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S Paneesha

Publications and source records attributed to S Paneesha.

7 recordsLinked to original sources
PubMed2006

High D-dimer levels at presentation in patients with venous thromboembolism is a marker of adverse clinical outcomes.

Qualitative D-dimer results, together with clinical probability scores, are well established in the diagnosis of venous thromboembolism (VTE). The predictive value of quantitative D-dimer levels for various clinical outcomes in VTE patients is not fully understood. D-dimer levels obtained at presentation were analysed in 699 (360 men; 339 women) VTE patients for survival and occurrence of malignancy. Patients were followed for a median of 23 months. 17.2% patients had a D-dimer level >8000 ng FEU/mlat presentation, which was associated with decreased overall survival (OS) (P < 0.001) and event-free survival (EFS) (P < 0.001). 25.4% patients had malignancy and 4% subsequently developed malignancy following VTE. 29.9% of patients with VTE and malignancy had a D-dimer level >8 mg/l when compared with 13.4% of patients with VTE without malignancy (P < 0.001). 50% of patients who developed subsequent malignancy following VTE had a presentation D-dimer >8000 ng FEU/mlas compared with 13.3% of patients with VTE with out malignancy (P = 0.009). In conclusion, D-dimer >8000 ng FEU/ml at presentation in patients with VTE is a marker of poor OS, EFS and underlying malignancy. Consideration of screening for malignancy is recommended in patients with VTE with a presentation D-dimer >8000 ng FEU/ml and age >60 years.

Adolescent↗
PubMed2006

The SDF-1 G > A polymorphism at position 801 plays no role in multiple myeloma but may contribute to an inferior cause-specific survival in chronic lymphocytic leukemia.

The growth and circulation of B lymphocytes is largely under the control of bone marrow stromal cells, cytokines and chemokines. The gene responsible for the pivotal B cell growth factor, stromal derived factor-1 (SDF-1), has recently been shown to contain a single nucleotide polymorphism G > A at position 801 which leads to higher SDF-1 secretion. This polymorphism is common in the normal population and has been shown to play a potential role in the development of both HIV and non-HIV related non-Hodgkin's lymphoma. We therefore undertook a large single-centre study to ascertain its role in the pathogenesis of two other common B-cell malignancies, notably chronic lymphocytic leukemia (CLL- 197 patients) and multiple myeloma (126 patients). We show that the 801 G > A polymorphism plays no role in the incidence of multiple myeloma or CLL nor the outcome in multiple myeloma. By contrast, it trends towards an inferior cause-specific survival in CLL.

Adult↗
PubMed2005

Stem cell transplantation for chronic lymphocytic leukaemia.

Early results of autologous stem cell transplantation (ASCT) in chronic lymphocytic leukaemia (CLL) suggested a significant proportion of patients remained disease-free for years, raising the possibility of cure. More recent studies have shown no evidence of a plateau in the survival curves indicating that, at best, ASCT may only prolong disease-free survival. Problems remain over progenitor cell mobilization and one study has raised anxieties about post-transplant myelodysplasia. The impact of ASCT in CLL will only be properly ascertained in a randomized clinical trial and this in underway in Europe. Initial results of conventional allogeneic transplantation (allo-SCT) were very disappointing, with an unacceptably high mortality, but did show that cure was possible in some patients. The introduction of reduced intensity conditioning has limited the early transplant-related mortality but it remains too early to determine what proportion of patients will be cured. In view of these uncertainties, is important that reduced intensity allo-SCT for CLL is conducted in the context of a clinical trial. Finally, CLL is very heterogeneous condition and great deal more is becoming understood about the prognostic factors. These will become important in allowing patients and their physicians a choice in balancing the risks of various treatment options.

Disease-Free Survival↗
PubMed2005

Successful treatment of a patient with chronic lymphocytic leukaemia (CLL) presenting with bony metastases with aggressive antibody and chemotherapy.

Osteolytic lesions are rare in chronic lymphocytic leukaemia (CLL) and thought to result from Richter's transformation or metastatic disease from nonlymphoid malignancies. We report a patient who presented with a large femoral metastatic lesion and hypercalcaemia caused by CLL itself. Complete remission of CLL with resolution of the osteolytic lesion was achieved with rituximab and cyclophosphamide, adriamycin, oncovin and prednisolone [CHOP (R-CHOP)] combination chemotherapy.

Aged, 80 and over↗
PubMed2002

Peripheral blood stem cell transplantation for POEMS syndrome.

In common with other plasma cell dyscrasias in which a small tumour burden is associated with severe clinical symptoms (notably systemic AL amyloidosis) the possible benefits of dose intensification are yet to be fully explored in POEMS syndrome. One important issue is whether the toxicity of the procedure is significantly increased in this group. We report two cases of POEMS syndrome with solitary asymptomatic bone lesions treated with high-dose melphalan (200 mg/m(2)) and peripheral blood stem cell (PBSC) rescue. In both cases there was minimal peri-transplant morbidity and a subsequent substantial and maintained improvement in the peripheral neuropathy.

Adult↗
PubMed2002

Burkitt's lymphoma: single-centre experience with modified BFM protocol.

Burkitt's lymphoma is a rare aggressive lymphoma, which responds poorly to standard chemotherapy regimens used to treat high-grade non-Hodgkin's lymphoma (NHL). The use of intensive chemotherapy protocols using alkylating agents and intensive CNS prophylaxis has dramatically altered prognosis. We have treated eight patients with Burkitt's lymphoma with a modified BFM protocol. The dose of methotrexate was reduced from 5 g/m2 to 1.5 g/m2 with the aim of reducing toxicity. Seven patients received a total of six cycles of chemotherapy each and one patient received five cycles of chemotherapy. Each cycle included high-dose methotrexate, an alkylating agent (ifosphamide or cyclophosphamide) and two triple intrathecal injections of chemotherapy. Two patients with bulky abdominal disease in addition received an autologous stem cell transplant. The regimen was well tolerated with minimal toxicity. At a median follow-up of 16 months (range 10-28), six of the eight patients (75%) were alive and in complete remission. Two patients relapsed, one 24 months post-BFM chemotherapy and the other 1-month post-autologous stem cell transplantation and 2 months post-BFM chemotherapy.

Adolescent↗