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Article ; Online: "Myelodysplasia" from copper deficiency.

Siddiqui, Salahuddin / Ramlal, Reshma

2019 Volume 133, Issue 8, Page(s) 883

MeSH term(s)	Bone Marrow/metabolism ; Bone Marrow/pathology ; Copper/deficiency ; Female ; Humans ; Middle Aged ; Myelodysplastic Syndromes/diagnosis ; Myelodysplastic Syndromes/metabolism ; Myelodysplastic Syndromes/pathology ; Pancytopenia/diagnosis ; Pancytopenia/metabolism ; Pancytopenia/pathology
Chemical Substances	Copper (789U1901C5)
Language	English
Publishing date	2019-02-19
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80069-7
ISSN	1528-0020 ; 0006-4971
ISSN (online)	1528-0020
ISSN	0006-4971
DOI	10.1182/blood-2018-11-884981
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Article ; Online: Multimodality Imaging Guided Diagnosis and Treatment Response Evaluation in a Patient with Lymphoma with Right Atrioventricular Involvement.

Chen, Jeff / Ahmed, Taha / Ahmed, Taimoor / Iragavarapu, Chitanya / Ramlal, Reshma / Arbune, Amit

Current problems in cardiology

2022 Volume 47, Issue 9, Page(s) 101273

Abstract: A 42-year-old female was transferred to our center from a regional hospital with 5-day history of flushing, fatigue, and chest pressure. On initial presentation to the regional hospital, computed tomography of chest revealed a large mediastinal mass with ...

Abstract	A 42-year-old female was transferred to our center from a regional hospital with 5-day history of flushing, fatigue, and chest pressure. On initial presentation to the regional hospital, computed tomography of chest revealed a large mediastinal mass with cardiac involvement. Supraclavicular lymph node biopsy demonstrated nongerminal center diffuse large B-cell lymphoma with Ki67 index near 100%. A transthoracic echocardiogram revealed a solid mass infiltrating the right atrium (RA) and right ventricle (RV), moderate tricuspid regurgitation, and a moderate pericardial effusion. Further assessment with cardiac magnetic resonance imaging demonstrated a contrast avid mass with necrotic center invading into the RA and RV consistent with metastatic lymphoma. Prior to induction chemotherapy, her clinical course was complicated by supraventricular tachycardia that resolved after initiation of targeted chemotherapy against the lymphoma. Follow-up cardiac imaging 3 months later demonstrated decrease in size of the cardiac mass and the amount of pericardial effusion. This case demonstrates utility of multi-modality cardiac imaging in the diagnosis and assessing therapeutic response of diffuse large B-cell Lymphoma with cardiac involvement.
MeSH term(s)	Adult ; Cardiac Imaging Techniques ; Echocardiography ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse/diagnosis ; Lymphoma, Large B-Cell, Diffuse/diagnostic imaging ; Pericardial Effusion/complications ; Pericardial Effusion/etiology ; Tomography, X-Ray Computed
Language	English
Publishing date	2022-06-02
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	441230-8
ISSN	1535-6280 ; 0146-2806
ISSN (online)	1535-6280
ISSN	0146-2806
DOI	10.1016/j.cpcardiol.2022.101273
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Article: Advances in the Use of Regulatory T-Cells for the Prevention and Therapy of Graft-vs.-Host Disease.

Ramlal, Reshma / Hildebrandt, Gerhard C

Biomedicines

2017 Volume 5, Issue 2

Abstract: Regulatory T (Tregs) cells play a crucial role in immunoregulation and promotion of immunological tolerance. Adoptive transfer of these cells has therefore been of interest in the field of bone marrow and solid organ transplantation, autoimmune diseases ... ...

