenever they suspect a bleed, with a mean (SD) travel time of 3.0 (4.6) hours. 31% of suspected bleeds were checked with Ultrasound at HTCs, of which 81% were confirmed.
Conclusions: Delays between suspicion and treatment of joint bleeds are substantial. Ultrasound usage is limited, despite Ultrasound confirming joint bleeds at high rates. Increasing the use of Ultrasound at HTCs, and the availability of at-home US for patients could facilitate joint bleed diagnosis and mitigate delays.
Key words: Hemophilia, joint Bleed |
| 410 |
Etiological Spectrum of Pancytopenia in patients undergoing Bone marrow examination at a tertiary care centre in North India: A retrospective study |
1994-04-20 |
Female |
No |
- | H_LKO |
Benign |
Miscellaneous |
Clinical |
Namrata P Awasthi, Pradyumn Singh, Nuzhat Husain |
Vibhuti Mathur |
Dr Ram Manohar Lohia Institute of Medical sciences |
Lucknow |
9936520999 |
vibhutimathur2000@gmail.com |
Oral |
Title: Etiological Spectrum of Pancytopenia in patients undergoing Bone marrow examination at a tertiary care centre in North India: A retrospective study Introduction: Pancytopenia is a commonly encountered condition in clinical practice. However, the causes and presentation of pancytopenia vary among various population groups. Bone marrow examination is an essential part of work up in establishing the aetiology of pancytopenia. This study aims at assessing the spectrum of bone marrow findings and their clinic-haematological correlation in patients with pancytopenia presenting in haematopathology department of a tertiary care centre. Methods: A retrospective observation study was conducted on patients with pancytopenia presenting for bone marrow examination at the department of haematopathology. Clinical records as well as investigation reports of all patients presenting over a period of six months were re-assessed.Those with complete clinical and pathological records were included in the study. Clinical,haematological and bone marrow findings were recorded and data obtained was analysed statistically. Results: A total of 51 patients were included in the study, with a mean age of 35.1 year (range 4 years-76years). 10 cases were paediatric whereas 41 were adults. Most common presenting complaints were fever (31 cases), generalized weakness(30 cases) and dyspnoea (9 cases). Bone marrow was hypercellular in 23(45%), hypocellular in 18 (35.2%) and normocellular in rest. Neoplastic findings in marrow were noted in 18 (35.3%), normal marrow in 15 (29%), Aplastic in 10 (19.6%), reactive in 3 (6%), infective in 2, megaloblastic anaemia in 2 and lysosomal storage disorder in 1 case. Among neoplastic, Acute leukaemia was noted in 14 while Myelodysplastic syndrome was observed in 2 cases and non hodgkin lymphoma in one. Conclusion: In contrast recent studies, Acute leukaemia was observed to be the most common cause of pancytopenia in our study population.
Keywords: Acute leukemia, pancytopenia, bone marrow examination, clinico-hematological profile, |
| 411 |
Rare Trajectories of CLL Progression: From Chronic Lymphocytic Leukaemia to Myeloid and Aggressive Lymphoid Phenotypes |
1996-11-09 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Anil Aribandi, Dr. Chaitanya GB, Dr. Ranjit Kumar CS, Dr. S. K. Waheed Hussain, Department of Haemato-Oncology and Bone Marrow Transplant Sindhu Hospitals |
Dr. ADLIN HO |
Sindhu Hospitals |
Hyderabad |
9573167405 |
hoadlin@gmail.com |
Oral |
Title: Rare Trajectories of CLL Progression: From Chronic Lymphocytic Leukaemia to Myeloid and Aggressive Lymphoid Phenotypes
Authors: Dr. Adlin Ho, Dr. Anil Aribandi, Dr. Chaitanya GB, Dr. Ranjit Kumar CS, Dr. S. K. Waheed Hussain
Introduction: Chronic lymphocytic leukemia (CLL) is the most common adult leukemia, typically exhibiting an indolent course but with highly variable clinical outcomes. A recognised complication is Richter’s transformation (RT), in which CLL progresses to an aggressive lymphoma, usually diffuse large B-cell lymphoma (DLBCL), occurring in 2–10% of cases. In contrast, the development of chronic myeloid leukemia (CML) as a secondary malignancy in CLL is exceedingly rare, with very few reports in the literature. Both scenarios highlight the genetic instability and clonal evolution underlying CLL.
Method: Case 1: A 77-year-old female with relapsed CLL presented with leukocytosis and splenomegaly. Peripheral smear suggested a myeloproliferative process. FISH revealed BCR-ABL1 positivity, confirming CML. She commenced Imatinib with good response.
Case 2: A 65-year-old male on ibrutinib for CLL developed weight loss, back pain, and B symptoms. PET-CT showed metabolically active nodal disease. Biopsy confirmed DLBCL, non-germinal center subtype, consistent with RT. He was treated with R-CHOP.
Result: These cases underscore two rare but important evolutionary pathways of CLL. RT is well recognised, whereas progression to CML through acquisition of BCR-ABL1 highlights the impact of secondary genetic lesions. Such transformations necessitate vigilance when unexpected haematology or systemic features arise. Molecular profiling and tissue diagnosis are crucial to distinguish treatment resistance from true transformation, ensuring appropriate management.
Conclusion: Divergent CLL trajectories toward either CML or aggressive lymphoma reflect its biological complexity. Prompt recognition, thorough molecular evaluation, and tailored therapy are essential to optimise patient outcomes.
Keywords: Chronic lymphocytic leukemia, Richter’s transformation, chronic myeloid leukemia, diffuse large B-cell lymphoma, clonal evolution, BCR-ABL1. |
| 412 |
autoimmune hemolytic anemia i pediatric age group a case report |
1990-07-24 |
Male |
No |
- | _lbfR |
Benign |
Anemia |
Clinical |
DR JINA BHATTACHARYYA DR SMITA DAS DR DAMODAR DAS |
DR PRIANIUZ DEWRAJA |
Gauhati medical college and hospital |
GUWAHATI |
9577424161 |
prianuzdewraja@gmail.com |
Poster |
Title:AUTOIMMUNE HEMOLYTIC ANEMIA IN A PEDIATRIC GROUP- A CASE REPORT
Introduction:AIHA is a rare condition in which immune system destroys the rbcs leading o fatigue pallor and jaundice
Methods:we report a case of a 1year 11 months child with recurrent blood tranfusion for 5 months and was diagnosed a case AIHA his dct ict was plus patient was giben ivig and steroids however his condition did noyt improve and and was started on rituximab
Results:patient condition significantly improved following rituximab
Conclusions:it is suggested that rituximab can be a very good option in steroid dependant AIHA
Key words:AIHA , ivig, steroids,Rituximab |
| 413 |
Use of an Unsupervised Machine Learning Algorithm to Differentiate CD5+ B-NHLs in the Grey Zone |
2000-05-06 |
Female |
No |
- | Pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Phaneendra Datari, Divya Meghanathan, Kotteeswari Kathirvel, Vikram Mathews, Arun Kumar Arunachalam |
Keerthana giri |
Christian Medical college |
Vellore |
08778237225 |
KEERTHANAG2020@GMAIL.COM |
Poster |
Title:Use of an Unsupervised Machine Learning Algorithm to Differentiate CD5+ B-NHLs in the Grey Zone Introduction:CD5-positive B-cell non-Hodgkin lymphomas (B-NHLs) mainly comprise chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) and mantle cell lymphoma (MCL). Their overlapping morphologic and immunophenotypic features create a diagnostic “grey zone.” Atypical CLL may show strong B-cell marker expression or loss of defining antigens, while some MCLs display aberrancies such as CD23 positivity or weak light chain intensity. Scoring systems, multiparametric flow cytometry, and molecular markers (SOX11, cyclin D1) assist diagnosis, yet a subset remains unresolved. We applied unsupervised clustering to explore differentiating markers in such cases. Methods:Ambiguous CD5+ cases diagnosed between 2021–2025 were studied. Flow cytometry (FCS) files were reanalysed, and mean fluorescence intensities (MFIs) of clonal B cells were normalised against T cells. K-means clustering was performed after selecting the optimal K value using the elbow method. Demographic data were obtained from electronic records. Results:Thirty-four cases were included (median age 60 years; range 37–82; male-to-female ratio 2.4). Bone marrow was the commonest sample (n=19). Elbow curve analysis indicated K=3, producing three distinct clusters on PCA Cluster 1 (n=27): Negative for IgM, IgD, CD22, CD71, resembling CLL. Cyclin D1 (11/27) was negative. Cluster 2 (n=4): Bright IgM, CD22; dim IgD, CD71, resembling MCL. Cyclin D1 (3/4) was positive. Cluster 3 (n=4): Dim IgM, negative IgD, CD22, CD71, suggesting a post-germinal centre phenotype. Cyclin D1 (2/4) was negative. IgM, followed by CD22, CD71, and IgD, were most discriminatory across clusters. Conclusions:Unsupervised clustering revealed three phenotypic groups within CD5+ grey zone B-NHLs. IgM and IgD were key in distinguishing atypical CLL from MCL. This approach highlights immunophenotypic heterogeneity and may aid predictive algorithm development for refined lymphoma classification. Key words:CD5-positive, B-cell non-Hodgkin lymphoma, Chronic lymphocytic leukaemia (CLL),Mantle cell lymphoma (MCL),Predictive algorithms,IgM / IgD |
| 414 |
Plasma Cell Leukemia Masquerading as Left Hypochondrial Pain: A Case Report |
1994-11-19 |
Male |
No |
- | 93777 |
Malignant |
Plasma cell disorders |
Clinical |
|
Dr. Viral Jain |
BLK MAX Super Specialty Hospital |
New Delhi |
6376293549 |
dr.viraljain@yahoo.com |
Poster |
Title: Plasma Cell Leukemia Masquerading as Left Hypochondrial Pain: A Case Report
Introduction: Plasma cell leukemia (PCL) is a rare and aggressive plasma cell neoplasm defined by ≥20% plasma cells in peripheral blood or an absolute plasma cell count >2 × 10⁹/L. It often presents with systemic manifestations such as cytopenias, organomegaly, and bone lesions. Its nonspecific presentation can mimic other conditions, causing diagnostic delays.
Methods: We present a case of a 50-year-old female with sudden-onset left hypochondrial pain radiating to the shoulder, associated with intermittent chills and evening sweats. Comprehensive clinical evaluation, imaging (PET-CT, MRI), hematological investigations (CBC, biochemical markers), bone marrow biopsy, immunophenotyping, and cytogenetic testing were performed.
Results: Findings revealed hepatosplenomegaly, multiple lytic skeletal lesions, and FDG-avid marrow infiltration. Peripheral blood smear showed 23% circulating plasma cells. Bone marrow biopsy demonstrated 80–90% CD138-positive plasma cells with reduced hematopoiesis. Flow cytometry confirmed 22.6% abnormal kappa-restricted plasma cells. FISH revealed high-risk abnormalities: del(13q14.3), del(17p13.1), IGH rearrangement, and t(14;16). Serum immunology showed elevated free kappa light chains with a monoclonal kappa band. A diagnosis of plasma cell leukemia with systemic involvement was established.
Conclusions: This case emphasizes the diagnostic complexity of PCL, which may initially masquerade as abdominal pathology. Hematologic malignancies should be considered in patients with unexplained systemic symptoms and organomegaly. Early use of bone marrow evaluation, immunophenotyping, and cytogenetics is crucial given the aggressive nature of PCL.
Key words: Plasma cell leukemia, hepatosplenomegaly, cytogenetics |
| 415 |
Liver as the First Witness: Two Rare Cases of AL Amyloidosis Presenting with Hepatomegaly |
1992-02-28 |
Male |
Yes |
L-2142 | 93777 |
Malignant |
Plasma cell disorders |
Clinical |
Anamika Bakliwal1 , Swati Saxena2 , Aditi Mittal3 , Amrish Sahney4 , Rajan Duggal2 , Manav Wadhawan4 , Anil Handoo3 , Sanjeev Kumar Sharma1. 1 Department of Hemato-oncology and Bone Marrow Transplantation, BLK-MAX Super Speciality Hospital, New Delhi. 2 D |
Neelkumar Patel |
BLK-Max Super Speciality Hospital |
New Delhi |
9537471266 |
neelpatel1353@gmail.com |
Poster |
Title: Liver as the First Witness: Two Rare Cases of AL Amyloidosis Presenting with Hepatomegaly
Introduction: AL amyloidosis is a rare plasma cell dyscrasia caused by deposition of misfolded light chains, most often involving heart, kidneys, and nerves. Hepatic presentation as the primary feature is uncommon and diagnostically challenging.
Case 1: A 43-year-old woman presented with abdominal distension, pedal oedema, weight loss, and nephrotic-range proteinuria. Liver function revealed elevated alkaline phosphatase and GGT with normal bilirubin and transaminases. Liver biopsy confirmed lambda-restricted amyloid. Bone marrow showed 55% plasma cells with amyloid deposits, and FISH identified del(13q14.3). Cardiac evaluation was normal. She was started on bortezomib-cyclophosphamide-dexamethasone (VCd).
Case 2: A 42-year-old woman had abdominal fullness, weakness, and marked weight loss. She had hepatomegaly with elevated cholestatic enzymes, preserved bilirubin, and moderate proteinuria. Liver biopsy confirmed lambda-restricted amyloid. Bone marrow revealed diffuse infiltration with plasma cells, and FISH detected del(13q14.3), gain of 1q21, IGH rearrangement, and t(4;14). Cardiac biomarkers and echocardiography were normal. She was initiated on VCd therapy.
Discussion: Both cases illustrate rare hepatic-dominant AL amyloidosis where hepatomegaly and cholestatic enzyme elevation were the leading features. Cardiac sparing, despite systemic disease, underscores heterogeneity of organ involvement. Diagnostic confirmation relied on Congo red staining, immunofluorescence, and cytogenetics. Detection of del(13q14.3) and additional high-risk markers highlight aggressive clonal biology. Early recognition and treatment with proteasome-inhibitor–based regimens are essential to improve outcomes.
Conclusions: Primary hepatic involvement in AL amyloidosis is rare but should be suspected in unexplained hepatomegaly with raised cholestatic enzymes. Tissue biopsy and advanced diagnostics enable early diagnosis, guiding timely therapy and potentially better prognosis.
Key words: AL amyloidosis; Hepatomegaly; Light chain deposition; Congo red; Kappa; Lambda |
| 416 |
Outcomes of using Letermovir for CMV prophylaxis in HSCT: Retrospective Analysis
|
1998-02-25 |
Female |
No |
- | pay_R |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Clinical |
Dr. Anil Aribandi, Dr. Ranjit Kumar CS, Dr. Chaitanya GB, Dr. Syed Khaja Waheed Hussain |
Dr. Manvitha Malepati |
Sindhu Hospitals |
Hyderabad |
8712189469 |
manvithambbs@gmail.com |
Oral |
Title:Outcomes of using Letermovir for CMV prophylaxis in HSCT:Retrospective Analysis
Introduction:Cytomegalovirus(CMV)reactivation is a major complication following allogeneic hematopoietic stem cell transplantation(HSCT),particularly in haploidentical HSCT.Prophylaxis with Ganciclovir or Valganciclovir is limited by myelosuppression.Letermovir offers an alternative with minimal side effects.
Methods:Retrospective study was done of all patients undergoing allogeneic HSCT between March and August 2025 at Sindhu Hospitals,Hyderabad.All patients were initiated on Letermovir prophylaxis from Day+1 of transplantation.Patients who died prior to engraftment were excluded.Data collected included demographics, transplant details, details of letermovir prophylaxis and antiviral therapy if any.CMV monitoring was done by quantitative PCR.Statistical analyses were performed using SPSS software.
Results:In this retrospective study,we recruited a total of 16 patients,with data retrieved from the EMR.Patients included both children and adults,9(56.25%)were children<18yrs and 7(43.75%)were adults>18yrs. There was a male predominance (M:F=12:4).Ages ranged from 10months to 45years(540 months).Both donor and recipient were 100%CMV IgG seropositive and CMV IgM negative. Diagnoses included Acute Leukemia(5),CML(1),Relapsed ALCL(1),Thalassemia major-Class III(3),Sickle cell anemia(1),IBMFS(2),CGD(1),MPS(1),and SAA(1).Haploidentical HSCT predominated(n=12).Full HLA-matched patients were included due to high-risk disease.Graft sources were bone marrow(3),peripheral blood stem cells(11),and combined(2).Letermovir dose was adjusted based on GVHD prophylaxis drugs-cyclosporine or tacrolimus.In small children, the drug was given crushed via nasogastric tube(n=4).Letermovir doses ranged from 5.7mg/kg to 13.5mg/kg.CMV reactivation occurred in 9 patients(56.25%).CMV copy numbers ranged from 687 to 31,00,000copies/mL, observed between days+12 and+68 post-transplant.Upon reactivation, patients were initiated with valganciclovir/cidofovir/ganciclovir/foscarnet. At last follow-up,one mortality was noted due to diffuse alveolar haemorrhage.No CMV-related deaths were observed.
Conclusions: In our cohort the incidence of CMV reactivation is higher than the data presented from the West.Letermovir appears to mitigate onset of severe disease in high risk transplants,even if it does not completely prevent reactivation.While limited by small sample size,a single-centeranalysis, and lack of control group,there is a need for prospective study.
Key words:Letermovir, Cytomegalovirus, Hematopoietic stem cell transplant |
| 417 |
Blood Cell-Derived Small Extracellular Vesicles as Novel Carriers of Endogenous and Exogenous cargo: A Paradigm Shift |
1996-08-15 |
Female |
No |
- | pay_R |
Benign |
Miscellaneous |
Laboratory |
Suryyani Deb, Assistant Professor (UGC), Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Haringhata, West Bengal |
Sreeja Mukherjee |
Maulana Abul Kalam Azad University of Technology |
Kolkata |
9874196670 |
sreeja.mukherjee@makautwb.ac.in |
Poster |
Title: Blood Cell-Derived Small Extracellular Vesicles as Novel Carriers of Endogenous and Exogenous cargo: A Paradigm Shift
Authors: Sreeja Mukherjee, Suryyani Deb
Introduction: Small extracellular vesicles (sEVs) have emerged as biologically compatible nano-carriers that help shield, transport, and deliver diverse therapeutic payloads. Since sEVs are derived from donor cells, their lipid, protein, and nucleic acid repertoires partially mirror their parent, enabling them to carry native bioactives and additional, exogenously loaded payloads. A systematic literature review was conducted to identify which blood cell types are utilized as sources in preclinical therapeutic applications.
Methods: PubMed only search using MeSH/keywords “exosomes” and “small extracellular vesicles,” combined with "blood cell types" and "therapy" in Title/Abstract was set as query.
Results: Blood cells, both circulating and tissue-resident immune populations predominate as sEV sources. Among circulating donors, red blood cells and platelets are favored due to their abundance and minimally invasive isolation from whole blood or platelet concentrates. In contrast, tissue-resident immune cells(macrophages, dendritic cells, natural killer cells, B cells, and T cells) are often selected to leverage their anti-inflammatory cargo and inflammation-directed tropisms with macrophage as the leading cell source. Cargos included small molecules, proteins, and RNAs loaded by incubation, electroporation, sonication, freeze–thaw, extrusion, or transfection or donor cell engineering. Applications span organs with discontinuous (liver, kidney, bonemarrow) and continuous endothelium, including brain via crossing of blood brain barrier. Functionally, blood cells communicate with vascular and tissue targets via receptor-ligand interactions, soluble mediators, and metabolites and predominantly through extracellular vesicles; sEV therapies leverage this native network.
Conclusions: Therefore, current evidence positions blood cell-derived sEVs as leading source cells for vesicle production and supports their accelerated translational use in targeted therapies across diverse disease settings; however, additional clinical trials are needed to confirm biocompatibility, characterize clearance, and assess off-target accumulation.
Keywords:Blood cell-derived sEVs, cargo, therapy, nano-carriers |
| 418 |
“Diagnostic Utility of Myeloma Work-up in Suspected Cardiac Amyloidosis” A case series from a tertiary care centre in India. |
1972-06-10 |
Female |
Yes |
L-1316 | H_LK |
Malignant |
Plasma cell disorders |
Laboratory |
Amrita Saraf1, B.S.Vivek, Nitin Gupta, Sabeena Langer, Pallavi Prakhar, Surbhi Dahiya, Jyoti Kotwal, Sir Ganga Ram Hospital, New Delhi, India |
Dr. Amrita Saraf |
Sir Ganga Ram Hospital |
New Delhi |
09811624334 |
amrita.saraf1@gmail.com |
Poster |
Title :Diagnostic Utility of Myeloma Work-up in Suspected Cardiac Amyloidosis”A case series from a tertiary care centre in India I
ntroduction: Cardiac amyloidosis (CA) is the most common type of restrictive cardiomyopathy A significant proportion is related to immunoglobulin light-chain (AL) amyloidosis, arising from an underlying plasma cell dyscrasia. AL (Light chain) and ATTR (Transthyretin) are the two most common forms of amyloid affecting the heart. Though cardiac involvement is seen in more than 50% of patients with systemic amyloidosis, a cardiomyopathy as the presenting manifestation of amyloidosis is rare.
Methods:Twelve patients of cardiac amyloidosis were retrospectively analyzed including clinical history, investigations including imaging studies, biochemical and detailed myeloma work up. The comprehensive myeloma work-up (including SPE, IFE, sFLC,, beta-2 microglobulin and Ig levels) along with 24 hr UPE, bone marrow & flowcytometry wherever available.
Results: Among 12 patients with one or more red flag signs of cardiac amyloidosis, 10 patients were found to have AL CA and 2 had ATTR CA. The mean age was 58.7 years with slightly male preponderance (66.7%). All patients showed either monoclonal band or abnormal sFLC n ratio or both. Abnormal sFLC ratio was seen in 90% cases with 80% cases showing lambda LC restriction.
Conclusions: Cardiac amyloidosis (CA) is a life-threatening condition,. Cardiac amyloid can be a presenting feature of multiple myeloma which unless diagnosed early can have worse prognostic implications. The comprehensive myeloma work-up provides critical evidence for monoclonal protein detection and clonal plasma cell identification, serving as a non-invasive first-line approach. In patients presenting with unexplained cardiomyopathy, these tests not only aid in differentiating the lethal AL amyloidosis from transthyretin-related amyloidosis but also help in directing appropriate therapeutic strategies and enhancing patient prognosis.
Keywords : Cardiac amyloidosis, comprehensive myeloma work up, protein electrophoresis, immunofixation electrophoresis, serum free light chain assay |
| 419 |
Flowcytometry analysis of serous effusions: experience from a tertiary care hospital in Punjab |
1990-02-20 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Vikram Narang Pavneet kaur Bhavna Garg Ruchita tyagi |
Saloni goyal |
Dayanand medical college and hospital |
Ludhiana |
7837201700 |
Saloniarora2030@gmail.com |
Poster |
Title: Flow Cytometric Analysis of Serous Effusions: Experience from a Tertiary Care Hospital in Punjab
Introduction: Serous effusions—pleural, peritoneal, and pericardial pose diagnostic challenges, particularly in distinguishing reactive from malignant processes. Conventional cytology, while informative, often lacks sensitivity in detecting hematolymphoid malignancies or atypical cells. Flow cytometry (FCM), with its ability to perform multiparametric immunophenotyping on fluid samples, offers a valuable adjunct. This study presents our institutional experience utilizing FCM for serous effusion analysis in a tertiary care in Punjab.
Methods: A retrospective analysis was conducted on serous effusion samples received over a 5-year period in the Department of Pathology, Dayanand Medical College and Hospital, Punjab. Samples included pleural, peritoneal, and pericardial fluids submitted for flow cytometric evaluation due to clinical suspicion of malignancy or inconclusive cytology. Mononuclear cells were processed using standard protocols and stained with panels targeting B-cell, T-cell, and myeloid markers. Immunophenotypic profiles were analyzed and correlated with cytological and clinical findings.
Results: A total of 26 serous effusion samples were analyzed using flow cytometry. Hematolymphoid malignancy was detected in 12 cases (46%), with precursor T-lymphoblastic leukemia being the most common diagnosis (n=9). Additionally, one case each of aberrant B-cell population, mixed phenotypic acute leukemia (MPAL), and B-cell lymphoproliferative disorder were identified. The remaining 14 cases (54%) showed immunophenotypic profiles consistent with reactive or inflammatory processes.
Conclusions: Flow cytometry serves as a powerful diagnostic tool in the evaluation of serous effusions, particularly for detecting hematolymphoid malignancies. Its integration into routine diagnostic workflow enhances diagnostic accuracy and guides appropriate clinical management. Our experience emphasizes the utility of FCM as a complementary modality to conventional cytology in high-volume healthcare environments such as Punjab
Key words: Flow Cytometry, Serous Effusions, Hematolymphoid, Immunophenotyping, Cytology |
| 420 |
The relation between L-asparaginase trough levels and MRD negativity on day 35 of induction therapy, as well as early clinical outcomes including survival and relapse within six months. |
1987-12-29 |
Male |
Yes |
L-2189 | pay_R |
Malignant |
Leukemia & lymphoma |
Clinical |
Abhishek Sharma,Sounik Sarkar,Bijurica Chakraborty, Stuti Roy, Praveen kumar,Tuphan Kanti Dolai,Rajib De |
PRAVEEN KUMAR JHA |
NILRATAN SIRCAR MEDICAL COLLEGE AND HOSPITAL |
KOLKATA |
09523816868 |
coloneljhajee@gmail.com |
Oral |
Title:The relation between L-asparaginase trough levels and MRD negativity on day 35 of induction therapy, as well as early clinical outcomes including survival and relapse within six months.
Introduction:Acute Lymphoblastic Leukemia (ALL)-the most common paediatric cancer with cure-rate exceeding 90% in developed countries, lags at around 60-70% in India. Induction mortality following high-dose chemotherapeutic regimen is an important contributor to dismal cure-rate in India, the other causes being relapse, treatment interruption and non- adherence to planned protocol. This is amplified by limited and poor infrastructure in resource-poor public hospitals. To overcome such predicament, the ICiCLe protocol employs a less-intensive regimen with customised intensification on the basis of FISH and MRD based restratification. Here we are presenting the early outcome of the said protocol along with effect of L-Asperginase level on postinduction MRD status.
Methods:1. Screening of patients (age: 1-18 years) with suspected acute leukemia 2. Confirmation of diagnosis by immunophenotyping 3. Restratification by triple-probe FISH 4. Initiation of ICiCLe protocol 5.mesurement of L-Asperginase trough level on 7 and 14 of Peg L-Asp 6. Post-induction evaluation of patient outcome and MRD based final risk-stratification 7.effect of L-Asperginase level on MRD status.
Results:This prospective study evaluated the relationship between L-asparaginase trough levels, post-induction MRD status, and early clinical outcomes in 60 pediatric ALL patients (aged 1–18 years) treated under the ICiCLe protocol at NRS Medical College. B-ALL was predominant (91.7%), with a mean age of 7.13 years. PEG-L-asparaginase was administered on schedule in 61.1% of cases. Optimal drug levels were more frequent when infusions were timely, especially on day 7 (84.4%) and day 14 (52.7%). MRD assessment on day 35 revealed 66% MRD negativity. The study highlights the impact of timely L-asparaginase administration on therapeutic response in a resource-limited setting.
Conclusions:L-asperginase during induction doesn’t effect the MRD status .
Key words:ALL,MRD |
| 421 |
T cell repleted Haploidentical Hematopoietic Stem Cell Transplantation (HSCT) for Pediatric Acute Leukemia using Treosulfan based conditioning is Highly Effective.
|
1981-03-27 |
Male |
Yes |
done | done |
Malignant |
Leukemia & lymphoma |
Clinical |
Punit Jain, Kanika khandelwal, Pradnya Chaudhari , Dipali patil , Dipalee Borade, Abhijit bagade, Rahul verma, Narjohan Meshram, Dhanya Dharamapalan,Vijay Yewale,Sandeep sawant, Ashok Gawdi, Vitty Mole. Department of Hemato-oncology and Stem cell Trans |
vipin khandelwal |
Apollo hospitals Navi mumbai |
Navi Mumbai |
09910413809 |
khandelwal_vipin@yahoo.com |
Oral |
Title: Background: Haploidentical HSCT is emerging as an alternative choice for children with leukemia requiring stem cell transplant. Here we describe our experience of treating children with acute leukemia by haploidentical HSCT with post transplant cyclophosphamide (PTCy).
Methods: We retrospectively analyzed the outcome data of 7 children with Acute leukemia (5 children had acute lymphoblastic leukemia, 1 each of Acute myeloid leukemia and Chronic myeloid leukemia blast crisis) who underwent related haploidentical HSCT. All were in complete remission (CR) and minimal residual disease (MRD) negative before HSCT. Five in CR1 and two in CR2. Donors were mobilized with granulocyte colony stimulating factors. The conditioning protocol was Inj Fludarabine 30 mg/m2/day from day -6 to -2, Inj Treosulfan 14 gm/m2/day from Day -6 to – 4 and total body irradiation(TBI) 2 Gy on Day -1 . All received PTCy 50 mg/kg on days 3 and 4 as graft-versus-host disease (GVHD) prophylaxis along with tacrolimus and mycophenolate mofetil. A median of 10 million CD34+ cells/kg was infused.
Results: All patients engrafted. Median time of neutrophil engraftment was 15 days (range 12-18) and platelet engraftment was 20 days (range 15-25). All achieved complete donor chimerism on day+30. Acute GVHD was seen in 4 patients (grade III-IV in 2)which was maged. Chronic GVHD was seen in 2 patients only .Viral reactivation of CMV was seen in 5 patients which was managed . Chimerism at 1 year post HSCT is available on 4 patients,which was full donor chimerism in all 4 patients.Two children have completed more than 6 months post HSCT. Only one child is having follow up till day+100 post HSCT. All 7 are in complete remission till the last follow up.
Conclusion - Treosulfan based conditioning is less toxic and highly effective in children undergoing haploidentical HSCT with PTCy for Acute leukemia. |
| 422 |
CD44 IN PAEDIATRIC B-ALL: EXPRESSION AND ITS ROLE IN UNMASKING MEASURABLE RESIDUAL DISEASE (MRD)
|
1998-09-17 |
Female |
No |
- | 24AAN |
Malignant |
Leukemia & lymphoma |
Laboratory |
P. Lalita Jyotsna (dept. of pathology), Shailaja Shukla (dept. of pathology), Mukesh Dhankar (dept. of paediatrics) Lady Hardinge Medical college,New Delhi |
Nisha Naaz |
Lady Hardinge Medical college,New Delhi |
New Delhi |
8077423844 |
naazqureshi11491@gmail.com |
Oral |
Title: CD44 IN PAEDIATRIC B-ALL: EXPRESSION AND ITS ROLE IN UNMASKING MEASURABLE RESIDUAL DISEASE (MRD)
Introduction: Acute lymphoblastic leukemia (ALL) is a haematological malignancy of immature lymphoid cells that predominantly affects children and involves the bone marrow, peripheral blood, and extramedullary sites. Measurable residual disease (MRD) refers to the presence of a small number of leukemic cells that persist after chemotherapy and remain undetectable by conventional microscopy. MRD is a significant prognostic indicator for relapse and survival and is detectable only by advanced techniques at various time points. CD44 is a non-kinase transmembrane glycoprotein highly expressed on hematopoietic cells.
Methods: This study was conducted on 40 newly diagnosed paediatric B-ALL cases. Complete hemogram, peripheral blood and bone marrow aspirate smears evaluation and cytochemistry were performed. Immunophenotyping was carried out using a 12-color flow cytometry panel on day-0 and day-35.
Results: Of the 40 B-ALL cases, 30% (12/40) were MRD-positive at the end of induction therapy (day 35). On day 0, CD44 expression was observed in 90% (36/40) of cases. Among MRD-positive cases, 83.3% (10/12) showed abnormal CD44 expression on day 35. CD44 demonstrated a high frequency of retention (FOR) and a low frequency of loss (FOL), indicating its persistence on residual leukemic cells.
Conclusions: CD44 is frequently expressed on residual leukemic cells and contributes to MRD detection when included in a multiparametric flow cytometry (MFC) panel. In combination with other high-yield markers such as CD38, CD58, CD73, CD81, CD123 and CD304, CD44 enhances the identification of stable leukemia-associated immunophenotypes (LAIPs). This reduces the risk of false-negative MRD results, particularly in cases with low event counts or when antigen modulation affects other markers after chemotherapy.
Key words: B-ALL, CD44, MFC, MRD, LAIP. |
| 423 |
Granulocyte Colony Stimulating Factor–Induced Cytokine Release Syndrome with Pulmonary Toxicity in a Patient with Classical Hodgkin Lymphoma on ABVD Therapy |
1993-05-02 |
Male |
Yes |
L-2141 | 93777 |
Benign |
Miscellaneous |
Clinical |
|
Dr. Vikrant Madre |
BLK MAX Superspeciality hospital, New Delhi. |
New Delhi |
08888869380 |
vikrantmadre15@gmail.com |
Poster |
Title: Granulocyte Colony Stimulating Factor–Induced Cytokine Release Syndrome with Pulmonary Toxicity in a Patient with Classical Hodgkin Lymphoma on ABVD Therapy.
Introduction: Cytokine Release Syndrome (CRS) is a rare but potentially fatal complication in hematology. While most commonly associated with immunotherapies, G-CSF–related CRS is under-recognized. Bleomycin, a key component of ABVD, is a known pneumotoxic agent, and prior exposure has been hypothesized to predispose to exaggerated pulmonary inflammation when G-CSF is subsequently administered.
Methods: A 58-year-old woman with stage IV classical Hodgkin lymphoma, post six cycles of ABVD chemotherapy, presented with neutropenia, oral mucositis, and fever. Supportive therapy with antibiotics and G-CSF was initiated. Within 48 hours, she developed acute hypoxemic respiratory failure, hypotension, and persistent fever requiring ICU care.
Comprehensive infectious evaluation—including serial blood and urine cultures, bronchoalveolar lavage panels, and fungal/mycobacterial assays—was negative. Echocardiography revealed mild new-onset left ventricular dysfunction (EF 50%). Inflammatory markers were elevated, with raised interleukin-6 (15.05 pg/mL), supporting cytokine storm. Despite broad-spectrum antimicrobials, her clinical course deteriorated, consistent with G-CSF–induced CRS.
Results: The close temporal association with G-CSF, sterile cultures, elevated IL-6, and systemic inflammatory decline supported a diagnosis of CRS. Prominent pulmonary involvement in the setting of prior bleomycin exposure raised the possibility of a synergistic mechanism of lung injury, though this remains a hypothesis requiring further study.
Conclusions: This case highlights the diagnostic challenge of G-CSF–induced CRS in Hodgkin lymphoma patients. In those previously treated with bleomycin, pulmonary manifestations may be accentuated, although causality is not proven. Early recognition, G-CSF discontinuation, and cytokine-directed therapy are critical to optimize outcomes.
Key words: Hodgkin lymphoma, G-CSF, Cytokine Release Syndrome, ABVD, Bleomycin, Pulmonary toxicity. |
| 424 |
B-ALL with CD56 Positivity |
1995-04-16 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Phaneendra Datari, Mohammed Aakif, Gayathri Kuppusamy, Kotteeswari Kathirvel, Uday P Kulkarni, Sushil Selvarajan, Sharon Lionel, Anu Korula, Aby Abraham, Biju George, Poonkuzhali Balasubramanian, Vikram Mathews, Arun Kumar Arunachalam. |
Merlin J Priyanka |
Christian Medical College |
Vellore |
7094825247 |
merlyncytogen16@gmail.com |
Poster |
Title: B-ALL with CD56 Positivity
Introduction: CD56, a neural cell adhesion molecule typically expressed on natural killer (NK) cells and subsets of T cells, has been occasionally detected on leukemic B-cell precursors. Rare studies suggest that CD56 expression in B-ALL may be associated with an aggressive clinical course, particularly in paediatric and adult cohorts. Given the limited data and conflicting prognostic implications, we aimed at performing a retrospective study on B-ALL with CD56+ to look for associated cytogenetic alterations and MRD positivity in the cases with follow-up.
Methods: B-ALL cases diagnosed at our centre between March 2021 and August 2025 were assessed, and those with CD56+ were included in the study. Cases with follow-up were assessed for MRD and relapse rates.
Results: CD56 was positive in 34 B-ALL cases between 2021 and 2025. The male-to-female ratio was 2.8, with a median age of the cohort being 17 years (2-64 years). There was no paediatric preponderance in our cohort. Median blast percentage was 77% (16-93%). The immunophenotype was of a typical B-ALL with no association with any specific LAIP marker. Two cases were CD34 negative, and one case was CD10 negative. CNS involvement was seen in 5/34 cases. Cytogenetic data were available in all 34 cases. Normal karyotype was seen in 11/34 cases, t(9;22) was seen in 7/34 cases, and t(1;19) and complex karyotype were seen in two each out of 34 cases. Other cases showed miscellaneous deletions and additions of chromosomes, which were not clinically significant. Follow-up was available in 24/34 cases. MRD post-induction was >0.01% in 7/24 cases and <0.01% in 2/24 cases.. Only 10/24 had a second MRD data, and 1/10 had MRD positivity. 2/10 cases had frank relapse with 15% and 90% blasts.
Conclusion: In our cohort, it was seen associated with t(9;22) in 7 cases, but the association was not significant. Nevertheless, MRD positivity and relapse rates were comparable to B-ALL with standard risk. |
| 425 |
Beyond Albinism: Unmasking Hermansky-Pudlak syndrome in a pediatric patient with Bleeding Diathesis |
1992-02-21 |
Female |
No |
- | pay_Q |
Benign |
Platelet disorders |
Laboratory |
DR SARITA PRADHAN (PROFESSOR, PATHOLOGY ) ,DR SHIVANGI HARANKHEDKAR (ASSOCIATE PROFESSOR & HOD, MOLECULAR LABORATORY), DR BISWAPRAKASH PATRI (ASSISTANT PROFESSOR ,CLINICAL HEMATOLOGY) |
GOLDI KUMARI |
INSTITUTE OF MEDICAL SCIENCE & SUM HOSPITAL |
BBSR |
8709309158 |
kumaridrgoldi@gmail.com |
Poster |
Title: Beyond Albinism: Unmasking Hermansky-Pudlak syndrome in a bleeding pediatric patient .
Authors: Dr Goldi kumari , Dr Sarita Pradhan , Dr Shivangi Harankhedkar , Dr Biswaprakash Patri Affiliation: IMS and SUM Hospital, Bhubaneswar, Odisha
INTRODUCTION : Hermansky pudlak syndrome(HPS) is a rare autosomal recessive multi-system disorder characterized by oculocutaneous albinism, bleeding diathesis due to platelet storage pool deficiency and systemic complications like pulmonary fibrosis and granulomatous colitis. . Bleeding manifestations are variable , may be mild and can sometimes go unrecognised.
CASE REPORT: A 6 year old male, born of consanguineous marriage, presented with recurrent episodes of hematemesis for 15 days, occurring 2-3 times daily(approximately 5 ml each time ). He had a similar episodes, one year back . He had features of oculocutaneous albinism , white hair and nystagmus .His siblings were healthy . Laboratory investigations showed mild microcytic hypochromic anemia , normal platelet count and morphology .Bleeding workup revealed normal PT,APTT ,fibrinogen, factor VIII ,Factor IX ,urea clot solubility test and vWF . Platelet aggregometry demonstrated reduced response to ADP and collagen , consistent with platelet storage pool disorder. Whole genome sequencing revealed homozygous state for a likely pathogenic variant in the BLOC1S6 gene associated with Hermansky Pudlak syndrome9: HSP9 .The patient was managed with hemostatic support and family was counselled regarding genetic basis and bleeding precautions. DISCUSSION: HPS is caused by mutations affecting lysosome –related organelles, resulting in platelet dense granules. Patients typically present with albinism, visual defects and bleeding tendency despite normal platelet counts. Diagnosis requires clinical suspicion, platelet function testing and genetic confirmation. Management is supportive including antifibrinolytics, desmopressin or platelet transfusion . CONCLUSION: This case underscores the importance of considering HPS in children with albinism and recurrent bleeding. Early diagnosis , supportive care significantly reduce morbidity. KEYWORDS: Hermansky-Pudlak syndrome; Oculo-cutaneous albinism; storage pool |
| 426 |
Acquired Hemophilia A Presenting as Spontaneous Musculoskeletal Bleeding and Disproportionate Post-Venipuncture Hematoma in a Middle-Aged Female |
1994-01-13 |
Female |
No |
- | pay_R |
Benign |
Hemeostasis |
Clinical |
DR JINA BHATTACHARYYA,DR DAMODAR DAS,PROFESSOR & ASST PROFESSOR,DEPT OF CLINICAL HAEMATOLOGY,GMCH |
DR MEHJABIN LASKAR |
GAUHATI MEDICAL COLLEGE AND HOSPITAL |
GUWAHATI |
9401707407 |
mehjabinlskr@gmail.com |
Poster |
Title: Acquired haemophilia A presenting as spontaneous musculoskeletal bleeding and disproportionate post venipuncture haematoma in a middle aged female
Introduction: Acquired haemophilia A is a rare bleeding disorder caused by inhibitory antibodies against factor viii.It typically affects elderly individuals or postpartum women,presenting as spontaneous soft tissue or muscle bleeds without any prior bleeding history.Early recognition is essential as delays increase morbidity and mortality.
Methods: We describe a 50 year old postmenopausal woman,recently diagnosed with type 2 diabetes mellitus,who developed insidious onset bilateral ankle swelling and pain for two weeks.She first attended casualty where she was discharged with symptomatic treatment.On subsequent outpatient evaluation,routine intravenous sampling led to rapidly progressive swelling,pain and bluish-purple discoloration of the right hand,grossly disproportionate to needle trauma.
Results:Examination revealed extensive ecchymosis and tense swelling over the right forearm.There was no pallor,icterus,lymphadenopathy,organomegaly or mucosal bleeding.Neurological examination was normal.Laboratory evaluation showed normal hemogram and platelet count,isolated prolongation of activated partial thromboplastin time,lack of correction on mixing study,markedly reduced factor viii activity and a high titer factor viii inhibitor on Bethesda assay,confirming Acquired Haemophilia A.She was started on bypassing agents for bleed control and immunosuppressive therapy for inhibitor eradication.
Conclusions: This case underlies the need to suspect AHA in middle aged patients presenting with new onset spontaneous or trauma provoked soft tissue bleed without prior bleeding history.Prompt diagnosis with coagulation studies and inhibitor assays followed by early initiation of hemostatic and immunosuppressive therapy is crucial to improve outcomes.
Key words:Acquired haemophilia A,autoantibody,factor viii inhibitor |
| 427 |
T-cell Large Granular Lymphocytic Leukemia: A Case Series |
1988-12-18 |
Female |
No |
- | H_LKO |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Chaitanya G B, Dr. Adlin Ho, Dr. S.K.Waheed Hussain, Dr. Ranjit Kumar C S, Dr. Anil Aribandi |
Dr Chaitanya G B |
Sindhu hospitals |
Hyderabad |
9490417717 |
chaitu.1.master@gmail.com |
Oral |
Title: T-cell Large Granular Lymphocytic Leukemia: A Case Series
Introduction:T-cell large granular lymphocytic leukemia (T-LGLL) is a rare chronic lymphoproliferative disorder characterized by clonal expansion of cytotoxic T-cells. It accounts for 2–5% of chronic lymphoproliferative disorders. The disease typically presents in the sixth decade, often with cytopenias, splenomegaly, or autoimmune associations. We present two cases highlighting the heterogeneity of presentation and diagnostic challenges.
Methods: Case 1: A 31-year-old female, initially diagnosed as pure red cell aplasia and treated with cyclosporine,had persistent transfusion dependent anemia. Repeat bone marrow biopsy demonstrated atypical lymphoid infiltration; immunohistochemistry confirmed mature T-cell neoplasm consistent with T-LGL. STAT3 sequencing revealed no pathogenic variants.She was diagnosed with T-LGLL and commenced on cyclophosphamide,after which she attained CR with transfusion independence. Case 2: A 60-year-old male presented with facial puffiness, fever, significant weight loss and transfusion dependent anemia since 1 month (Hb 3 g/dL) with splenomegaly on examination.Bone marrow revealed diffuse infiltration by atypical lymphoid cells. Flow cytometry confirmed T-LGLL. Autoimmune screening was unremarkable. He was treated with cyclophosphamide, achieving a good response with transfusion independence.
Results:These cases illustrate the spectrum of T-LGLL.While Case 2 reflected the more typical presentation of transfusion-dependent anemia and splenomegaly in an older male, Case 1 underscores a rarer presentation in a young female,masquerading as PRCA. Notably, STAT3 mutation,frequently implicated in T-LGLL pathogenesis, was absent in Case 1,suggesting that diagnosis cannot rely solely on molecular findings but requires integrated clinicopathological correlation. Both patients responded to immunosuppressive therapy with cyclophosphamide, reinforcing its role as a first-line agent in patients presenting with anemia. Conclusions:T-LGLL is rare and heterogeneous disorder with varied presentations ranging from autoimmune cytopenias in young patients to severe transfusion dependence in older individuals. Accurate diagnosis and timely immunosuppressive therapy remains the cornerstone of therapy.