Abstract	Regulatory T (Tregs) cells play a crucial role in immunoregulation and promotion of immunological tolerance. Adoptive transfer of these cells has therefore been of interest in the field of bone marrow and solid organ transplantation, autoimmune diseases and allergy medicine. In bone marrow transplantation, Tregs play a pivotal role in the prevention of graft-verus-host disease (GvHD). This has generated interest in using adoptive Treg cellular therapy in the prevention and treatment of GvHD. There have been several barriers to the feasibility of Treg cellular therapy in the setting of hematopoietic stem cell transplantation (HSCT) which include low Treg concentration in peripheral blood, requiring expansion of the Treg population; instability of the expanded product with loss of FoxP3 expression; and issues related to the purity of the expanded product. Despite these challenges, investigators have been able to successfully expand these cells both in vivo and in vitro and have demonstrated that they can be safely infused in humans for the prevention and treatment of GvHD with no increase in relapse risk or infections risk.
Language	English
Publishing date	2017-05-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines5020023
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Article ; Online: Prognostic impact of Philadelphia chromosome in mixed phenotype acute leukemia (MPAL): A cancer registry analysis on real-world outcome.

Qasrawi, Ayman / Ramlal, Reshma / Munker, Reinhold / Hildebrandt, Gerhard C

American journal of hematology

2020 Volume 95, Issue 9, Page(s) 1015–1021

Abstract: Mixed phenotype acute leukemia (MPAL) is thought to have poor outcome, and presence of the Philadelphia chromosome (Ph+) has been considered to be an adverse prognostic marker. However, most of these reports were in the pre-tyrosine kinase inhibitors ( ... ...

Abstract	Mixed phenotype acute leukemia (MPAL) is thought to have poor outcome, and presence of the Philadelphia chromosome (Ph+) has been considered to be an adverse prognostic marker. However, most of these reports were in the pre-tyrosine kinase inhibitors (TKIs) era. Recent limited reports indicate improved outcomes for MPAL with the addition of TKIs. We examined the outcomes of 241 cases of MPAL according to the 2008 WHO classification from the Surveillance, Epidemiology, and End Results registry. The MLL+ patients had a median age of 6 years while other subtypes occurred mostly in adults and had comparable age. On multivariate analyses and after adjustment for age, year of diagnosis and chemotherapy status, Ph+ MPAL patients had reduced risk of death in comparison to Ph(-) MPAL patients (hazard ratio [HR] = 0.28, P = .002). So, MLL+ MPAL had the worst outcome with a 10-fold increased risk of death in comparison to Ph+ MPAL patients (HR = 10.2, P < .001). Importantly, the outcome of Ph+ MPAL was comparable to Ph+ acute lymphoblastic leukemia in a 1:1 matched case-control analysis. In conclusion, this is the largest registry study which examines the outcomes of MPAL subtypes. We confirm that MPAL is a heterogenous disease. Note, Ph+ MPAL nowadays has a better OS in comparison to other subtypes and is comparable to Ph+ ALL patients. This is most likely secondary to changes in practice and more utilization of TKIs. On the other hand, MLL rearrangement is associated with infantile MPAL and has a dismal prognosis.
MeSH term(s)	Adolescent ; Adult ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Humans ; Infant ; Male ; Middle Aged ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy ; Risk Factors ; Survival Rate ; United States/epidemiology
Language	English
Publishing date	2020-06-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	196767-8
ISSN	1096-8652 ; 0361-8609
ISSN (online)	1096-8652
ISSN	0361-8609
DOI	10.1002/ajh.25873
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Article: Myocarditis Concurrent with Sweet Syndrome: A Presentation of Acute Myeloid Leukemia.

Burkeen, Christopher G / Pottinger, David / Iragavarapu, Chaitanya / Ramlal, Reshma / Hildebrandt, Gerhard

Case reports in hematology

2021 Volume 2021, Page(s) 6621007

Abstract: Acute myeloid leukemia (AML) is the most common acute leukemia in American adults and portends a poor prognosis if untreated. Commonly, AML presents with symptoms related to concurrent leukopenia, anemia, or thrombocytopenia; however, due to its ability ... ...