Keywords: T-cell large granular lymphocytic leukemia; cytopenia; splenomegaly; cyclophosphamide; PRCA |
| 428 |
A Cross-sectional Study exploring Psycho-social needs of Haematology patients - developing an Integrative model of Care |
1988-12-18 |
Female |
No |
- | H_LKO |
Malignant |
|
Clinical |
Dr. Chaitanya G B, Dr. Bindu Menon K, Dr. Bhavya Sri Vallamshetla, Dr. S.K.Waheed Hussain, Dr. Ranjit Kumar C S, Dr. Anil Aribandi |
Dr. Chaitanya G B |
Sindhu hospitals |
Hyderabad |
9490417717 |
chaitu.1.master@gmail.com |
Oral |
Title: A Cross-sectional Study exploring Psycho-social needs of Haematology patients - developing an Integrative model of Care
Introduction:Haematology patients have diverse psycho-social needs. Patients with their own estimation of bad prognosis and with poor perceived social support may experience significant distress; leading to poor treatment compliance and outcome. The present study aims to investigate the psychological distress, symptom assessment, psycho-social needs and its impact on their quality of life. Secondly, an integrative approach to hematology patients and the scope of Mindfulness therapy for systemic benefits is explored.
Methods:A cross sectional, observational research design with a mixed method approach Is implemented. Purposive sampling method was used. Prevalence of distress and Symptom assessment was quantified using Standardized Psychological instruments - Distress thermometer (DT) And Edmonton Symptom Assessment Scale (ESAS).Semi structured in-depth interviews were conducted with 12 haematology patients and their responses were recorded.The data underwent thematic analysis,generating subthemes and themes. The study was conducted and reported according to COREQ Checklist.
Results: Distress extends along a continuum.DT instrument measured moderate to severe distress (DT>7),spiritual and existential crisis.ESAS rated high (>8) gastrointestinal problems,pain,anxiety,fatigue,disturbed sleep,concern of body image disposition,fear of recurrence or death.Qualitative analysis revealed two main themes and its sub-themes. The first theme is perception towards hematological cancer, with the sub-themes of physical debility,psychological distress,social alienation,social stigma and existential crisis. The second theme-Pathways of adaptive coping with sub-themes of disease management, inner harmony and psycho-social support.
Conclusions:The present study highlights the need for systematic screening for psychological distress, symptom assessment and qualitative approach to evaluate and address the unmet psycho-social needs of patients. The scope of integrating indigenous methods like Mindfulness therapy has a very important role to play in improving health outcomes and quality of life in this subset of patients.
Keywords:Psychological distress, mindfulness therapy, quality of life |
| 429 |
TECLISTAMAB IN PENTA REFRATORY MULTIPLE MYELOMA: A SINGLE CENTRE EXPERIENCE |
1977-08-18 |
Male |
Yes |
L-911 | pay_R |
Malignant |
Plasma cell disorders |
Clinical |
Priyamvadha Ramesh, Shruti Sinha, Naman Bansal, Navneet Mishra, Meena Verma |
Nitin Gupta |
GANGA RAM INSTITUTE OF POST MEDICAL EDUCATION AND |
NEW DELHI |
9868445655 |
docnitingupta@gmail.com |
Oral |
TITLE
TECLISTAMAB IN PENTA REFRATORY MULTIPLE MYELOMA: A SINGLE CENTRE EXPERIENCE
Authors: Priyamvadha Ramesh, Shruti Sinha, Naman Bansal, Navneet Mishra, Meena Verma, Nitin Gupta
Ganga Ram Institute of Post Medical Education and Research, New Delhi
Background:
Treatment option for triple class refractory myeloma includes Bispecific antibodies or CAR T cell therapy. Teclistamab is the first approved bispecific T-cell engager (BiTE) targeting BCMA, has shown high efficacy in relapsed/refractory multiple myeloma (RRMM) and is being explored in AL amyloidosis. However, real-world data from India is lacking and we present our early experience with Teclistamab, focusing on treatment response and safety.
Methods:
A retrospective analysis of triple class refractory myeloma treated with Teclistamab was done from (Sept 2024–August 2025). Responses were assessed using IMWG criteria and toxicities were graded per standard guidelines.
Results:
Six patients (all males), median age 59 years (43-64 years) were treated. All had penta refractory disease and 3 had past autologous transplants. All patients achieved ≥PR (100% ORR) with 66.6%, ≥VGPR. Time to best response was 1.5 cycles. Responses occurred irrespective of risk stratification and prior ASCT. Grade 1 CRS occurred in 66.6% but no grade 3-4 CRS/ICANS was seen. Severe hypogammaglobulinemia developed in all patients requiring IVIG monthly maintenance. Median follow up 4 months (3-10), One death in CHR after 1 cycle due to multiple organ failure of underlying amyloidosis and 1 stopped treatment in CR after 1 cycle due to financial constraints, one underwent allogenic bone marrow transplant while 3 are in monthly treatment.
Conclusion:
In this first Indian real-world series, teclistamab induced rapid and deep responses in heavily pretreated RRMM with manageable toxicity.
Keywords:
Teclistamab, Refractory myeloma, CRS
|
| 430 |
From Panniculitis to Pancytopenia: A Clue to VEXAS Syndrome |
1984-08-25 |
Male |
Yes |
L-1970 | pay_REzvE6bfCkl3cb |
Benign |
Miscellaneous |
Laboratory |
|
ANURAG SINGH |
SANJAY GANDHI POSTGRADUATE INSTITUTE OF MEDICAL SC |
LUCKNOW |
09792581370 |
anugsvm@yahoo.com |
Poster |
Title: From Panniculitis to Pancytopenia: A Clue to VEXAS Syndrome
Introduction: VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome is a recently recognised late-onset autoinflammatory condition caused by somatic mutations in the UBA1 gene. It is characterised by systemic inflammation, cytopenias, and steroid dependence.
Case report: We report a 41-year-old male with a one-year history of relapsing systemic inflammation involving periorbital inflammation, skin rash associated with fever and significant weight loss. The skin biopsy showed lobular panniculitis with leukocytoclastic vasculitis. Initially he demonstrated a partial response to glucocorticoids but experienced multiple relapses upon tapering.
Hematological evaluation revealed pancytopenia with markedly elevated mean corpuscular volume unresponsive to B12 and folate supplementation. Bone marrow aspiration smears were cellular with trilineage haematopoiesis and displayed vacuolation and dysplasia in the erythroblasts. Infectious, autoimmune, and granulomatous disorders were excluded. Clinical exome sequencing focusing on UBA1 mutation was requested, which showed a positive result.
This case underscores the importance of considering VEXAS syndrome in adult males with multisystem inflammation, steroid dependence, and macrocytic anemia with cytopenias. Recognition is critical for targeted therapy, including JAK inhibitors or hypomethylating agents in refractory cases.
Conclusions: VEXAS should be a differential diagnosis in unexplained relapsing systemic inflammation with hematological abnormalities. Early suspicion and genetic confirmation are key for appropriate management and prognostication.
Key words: Autoinflammation, pancytopenia, paniculitis, VEXAS syndrome |
| 431 |
Hepatitis C and Myelodysplastic Syndrome : Unravelling the connection |
1994-03-01 |
Male |
No |
- | T2509011651446728567738 |
Malignant |
Myelodysplastic syndrome |
Laboratory |
Dr Kulwant Singh, Dr Parveen Rana Kundu, Dr Sunaina Hooda, Dr Monika B Gathwal, Dr Swaran Kaur Saluja, Dr. Nitika Chawla. |
Dr. Raj Aravind K |
BPS GMC for women, Khanpur Kalan, Sonipat |
Sonipat |
8825626993 |
rajkaravind13@gmail.com |
Poster |
Title:Hepatitis C and Myelodysplastic Syndrome : Unravelling the connection
Introduction:Myelodysplastic syndromes (MDS) refers to a heterogenous group of closely related clonal hematopoietic disorders commonly found in aging population. MDS is observed as one of the significant extrahepatic manisfestations in hepatitis C virus infection. The correlation between HCV infection and myelogenous disorder is still debated.
Methods:A 62 year old male came to emergency with the complaint of generalised body weakness for the past 1 year. There was prior history of blood transfusion twice. He was detected as HCV positive 3years ago. Laboratory testing showed hemoglobin 9.0 gm%, TLC 2000/cumm, platelet count 40,000/cumm, neutrophils 40%, lymphocytes 50%, monocyte 8%, eosinophil 2%, basophil 0%, RBC 3.14 million/cumm, MCV 91.5 fL, MCH 29.3 pg, RDW 25.8%, hematocrit 28.8% and corrected reticulocyte count was 3.2%. Peripheral blood smear showed dimorphic blood picture with anisopoikilocytosis and target cells.
Results:Bone marrow aspiration was done. Smears were hypercellular for age with increased myeloid to erythroid ratio. Myeloid series appeared adequate with slight predominance of eosinophil precursors. Erythroid series were hyperplastic with micro normoblastic and dyspoietic changes. Megakaryocytes were slightly reduced in number and showed dyspoietic changes. Iron stores were slightly increased (4+). Possibility of Myelodysplastic Syndrome with thrombocytopenia was considered.
Conclusions:The incidence of Myelodysplastic Syndrome during HCV infection is rare. Most common mutation observed in elderly population is in germline DDX41. The correlation between HCV infection and myelodysplastic syndrome is still under research. Aetiologies can be an inflammatory response, an autoimmune response or the virus's direct effect on bone marrow. Therefore, further studies are highly essential to identify the risk factors, to prevent and to effectively manage the myelodysplastic syndrome in HCV infected patients.
Key words:Myelodysplastic, hepatitis C virus, heterogenous, metamyelocytes, dyspoietic. |
| 432 |
CHILDHOOD RHABDOMYOSARCOMA – A CASE REPORT |
1959-08-27 |
Female |
Yes |
L 1360 | UPI transaction ID:513510381536 |
Malignant |
Rare hematological malignancies |
Laboratory |
Dr.Vinila B Reddy [Professor], Dr.ManiMekhala P [Professor &HOD], Dr.Naveenkumar M [Associate Professor] Pathology,Dr.SVSS.Prasad [Senior Consultant Medical Oncologist] |
Vanajakshi |
Apollo Institute of Medical Sciences & Research |
Hyderabad |
+91 9849667000 |
balakrishnanvanajakshi@gmail.com |
Poster |
Title: Childhood Rhabdomyosarcoma A case report
Authors: Vanajakshi.S, Vinila B Reddy, Mani mekhala P , Aruna L, Naveen kumar.M, SVSS Prasad.
Introduction: Rhabdomyosarcoma [RMS] is malignant soft tissue tumor orginate from primitive mesenchymal cells. It is the most common soft tissue sarcoma diagnosed in male children . RMS is classified into Embryonal, Alveolar, Pleomorphic, Spindle & mixed - histologic types .Embryonal is the most commonly occuring sub type in head & neck region & has the best prognosis.RMS involving the extremities is more frequently observed with the alveolar subtype.The pleomorphic & alveolar subtypes have the highest rates of metastasis & poor prognosis. The most common metastatic sites include the lungs, bone marrow & lymphnodes.
Methods & Results: A five year old child P/W left elbow swelling, biopsy from the lesion reported as alveolar RMS, based on morphology & IHC. Trephine marrow core biopsy for staging showed diffuse infiltration with RMS replacing the entire native marrow.
Conclusion: Diagnosed as metastatic RMS invoving marrow based on histomorphology & clinical presentation .
Keywords: RMS,trephine core biopsy, embryonal, alveolar ,splndle cell
|
| 433 |
Lymphoma: Epidemiology and Outcomes of frontline treatment patients treated in the last decade |
1992-07-12 |
Female |
No |
- | pay_RFUIZEj1gYgVHZ |
Malignant |
Leukemia & lymphoma |
Clinical |
Payal Mondal, Zameer Latif, Indu P, Rimpa b Achari, Arijit Nag, Jeevan Kumar, Mayur Pariher, Deepak Mishra, Ramesh Nimmagadda*, Reena Nair. |
Sreya Das |
Tata Medical Center |
Kolkata |
7550931078 |
dasshreya58@gmail.com |
Oral |
Title:Lymphoma: Epidemiology and Outcomes of frontline treatment patients treated in the last decade Introduction:This study aims to survey the clinical spectrum of lymphoma in terms of epidemiology, pathological subtypes, stage, prognostic factors and outcomes of first line therapy. Methods:A tertiary cancer center in Eastern India audited the histology, clinical features and survival of adult (≥ 18 years) of all patients presenting with a diagnosis or suspicion of lymphoma. Using the Hospital Management System (HMS), data was collected from 2011 to 2020 for 3854 patients. Post relapse after therapy in another center or those who did not take treatment were considered 2nd opinion seekers. The diagnostic pathology, according to the WHO classification 2008, clinical features and survival details were loaded on the OncoCollect software and analyzed. 2210 patients receiving front-line therapy were evaluated for outcomes till June 2025. Results:The median age of 3854 patients was 55 years (range 18-95 years). Adolescents and Young adults (18 to 39 years) comprised 21%, adults (40 to 64) 53% and older patients (≥ 65) 25%. Male to female ratio was 1.4:1. Of the 2210 patients who received front line therapy, 16% were Hodgkin Lymphoma, 77% were B-cell lymphoma, 5% T/NK cell lymphoma (TNKCL) and 1.5% were Precursor T and B cell Lymphoma. B cell subtypes included 49% aggressive lymphoma, and 26% low grade B cell. At presentation B symptoms were present in 41%, early stage (1 &2) in 37%, late stage (3 & 4) in 62%. HBsAg reactive in 14 patients, HCV in 5 and HIV in 8 tested patients. With a median Follow Up of 48 months, the 5-year progression free survival (PFS) after 1st line therapy was 80% for HL, 65% for Bcell lymphoma amd 40% for T/NK cell lymphoma.
Conclusions:This is a registry based epidemiological, clinical spectrum and outcomes after 1st line |
| 434 |
CORRELATING HEMATOLOGY ANALYZER GRAPHS WITH FLOW CYTOMETRY FINDINGS IN HEMATOLYMPHOID MALIGNANCIES. |
1994-10-22 |
Female |
No |
- | pay_RFVa20x1ZR25wF |
Malignant |
Leukemia & lymphoma |
Laboratory |
2-Dr.Irfana Nisam,2.Junior Resident,Department of Pathology.3-Dr.Sarika Singh,Professor, Department of Pathology.4-Dr.Zoya Hasan,Senior Resident, Department of Pathology.5-Dr.Rishika Tripathi,Undergraduate Student |
Dr.Neha Pandey |
Maulana Azad Medical College and Associated Hospit |
New Delhi |
9717453830 |
neha.npandey999@gmail.com |
Oral |
Title:CORRELATING HEMATOLOGY ANALYZER GRAPHS WITH FLOW CYTOMETRY FINDINGS IN HEMATOLYMPHOID MALIGNANCIES. Introduction:Hematology analyzers and Flow cytometry are pivotal technologies used in diagnosis and management of hematolymphoid malignancies.Hematology analyzers are automated machines that provide rapid and comprehensive complete blood counts.They offer preliminary insights into hematological abnormalities.Flow cytometry,on the other hand, is a sophisticated technology that analyzes physical and chemical characteristics of cells or particles providing detailed information on cell populations including size,granularity,and the presence of specific surface markers.At times in cytopenic samples and marrow aspirates with inadequate cellularity,diagnosis could be challenging.So,to triage sample testing automated hematology analyzer can be very significant.The integration of data from hematology analyzers and flow cytometry holds the promise of enhancing diagnostic precision in hematolymphoid malignancies.By correlating the graphical outputs of hematology analyzers with flow cytometry findings,this study aims to identify patterns and correlations that could improve diagnostic accuracy Methods:This is a retrospective observational study conducted in the Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, spanning January 2022–December 2024.253 cases of all hematolymphoid malignancies diagnosed during the period were included.For each case, hematology analyzer outputs (CBC,histograms,WDF/WNR scattergrams,analyzer flags,and newer RBC parameters)from the Sysmex XN-1000i have been extracted alongside corresponding flow cytometry data(scatter properties and immunophenotypic marker panels).The primary objective was to measure concurrence between analyzer graphs and flow cytometry results;secondary objectives included identifying reproducible analyzer patterns linked to specific immunophenotypes,benchmarking diagnostic accuracy and exploring whether combined data improves classification and triage Results:We expect distinct WDF/WNR signatures to align with key diagnoses, while analyzer flags and scattergrams sensitively detect abnormalities and flow cytometry adding specificity.Our proposition is an integrated approach may streamline triage, reduce nondiagnostic workups, and boost peripheral blood positivity rates. If confirmed,this supports standardized analyzer phenotypes,cost-effective reflex algorithms,improved training in identifying diagnostic graphical cues within few hours.
Keywords:Hematological Analyzers,Flow cytometry |
| 435 |
Genomic Insights into Thrombophilia: Decoding the Molecular Landscape of Unprovoked Deep Vein Thrombosis in North Indian Patients. |
1998-07-23 |
Male |
No |
- | pay_RFO5MENDa6XcoM |
Benign |
Hemeostasis |
Laboratory |
Manu Jamwal1, Chander Hans1, Arihant Jain2, Pankaj Malhotra2, Jasmina Ahluwalia1, Reena Das1, Narender Kumar1, Department of 1 Hematology and Clinical Hematology and Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh- 1 |
Vasant Kumar |
PGIMER Chandigarh |
Chandigarh |
7065843282 |
vasantkumar.9501998@gmail.com |
Oral |
Title: Genomic Insights into Thrombophilia: Decoding the Molecular Landscape of Unprovoked Deep Vein Thrombosis in North Indian Patients.
Introduction: Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, is the third most common vascular disorder globally. DVT, predominantly in lower limb veins, may progress to PE and is classified as provoked (linked to transient risk factors) or unprovoked (risk factors unidentified). Conventional thrombophilia testing identifies few inherited cases and is resource-intensive. Next-generation sequencing (NGS) provides a rapid, comprehensive, and cost-effective approach to define the genomic landscape of thrombophilia in North Indian patients.
Methods: Forty-five unprovoked VTE patients were enrolled. Screening included protein C (PC), protein S (PS), antithrombin (AT), and lupus anticoagulant on an automated coagulation analyzer. Anti-cardiolipin and anti-β2GP1 antibodies were tested by chemiluminescence. Targeted resequencing using a custom AmpliSeq panel was performed on Illumina MiSeq; variants were analyzed using Local Run Manager and in silico pathogenicity prediction tools.
Results: Among 45 unprovoked DVT patients (mean age 32.5 years, M:F ratio 1.5:1), 6/45 (13.3%) also had PE. Thrombophilia screening in 29 patients showed protein C deficiency in 3/29 (10.3%), protein S deficiency in 11/29 (37.9%), and antithrombin deficiency in 1/18 (5.5%); all were APLA-negative (single testing). Genetic analysis identified 15 variants in 15/45 (33.3%) cases: 10/15 (66.7%) missense, including 12 SNVs, 2 deletions, and 1 insertion; all heterozygous except one homozygous variant. Gene distribution included PROS1 5/16, SERPIN family 5/16, PROC 3/16, F5 3/16, and F13 1/16. Seven variants were novel; eight pathogenic/likely pathogenic, and seven VUS, including cases with normal assays.
Conclusions: Targeted resequencing effectively identifies thrombophilia-associated variants in DVT patients. Integrating genetic profiling with conventional workup enhances risk assessment, optimization of anticoagulation therapy and its duration, for DVT.
Key words: Venous thromboembolism, Deep vein thrombosis, Thrombophilia, Next-generation sequencing, Genetic variants |
| 436 |
To study the role of D-dimer and plasma fibrinogen in patients of breast carcinoma. |
1997-01-01 |
Female |
No |
- | 561724831030 |
Malignant |
Plasma cell disorders |
Laboratory |
|
RUBY YADAV |
JNMC AMU |
ALIGARH |
9340521432 |
ruby1430yadav@gmail.com |
Oral |
Title: To study the role of D-dimer and plasma fibrinogen in patients of breast carcinoma. Introduction:Ruby Yadav Resident, Umrah Malik Resident, Kiran Alam Professor, Kafil Akhtar Professor,*SA Rizvi Professor; From the: Department of Pathology and *General Surgery, JNMC, Faculty of Medicine, A.M.U., Aligarh-India. Abstract Objectives: The aim of the present study was to study the role of D-dimer and plasma fibrinogen in patients of breast carcinoma. Methods: Seventy eight patients of diagnosed breast carcinoma with all the relevant clinical details, physical examinations and investigations were taken for the study. Pre-treatment blood sample were evaluated for D-dimer and fibrinogen levels. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) (v.23.USA) software and Microsoft Excel. Results: : D-dimer was high in 75.6% of the cases. Mean of D-dimer in cases was 0.93 ± 0.91, which was significantly higher as compared to controls (0.22 ± 0.05), with p value <0.0001. Mean of D-dimer in. Mean of D-dimer was highest in metaplastic carcinoma as 1.67 ± 2.04. Mean D-dimer in Grade 3 (2.14 ± 1), T4 (1.63 ± 1.24), stage IIIC (2.22 ± 0.44) was the highest. Plasma fibrinogen level was high in 53(68.0%) of the cases and low in 5(14.3%) of the controls. Mean fibrinogen level was highest in invasive papillary carcinoma as 6.86 ± 0. Mean fibrinogen levels in Grade 3(8.57 ±1.43), T4 (7.58 ± 2.31), N3 (8.58 ± 1.73), stage IIIC (8.58 ± 1.73) and luminal A (5.69 ± 2.7) was the highest. Conclusions: : There is significant correlation between elevated levels of plasma D-dimer and fibrinogen depending on the subtype, grade, stage of the tumor and lymph node status. They can be used as an effective tool for the early diagnosis, staging and prognostication of breast carcinomas and aid in better management. KEYWORDS:Breast, Cancer, D-dimer, Plasma, Fibrinogen, Prognosis. |
| 437 |
Chronic Enteropathy Associated with SLCO2A1 Gene Mutation Presenting as Refractory normocytic to macrocytic Iron-Deficiency Anemia, short stature, hypogonadotropic hypogonadism, and protein energy malabsorption: A Diagnostic Dilemma for the Hematologist |
1989-12-30 |
Male |
No |
- | pay_RFaNuwRsYsj36L |
Benign |
Anemia |
Clinical |
Dr. Tulika Seth, Professor AIIMS, New Delhi |
Dr. Saurabh Pandey |
All India Institute Of Medical Science |
New Delhi |
09797790045 |
saurabh007362@gmail.com |
Oral |
Chronic Enteropathy Associated with SLCO2A1 Gene Mutation Presenting as Refractory normocytic to macrocytic Iron-Deficiency Anemia, short stature, hypogonadotrophic hypogonadism and protein energy malabsorbtion: A Diagnostic Dilemma for the Hematologist Abstract Introduction: Chronic enteropathy associated with SLCO2A1 (CEAS) is a rare autosomal recessive disorder characterized by persistent small bowel ulcers, protein-losing enteropathy, and anemia. Due to its rarity and overlapping features with Crohn’s disease, GI tuberculosis and NSAID enteropathy, diagnosis is often delayed. Case Presentation: We report a 21-year-old male presenting to hematology department with recurrent normocytic to macrocytic, hypochromic iron-deficiency anemia requiring multiple transfusions. He gives history of recurrent abdominal pain, moderate to severe bony pain, h/o pathological fracture of Lt upper limb, failure to grow and generalized anasarca. Despite adequate supplementation, anemia persisted, and work-up for hemolysis and bone marrow disorders was negative. Gastrointestinal evaluation revealed multiple small intestinal ulcers. Histopathology was nonspecific, and initial suspicion of Tuberculosis Vs Crohn’s disease was made. Lack of response to ATT and corticosteroids prompted genetic testing, which identified a pathogenic SLCO2A1 exon 3 c.310G>A (p.Gly104Arg) mutation, confirming CEAS. His further evaluation revealed evidence of hypogonadotrophic hypogonadism, short stature, hypothyroidism, severe osteoporosis , global hematohysial dysplasia. The patient was managed with supportive care including iron replacement, albumin infusions, and nutritional support, with stabilization on follow-up. Conclusion: CEAS should be considered in the differential diagnosis of unexplained, transfusion-dependent iron-deficiency anemia with small bowel ulcers unresponsive to immunosuppression therapy. Awareness of this entity is crucial for hematologists, as patients often first present with refractory anemia rather than gastrointestinal complaints. Often misdiagnosis leads to delay in appropriate therapy and psychological distress for the patients and family. Perhaps timely institution of appropriate measures could prove to be preventive of many complications and thus awareness and early and appropriate work up for the disease will help in timely |
| 438 |
A Comparative Analysis of Five Disseminated Intravascular Coagulation (DIC) Scoring Systems in a Pediatric Cohort: Concordance, Discrepancy, and the Unique Challenge of Thrombocytopenia |
1994-03-01 |
Female |
No |
- | pay_RFaNYFZ67vQGEk |
Benign |
Hemeostasis |
Clinical |
Dr. Vandana Puri, Dr. Shikha , Dr. Shailaja Shukla, Dr. P.L. Jyotsna |
Sakshi Aggarwal |
Lady Hardinge Medical College & Associated Hospita |
New Delhi |
8376957957 |
sakshi.aggarwal94@gmail.com |
Oral |
TITLE-A Comparative Analysis of Five Disseminated Intravascular Coagulation (DIC) Scoring Systems in a Pediatric Cohort: Concordance, Discrepancy, and the Unique Challenge of Thrombocytopenia
Authors:
Dr. Sakshi Aggarwal, Dr.VandanaPuri,Dr.Shikha,Dr.ShailajaShukla, Dr.P.L Jyotsna
INTRODUCTION
Disseminated Intravascular Coagulation (DIC) is a complex thrombo-hemorrhagic condition that presents a significant clinical challenge in children. Timely and accurate diagnosis is critical for effective management and improved patient outcomes. The International Society on Thrombosis and Hemostasis(ISTH) Overt DIC score is widely used diagnostic system, often considered a standard in adult populations. However, its heavy reliance on laboratory parameters, particularly platelet count, may lead to misclassification in pediatric patients where thrombocytopenia is a common finding in many non-DIC conditions.
MATERIALS AND METHODS
This study retrospectively analyzed data from 325 pediatric patients suspected of DIC over three years. We compared the diagnostic performance of the ISTH Overt DIC score against four alternative scoring systems:Japanese Ministry of Health and Welfare(JMHW), Korean Society on Thrombosis and Hemostasis(KSTH), Chinese DIC Scoring System(CDSS) and Japanese Association for Acute Medicine(JAAM).
RESULTS
The ISTH score classified all 325 patients as having Overt DIC, a 100% DIC-positive rate that contrasted sharply with the JMHW and CDSS systems, which categorized 83% and 72% of patients as DIC-negative, respectively.The KSTH and JAAM scores showed high concordance, classifying 91.7% and 90.5% as DIC-positive, respectively. An in-depth analysis of these discrepancies revealed that a large number of patients achieved a high ISTH score predominantly due to severe thrombocytopenia with other coagulation parameters showing minimal derangement.
CONCLUSION
ISTH Overt DIC scoring system lacks diagnostic specificity in children and may lead to overdiagnosis of DIC due to its high sensitivity to thrombocytopenia.This study underscores the need for a more comprehensive diagnostic approach and suggests alternative scoring systems, or a combination of clinical and laboratory criteria, maybe more appropriate for the pediatric population. KEYWORDS-Scoringsytem
|
| 439 |
Non-Hodgkin Lymphoma Presenting as Paraneoplastic Inflammatory Myositis with Anti-TIF1 Positivity: A Case Report |
1999-04-05 |
Male |
No |
- | H_LKO-611 |
Malignant |
Leukemia & lymphoma |
Clinical |
DR. NILESH KUMAR ,DR ABHISHEK MAURYA |
DR DHIRENDRA KUMAR |
INSTITUTE OF MEDICAL SCIENCES , BHU |
VARANASI |
7054773746 |
dhirendrakr@bhu.ac.in |
Poster |
Title:Non-Hodgkin Lymphoma Presenting as Paraneoplastic Inflammatory Myositis with Anti-TIF1 Positivity: A Case Report
Introduction:Paraneoplastic myositis is a rare but recognized manifestation of underlying malignancies, most commonly associated with solid tumors. Association with non-Hodgkin lymphoma (NHL) is uncommon. We report a case of NHL presenting initially with features of inflammatory myositis.
Methods:A 50-year-old male presented with progressive proximal muscle weakness, myalgia and Clinical examination revealed inguinal lymphadenopathy and signs consistent with inflammatory myopathy. Laboratory evaluation showed elevated muscle enzymes. Myositis antibody panel demonstrated anti-TIF1 antibody strongly positive (3+). Excisional biopsy of the inguinal lymph node confirmed the diagnosis of NHL.
Results:The patient fulfilled diagnostic criteria for inflammatory myositis with concomitant lymph node biopsy-proven NHL. The constellation of muscle involvement, serological positivity for anti-TIF1, and temporal association with lymphoma favored a diagnosis of paraneoplastic myositis. The patient was initiated on chemotherapy for NHL, with concurrent immunosuppressive therapy, resulting in improvement of symptoms.
Conclusions:This case highlights the importance of considering paraneoplastic myositis in patients presenting with inflammatory myopathy and anti-TIF1 antibody positivity. Early recognition of the underlying malignancy—in this case NHL—is crucial for guiding therapy and improving outcomes.
Key words: NHL ,Paraneoplastic myositis |
| 440 |
Linking miRNA-326 Expression with Minimal Residual Disease in Pediatric B-ALL |
1995-03-30 |
Male |
No |
- | H_LKO-367 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Sarika Singh (Professor, Department of Pathology, Maulana Azad Medical College), Dr Binita Goswami (Professor, Department of Biochemistry, Maulana Azad Medical College), Dr. Khuraijam Bembem (Professor, Department of Pathology, ABVIMS and Dr RML hospi |
Dr. Robin |
Maulana Azad Medical College |
Central Delhi |
9654238026 |
robinyadav2009@gmail.com |
Oral |
Title: Linking miRNA-326 Expression with Minimal Residual Disease in Pediatric B-ALL
Introduction: ALL is the most common malignancy of childhood accounting for 25-30% of all paediatric neoplasms worldwide. MRD based risk stratification is considered the standard of care for B ALL.
Methods: 20 newly diagnosed cases of B ALL in paediatric population, diagnosed on CBC, PS, BM examination and Flow cytometry. microRNA 326 levels (miRNA 103a as internal controls) were measured at the time of diagnosis and post induction during MRD assessment. 5 age matched healthy controls were taken for reference.
Results: The current study analyzed 20 pediatric patients diagnosed with B-cell Acute Lymphoblastic Leukemia (B-ALL), predominantly in the 0–12 year age group (mean age of 4.6 years), with a male preponderance (M:F = 1.22:1). Fever was the most common presenting symptom (100%), followed by weight loss (90%) and abdominal pain (60%), while splenomegaly (95%) and hepatomegaly (80%) were the most frequent clinical signs. Hematological evaluation showed anemia in 19 out of 20 patients (95%) and thrombocytopenia in 15 out of 20 patients (75%). BMA revealed a mean blast count of 75%, and FCM confirmed B-cell lineage with CD19 positivity in all cases along with variable expression of CD10, CD22, CD34, CD58, and HLA-DR. MRD follow-up was available in 16 patients, of whom 18.7% were MRD-positive. Analysis of microRNA-326 showed significant downregulation in cases compared to healthy controls (p = 0.024) (consistent with literature), with negative correlations observed between blast count and miRNA-326 (p = 0.032) as well as CD34 expression and miRNA-326. At MRD 2 out of 3 positive patients showed a downregulation of miRNA 326 as compared to healthy controls but the sample size was small for significant correlation.
Conclusion: microRNA 326 was downregulated in newly diagnosed ALL cases as compared to controls making it a potential_biomarker.
Keywords:B-ALL,MRD,microRNA326,Acute_Leukemia,FlowCytometry |
| 441 |
Spectrum Of Paediatric Leukemia in A Tertiary Care Hospital in North India |
1992-04-21 |
Male |
No |
- | 111056768092 |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr Poonam Chaurasia(JR), Dr Rashmi(JR), Dr Prerna Arora(PROFESSOR), Dr Monica Juneja(HOD PEDIATRICS), Dr Ashish Jain(HOD NEONATOLOGY) |
VIPUL RANJAN BHATT |
MAULANA AZAD MEDICAL COLLEGE AND ASSOCIATE HOSPITA |
DELHI |
9013572866 |
VIPULMAMC@GMAIL.COM |
Oral |
Title: Spectrum Of Paediatric Leukemia in A Tertiary Care Hospital in North India
Introduction: Childhood malignancies account for up to 5% of all malignancies in India, with leukemia accounting for upto 40% incidence with majority being T-cell Acute Lymphoblastic Leukemia (T-ALL) with 72% incidence. This is followed by Acute Myeloid Leukemia(AML) (18%) and only 9% of as cytochemically Undifferentiated acute leukemias(UAL). Genetic predisposition, including prenatal translocations, Downs syndrome, Klinefelter’s syndrome, Fanconi anemia and male sex contribute to its etiology amongst other factors such as socioeconomic status, demography, ethnicity and environmental factors. Atypical symptoms such as, hematemesis, melena, diarrhoea and proptosis or isolated lymphadenopathy should warrant a detailed examination.
Methods:An observational study was conducted over a period of 2 years [2024-2025]. Paediatric patients (0 -12 years) suspected of leukemia were included. Data were collected on demographic details, clinical presentation, haematological parameters, bone marrow findings, and immunophenotyping results. The distribution of leukemia subtypes and their presenting features were analysed.
Results:A total of 26 paediatric leukemia cases were included. ALL was the predominant subtype, accounting for 61.53% of cases with B-ALL reported in 75% cases, followed by AML (11.5%), and UAL (7.6%). Transient Abnormal Myelopoiesis was reported in 4% cases. The median age at diagnosis was 4.5 years, with a male-to-female ratio of 1.6:1. Common presenting features included pallor, fever, and hepatosplenomegaly.
Conclusions:The study highlights the predominance of ALL among paediatric leukemias in North India, with significant clinical and immunophenotypic heterogeneity. These findings underscore the importance of early diagnosis and tailored treatment strategies in improving patient outcomes.
Key words: ALL, AML, TAM, Down's |
| 442 |
Tiny Patient, Fierce Disease: Early-Onset JMML with PTPN11 Mutation and Marrow Fibrosis |
1998-09-24 |
Female |
No |
- | pay_RFqF8dVeRVVsBO |
Malignant |
Leukemia & lymphoma |
Laboratory |
Lokeshwari S1, Prabhu Manivannan1, Venkatesh Chandrasekaran2, Rakhee Kar1 Affiliations: Departments of Pathology1 and Pediatrics2, Jawaharlal Institute of Postgraduate Medical Education & Research, JIPMER, Puducherry |
SWATHI BHANU |
JIPMER, Puducherry |
Pondicherry |
6383993283 |
swathibhanu998@gmail.com |
Poster |
Title: Tiny Patient, Fierce Disease: Early-Onset JMML with PTPN11 Mutation and Marrow Fibrosis
Authors: Swathi Bhanu1, Lokeshwari S1, Prabhu Manivannan1, Venkatesh Chandrasekaran2, Rakhee Kar1
Affiliations: Departments of Pathology1 and Pediatrics2, Jawaharlal Institute of Postgraduate Medical Education & Research, JIPMER, Puducherry
Abstract
Introduction:
Juvenile myelomonocytic leukemia (JMML) is a rare and aggressive pediatric leukemia that straddles the boundary between myeloproliferative and myelodysplastic neoplasms. Affecting fewer than 1% of children with leukemia, it often masquerades as benign hematological disorders before revealing its true nature.
Case Summary:
We report the case of a 2-year-old boy who initially presented with pallor and leukocytosis. Hemogram revealed anemia (Hb 10.1 g/dL), thrombocytopenia (113 ×10³/µL), and marked leukocytosis (50.7 ×10³/µL) with monocytosis (13.4%). Over subsequent evaluations, his counts surged to >90 ×10³/µL, with monocytes rising to 21% and blasts appearing up to 7%. Bone marrow aspirate showed hypercellularity with 4% blasts, 7% promonocytes, and myeloid hyperplasia. Biopsy revealed 80–90% cellularity with WHO grade I fibrosis. Immunohistochemistry confirmed monocyte lineage (CD14/CD68) and highlighted 5–10% CD34+ immature precursors. Hb-HPLC demonstrated elevated HbF (3.2%). Molecular studies identified a heterozygous PTPN11 exon 3 mutation, confirming JMML.
Conclusion:
This case captures the dramatic evolution of JMML—from subtle cytopenias to overwhelming leukocytosis with marrow fibrosis in a toddler. The diagnosis demanded a multidisciplinary lens, integrating morphology, immunophenotyping, hemoglobin analysis, and molecular genetics. The presence of a PTPN11 mutation alongside early marrow fibrosis emphasizes the aggressive trajectory of this disease. JMML remains a formidable diagnostic challenge—unravelled only when all clinical, hematological, and genetic threads are woven together.
Keywords: Juvenile myelomonocytic leukemia, JMML, pediatric leukemia, PTPN11 mutation, marrow fibrosis, monocytosis.
|
| 443 |
Systemic Mastocytosis Progressing to Mast Cell Leukemia: The Disease That Waited to Strike |
1998-07-02 |
Female |
No |
- | pay_RFqIlSr8X6JLAm |
Malignant |
Leukemia & lymphoma |
Laboratory |
Aishwarya Karthikeyan(Senior Resident), Sanjay Sriram(Assistant Professor), Rakhee Kar(Professor) |
Neha Behera |
JIPMER |
Puducherry |
8895007181 |
nehabehera027@gmail.com |
Poster |
Title:Systemic Mastocytosis Progressing to Mast Cell Leukemia: The Disease That Waited to Strike
Authors: Neha Behera, Aishwarya Karthikeyan, Sanjay Sriram, Rakhee Kar
Introduction: Mast cell leukemia (MCL) is the rarest and most aggressive subtype of systemic mastocytosis, accounting for less than 1% of cases. It is defined by ≥20% mast cells in the bone marrow or ≥10% circulating mast cells. The disease typically follows a fulminant course with limited therapeutic options. We report the case of a young adult female with childhood-onset systemic mastocytosis who evolved to MCL after a decade of latency.
Case-summary: A 23-year-old female was initially diagnosed with smouldering systemic mastocytosis in 2011. At that time, molecular analysis demonstrated KITD816V mutation. Her disease course remained relatively indolent for several years. She recently presented with cytopenias and thrombocytopenia (C-symptoms). Complete blood counts revealed anemia (Hb 10.2 g/dL) and thrombocytopenia (97 ×10³/µL), with no circulating blasts initially; subsequent smears showed ~3% circulating mast cells.
Bone marrow aspirate was hypercellular with suppression of trilineage hematopoiesis and replacement by 45% mast cells, morphologically ovoid-to-round with abundant granular cytoplasm. Biopsy demonstrated 70–80% cellularity with diffuse sheets of mast cells replacing hematopoiesis. Immunohistochemistry showed mast cells positive for CD117, CD34, and CD30, with WHOgrade0 fibrosis. Flowcytometry identified 18.7% CD45 bright/highSSC cells expressing CD33, CD117, CD2, and CD25, confirming a neoplastic phenotype. Skin biopsy revealed dermal infiltration by mast cells. Overall findings fulfilled criteria for mast cell leukemia secondary to systemic mastocytosis.
Conclusion: This case illustrates the rare progression of smouldering systemic mastocytosis to mast cell leukemia. It underscores the importance of long-term surveillance in systemic mastocytosis, as indolent disease may evolve into aggressive subtypes even after years of apparent stability. Early recognition of transformation is essential given the dismal prognosis in MCL.
Keywords: Mast cell leukemia,smouldering mastocytosis, KIT mutation, disease progression
|
| 444 |
TTP vs Evans Syndrome: An interesting case presenting with menorrhagia |
1998-09-09 |
Female |
No |
- | 110982475586 |
Benign |
Miscellaneous |
Clinical |
Dr Vipul Ranjan Bhatt2,Dr Shalu Gupta3, Dr Prerna Arora4, Dr Sumit Singhla5 , Senior Resident, Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi Resident, Department of Medicine, Maulana Azad Medical College and |
Shalu Jha |
Maulana Azad Medical College |
New Delhi |
9304496708 |
jhashalu28@gmail.com |
Poster |
Background:
Evans syndrome is an autoimmune disorder characterized by autoimmune hemolytic anaemia (AIHA) and Immune thrombocytopenia (ITP). These features can occur sequentially or simultaneously. Patients present with symptoms such as pallor, fatigue or mucosal bleed. Menorrhagia as a presenting symptom being extremely rare. With a disease course showing relapse-remission cycle, it becomes ardous to diagnose this rare entity with diagnostic overlap.
Case report:
15 year old female presented with the chief complaint of menorrhagia with monthly hospital admissions, requiring multiple PRBCs and platelet transfusions. Her clinical state pendulated, improving with transfusions. Hemogram findings revealed severe anemia (Hb 4.6 gm/dl) and thrombocytopenia (16000/mm3) with reticulocytosis (Ret - 15.68%). On peripheral smear 15% schistocytes were noted. Bone marrow showed no evidence of lymphoproliferative infiltration or granuloma . In view of schistocytes, possibilities of TTP was also kept in mind.
Conclusion:
Evans syndrome is a rare autoimmune disorder and a diagnosis of exclusion. Our case highlights that an otherwise unusual history of menorrhagia with severe anaemia in a young female with reticulocytosis, schistocytosis and thrombocytopenia should not distract us and a remote possibility of Evans should never be neglected unless proven otherwise. Hence a comprehensive multidisciplinary approach, detailed clinical history, examination, biochemical and hematological accumen is needed to make this rare diagnosis.
|
| 445 |
Title: Plasma Cell Leukemia. A rare and aggressive variant of Multiple Myeloma- A case report. |
1997-05-02 |
Male |
No |
- | H_LKO-617/ pay_RFEmAz4wYpaFTo |
Malignant |
Plasma cell disorders |
Laboratory |
Dr Maneesh Sulya , Prof and Head Department Of Pathology GMC Bhopal |
Utkarsh Rao |
Gandhi Medical College Bhopal |
Bhopal |
9532762114 |
utkarshrao27@gmail.com |
Poster |
Title: Plasma Cell Leukemia A rare and aggressive variant of Multiple Myeloma- A case report.
Introduction: Plasma cell leukemia (PCL) is an uncommon and highly aggressive plasma cell dyscrasia, accounting for <2% of all plasma cell malignancies. It is characterized by the presence of >20% circulating plasma cells or an absolute plasma cell count >2 × 10⁹/L in peripheral blood. Due to its rarity and fulminant clinical course, timely diagnosis is crucial.
Methods: The patient underwent complete clinical evaluation and laboratory investigations. Peripheral blood counts and smear were analyzed, followed by bone marrow aspiration and biopsy. Immunophenotyping was performed using flow cytometry for plasma cell markers (CD38, CD138, CD56, kappa/lambda light chains). Serum protein electrophoresis was done to assess monoclonal protein. Radiological evaluation was done [X-ray/MRI/CT] to detect osteolytic lesions.
A 35year-old female presented with fever, decreased appetite, weight loss, shortness of breath, weakness, bone pain. Peripheral smear revealed >20% circulating plasma cells with characteristic morphology. Bone Bone marrow examination showed diffuse infiltration by plasma cells. Serum electrophoresis demonstrated monoclonal spike in the gamma region, and renal function was impaired.
Result: Peripheral smear revealed >20% circulating plasma cells. Bone marrow aspiration showed near-total replacement by plasma cells. Serum protein electrophoresis demonstrated a monoclonal spike in the gamma region. Imaging revealed multiple lytic lesions with hepatosplenomegaly. These findings established the diagnosis of primary plasma cell leukemia.
Conclusion: Plasma cell leukemia is an exceptionally rare and aggressive plasma cell disorder with poor prognosis. This case highlights the pivotal role of peripheral smear, bone marrow examination and flow cytometry in early recognition. Given its fulminant course and limited therapeutic options, timely diagnosis is critical to improving outcomes. Increased awareness among clinicians and pathologists is essential to avoid diagnostic delays in such rare presentation.
Key Words- Plasma cell Leukemia, Multiple Myeloma, plasma cells.
|
| 446 |
miRNA signatures of aggressive Chronic Lymphocytic Leukaemia |
1980-11-21 |
Female |
No |
- | pay_RFsAHRy5DnwGag |
Malignant |
Leukemia & lymphoma |
Laboratory |
Ritu Gupta2, Ajay Gogia3 Author affiliations: 2Laboratory Oncology Unit, Dr. B.R.A.IRCH, All India Institute of Medical Sciences, New Delhi, India; 3Department of Medical Oncology, Dr. B.R.A.IRCH, All India Institute of Medical Sciences, New Delhi, India |
Dr Lata Rani |
AIIMS, Delhi |
New Delhi |
9910264096 |
lata2111@gmail.com |
Poster |
Title: miRNA signatures of aggressive Chronic Lymphocytic Leukemia
Introduction: The study aimed to identify miRNA signatures that can predict aggressive CLL by comparing the miRNA profiles of patients with indolent disease against those with progressive disease.
Methods: A discovery cohort of 30 early stage CLL (indolent=12, progressive=18) patients was evaluated for differential expression of 744 miRNAs using Taqman Low Density Array (TLDA) Cards (Thermofisher Scientific) on Quantstudio 12K Flex and the data was analyzed using Expression Suite software V1.0.4. CLL patients who did not require any therapy for at least two years were considered indolent and patients requiring therapy within two years of diagnosis were classified as Progressive. Validation of differentially expressed miRNAs (DEMs)was carried out by RQ-PCR using commercially available miRCURY LNA based assays (Exiqon, South Korea) in 70 treatment naive CLL patients.
Results & Conclusion: miRNA profiling revealed 17 DEMs in progressed as compared to indolent CLL subgroup (FC≥ 2.0 or 0.5, p0.05). In the validation cohort, expression levels of 4 miRNAs i.e. miR-223-3p, miR-551a, miR-582-3p, miR-338-3p, were significantly downregulated between indolent and progressed subgroups (FC0.5, p0.05).Using miRNet database, 357 genes were identified as putative gene targets of these miRNA and included driver genes such as MEF2C (targeted by miR223-3p, miR-551a); genes involved in disease progression such as HIF-1 alpha and MMP9 (targeted by miR-338-3p); genes involved in Wnt-catenin signaling pathway such as AXIN2 and SFRP1 (miR-582-3p) and; therapeutic targets such as IGF1-R (targeted by miR-223-3p).Conserved targets of down-regulated miRNAs were greatly enriched (p<0.05) in the pathways closely related to CLL such as Pathways in cancer, TNF signaling pathway, Transcriptional dysregulation in cancer, Cell cycle and p53 signaling pathways. The differential regulation of miRNAs highlights the role played by them in disease progression in CLL.
Key words: CLL, miRNA, indolent |
| 447 |
Myeloid Sarcoma-An Unusual presentation of Retroperitoneal and Duodenal mass |
1996-09-02 |
Female |
No |
- | pay-RFisFPfzfvEaNY |
Malignant |
Rare hematological malignancies |
Laboratory |
,Dr Vipul Ranjan Bhatt 2 ,Dr Prerna Arora 3 ,Dr Shramana Mandal4 ,Dr. Chandra Bhushan singh5. Senior Resident, Department of Pathology, Maulana Azad Medical College, Delhi-110002 3. Professor, Department of Pathology, Maulana Azad Medical College, Delhi- |
Dr Ambika Kaushal |
Maulana Azad Medical College |
Delhi |
9910775292 |
drakeramoray181@gmail.com |
Poster |
Title:Myeloid Sarcoma- An Unusual presentation of Retroperitoneal and Duodenal mass.
Background: Myeloid sarcoma (MS) is a rare extramedullary tumor of immature granulocytic cells. MS can be detected upto 30% of Acute Myeloid Leukemia cases or occur de-novo without bone marrow involvement. Most affected sites include the skin, soft tissues, lymph nodes, and gastrointestinal tract. Gastric presentation are infrequent and can be misdiagnosed. Patients initial symptoms are localized that causes delayed diagnosis and more aggressive presentation. AML develops inadvertently in cases of MS and vice versa as relapse of AML post therapy, with an unfavorable outcome, It thus becomes crucial to diagnose the entity at earliest for prompt initiation of therapy.
Case Report: 38 year old male patient presented with abdominal pain, radiating to back, and associated with multiple episodes of vomiting and non passage of flatus and faeces for 5-6 days .Hemogram findings revealed leukocytosis with presence of 30% abnormal monocytic cells. Flow cytometry findings confirmed AML with monocytic differentiation. Contrast Enhanced Computed Tomography abdomen revealed homogenous retroperitoneal soft tissue mass measuring 4*3*7cm with circumferential mural thickening involving duodenum. Histopathology examination reveal diffuse infiltration of duodenal mucosa and retroperitoneal lymph node by abnormal cells confirmed on Immunohistochemistry to be myeloid blasts. In view of hemogram findings and histopathological findings features are suggestive of myeloid sarcoma.
Conclusion: Isolated myeloid sarcoma is a rare presentation that requires a high index of suspicion and appropriate IHC analysis for diagnosis. Prompt initiation of systemic chemotherapy is crucial and improve prognosis.
|
| 448 |
Paraneoplastic Leukocytoclastic Vasculitis as a Rare Initial Manifestation of Hairy Cell Leukemia: A Case Report and Literature Review |
1995-09-12 |
Female |
No |
- | pay_RFoH2yqzypv8hA |
Malignant |
Leukemia & lymphoma |
Laboratory |
Co-Authors: , Srinivas B H, Prabhu Manivannan, Rakhee Kar. Affiliations: Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education & Research, JIPMER, Puducherry. |
Janani P |
Jawaharlal Institute of Postgraduate Medical Educa |
Puducherry |
9597651003 |
jananijeev22@gmail.com |
Poster |
Title: Paraneoplastic Leukocytoclastic Vasculitis as a Rare Initial Manifestation of Hairy Cell Leukemia: A Case Report and Literature Review.
Authors: Janani Parthasarathy
Introduction: Hairy cell leukemia (HCL) is a rare indolent B-cell lymphoproliferative disorder, typically presenting with cytopenias and splenomegaly. Cutaneous manifestations are uncommon and often secondary to infections or drug reactions. Leukocytoclastic vasculitis (LCV) as a paraneoplastic phenomenon in HCL is exceedingly rare, with few cases reported in literature. This case highlights the diagnostic challenge and clinical significance of recognizing vasculitis as a potential paraneoplastic clue.
Case Presentation: A 50-year-old male presented with non-blanching purpuric lesions over the left forearm. Peripheral smear revealed 28% atypical lymphocytes with mild thrombocytopenia. Bone marrow aspirate showed 79% infiltration by atypical lymphoid cells. Bone marrow biopsy showed diffuse sheets of atypical lymphoid cells with characteristic fried egg appearance. Flow cytometry demonstrated positivity for CD19, CD20, CD79a, CD11c, CD25, CD103, CD123, CD43, FMC7, CD49d, CD180, CD200, and weak kappa light chain restriction—consistent with classic HCL immunophenotype. Skin biopsy from the forearm confirmed leukocytoclastic vasculitis. No infectious or autoimmune etiology was identified. The patient was initiated on cladribine, resulting in resolution of both hematologic and cutaneous manifestations. Discussion: Paraneoplastic vasculitis, particularly LCV, is a rare but documented association with hematologic malignancies, including HCL. The pathogenesis is hypothesized to involve immune complex deposition or cross-reactivity between malignant B-cells and vascular endothelium. Recognition of vasculitis as a presenting feature can expedite diagnosis and treatment of underlying malignancy. Conclusions: This case underscores the importance of considering paraneoplastic vasculitis in patients with unexplained cutaneous vasculitis. Early recognition and treatment of the underlying HCL can lead to complete remission of both hematologic and dermatologic manifestations. Keywords: Hairy cell leukemia, Leukocytoclastic vasculitis, Paraneoplastic, Flow cytometry |
| 449 |
Not All CML: Morphologic Mimics in the Spectrum of Myeloid Neoplasms |
1996-08-03 |
Female |
No |
- | H_LKO-203 |
Malignant |
MPN & MDS/ MPN |
Laboratory |
Sanjay Sriram (Assistant Professor), Prabhu Manivanan (Additional Professor), Rakhee Kar (Professor) |
Aishwarya Karthikeyan |
Jawaharlal Institute of Postgraduate Medical Educa |
Puducherry |
9442570021 |
aishuhrudaya@gmail.com |
Poster |
Title: Not All CML: Morphologic Mimics in the Spectrum of Myeloid Neoplasms
Authors: Aishwarya Karthikeyan, Sanjay Sriram, Prabhu Manivanan, Rakhee Kar
Affiliations: Department of Pathology, JIPMER, Puducherry
Abstract
Introduction
Chronic myeloid leukemia (CML) is classically suspected in patients with leukocytosis, myeloid left shift, and basophilia. However, morphology alone can be misleading, as several chronic myeloid neoplasms closely mimic CML. We present two cases initially diagnosed as CML but subsequently reclassified after advanced work-up, both negative for BCR-ABL1 rearrangement.
Case Summaries
Case 1: A 60-year-old male presented with leukocytosis (WBC 86 ×10³/µL), anemia, and thrombocytopenia. Peripheral smear showed a myeloid bulge with 15% blasts and basophilia. Bone marrow was hypercellular with 16% blasts, myeloid predominance, erythroid suppression, and WHO grade I–II reticulin fibrosis. BCR-ABL1 testing was negative. Next-generation sequencing demonstrated pathogenic mutations in ASXL1, RUNX1, SRSF2, BCOR, and SETBP1, along with additional NRAS and FLT3 variants. This constellation of findings confirmed myelodysplastic/myeloproliferative neoplasm with neutrophilia (MDS/MPN-N, formerly atypical CML).
Case 2: A 65-year-old female presented with leukocytosis (WBC 353 ×10³/µL) and basophilia (6%), initially suggestive of CML. Bone marrow aspirate showed myeloid hyperplasia with 1% blasts. Subsequent work-up revealed persistent monocytosis (15%). Flow cytometry demonstrated 28.6% monocytes with a CD14+/CD16– phenotype and aberrant CD56 expression. Cytogenetics showed a 5p deletion, and BCR-ABL1 was negative. The final diagnosis was chronic myelomonocytic leukemia (CMML).
Conclusion
These two cases illustrate the pitfalls of diagnosing CML on morphology alone. Both were initially labelled as CML but ultimately recognized as BCR-ABL1 negative mimics: MDS/MPN-N and CMML. Incorporation of molecular testing and flow cytometry was pivotal in establishing the correct diagnosis. Accurate subclassification of chronic myeloid neoplasms is essential, as therapeutic and prognostic implications differ significantly between CML and its mimics.
Keywords: CML; CMML; atypical CML; MDS/MPN-N
|
| 450 |
Navigating the Overlap: Distinguishing Mantle Cell Lymphoma from Chronic lymphocytic leukemia in the Face of Immunophenotypic Pitfalls |
1996-08-03 |
Female |
No |
- | H_LKO-203 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Kalaivanan Balasubramanian (Resident) , Prabhu Manivannan (Additional Professor), Rakhee Kar (Professor) |
Aishwarya Karthikeyan |
Jawaharlal Institute of Postgraduate Medical Educa |
Puducherry |
9442570021 |
aishuhrudaya@gmail.com |
Poster |
Title: Navigating the Overlap: Distinguishing Mantle Cell Lymphoma from Chronic lymphocytic leukemia in the Face of Immunophenotypic Pitfalls
Authors: Aishwarya Karthikeyan, KalaivananBalasubramanian, PrabhuManivannan, Rakhee Kar
Affiliations: Department of Pathology, JIPMER
Introduction
B-cell chronic lymphoproliferative disorders encompass a spectrum of entities with overlapping clinical and immunophenotypic features. Chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) are two such disorders that may mimic one another, particularly in cases with atypical immunophenotypic profiles. Accurate distinction is critical given their differing management.
CaseSummary
We report a 75-year-old male presenting with abdominal distension, hepatosplenomegaly, and lymphadenopathy. Laboratory investigations revealed anemia, leukocytosis (170,000 cells/cu.mm), thrombocytopenia, and a peripheral smear with 79% atypical lymphoid cells. Bonemarrow aspirate showed 75% atypical lymphocytes. Flowcytometry identified a B-cell population positive for CD19, CD20, cCD79a, CD5, CD23, CD200, CD38, and sIgM, but negative for kappa, lambda, CD10, and CD34, favoring a diagnosis of CLL. However, bonemarrow biopsy revealed infiltration by small to medium lymphoid cells, positive for CD20, CD5, and cyclin D1, but negative for CD23. Lymph-node excision biopsy confirmed diffuse effacement by similar cells with a high Ki67 index (60–70%). Immunohistochemistry reaffirmed CD5 positivity, cyclin D1 expression, and CD23 negativity, supporting a final diagnosis of MCL.
Discussion
This case underscores the diagnostic challenges in differentiating CLL from MCL, particularly when immunophenotypic overlap occurs. CD23 and CD200 positivity on flow cytometry may misleadingly suggest CLL; however, a subset of leukemic MCL cases may aberrantly express these markers. The discordance in CD23 detection between flowcytometry and immunohistochemistry likely reflects clone variability. Importantly, diffuse cyclin D1 expression and high Ki-67 favoured MCL, highlighting the need for correlation with tissue morphology, immunohistochemistry, and genetic testing. This case emphasizes vigilance in evaluating atypical flow findings and the importance of integrating multiparametric data to avoid misdiagnosis and ensure appropriate management.
Keywords: CLL; MCL; diagnostic pitfall;
|
| 451 |
Hydroxyurea versus Thalidomide: Clinical Perspectives in β-Thalassemia Management |
1996-08-14 |
Female |
No |
- | pay_RFti6LaBxx4MVX |
Benign |
Transfusion medicine |
Clinical |
DR. SURYYANI DEB, Assistant Professor (UGC) Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, West Bengal |
ROHITA DAS |
MAULANA ABUL KALAM AZAD UNIVERSITY OF TECHNOLOGY |
HARINGHATA, NADIA |
7980372010 |
rohita.das@makautwb.ac.in |
Poster |
Title: Hydroxyurea versus Thalidomide: Clinical Perspectives in β-Thalassemia Management
Introduction: β-thalassemia is a public health concern in India, characterized by ineffective erythropoiesis, anemia, and thrombotic risks. While regular transfusions alleviate anemia, impose significant financial and logistical burdens on patients and families. HbF inducers, like hydroxyurea and thalidomide, can reduce transfusion dependency by stimulating fetal hemoglobin production; however, prolonged use can be associated with adverse effects, altering hemostasis. Although HbF inducers have been studied individually and a few comparative reports exist, no comprehensive analysis of all the available evidence has yet been undertaken. A systematic evaluation therefore essential to understand their therapeutic potential while addressing their associated risks, thereby guiding future strategies for β-thalassemia management. This study aimed to evaluate and compare the efficacy on key clinical outcomes (hemoglobin response, HbF-induction, transfusion-requirements, serum-ferritin, spleen-size), genetic-responsiveness, and safety of hydroxyurea and thalidomide among subtypes of β-thalassemia.
Methods: A systematic literature review was conducted, including fifty-five eligible studies. The analysis focused on hemoglobin response, HbF-induction, transfusion-requirements, serum-ferritin, spleen-size, genetic-responsiveness, and reported adverse-effects.
Results: Thalidomide demonstrated efficacy comparable to hydroxyurea in increasing hemoglobin-levels, inducing HbF, and reducing transfusion-requirements, serum-ferritin, and spleen-size. However, thalidomide was also associated with concerning adverse outcomes, including portal vein thrombosis and cardiovascular accidents.
Conclusions: Current evidence suggests thalidomide may offer efficacy similar to hydroxyurea, with some studies reporting superior outcomes, but its safety profile remains a major concern. Further evaluation in HbE-β thalassemia is needed, as this highly prevalent subtype in West Bengal remains under-studied. Given the potential of HbF inducers to alleviate transfusion burden, rigorous investigation is still important to define their clinical utility without compromising patient safety.
Key words: Hydroxyurea, Thalidomide, Systematic literature review, β-thalassemia |
| 452 |
Translating Synapse to Serum: Platelet Profiles in Alzheimer’s Disease |
1996-08-15 |
Female |
No |
- | pay_REjlq99s9plr51 |
Benign |
Miscellaneous |
Clinical |
Sibashis Pramanick, M.Sc. in Microbiology, Department of Life Science, Maulana Abul Kalam Azad University of Technology, Haringhata, West Bengal; Savta Shivaji Tidke,Mtech in Biotechnology, Department of Biotechnology, Maulana Abul Kalam Azad University o |
Sreeja Mukherjee |
Maulana Abul Kalam Azad University of Technology |
Kolkata |
9874196670 |
sreeja.mukherjee@makautwb.ac.in |
Poster |
Title:Translating Synapse to Serum: Platelet Profiles in Alzheimer’s Disease
Authors:Sreeja Mukherjee,Sibashis Pramanick,Savta Shivaji Tidke,Suryyani Deb
Introduction: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by memory loss, cognitive decline, and synaptic dysfunction. Current diagnostic methods such as cerebrospinal fluid (CSF) biomarkers and neuroimaging are invasive, expensive, and not widely accessible. Blood-based biomarkers are emerging as a feasible alternative, and platelets are particularly promising given their molecular similarity to neurons. Platelets store amyloid precursor protein (APP), tau, monoamine oxidase-B, and other neurodegeneration-related molecules, reflecting pathological changes observed in AD brains.
Methods: A systematic literature review of PubMed and other databases was conducted using “platelet function/platelet activation/hemostasis” and “Alzheimer’s disease” as key terms. Clinical and experimental studies reporting morphological, biochemical, and molecular changes in platelets from AD patients were included.
Results:Multiple studies report distinct alterations in AD platelets compared to healthy controls. Morphological changes include increased mean platelet volume (MPV), platelet distribution width, and large platelet ratio, with altered platelet density. Protein profiling reveals downregulation of ADAM-10, APP, tau, sGPVI, and glutamate transporter EAAT1, alongside upregulation of beta-secretase, soluble P-selectin, TDP-43, nitric oxide synthase, and phospholipase A2. Lipidomic studies demonstrate increased cholesterol and ganglioside GM1 within platelet lipid rafts, paralleling AD-associated membrane dysfunction. Platelet serotonin and mitochondrial activity are significantly reduced, while intracellular Ca²⁺ is elevated. Moreover, reduced APP ratio (130/110 kDa) and elevated GSK3B activity in platelets mirror the tau hyperphosphorylation observed in AD pathology.
Conclusions:Platelets exhibit robust and disease-specific alterations in morphology, protein, lipid profiles that mirror central AD pathology. These findings strongly support the use of platelets as a minimally invasive, cost-effective peripheral biomarker for Alzheimer’s disease. Establishing standardized platelet-based assays could complement or replace invasive CSF sampling, thereby enabling earlier diagnosis, improved disease monitoring, and enhanced patient care.
Keywords: Alzheimer’s disease, platelets, biomarkers, APP, tau, blood-based diagnosis
|
| 453 |
Diagnostic Complexity of a Pediatric High-Grade B-cell Neoplasm with Overlapping Features of Burkitt Lymphoma and B-lymphoblastic Leukemia: A Case report and review of literature. |
1997-06-04 |
Female |
Yes |
LM146 | pay_RFoCzWifna7qMX |
Malignant |
Leukemia & lymphoma |
Laboratory |
Co-authors: Janani Parthasarathy, Prabhu Manivannan, Rakhee Kar. Affiliations: Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education & Research, JIPMER, Puducherry |
Dr. Visaali S |
JIPMER |
Puducherry |
9751804132 |
visaalisivakumar@gmail.com |
Poster |
Title: Diagnostic Complexity of a Pediatric High-Grade B-cell Neoplasm with Overlapping Features of Burkitt Lymphoma and B-lymphoblastic Leukemia (B-ALL): A Case report and review of literature. Introduction: High-grade B-cell neoplasms often demonstrate overlapping morphology and immunophenotype, posing diagnostic challenges when differentiating Burkitt lymphoma, B-ALL, and high-grade B-cell lymphoma with MYC and BCL2 co-expression. Accurate classification is critical for guiding therapy. Case report: A 17-year-old girl presented with heavy menstrual bleeding, exertional breathlessness, weight loss, and moderate splenomegaly. Peripheral smear showed anemia, thrombocytopenia, and 5–6% atypical lymphoid cells. Bone marrow was infiltrated (50–60%) by variable sized atypical cells with Burkitt-like morphology. Flow cytometry demonstrated a mature pre-B phenotype (CD34 and TdT negative; CD19, CD10, CD20 were strong positive, surface immunoglobulin positive with kappa restriction), suggesting differential diagnoses of Burkitt lymphoma, B-ALL, and high-grade B-cell lymphoma. Immunohistochemistry revealed TdT positivity in ~50% of cells, variable cMYC expression (~40%), and strong BCL2 expression, excluding Burkitt lymphoma. The mature phenotype with kappa restriction raised concern for high-grade B-cell lymphoma with cMYC and BCL2 co-expression, but the significant TdT positivity warranted further evaluation. Integrating morphology, flow cytometry, and immunohistochemistry findings with proposed diagnostic scoring systems (Khanlari et al., Qiu et al.) supported a diagnosis of B-ALL over medullary blastoid high-grade lymphoma. Cytogenetic analysis confirmed trisomy 10, a finding characteristic of B-ALL and rarely reported in other high-grade B-cell neoplasms. The patient was initiated on a B-ALL treatment protocol and demonstrated a favorable early response. Conclusion: This case highlights the diagnostic challenges posed by high-grade B-cell neoplasms with overlapping features. Integrated morphology, immunophenotyping, immunohistochemistry, and scoring systems established a definitive diagnosis of B-ALL. The report underscores the value of integrated diagnostic algorithms in achieving accurate classification and ensuring optimal therapeutic decisions. Key words: B-lymphoblastic leukemia; high-grade B-cell lymphoma; Burkitt lymphoma; immunohistochemistry; diagnostic algorithm. |
| 454 |
Uncovering Hairy Cell Leukemia: A Rare Hematological Diagnosis During Evaluation of Cavitary Lung Lesions |
2000-12-05 |
Female |
No |
- | pay_RFpsZ2QScWquC6 |
Malignant |
Leukemia & lymphoma |
Clinical |
PROF KAILASH KUMAR , PROFESSOR, DEPARTMENT OF GENERAL MEDICINE |
LOVELY SINGH |
INSTITUTE OF MEDICAL SCIENCE, BANARAS HINDU UNIVER |
VARANASI |
9129536187 |
lvlysingh0512@gmai.com |
Poster |
TITLE: Uncovering Hairy Cell Leukemia: A Rare Hematological Diagnosis During Evaluation of Cavitary Lung Lesions
INTRODUCTION : Hairy Cell Leukemia (HCL) is a rare indolent B-cell lymphoproliferative disorder characterized by pancytopenia, splenomegaly, and recurrent infections. Diagnosis requires a high index of suspicion, especially when identified incidentally. Purine analogs such as cladribine remain the cornerstone of therapy, although hematological recovery may take weeks to months. Rituximab has been used as consolidation or in selected situations where additional therapy is warranted.
CASE REPORT: We report the case of a 55-year-old male, known case of Chronic Obstructive Pulmonary Disease (COPD), who presented with acute exacerbation of respiratory symptoms. During evaluation for bilateral upper lobe cavitary lesions, routine hematology revealed persistent pancytopenia. Peripheral smear showed few atypical lymphoid cells. Bone marrow aspiration was a “dry tap,” while biopsy demonstrated infiltration by atypical lymphoid cells. Flow cytometry confirmed Hairy Cell Leukemia, with positivity for CD11c, CD25, CD103..
The patient required repeated transfusions for cytopenias. He received a 5-day course of cladribine as initial therapy. As he was simultaneously initiated on antitubercular therapy (ATT) for cavitary lung disease, hematological recovery was closely monitored. After three months, due to persistent pancytopenia, rituximab (8 weekly doses) was added. Following rituximab, the patient’s counts improved significantly, and transfusion independence was achieved. His respiratory symptoms also improved with standard COPD and ATT management.
CONCLUSION : This case highlights Hairy Cell Leukemia as a rare incidental diagnosis in a patient presenting primarily with pulmonary disease. It underscores the need for systematic evaluation of pancytopenia, awareness of the delayed hematological response to cladribine, and the potential role of rituximab as an adjunct in selected patients to hasten recovery and reduce transfusion burden.
KEY WORDS : Hairy Cell Leukemia, COPD, Cladiribine, Rituximab |
| 455 |
Standardising G6PD Deficiency Screening By Flow Cytometry To Identify Deficient Individuals |
1992-03-25 |
Male |
No |
- | H_LKO-062 |
Benign |
Anemia |
Laboratory |
Jasmita Dass1, Shailja Singh2, Richa Chauhan1, Mukul Aggarwal1, Ashok Jaiswal 1, Shreeja Biswas2, Swati Garg2, Ganesh Kumar V1, Tulika Seth1, Anu Sachdeva1, Vishal Gupta1, Ravi Ranjan 1, Rishi Dhawan1, Pradeep Kumar1, Manoranjan Mahapatra1 1All India Ins |
Shreyam Acharya |
All India Institute of Medical Sciences, New Delhi |
New Delhi |
09643073165 |
Shreyam2503.jul21@aiims.edu |
Oral |
Title: Standardising G6PD Deficiency Screening By Flow Cytometry To Identify Deficient Individuals
Introduction: Flow cytometric testing (FCM) can aid in identifying the G6PD-deficient RBC population in the background of normal RBCs. The application of the methemoglobin reduction test (MRT) and quantitative assays is limited in reticulocytosis, a recent history of blood transfusion, and severe anemia. Objective: To validate the FCM-based G6PD screening test for diagnosing G6PD-deficient individuals and female carriers, regardless of reticulocytosis or blood transfusion. Methodology: This study included 131 subjects (including 20 female family members of deficient male individuals) categorized into deficient (n=32) and normal males (n=31), deficient (n=16) and normal (n=33) females, as well as unclassifiable groups (6 males, 13 females) using both quantitative spectrophotometric assays and flow cytometric approaches. FCM assessments were performed using BD FACSCanto II/BD FACSLyric. Data were analyzed using BD FACSDiva. Quantitative assay was done using an in-house method. FCM protocols were optimized using 0.3% hydrogen peroxide to prevent red cell degeneration, and diagnostic cut-offs for %G6PD-positive red blood cells were determined via ROC analysis. Result: The FCM method demonstrated good agreement with quantitative assays (Cohen’s kappa 0.698) and outperformed conventional methods like the qualitative MRT in identifying carrier states, achieving high sensitivity and specificity; a cut-off of <82.1% for deficient males (n=32), <92.3% for deficient females (n=16), and <88.7% for possibly heterozygous females (n=15) using ROC curve. It was also able to suspect G6PD deficiency in the six males from unclassifiable group. Sample and stain stability analyses showed that samples should be processed and acquired immediately after collection and processing, respectively. Conclusion: FCM showed a good correlation with quantitative assay, and it was able to detect a deficient RBC population with normal quantitative assay values and normal MRT, specifically for suspected heterozygous females and hemizygous males with significant family and clinical history. |
| 456 |
PANCYTOPENIA IN CHRONIC LIVER DISEASE: A DIAGNOSTIC PUZZLE WITH WEAK IgM LAMBDA BAND AND ELEVATED BETA 2- MICROGLOBULIN |
1997-10-17 |
Female |
No |
- | H_LKO-610 |
Benign |
Anemia |
Laboratory |
Dr. Ruchi Gupta, Dr. Khaliqur Rahman, Dr. Dinesh Chandra, Dr. Anurag Singh |
Dr. Akanksha Rastogi |
Sanjay Gandhi Institute of Medical Sciences |
Lucknow |
8005117522 |
drar1710@gmail.com |
Poster |
TITLE: PANCYTOPENIA IN CHRONIC LIVER DISEASE: A DIAGNOSTIC PUZZLE WITH WEAK IgM LAMBDA BAND AND ELEVATED BETA 2- MICROGLOBULIN
Introduction: Pancytopenia in chronic liver disease (CLD), accompanied by hepatomegaly, is generally imputed to hypersplenism; however, unusual haematological markers may obscure the diagnosis and resemble plasma cell dyscrasias.
Case Report: We present a 56-year-old female with chronic liver disease and portal hypertension who manifested persistent pancytopenia (haemoglobin 10.4 g/dL, total leukocyte count 2.5×10³/µL, platelets 1.1×10⁵/µL). Imaging demonstrated mild splenomegaly (13 cm), disproportionate to the extent of cytopenia. The bone marrow aspiration exhibited hypercellularity with maintained trilineage haematopoiesis and modest plasmacytosis (5%). Serum immunofixation identified a weak IgM lambda band; however, no distinct monoclonal band was observed in the gamma region. The κ/λ ratio was within normal limits (1.03); however, β2-microglobulin was markedly increased (4.68 mg/L). This collection of findings presented a diagnostic challenge. Although hypersplenism associated with chronic liver disease may account for cytopenias, the diminished IgM lambda band and elevated β2-microglobulin suggested a potentially developing plasma cell or lymphoplasmacytic disorder. The lack of a distinct M-protein and a normal κ/λ ratio suggests a reactive or oligoclonal response, potentially induced by persistent inflammation or liver malfunction. This ambiguous circumstance underscores the importance of vigilance, as these patients may indicate a pre-MGUS condition or progress into a lymphoproliferative disorder over time.
Conclusion: In CLD, hypersplenism is not the only cause of cytopenias. Subtle laboratory abnormalities, including weak monoclonal bands or increased β2-microglobulin, may indicate early haematological disorders but might represent reactive alterations due to persistent inflammation. This case study illustrates the significance of comprehensive assessment and meticulous longitudinal monitoring in patients with chronic liver disease with unexplained pancytopenia.
Keywords: Pancytopenia, Hypersplenism, Plasma cell disorders |
| 457 |
Marked hyperbilirubinemia with mixed Autoimmune hemolytic anaemia complicated by multisystem involvement: A DIAGNOSTIC CONUNDRUM |
1992-01-09 |
Female |
No |
- | pay_RFrM1wli6Mv5EV |
Benign |
Anemia |
Clinical |
Senior resident, Department of Pathology, Maulana Azad Medical College, Delhi-110002 3. Professor, Department of Pathology, Maulana Azad Medical College, Delhi-110002 4. Professor, Department of Medicine, Maulana Azad Medical College, Delhi-110002 |
Dr. Poonam Chaurasia |
Maulana Azad Medical College |
Delhi |
8851491605 |
poonamchaurasia064@gmail.com |
Poster |
TITLE: Marked hyperbilirubinemia with mixed Autoimmune hemolytic anaemia complicated by multisystem involvement: A DIAGNOSTIC CONUNDRUM
Authors: Dr. Poonam Chaurasia1, Dr. Vipul Ranjan Bhatt2, Dr. Prerna Arora3, Dr. Sumit Singhla4, Dr. S. Anuradha5
1. Post graduate resident, Department of Pathology, Maulana Azad Medical College, Delhi-110002
2. Senior resident, Department of Pathology, Maulana Azad Medical College, Delhi-110002
3. Professor, Department of Pathology, Maulana Azad Medical College, Delhi-110002
4. Professor, Department of Medicine, Maulana Azad Medical College, Delhi-110002
5. HOD, Department of Medicine, Maulana Azad Medical College, Delhi-110002
Background:
Autoimmune hemolytic anaemia (AIHA) has a variable clinical course ranging from fully compensated low grade hemolysis to severe life-threatening cases. Association of AIHA with liver disorder is a rare occurrence. Marked hyperbilirubinemia associated with AIHA is further rarer creating diagnostic dilemma .
Case Report:
A 40 year old Male presented with yellowish discolouration of the eyes, progressing to whole body for 2 months, along with recent onset hematemesis, melena for 5 days, shortness of breath, and constipation. He had a history of multiple blood transfusions. Mild Hepatosplenomegaly was noted on examination. Laboratory workup showed mixed AIHA (positive DCT and ICT), markedly elevated reticulocyte count(49.12%), hyperbilirubinemia(Total bilirubin/Conjugated bilirubin = 189/90mg/dl), elevated LDH with ANA positivity. Viral serology for Hepatitis C was positive. Imaging revealed hepatosplenomegaly, and liver hemangioma. CECT chest revealed pulmonary artery hypertension with emphysematous changes.
Conclusion:
Severe AIHA is a life threatening condition with significant clinical heterogeneity and high mortality. This case highlights the diagnostic complexity of mixed AIHA with multisystem involvement and marked hyperbilirubenemia . The lack of marked improvement despite immunosuppressive therapy points towards a potential unidentified underlying liver pathology. A thorough systemic evaluation needed in atypical presentations of AIHA.
|
| 458 |
TITLE: A RARE CASE OF COMBINED MILD HEMOPHILIA A AND THROMBOXANE RECEPTOR DEFECT ON PLATELETS
|
1989-04-22 |
Female |
No |
- | 111072843264 |
Benign |
Platelet disorders |
Laboratory |
Dr Tulasi Geevar, Dr Nitty Mathews, Dr Sukesh Chandran Nair |
Dr Ariya S |
Christian Medical College, Vellore, Tamil Nadu |
Vellore |
7999758541 |
drariya3232@gmail.com |
Poster |
TITLE: A RARE CASE OF COMBINED MILD HEMOPHILIA A AND THROMBOXANE RECEPTOR DEFECT ON PLATELETS Authors: Dr Ariya S (Presenting author), Co-authors-Dr Tulasi Geevar, Dr Nitty Mathews, Dr Sukesh Chandran Nair
INTRODUCTION :Thromboxane receptor defect is a rare platelet function disorder with minimal literatures. This is a rare case of combined Hemophilia A and thromboxane receptor defect on platelets.
DETAILS OF THE CASE Two years old boy born to third degree consanguineously married parents with family history of Hemophilia A presented with complaints of prolonged bleeding from oral cavity (BAT score: 3). There is documented diagnosis of mild hemophilia in elder brother (FactorVIII:C 11.2%) and maternal cousins (Factor VIII:C : 15.6 and 14.9%) Activated Partial Thromboplastin Time was prolonged to 55.9sec (Reference range: 25.2-38.0 seconds). Factor VIII levels was 9% and Ristocetin cofactor assay was normal. PT and fibrinogen was within normal limits Platelet aggregometry showed absent response with arachidonic acid and Thromboxane receptor agonist and mildly reduced response with Epinephrine, ADP and collagen. Flowcytometry for platelet function PAC-1 and CD62P showed normal response on agonist stimulation (Convulxin, TRAP and ADP). CD63 expression and mepacrine uptake and release ratio were normal, ruling out platelet storage defects.
DISCUSSION This case presented with strong family history of Hemophilia with absent response with thromboxane receptor agonist and mildly reduced response with ADP. Any kind of drug interactions were excluded. Defective TXA2 receptor function is associated with impaired platelet aggregation to arachidonic acid. Even with strong family history of hemophilia, it is also important to rule out platelet defects.
CONCLUSION This is a rare case of Hemophilia A combined with Thromboxane receptor defect on platelets as supported by the platelet aggregometry. Further molecular tests can be helpful to confirm the diagnosis.
Key words: Hemophilia, thromboxane receptor defect |
| 459 |
Peripheral T-cell Lymphoma with Marrow Fibrosis mimicking Primary Myelofibrosis: A Diagnostic Challenge and Aggressive Clinical Course |
1997-10-17 |
Female |
No |
- | H_LKO-610 |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr. Ruchi Gupta, Dr. Khaliqur Rahman, Dr. Dinesh Chandra, Dr. Anurag Singh |
Dr. Akanksha Rastogi |
Sanjay Gandhi Institute of Medical Sciences |
Lucknow |
8005117522 |
drar1710@gmail.com |
Poster |
Title: Peripheral T-cell Lymphoma with Marrow Fibrosis mimicking Primary Myelofibrosis: A Diagnostic Challenge and Aggressive Clinical Course
Introduction: Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of nodal and extranodal non-Hodgkin T-cell lymphoma. Bone marrow infiltration with reactive fibrosis can mimic primary myelofibrosis (PMF), thereby causing diagnostic difficulties. Therefore, it turns out crucial to differentiate between myeloproliferative neoplasms and lymphoma-associated marrow fibrosis for effective treatment.
Case Report: A 53-year-old female had anaemia (haemoglobin 9 g/dL), leukocytosis (total leukocyte count 14,900/µL), thrombocytopenia (90,000/µL) and hepatosplenomegaly. The bone marrow examination revealed hypercellular marrow displaying normoblastic erythropoiesis, myeloid predominance and dysplastic megakaryocytes. The reticulin stain displays grade 1 fibrosis. With all these findings, a preliminary diagnosis of myeloproliferative neoplasm, with the possibility of primary myelofibrosis (cellular phase), was proposed. However, molecular analysis for JAK2, CALR, and MPL mutations gave negative results.
After a span of two months, the same patient presented with generalised lymphadenopathy, hepatosplenomegaly and para-aortic lymphadenopathy on radiological examination. The cervical lymph node biopsy revealed architectural effacement by atypical small to medium lymphocytes, with interspersed high endothelial venules and follicular dendritic-like cells. Immunohistochemistry was positive for CD3, CD4 and CD8 with focal expression of CD5. CD20, CD10, Bcl-6, MUM-1, EMA, CD15 and CD30 were negative. The Ki-67 index was approximately 50%. With all these findings, a provisional diagnosis of Peripheral T-cell lymphoma-NOS was kept. The marrow fibrosis was retrospectively ascribed to invasion by atypical lymphoid cells. The disease advanced swiftly, and the patient expired from her ailment.
Conclusions: Therefore, this case of Peripheral T-cell lymphoma ( PTCLs-NOS) displays an early marrow infiltration along with subsequent fibrosis. This gives a resemblance to primary myelofibrosis. Hereby, a comprehensive methodology that incorporates morphology, immunohistochemistry and molecular analyses to prevent misdiagnosis.
Key words: Peripheral T-cell lymphoma, bone marrow fibrosis, primary myelofibrosis |
| 460 |
Early Stage B-cell Lymphoma: Audit of Clinical presentation and treatment Outcomes from a Tertiary Cancer Hospital |
1989-03-06 |
Female |
No |
- | H_LKO-489 |
Malignant |
Leukemia & lymphoma |
Clinical |
Sreya Das, Payal Mondal, Zameer Latif, Rimpa Basu, Arijit Nag, Jeevan Kumar, Nimmgadda*, Reena Nair1 Affiliations: 1 Tata Medical Center, Kolkata and * Apollo Cancer institute, Chennai |
Dr Himadri Sonowal |
Tata Medical Center |
Kolkata |
9163550068 |
himadrisonowal@gmail.com |
Oral |
Title: Early Stage Large B-cell Lymphoma: Audit of Clinical presentation and treatment outcomes from a Tertiary Cancer Hospital
Authors: Himadri Sonowal, Sreya Das, Payal Mondal, Zameer Latif, Rimpa Basu, Arijit Nag, Jeevan Kumar, Nimmagadda, Reena Nair
Introduction: Early stage (1 & 2) Large B-cell lymphoma (LBCL) is highly curable and de-escalation of therapy in terms of cycle numbers and omission of radiation is a norm as a part of PET adapted therapy. The objective is to evaluate the clinical presentation, and treatment outcomes of patients with early stage LBCL.
Methods: Data was collected from the Electronic Medical records (EMR) between 2011 and 2020. The study was approved by the respective Institute Review Board and a consent waiver granted. Lymphoma subtyping was done according to WHO 2008. The clinical features, prognostic stratification, response to 1st line treatment and 5-year progression free survival (PFS) of adult patients with DLBCL were analysed. Patients were followed up till June 2025. OncoCollect software developed by Ramesh Nimmagadda Cancer Foundation (RNCF) has been used to collect data. Results: There were 1028 patients, of which 463 patients took first line treatment at the center. They include 456 DLBCL NOS, 4 PMBCL and 3 high grade LBCL. The median age at presentation was 55 years. Gender ratio 1.5:1. At presentation, B symptoms were present in 29%, Stage I disease in 38%, Stage 2 in 62% and extra nodal disease was present in 29%. Stage 1 disease in 38% and Stage 2 in 62% and extranodal disease was present in 29%. Commonest treatment was CHOP-R for 4-6 cycles. Complete response seen in 74% and partial response in 8%. 5% had progressive disease. Median follow up period 60 months. 5 year PFS 80% for nodal and 84% for extranodal disease.
Conclusions: Early stage LBCL is highly curable.
Keywords: early-stage, LBCL |
| 461 |
CD3-negative Hepatosplenic T-cell Lymphoma – A Rare Case and Diagnostic Challenge |
1994-08-09 |
Female |
No |
- | pay_RFs1gyaYm4PAqM |
Malignant |
Leukemia & lymphoma |
Laboratory |
Elanthenral S 1, A Nishanth Daniel 1, Sanjeet Roy 1, Priyadharshini M 2, Arpana P 2, Phaneendra D V 3, Alpeshkumar Bipinbhai Kapadia 3, Soma Pradhan 3, Venkatachalam R M 3, Biju George 3, Anu Korula 3 1 Department of Pathology, Christian Medical College |
Dr. Zambare Riya Prakash |
CMC, Vellore |
Vellore |
9403421504 |
riya.prakash@cmcvellore.ac.in |
Poster |
Title: CD3-negative Hepatosplenic T-cell Lymphoma – A Rare Case and Diagnostic Challenge
Introduction: Hepatosplenic T-cell lymphoma (HSTCL) is an aggressive lymphoma of young adults, usually characterized by sinusoidal infiltration of T lymphocytes expressing surface CD3, CD2, and CD7, with absence of CD5, CD4, and CD8. CD3 negativity is extremely rare and creates a diagnostic dilemma, particularly with natural killer (NK)-cell neoplasms. Fewer than ten such cases have been reported to date.
Methods: Imaging studies, complete blood count with peripheral smear, bone marrow aspiration and biopsy with immunohistochemistry, immunophenotyping by flow cytometry and cytogenetic studies were performed.
Results: A 19-year-old male presented with fever, abdominal pain, weight loss, and lymphadenopathy of two months’ duration. Examination revealed cervical and inguinal lymphadenopathy with mild hepatosplenomegaly. Peripheral smear showed 5% abnormal lymphoid cells with blast-like morphology. Bone marrow aspirate revealed 29% atypical mononuclear cells, while biopsy showed prominent sinusoidal infiltration by medium-sized atypical lymphoid cells with vesicular nuclei, fine chromatin, inconspicuous nucleoli, and scant cytoplasm.
Immunohistochemistry demonstrated negativity for CD3, CD5, and EBER-ISH, with weak diffuse CD7 expression and focal CD4, CD8, TIA1, and CD57 positivity. Flow cytometry showed 47% abnormal lymphoid cells positive for CD2, CD7, CD226, CD117, and CD56, with both surface and cytoplasmic CD3 negative, raising overlap with NK-cell neoplasms. Cytogenetic analysis revealed isochromosome 7q and a complex karyotype. Based on clinical, morphologic, immunophenotypic, and cytogenetic correlation, a final diagnosis of HSTCL, γδ subtype, was established.
Conclusions: CD3-negative HSTCL is an extremely rare diagnostic variant. Its overlapping immunophenotype with NK-cell neoplasms underscores the importance of integrating morphology, flow cytometry, cytogenetics, and molecular data to arrive at an accurate diagnosis and avoid misclassification.
Key words: CD3-negative, hepatosplenic T-cell lymphoma, gamma-delta subtype, diagnostic challenge |
| 462 |
Decoding TP53 mutations through p53 protein expression in haematological neoplasms: From mutation spectrum to immunohistochemical staining pattern in 37 cases. |
1987-09-16 |
Female |
Yes |
- | pay_RFv3WyavcclcRN |
Malignant |
Leukemia & lymphoma |
Laboratory |
Richa Chauhan, Jasmita Dass, Ganesh Kumar Vishwanathan, Mukul Aggarwal, Pradeep Kumar, Rishi Dhawan, Manoranjan Mahapatra |
MEGHNA YADAV |
ALL INDIA INSTITUTE OF MEDICAL SCIENCE NEW DELHI |
NEW DELHI |
9797415805 |
meghnay@yahoo.com |
Poster |
Decoding TP53 mutations through p53 protein expression in haematological neoplasms: From mutation spectrum to immunohistochemical staining pattern in 37 cases. Introduction: TP53, located on 17p13.1, encodes p53, a key regulator of apoptosis, DNA repair, and cell cycle control. While p53 IHC is established in solid tumors, its value in hematologic neoplasms beyond acute myeloid leukemia (AML), myelodysplastic neoplasms (MDS), and erythroid leukemia is underexplored. A broader evaluation across myeloid and lymphoid neoplasms may yield important diagnostic and prognostic insights. Methods: We retrospectively evaluated p53 IHC in 300 hematologic neoplasms, identifying 42 NGS-confirmed TP53 pathogenic variants in 37 cases. Diagnoses included AML (n=13), acute erythroid leukemia (n=6), MDS (n=4), ALL (n=6), and others (MPAL, Richter transformation, plasma cell leukemia, mastocytosis). p53 IHC was performed on diagnostic tissue and counted as 1+(dim nuclear), 2+(moderate nuclear), 3+ (strong nuclear) positivity. The cases were categorized as aberrant (diffuse/strong), wild-type (focal/mosaic), or null (absent or diminished) type patterns on IHC. Results were correlated with mutation type, cytogenetic complexity, and clinical outcomes. Results:p53 IHC patterns correlated strongly with TP53 variants in 36 cases (excluding one follow-up case of TP53-mutated CLL whose baseline NGS was unavailable). Missense variants (n=28) with VAF >10% showed diffuse strong positivity in 80%, while low-VAF cases mostly retained wild-type patterns. Frameshift (n=3) and copy number loss (n=2) predominantly showed null staining; splice-site variants (n=3) were variable. All multiple-variant cases (n=4) demonstrated diffuse strong aberrant positivity. No correlation was seen between VAF and staining intensity. Concordance was strongest in AML, MDS, and erythroid leukemia, though aberrant expression also appeared in ALL, MPAL, and Richter transformation. Conclusion: This large series demonstrates that p53 IHC reflects TP53 mutation type, cytogenetic complexity, and prognosis across hematologic neoplasms, supporting its cost-effective use to rapidly identify high-risk cases.
Keywords: TP53 mutation, p53 protein, immunohistochemistry, next-generation sequencing |
| 463 |
Classic Hodgkin Lymphoma with Castleman-like Features (Hyaline Vascular Variant): A Diagnostic Challenge |
1994-08-09 |
Female |
No |
- | pay_RFs1gyaYm4PAqM |
Malignant |
Leukemia & lymphoma |
Laboratory |
Elanthenral S 1, Marie T Manapadam 1, A Nishanth Daniel 1, Sasikumar V 1 1Department of Pathology, Christian Medical College & Hospital, Vellore, India |
Dr. Zambare Riya Prakash |
CMC, Vellore |
Vellore |
9403421504 |
riya.prakash@cmcvellore.ac.in |
Oral |
Title: Classic Hodgkin Lymphoma with Castleman-like Features (Hyaline Vascular Variant): A Diagnostic Challenge
Introduction: Classic Hodgkin lymphoma (CHL) with Castleman-like features, particularly the hyaline vascular (HV) variant, is extremely rare. Overlapping inflammatory changes in both entities, partly driven by cytokines such as IL-6, can obscure Hodgkin–Reed–Sternberg (HRS) cells and delay diagnosis. This series describes three such cases, highlighting morphologic and immunophenotypic clues to improve diagnostic accuracy.
Methods: We retrospectively reviewed three cases of CHL with Castleman-like morphology. Clinical data, histopathology, and immunophenotyping were analyzed to identify distinguishing features.
Results:
Case 1: 27F with pleural effusion and mediastinal mass. Lymph node biopsy showed regressed germinal centres, paracortical expansion, interfollicular plasmacytosis, and scattered HRS cells (CD30+, CD15+, weak PAX5+).
Case 2: 45F with bilateral cervical nodes. Biopsy displayed atretic follicles, vascular proliferation, plasmacytosis, and scattered HRS cells in paracortex (CD30+, CD15+).
Case 3: 10F with fever and right cervical swelling. Biopsy revealed patchy interfollicular infiltrates of HRS cells with plasmacytosis, few eosinophils, and atretic germinal centres [CD30+, CD15+(focal), PAX5+(weak), EBERish+).
Conclusions: CHL with Castleman-like features, especially of the hyaline vascular variant, represents a rare but important diagnostic pitfall. Castleman-type vascular and follicular changes may mask interfollicular CHL, particularly when HRS cells are scant. Careful attention to morphology, supplemented by immunohistochemistry, is critical to avoid misdiagnosis and to ensure timely treatment.
Key words: Classic Hodgkin lymphoma, Castleman-like features, hyaline vascular variant, diagnostic challenge. |
| 464 |
DLBCL |
1999-10-05 |
Female |
No |
- | pay_RFsOBcr5aDOGLz |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr prerna arora dr vipul ranjan bhatt |
Dr kritika upadhyay |
Maulana Azad medical college |
New delhi |
08368250706 |
kritikaup05@gmail.com |
Poster |
Title• Authors:Dr. Kritika upadhyay 1, Dr Prerna Arora ²,Dr Vipul Ranjan Bhatt Dr Sumit Singhla 1 Resident, Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi 2. Professor, Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi 3. Senior Resident, Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi 4. Professor, Department of medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi Background : Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, defined by diffuse proliferation of medium to large atypical lymphoid cells. The nuclei are at least the size of a histiocyte nucleus or two normal lymphocyte nuclei. DLBCL does not fit into other WHO-defined categories of large B-cell lymphomas and is broadly classified into two molecular subtypes: germinal center B-cell (GCB) and activated B-cell (ABC). Clinically, DLBCL can present with varied and nonspecific features, often mimicking infections, inflammatory conditions, or metastatic malignancy, making diagnosis a challenge. Case report: A 43-year-old female presented with generalized weakness for 5 months, diffuse body ache and bone pains for 4 months, and progressive lower back pain radiating to both legs, limiting mobility. She also had intermittent low-grade fever without chills. Initially, she was treated as typhoid following a travel history, with ultrasonography showing mild hepatosplenomegaly. Despite therapy, her symptoms persisted, and follow-up scans continued to reveal splenomegaly. Over time, her condition worsened with abdominal pain, persistent fever, and generalized weakness. Subsequent pyrexia of unknown origin warranted bone marrow examination. Histopathological and immunohistochemical studies confirmed the diagnosis of DLBCL. Conclusion:Conclusion: DLBCL with TdT expression is a rare and underreported phenomenon that may mimic lymphoblastic lymphoma, posing diagnostic challenges. Recognition of this unusual immunophenotype is critical to avoid misdiagnosis and ensure appropriate therapeutic strategy, as management differs significantly from precursor lymphoid
|
| 465 |
Challenges In Standardising A G6PD Deficiency Screening Method Based On Flow Cytometry |
1992-03-25 |
Male |
No |
- | H_LKO-062 |
Benign |
Anemia |
Laboratory |
Jasmita Dass 1, Shailja Singh 2, Richa Chauhan 1, Mukul Aggarwal 1, Ashok Jaiswal 1, Shreeja Biswas 2, Swati Garg 2, Ganesh Kumar V 1, Tulika Seth 1, Anu Sachdeva 1, Vishal Gupta 1, Ravi Ranjan 1, Rishi Dhawan1, Pradeep Kumar1, Manoranjan Mahapatra 1 |
Shreyam Acharya |
1. All India Institute of Medical Sciences, New De |
New Delhi |
09643073165 |
Shreyam2503.jul21@aiims.edu |
Oral |
Title: Challenges In Standardising A G6PD Deficiency Screening Method Based On Flow Cytometry.
Introduction: Flow cytometric G6PD testing offers an advantage over quantitative testing to detect G6PD-deficient cells in female heterozygotes, severe anemic patients, and post-PRBC transfusion. The detailed technical aspects of this assay —H2O2 concentration, reducing agent, and gating strategy —remain insufficiently addressed. Objective: To standardize the method using nile blue (NB), an alternative reducing agent, methylene blue (MB), and identify the optimal concentration between 3% and 0.3% H2O2. We also studied the sample and stain stability. Method: 14 deficient samples, 38 normal samples, and 9 samples from possibly heterozygous females were collected for NB and MB-based reduction test (n=61). In parallel, 0.3% and 3% H2O2 were compared for NB-based method (n=43). NB-based assay was repeated at 12 hours (n = 6) and 24 hours (n = 24) after sample collection. We have reacquired the processed tube after 12 hours for 18 samples to check for stain stability as well. Samples were acquired on a BD FACSCanto IITM/BD FACSLyricTM and analyzed on a BD FACSDivaTM. Result: A significant change happened in the scatter properties of the RBCs after treatment with 3% H2O2. Despite this, a considerable correlation remained between the MFI ratio in the NB-based method, and the Bland-Altman analysis suggested a bias of -0.36. NB and MB-based methods showed a significant correlation, and Bland-Altman analysis suggested a bias of 0.74. Stored samples exhibited an increase in MFI after 12 hours. This created difficulty in the gating algorithm. The stained tubes (n=18) that were reacquired showed a complete degeneration (14/18) after 12 hours. Conclusion: 3% H2O2 appears to cause excessive oxidation, resulting in significantly increased fluorescence. MB can be used as an alternative to NB, and sample storage was not recommended. keywords: Flow cytometry, G6PD deficiency, Nile blue. |
| 466 |
Title: High grade B cell lymphoma with unusual presentation and unusual immunophenotype: A double diagnostic challenge. |
1999-10-05 |
Female |
No |
- | pay_RFsOBcr5aDOGLz |
Malignant |
Leukemia & lymphoma |
Clinical |
Dr prerna arora dr vipul ranjan bhatt Dr.sandeep garg |
Kritika Upadhyay |
Maulana Azad medical college |
Delhi |
08368250706 |
kritikaup05@gmail.com |
Poster |
Title High grade B cell lymphoma with unusual presentation and unusual immunophenotype: A double diagnostic challenge.
Authors:Dr. Kritika upadhyay 1, Dr Vipul Ranjan Bhatt, Dr Prerna Arora, Dr Sandeep Garg
1 Resident, Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi
2. Senior resident Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi
3. Professor, Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi
4. Director Professor, Department of medicine, Maulana Azad Medical College and Associated Hospitals, New Delhi
Background :
Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, and can present with varied and nonspecific features, often mimicking infections, inflammatory conditions, or metastatic malignancy, making diagnosis a challenge. Presentation of DLBCL as osteolytic lesions is extremely rare.
Case report:
A 43-year-old female presented with generalized weakness associated with progressive lower back pain for last 4 months. She also had intermittent low-grade fever associated with weight loss. There was no lymphadenopathy. Examination and radiological investigations revealed mild hepatosplenomegaly with multiple lytic lesions . Possibility of multiple myeloma, metastasis was considered. Hemogram findings revealed pancytopenia while bone marrow aspirate was a dry tap. Bone marrow biopsy revealed diffuse proliferation by large lymphoid cells with suppressed trilineage hematopesis. On Immunohistochemistry, the cells were positive for LCA, CD19,CD20, BCL2, BCL6,MYC with Tdt expression. Final diagnosis of High grade B cell lymphoma was considered with aberrant Tdt expression.
Conclusion: High grade B cell lymphoma with TdT expression is a rare and underreported phenomenon that may mimic lymphoblastic lymphoma, posing diagnostic challenges. Moreover presence of osteolytic lesions can create diagnostic dilemma. Recognition of this unusual immunophenotype with unusual clinical presentation is critical to avoid misdiagnosis and ensure appropriate therapeutic strategy.
:
|
| 467 |
Implication of CD157 negativity by SY11B5 clone using flow cytometry for PNH detection its implication in diagnosis. |
1992-12-30 |
Male |
No |
- | pay_RFx48tNnvioTTA |
Benign |
Miscellaneous |
Laboratory |
Dr. Jasmita Dass AIIMS New Delhi, Dr. Manoranjan Mahapatra AIIMS New Delhi, Dr Tulika Seth AIIMS New Delhi, Dr. Ganesh K V AIIMS New Delhi, Dr Richa Chauhan AIIMS New Delhi, Dr. Mukul Aggarwal AIIMS New Delhi, Dr. Pradeep Kumar AIIMS New Delhi, Dr. Rishi |
ABHISHEK MALIK |
AIIMS New Delhi |
delhi |
7877544286 |
abmalik1593@gmail.com |
Oral |
Title: Implication of CD157 negativity by SY11B5 clone using flow cytometry for PNH detection its implication in diagnosis.
Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hematopoietic stem cell disorder that arises due to somatic mutations of PIGA gene. Fluorescent aerolysin (FLAER) and CD157 can be assessed on both neutrophils and monocytes to identify PNH. We aimed to identify cases with downregulation of CD157 despite normal expression of FLAER among the total PNH assays performed.
Methods: We screened all patients undergoing testing for PNH clones between January 2021 and August 2025 to identify cases with downregulation of CD157 using a panel of FLAER-AF488/CD157-PE (SY11B5 clone)/CD45 Per-CP Cy5.5/CD64 PE-Cy7/CD15-APC. These were also assessed with an alternate RF3 clone (OSB Biosciences, Japan).
Results: We have analysed 3557 cases of which 21 (0.59%) showed CD157 downregulation/loss. The median patient age was 37.5 years (8-71) with a male to female ratio of 3:2. Of these 21 cases, 6 showed a complete loss of CD157 and 15 showed downregulated CD157 intensity. Sixteen cases (76.19%) showed no PNH clone and only CD157 downregulation/ absence was seen while five case had a PNH clone as shown by FLAER in neutrophils and monocytes in addition to FLAER-positive/CD157 negative population.
Conclusions: With the loss of CD157 a diagnosis of non PNH clone is usually done by adding another GPI anchored antibody in the panel which amounts up in time and cost of diagnosis. The loss of CD157 expression may be on account of BST-1 gene polymorphism(s) with a report describing rs2302464 polymorphism as the cause. Unlike this report, RF3 clone gave similar results as the SY11B5 clone of CD157. Our data indicates that, though rare, CD157 downregulation exists in the Indian population also and requires further evaluation.
Key words: |
| 468 |
Methotrexate-Induced Marrow Dysplasia in Juvenile Idiopathic Arthritis: Morphologic Mimicry of Myelodysplastic neoplasm |
1998-10-17 |
Female |
No |
- | pay_REfy0IPtMcxAc1 |
Malignant |
Myelodysplastic syndrome |
Laboratory |
Dr. Vandana Puri ( Professor, LHMC), Dr. Anu Maheshwari (Professor, LHMC) |
Dr. Anushka Dhawan |
Lady Hardinge Medical College |
New Delhi |
9983232933 |
anushkadhawan4@gmail.com |
Poster |
Title: Methotrexate-Induced Marrow Dysplasia in Juvenile Idiopathic Arthritis: Morphologic Mimicry of myelodysplastic neoplasm Introduction: Methotrexate is a commonly prescribed disease-modifying antirheumatic drug (DMARD) for inflammatory arthritis, including juvenile idiopathic arthritis (JIA). Although low weekly dosing is considered safe, accidental prolonged or incorrect dosing can cause systemic toxicity, with hematological effects including myelosuppression and pancytopenia. Myelodysplasia secondary to methotrexate is rare but has been reported to mimic myelodysplastic syndrome (MDS), creating significant diagnostic challenges. Methods: A 5-year-old child with polyarticular JIA was diagnosed five months prior and presented with pancytopenia following an erroneous regimen of daily administration of methotrexate (15 mg), as opposed to the recommended weekly dose. Rescue therapy with leucovorin was initiated upon diagnosis of toxicity. Bone marrow aspirate and biopsy were performed, focusing on morphology and dysplastic features in erythroid, myeloid, and megakaryocytic lineages. Results: Complete blood count revealed pancytopenia with hemoglobin of 5.5 g/dL, total leukocyte count of 1.9 × 10³/µL, and platelet count of 8 × 10³/µL. Bone marrow aspirate showed megaloblastic erythropoiesis with dyserythropoiesis in 20% of cells, including nuclear budding, binucleation and ring forms. The myeloid series showed a left shift with dysgranulopoiesis in 40% of neutrophils, including pseudo-Pelger-Huet anomaly and hypolobation in 10%. Dysmegakaryopoiesis was seen in 30% of megakaryocytes, with forms showing separate nuclear lobes. Bone marrow biopsy revealed ~70% cellularity, marked megaloblastic reaction in erythroid lineage and prominent dysmegakaryopoiesis with hypolobated megakaryocytes.. Conclusions: Methotrexate overdose in pediatric patients can cause distinctive multilineage dysplasia mimicking MDS—with features such as megaloblastic erythropoiesis, pseudo-Pelger-Huët anomaly, and dysmegakaryopoiesis. Early bone marrow evaluation and prompt initiation of leucovorin rescue are essential to reverse hematologic toxicity and prevent permanent bone marrow damage. Clinicians should maintain a high index of suspicion for drug-induced myelodysplasia in similar clinical scenarios. Key words Methotrexate toxicity, Juvenile idiopathic arthritis, Myelodysplastic Syndrome, Pediatric |
| 469 |
Clinicopathological Spectrum and Outcomes of Early T-cell Precursor Acute Lymphoblastic Leukemia: A Case Series from a Tertiary Care Centre in North India |
1994-10-11 |
Female |
No |
- | H_LKO-403 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Dr. Namrata P Awasthi, Dr. Jai Jyoti Pandey, Dr. Kaushlendra Kumar |
Dr. Akanksha Verma |
Ram Manohar Lohia Institute Of Medical Sciences Vi |
Lucknow |
7052504054 |
akavermabbk@gmail.com |
Poster |
Title: Clinicopathological Spectrum and Outcomes of Early T-cell Precursor Acute Lymphoblastic Leukemia: A Case Series from a Tertiary Care Centre
Authors: Dr. Akanksha Verma, Dr. Jai Jyoti Pandey, Dr. Kaushlendra Kumar, Dr. Namrata P Awasthi
Introduction: Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is an aggressive subtype of T-ALL, first recognized in the 2016 WHO classification, characterized by an immature immunophenotype with absent CD1a, CD8, and weak/negative CD5 expression, along with aberrant stem cell or myeloid marker positivity. It accounts for approximately 10–15% of pediatric and 7–10% of adult T-ALL cases and is associated with poor induction response, high minimal residual disease, and adverse survival compared with other T-ALL subtypes.
Methods: We retrospectively analyzed patients diagnosed with ETP-ALL at our institute between 2019 and 2024. Diagnosis was based on flow cytometry with or without bone marrow/ lymph node biopsy or FNAC. A total of nine patients were identified, ranging from 11 to 34 years (median age 21 years), with a slight female preponderance. The majority presented with generalized lymphadenopathy, fever, and weight loss. One patient had an acute presentation with menorrhagia and fever with chills. Immunophenotyping consistently revealed positivity for CD34, cytoplasmic CD3, and stem cell/myeloid antigens, with negative CD1a, CD8, and dim/negative CD5. All patients were initiated with intensive frontline BFM 95–based, chemotherapeutic protocols. Treatment outcomes were however heterogeneous, four patients succumbed to progressive disease, one was lost to follow-up, three complied with complete treatment protocol, and one was scheduled later for allogeneic stem cell transplantation.
Conclusion: ETP ALL represent a continuum of maturational states in stem-like leukemias. It is regarded as high-risk T-ALL subgroup with elevated levels of end induction MRD and inferior survival rates. This case series highlights the aggressive clinical behaviour of ETP-ALL with nearly half of the patients having adverse outcomes. |
| 470 |
The perplexing nature of T-cell clones in hypereosinophilia: a bouquet of cases |
1995-03-27 |
Female |
No |
- | H_LKO-119 |
Malignant |
Rare hematological malignancies |
Laboratory |
1. Sampath K Srinivasagowda 2. Ayush Agarwal 3. Jasmita Dass 4. Richa Chauhan 5. Ganesh Kumar Viswanathan 6. Mukul Aggarwal 7. Pradeep Kumar 8. Rishi Dhawan. 9. Tulika Seth 10. Manoranjan Mahapatra1, Department of Hematology, AIIMS, New Delhi |
Karuna Balakrishnan |
AIIMS, NEW DELHI |
NEW DELHI |
9442610765 |
karuna.bala95@gmail.com |
Oral |
Title:
The perplexing nature of T-cell clones in hypereosinophilia: a bouquet of cases
Introduction:
Lymphocytic variant of hypereosinophilia is a rare entity, caused due to clonal T-cells producing eosinophilopoietic cytokines. With the advent of TRBC1 use in flow cytometry, diagnosing these populations has become more assertive.
Materials and methods:
A total of 69 cases with hypereosinophilia were evaluated for aberrant T-cell populations in peripheral blood from January 2021 to August 2025. Of these, seven turned out to have aberrant T-cell clones. Various panels were used; basic panels comprising CD3, CD5, CD7, CD2, CD4, CD8 or more sophisticated panels which included TRBC1 or occasionally cytoCD3 and cytoTRBC1 when required.
Results:
Age of these patients ranged from 19 to 77 years. On flow cytometry, three cases showed lymphocytic variant of hypereosinophilic syndrome (T-LHES) clone i.e., Th2 immunophenotype (CD3-, CD4+, CD2/5+, CD7-/+). Remaining four cases were reported as T-cell clone of uncertain significance (T-CUS). Of these four cases, all were sCD3 negative except for one. Also, one case was CD4 restricted, one was CD8 restricted, two were double negative. The clone size ranged from 0.02% to 1.98%. The monoclonal T-cell count ranged from 3 to 426/uL. On follow up, one of the T-CUS cases was recategorized as myeloid/lymphoid neoplasm with FLT3 rearrangement, and one other as peripheral T-cell lymphoma, not otherwise specified.
Conclusion:
The study shows that once a T-LHES/T-CUS clone is found in a case with hyperoesoinophilia, the workup must not halt and an attempt must be made to rule out myeloid/lymphoid neoplasm with eosinophilia or a T-cell lymphoma as it may make a significant difference in treatment decisions.
Keywords: T-HES, T-CUS, Hypereosinophilia, Th2 immunophenotype, myeloid/lymphoid neoplasm with eosinophilia |
| 471 |
Lymphohistiocytic Variant of ALK-Positive Anaplastic Large Cell Lymphoma in a Pediatric Patient: A case report and literature review. |
1995-09-12 |
Female |
No |
- | pay_RFoH2yqzypv8hA |
Malignant |
Leukemia & lymphoma |
Laboratory |
Sanjay Sriram S, Prabhu Manivannan, Rakhee Kar |
Janani P |
Jawaharlal Institute of Postgraduate Medical Educa |
Puducherry |
9597651003 |
jananijeev22@gmail.com |
Poster |
Title: Lymphohistiocytic Variant of ALK-Positive Anaplastic Large Cell Lymphoma in a Pediatric Patient: A case report and literature review.
Authors: Janani Parthasarathy
Introduction: Anaplastic Large Cell Lymphoma (ALCL) is a rare subtype of non-Hodgkin lymphoma, accounting for 10–20% of pediatric cases. The lymphohistiocytic (LH) variant, characterized by the presence of abundant reactive histiocytes that can mask the neoplastic nature of the lesion, leading to misdiagnose as “reactive lymphadenopathy, and is associated with aggressive clinical behavior in children.
Case Presentation:
We report an 11-year-old female presenting with persistent fever and generalized lymphadenopathy. Contrast-enhanced CT of the thorax and abdomen revealed necrotic lymph nodes in the left supraclavicular, axillary, mediastinal, and hilar regions. Excisional biopsy of a left level 2 cervical lymph node showed diffuse sheets of histiocytes admixed with highly pleomorphic large atypical cells. Immunohistochemistry demonstrated strong positivity for CD30, CD2, CD3, and ALK-1 in large atypical cells, with CD68 highlighting histiocytes. Ki-67 proliferation index was 40%, indicating moderate proliferative activity. Bone marrow biopsy showed no involvement.
Discussion:
The LH variant of ALK+ ALCL is characterized by neoplastic T-cells that are often masked by reactive histiocytes, leading to underdiagnosis. This variant is more frequently seen in pediatric populations and is associated with disseminated disease at presentation. Despite ALK positivity, which generally confers a favorable prognosis, the LH variant may have a higher relapse risk.
Conclusion:
This case underscores the importance of recognizing the LH variant of ALCL in pediatric patients, given its unique histopathological features and potential prognostic implications. Accurate immunophenotyping and awareness of variant morphology are essential for timely diagnosis and appropriate management.
Key words: Anaplastic large cell lymphoma- lymphohistiocytic variant, ALK positive large cell lymphoma. |
| 472 |
“Optimizing Stem Cell Product Quality: The Role of Mobilization and Cell Separation Techniques” |
1979-11-11 |
Male |
No |
- | pay_RFyJnIsP7aLHbw |
Malignant |
CAR-T & Stem cell transplant Miscellaneous |
Laboratory |
Dr Shashank Ojha, Dr Suryatapa S ,Department of Transfusion Medicine, Tata Memorial Centre-Advanced Centre for Treatment, Research and Education in Cancer |
Vimal Sathyan |
Department of Transfusion Medicine, Tata Memorial |
Kharghar, Navi Mumbai, Maharashtra |
9892769898 |
vimalsathyan@gmail.com |
Oral |
Title: Optimizing Stem Cell Product Quality: The Role of Mobilization and Cell Separation Techniques Introduction: Hematopoietic stem cell transplantation (HSCT) relies on the successful mobilization and collection of CD34+ hematopoietic progenitor cells (HPCs) and the collection is inherently complex due to wide range biological and procedural variability among patients and donors. The efficacy of the mobilization protocol and the choice of cell separator instrumentation are critical to the quality and consistency of the stem cell product. We evaluated how variations in mobilization strategies and apheresis instrumentation affect the yield and purity of HSCT products Methods: A retrospective evaluation was conducted over 8 months (January–August 2025) on patients and donors undergoing peripheral blood stem cell (PBSC) collection for haematological disorders. The cohort (n = 118) comprised 75 males (64%) and 43 females (36%), with a mean age of 34 ± 15.2 years. It included 64 autologous (54.2%) and 54 allogeneic (45.8%) transplant candidates, diagnosed with HD (20%), NHL (17%), Neuroblastoma (16%), ALL (11%) and Multiple Myeloma (35.8%). Stem cell product quality was compared across different mobilization strategies (Chemomobilization, G-CSF alone, G-CSF + plerixafor) and apheresis platforms (Fresenius Com-Tec, Amicus, Spectra Optia). The parameters assessed were CD34⁺ cell yield, collection efficiency (CE2) and product purity. Statistical analysis was done with SPSS software version 25 and p <0.05 was considered significant Results: Plerixafor co-mobilization was associated with higher CD34⁺ yield, while CE2 values on Com-Tec differed from other apheresis platforms (p < 0.001), but not when compared with G-CSF alone. Both Spectra Optia and Amicus consistently showed lower platelet and red cell contamination than Com-Tec, regardless of the mobilization strategy. Conclusions: The mobilization strategy and the type of apheresis instrument influences HSCT product quality. Tailoring protocols to patient-specific factors, combined with real-time monitoring through mid-sample checks and automated adjustments enhance HSCT product consistency. |
| 473 |
Inhibition of BCR::ABL1 Enhances Stability of CML-Derived iPSCs |
2000-01-09 |
Female |
No |
- | pay_RGBZV7MIfKd595 |
Malignant |
Leukemia & lymphoma |
Laboratory |
Manasi Rane, Esther Sathya Bama Benjamin, Bharathi M Rajamani, Senthamizhselvi Anandan, Manoj Moni V. T, Stallon Illengeshwara, Dhavapriya, Dinesh Babu, Shaji R Velayudhan, Poonkuzhali Balasubramanian |
Manasi Arun Rane |
Christian Medical College, Vellore |
Vellore, Tamil Nadu |
9689109681 |
manasi.rane@cmcvellore.ac.in |
Poster |
Title: Inhibition of BCR::ABL1 Enhances Stability of CML-Derived iPSCs
Introduction: Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm driven by the BCR::ABL1 oncogenic tyrosine kinase. The disease progresses through three distinct phases: chronic, accelerated, and blast crisis. The molecular mechanisms underlying this transition, including gene expression changes and pathway activation, remain incompletely understood. Patient-derived induced pluripotent stem cells (iPSCs) provide a unique model to study patient-specific genetic mutations, enabling the study of disease progression, leukemic stem cell (LSC) biology, and mechanisms of therapy resistance. • Objectives: (1) To generate iPSCs from CD34⁺ hematopoietic progenitors of CML patients; (2) To assess colony formation efficiency with and without BCR::ABL1 inhibition; and (3) To evaluate colony stability and pluripotency markers under both conditions.
Methods:Peripheral blood CD34⁺ cells were isolated from CML patients (n=4; TKI-responder, suboptimal, and refractory) and a healthy donor, and reprogrammed using episomal Yamanaka factors. Colonies were evaluated for morphology, pluripotency marker expression, and BCR::ABL1 transcript/karyotype status. We further tested the effect of supplementation with imatinib (IM) and other TKIs on colony morphology, stability, and pluripotency. Hematopoietic differentiation was induced using STEMdiff protocols with or without TKI supplementation, and CD34⁺CD45⁺ progenitors were assessed by flow cytometry and colony-forming assays. Results: Suppression of BCR::ABL1 enhanced the generation of stable CML-iPSC colonies compared to the untreated control. In IM-treated cultures, more robust, morphologically typical iPSC colonies emerged earlier and maintained stable growth over multiple passages. These colonies exhibited pluripotency marker expression and displayed normal karyotypes. Conclusions: Targeted inhibition of BCR::ABL1 tyrosine kinase activity markedly improves the stability of iPSC generation from CML-derived CD34⁺ cells, suggesting that oncogene suppression is a critical step in overcoming reprogramming barriers posed by malignant signalling pathways. Key words: CML, iPSCs, TKIs, malignancy, disease modelling. |
| 474 |
BET Bromodomain Inhibition: A Potential Therapeutic Avenue in MEF2D-HNRNPUL1-rearranged B-cell Acute Lymphoblastic Leukaemia |
1996-07-04 |
Female |
No |
- | H_LKO-123 |
Malignant |
Rare hematological malignancies |
Laboratory |
Kulwant Singh, SGPGIMS, Lucknow; Ambak Kumar Rai, MNNIT Allahabad; Chandra Prakash Chaturvedi, SGPGIMS, Lucknow |
Aditi Chauhan |
SGPGIMS |
Lucknow |
8130111580 |
acaditichauhan327@gmail.com |
Poster |
Title: BET Bromodomain Inhibition - A Potential Therapeutic Avenue in MEF2D-HNRNPUL1-rearranged B-cell Acute Lymphoblastic Leukemia
Introduction: B-cell acute lymphoblastic leukaemia harbouring MEF2D-translocations represents an aggressive subtype with poor prognosis. MEF2D fusion proteins drive leukemogenesis via super enhancer mediated transcriptional dysregulation, making them promising target for epigenetic intervention. BET proteins, especially BRD4, are key regulators of oncogenic enhancer activity.
Methods: Here, we explored the potential of BET bromodomain inhibition by well established inhibitors such as JQ1 as a targeted therapeutic strategy in MEF2D-HNRNPUL1 translocated B-ALL.
Results: Our study revealed that BET inhibitor, JQ1 inhibited proliferation and triggered apoptosis in leukemic cells, by targeting pre-BCR genes in addition to previously demonstrated targets, c-myc and IL-7R. A novel finding is that JQ1 induces DNA double-strand breaks by downregulating DNA repair genes.
Conclusions: These findings highlight that anti-leukemic activity of JQ1 offers a promising strategy to improve outcomes in this high-risk leukaemia subtype
Key words: MEF2D translocation, BET Bromodomain Inhibition, DNA Damage, B-Cell Acute Lymphoblastic Leukaemia, Super enhancer. |
| 475 |
IMPLEMENTATION OF A MANAGEMENT SYSTEM REQUIREMENTS IN ACCORDANCE WITH ISO15189 - EVALUATION OF ACCREDITED VERSUS NON-ACCREDITED RESOURCE LIMITED MEDICAL LABORATORIES IN SEVERAL INDIAN STATES |
1977-01-29 |
Male |
No |
- | pay_RGDE9n8yQyGVJe |
Benign |
Miscellaneous |
Laboratory |
Dr. Preeti Chavan (ACTREC, Tata Memorial Centre, Navi Mumbai), Dr. Arti Rauthan (Jigyasaya University, Dehradun), Dr. Anuja Pandey (Jigyasay University, Dehradun) |
Dr. Manikchandra R Tiwari |
ACTREC, Tata Memorial Centre |
Navi Mumbai |
8090110384 |
manik.tmh@gmail.com |
Oral |
Title: IMPLEMENTATION OF A MANAGEMENT SYSTEM REQUIREMENTS IN ACCORDANCE WITH ISO15189—EVALUATION OF ACCREDITED VERSUS NON-ACCREDITED RESOURCE-LIMITED MEDICAL LABORATORIES IN SEVERAL INDIAN STATES
Introduction: The reliability of test results is crucial in today's evidence-based medical care. Additionally, the international standard ISO15189 management system requirements (MSR) or other acceptable guidelines should be used. Because accreditation is optional in India, where the majority of the population is served by resource-limited medical labs (RLML), of which only a tiny number are accredited, results provided by unaccredited labs may be tainted. To understand the significance of accreditation, accredited and non-accredited RLMLs were assessed for meeting the ISO15189 MSR requirements.
Methods: Fifty RLMLs, both accredited and unaccredited, from various Indian states, were evaluated for conformity with forty-one MSR criteria taken from ISO15189. A chi-square test was employed to examine the RLMLs that satisfied each condition (p<0.005).
Results: A few accredited RLMLs failed to keep adequate records of clinical advice, risk assessments, independent work authorization for recruits, temperature-humidity monitoring, reagent acceptance-rejection, and updated reports. Non-accredited RLMLs met legal-entity requirements (100%), had a laboratory manager (58%), and had minimal records (51%); their p-value was non-significant (p>0.005). For the remaining forty-one MSR criteria, chi-square testing with a p<0.005 was significant.
Conclusions: Few accredited RLMLs' failures to comply may be attributed to routine procedural non-conformities discovered during their regular operations where the necessary documents were overlooked despite the lab's knowledge of the requirements. While the overwhelming majority of non-accredited RLMLs were found to have little to no knowledge of or awareness of many MSR requirements, demonstrating the need for standards. Accreditation enables the creation of acceptable, recognized laboratory practices.
Key words: Resource-limited medical laboratories, Management system requirements, ISO15189, Accreditation |
| 476 |
COMPARATIVE STUDY BETWEEN TWO HEMATOLOGY ANALYZERS FOR PLATELET AND ITS INDICES IN CANCER PATIENTS |
1977-03-01 |
Male |
No |
- | pay_RGDrBdd5SIrr2G |
Benign |
Miscellaneous |
Laboratory |
Dr. Preeti Chavan, Dr. Manikchandra Tiwari, Ms. Ulka Gosavi, Mrs. Swati Vaykar, Mr. Babu GS Pillai (ACTREC, Tata Memorial Centre) |
Mr. Sanjay Kumar |
ACTREC, Tata Memorial Centre |
Navi Mumbai |
9833503802 |
sanjaypaltmc@gmail.com |
Poster |
Title: To compare performance of hematology cell counters BC6000–Mindray and Advia2120i-SIEMENS for platelet parameters in an oncology center.
Introduction: In this correlation study we compared platelet parameters like Platelet Count (PLT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Large Platelets (LP), and Immature Platelet Fraction (IPF) results obtained from two different cell counters, BC6000–Mindray and Advia2120i-SIEMENS, and correlated them statistically.
Methods: We analyzed blood samples of 804 cancer patients, which were received for routine analysis in the laboratory on the SIEMENS cell counter—Advia 2120i. Leftover samples were processed on the BC6000–Mindray cell counter as part of the validation exercise.
Results obtained for the PLT, MPV, PDW, and LP/IPF parameters were compared between the two analyzers. Platelet and its indices results of 804 cancer patients obtained from both the cell counters were evaluated using linear regression analysis. A coefficient of correlation (r²) of more than 0.95 and a slope of 1.0 were considered as significant. Results: The linear regression analysis showed correlation for platelets (r² 0.9897) only, whereas other parameters like MPV (r² 0.012), PDW (r² 0.1702), and LP/IPF (r² -0.109) showed no correlation.
Conclusions: For cancer patients, PLT, MPV, PDW, and LP are some of the important parameters that help in the course of treatment and are very important for cancer care. In our study, parameters like platelet showed good correlation among the results obtained from the two cell counters. Among the platelet indices parameters, MPV, PDW, and LP/IPF did not show any correlation. It can be concluded that although BC6000–Mindray shows good correlation with Advia 2120i for platelet count, there was no correlation for MPV, PDW, or LP/IPF. The Advia 2120i-SEIMENS showed better comparability for MPV, PDW, and LP with peripheral stained smears using microscopy.
Key words: Cell counters, Correlation study, Platelets |
| 477 |
Incidence of syndrome of inappropriate Anti-Diuretic Hormone Secretion (SIADH) in Haematolymphoid Cancer Patients |
1977-04-12 |
Male |
No |
- | pay_RGEVSUhFd9oR5l |
Benign |
Miscellaneous |
Laboratory |
Dr. Preeti Chavan, Dr. Manikchandra Tiwari, Mr. Sanjay Kumar, Mrs. Swati Vaykar |
Mr. Babu GS Pillai |
ACTREC, Tata Memorial Centre |
Navi Mumbai |
9820996309 |
babucha77pillai@gmail.com |
Poster |
Title: Incidence of syndrome of inappropriate Anti-Diuretic Hormone Secretion (SIADH) in Haematolymphoid Cancer Patients
Introduction: The Syndrome of Inappropriate Secretion of Anti-Diuretic Hormone (SIADH) is responsible for 30–33% of hyponatraemia cases (serum sodium levels
less than 136 mmol/l), a common electrolyte disorder among cancer patients. Other causes of hyponatremia include narcotic medications, dehydration, chemotherapy-induced nausea and vomiting, etc. In this retrospective study, the incidence of SIADH was evaluated in hyponatremic cases of hematolymphoid malignancy.
Methods: Fifty hematolymphoid cancer patients (43 males and 7 females; of them, 4 were children and 46 were adults) were retrospectively examined for
hyponatremia over a three-year period. The patients in the cohort included those with acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. As per the hospital's protocol, daily blood electrolyte monitoring was conducted to assess levels of sodium, potassium, chloride, calcium, and magnesium. Further investigations on serum and urine osmolality in hyponatremic subjects were also carried out. Statistical analyses, including correlation studies and Bland-Altman analysis, were used.
Results: Sixty-six percent (33/50) of the individuals under study had hyponatremia due to SIADH. The prevalence of SIADH was 65% in males (28/43).
71% in females (5/7), 25% in pediatrics (1/4), and 70% in adults (32/46). In non-Hodgkin's lymphoma, SIADH incidence was 67% (14/22); in Hodgkin's lymphoma, 71% (5/8); in acute myeloid leukemia, 75% (6/9); in acute lymphoblastic leukemia, 83% (5/7); and in chronic myeloid leukemia, 25% (1/4). In every case with SIADH, concurrent hypocalcemia and hypomagnesemia were noted.
Conclusions: The incidence of SIADH in hyponatremic patients with hematolymphoid malignancies was higher than previously reported. However, there was no discernible bias between the primary disorders, age groups (adult versus pediatric), or genders.
Key words: Hyponatremia, SIADH, Haematolymphoid malignancy. |
| 478 |
Analysing CBC results using varying quantities of whole blood EDTA samples at an oncology centre |
1984-07-16 |
Female |
No |
- | pay_RGF0ZLmQbjDY6W |
Benign |
Miscellaneous |
Laboratory |
Dr. Preeti Chavan, Dr. Manikchandra Tiwari, Mr. Sanjay Kumar, Ms. Ulka Gosavi, Mr. Babu GS Pillai, Mr. Jitesh Dalvi (ACTREC, Tata Memorial Centre) |
Mrs. Swati Vaykar |
ACTREC, Tata Memorial Centre |
Navi Mumbai |
9987821717 |
smore188@gmail.com |
Poster |
Title: Analysing CBC results using varying quantities of whole blood EDTA samples at an oncology centre
Introduction: CBC may be requested twice daily or more in terminally ill cancer patients. Getting 3.0 ml of blood may be difficult many times. The study aims at verifying the reliability of CBC test parameters in lesser volumes ranging from 0.5 ml to 2.5 ml of K₂EDTA whole blood as compared to 3.0 ml. The requirements of the international standard ISO 15189:2022 insist that medical laboratories periodically review requirements for sample volume for various examinations. Hence, for CBC to meet the needs and requirements of its patients and clinicians and commit to good professional practice, the minimum amount of sample requirement is studied by using scientific/statistical methods.
Methods: Samples collected in pre-marked tubes for 0.5 ml, 1.0 ml, 1.5 ml, 2.0 ml, 2.5 ml, and 3.0 ml were collected from CBC examination. For this, twenty-one healthy volunteers from staff with either gender and varying age groups (20 to 50 years) were selected; similarly, twenty-one patients with different cancers, ages, and genders with informed consent were taken. CBC examination was done for all the samples, and the results were put on a Microsoft Excel spreadsheet. Comparison of CBC in low volumes with 3.0 ml volume was done. Linear regression analysis, Bland-Altman plot, and % variation (<10%) were used for statistical analysis.
Results: Variation was assessed for various CBC values, and it was discovered to be within 10%. For the CBC parameters, a linear regression analysis revealed R² ranging from 0.95 to 1.00.
Conclusions: It can be said that 1.0 ml volume also yields good outcomes, which could be clinically meaningful and comparable to those from 3.0 ml volume. Thus, underfilled spray-dried K₂EDTA gives reliable CBC results.
Keywords: CBC, EDTA-whole blood volume, comparison |
| 479 |
Deciphering the Immunophenotypic Heterogeneity of NPM1-Mutated AMLs Through a Genotypic Lens |
1/4/1996 |
Female |
No |
- | pay_R |
Malignant |
Leukemia & lymphoma |
Laboratory |
Phaneendra Datari, Alpesh Kapadia, Kotteswari Kathirvel, Merlin J Priyanka, Uday P Kulkarni, Sushil Selvarajan, Sharon Lionel, Anu Korula, Aby Abraham, Biju George, Poonkuzhali Balasubramanian, Vikram Mathews, Arun Kumar Arunachalam. |
Gayathri kuppuswamy |
Christian medical College, Vellore , ranipet campu |
Vellore |
9787538382 |
gayathrik223@gmail.com |
Poster |
Title:Deciphering the Immunophenotypic Heterogeneity of NPM1-Mutated AMLs Through a Genotypic Lens Introduction:Acute myeloid leukaemia (AML) with mutated NPM1 (NPM1m+) is a common subtype, typically showing low/absent CD34 and decreased/absent HLADR expression. Despite these hallmarks, NPM1m+ AML blasts display marked heterogeneity, with differentiation into immature, neutrophil, or monocytic lineages. This variability often reflects co-mutations in genes such as TET2, IDH1/2, and DNMT3A, which influence differentiation. Understanding these genotype–phenotype correlations is crucial for both disease biology and clinical decision-making. This study examined the relationship between genotype and immunophenotypic markers in NPM1m+ AML. Methods:NPM1m+ AML cases diagnosed from 2021–2024 were analysed. Immunophenotypic and cytogenetic data were extracted from institutional archives. Results:Two main subgroups were identified: Myeloid differentiation (44/60): CD34–, HLADR+/–, CD38+, CD117+, CD33+, CD13+/–. Monocytoid differentiation (16/60): CD34–, HLADR++, CD38+, CD117–, CD33++, CD13+/–, CD64++, CD11b+. In the myeloid subgroup, HLADR, CD13, and CD123 were expressed in 54%, 90%, and 83% respectively, overlapping with hypogranular APML. Cytogenetics were mostly normal, with only two cases showing trisomy 8 and 21.Common co-mutations included DNMT3A (40%), TET2 (16%), IDH1 (20%), IDH2 (23%), FLT3-ITD (46%), and WT1. Distribution of DNMT3A, FLT3-ITD, and IDH2 was similar across subgroups, while TET2 and IDH1 were enriched in the myeloid group. DNMT3A correlated significantly with CD13+ (p=0.002), CD123+ (p=0.047), and CD38+ (p=0.038), with a trend toward HLADR+. IDH2 mutations associated with CD13– (p=0.008). FLT3-ITD showed no immunophenotypic correlation. Conclusions:DNMT3A and IDH2 mutations strongly influenced CD13 expression. Given reports linking co-existing NPM1 and DNMT3A mutations to worse prognosis, these findings highlight the clinical relevance of immunophenotypic–genotypic associations in NPM1m+ AML. Key words: |
| 480 |
Standardization of rare CD138+ Plasma Cell Sorting Using the autoMACS® NEO Separator and CD138+ MicroBead Kit |
|
|
|
- | |
Malignant |
Miscellaneous |
Laboratory |
|
Jagruti Nikhil Gharat |
ACTREC, Kharghar |
Mumbai |
|
jagrutinikhil1908@gmail.com |
Both |
Introduction: Flow cytometry is a cornerstone for diagnosing hematological malignancies,
including multiple myeloma (MM), by enabling sensitive detection and immunophenotyping
of abnormal plasma cells. However, identification of very low-frequency plasma cell
populations in bone marrow and peripheral blood remains difficult. To address this
limitation, we incorporated a magnetic enrichment step prior to flow cytometry to improve
sensitivity and reliability.
Methods: We performed spike-and-dilution experiments using 30 clinical samples (20 bone
marrow, 10 peripheral blood) from patients with MM. Plasma cells were enriched with the
CD138+ MicroBead Kit on the autoMACS® NEO Separator. Both whole-blood and
mononuclear cell (MNC)-based preparations were assessed. Sorted fractions were
evaluated by multiparameter flow cytometry for plasma cell purity. Troubleshooting
addressed granulocyte contamination and sample processing times.
Results: The assay enabled reproducible detection of plasma cells down to 0.0007% (range
0.01–0.0007%). Granulocyte contamination was substantially lower in fresh samples (0.49–
8.37%) compared with those processed after 24 hours (14.8–89.1%), demonstrating the
critical importance of prompt processing. Comparative analysis of whole-blood versus
MNC-based enrichment showed no statistically significant difference (paired t-test, P =
0.1144); however, the MNC method was expensive with additional steps. Hence, based on
performance and feasibility, whole-blood processing was adopted. Sorted fractions yielded
plasma cell recovery ranging from 0.16–99.15% in the positive fraction, while the negative
fraction contained only 0.0002–10% plasma cells, confirming efficient enrichment.
Conclusion: We successfully standardized an automated magnetic-sorting protocol for
isolating rare plasma cells in MM. The method enables reliable enrichment even when
plasma cells represent as low as 0.0007%.. This enrichment substantially enhances the
diagnostic and research potential of limited or low-tumor-burden samples, supporting
downstream applications such as flow cytometric immunophenotyping, FISH, and
molecular genetic analyses. |