Abstract	Acute myeloid leukemia (AML) is the most common acute leukemia in American adults and portends a poor prognosis if untreated. Commonly, AML presents with symptoms related to concurrent leukopenia, anemia, or thrombocytopenia; however, due to its ability to affect many organ systems in the body, AML can have a highly varied clinical presentation. One such presentation is myocarditis, which is a rarely reported manifestation of AML. Myocarditis can have a varied clinical picture and often requires exclusion of other causes of cardiac dysfunction. Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is another presentation of AML; however, it is more commonly associated with AML than cardiac involvement. Sweet syndrome can occur in patients with an already established malignancy or can occur de novo in a patient with previously undiagnosed cancer and, interestingly, can also be accompanied by extracutaneous manifestations, one of which is myocarditis. Herein, we report a case of a 45-year-old male with a history of obesity and depression who presented with chest pain, a tender and diffuse rash, and pancytopenia. Heart catheterization performed at outside institution was negative for coronary artery disease. Cardiac MRI images were compatible with myocarditis. Dermal biopsy of the rash was consistent with sweet syndrome. Peripheral blood flow cytometry and bone marrow biopsy confirmed the diagnosis of AML. He was treated with an induction chemotherapy regimen of 7 days of cytarabine and 3 days of daunorubicin with resolution of his chest pain and skin lesions. The patient had persistent leukemia cells on day 14 postinduction bone marrow biopsy and was treated with high-dose cytarabine reinduction treatment. Bone marrow biopsy with count recovery after reinduction therapy revealed complete response (CR).
Language	English
Publishing date	2021-05-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627639-2
ISSN	2090-6579 ; 2090-6560
ISSN (online)	2090-6579
ISSN	2090-6560
DOI	10.1155/2021/6621007
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Article ; Online: Allogenic hematopoietic stem cell transplantation for prolonged bone marrow aplasia after chimeric antigen receptor (CAR) T-cell therapy for relapsed diffuse large B-cell lymphoma.

Qasrawi, Ayman / Arora, Ranjana / Ramlal, Reshma / Munker, Reinhold / Hildebrandt, Gerhard C

American journal of hematology

2020 Volume 95, Issue 4, Page(s) E89–E91

MeSH term(s)	Adrenal Cortex Hormones/administration & dosage ; Allografts ; Anemia, Aplastic/etiology ; Anemia, Aplastic/therapy ; Antibodies, Monoclonal, Humanized/administration & dosage ; Antigens, CD19/adverse effects ; Antigens, CD19/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carmustine/administration & dosage ; Combined Modality Therapy ; Cyclophosphamide/administration & dosage ; Cytarabine/administration & dosage ; Deoxycytidine/administration & dosage ; Deoxycytidine/analogs & derivatives ; Doxorubicin/administration & dosage ; Etoposide/administration & dosage ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunotherapy, Adoptive/adverse effects ; Lymphoma, Large B-Cell, Diffuse/drug therapy ; Lymphoma, Large B-Cell, Diffuse/therapy ; Male ; Melphalan/administration & dosage ; Middle Aged ; Oxaliplatin/administration & dosage ; Prednisone/administration & dosage ; Recurrence ; Rituximab/administration & dosage ; Salvage Therapy/adverse effects ; Transplantation, Autologous ; Vincristine/administration & dosage
Chemical Substances	Adrenal Cortex Hormones ; Antibodies, Monoclonal, Humanized ; Antigens, CD19 ; Cytarabine (04079A1RDZ) ; Oxaliplatin (04ZR38536J) ; Deoxycytidine (0W860991D6) ; Rituximab (4F4X42SYQ6) ; Vincristine (5J49Q6B70F) ; Etoposide (6PLQ3CP4P3) ; Doxorubicin (80168379AG) ; Cyclophosphamide (8N3DW7272P) ; gemcitabine (B76N6SBZ8R) ; tocilizumab (I031V2H011) ; Melphalan (Q41OR9510P) ; axicabtagene ciloleucel (U2I8T43Y7R) ; Carmustine (U68WG3173Y) ; Prednisone (VB0R961HZT)
Language	English
Publishing date	2020-01-21
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	196767-8
ISSN	1096-8652 ; 0361-8609
ISSN (online)	1096-8652
ISSN	0361-8609
DOI	10.1002/ajh.25725
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Article ; Online: Multicenter evaluation of arsenic trioxide dosing in obese patients with low-intermediate risk acute promyelocytic leukemia.

Hickey, Erin / Clemons, Bryant / Griffin, Shawn / Cox, Jessica / Sutphin, Stephanie / Ramlal, Reshma / Benitez, Lydia

Leukemia & lymphoma

2019 Volume 60, Issue 14, Page(s) 3557–3560

MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/adverse effects ; Arsenic Trioxide/administration & dosage ; Arsenic Trioxide/adverse effects ; Female ; Follow-Up Studies ; Humans ; Leukemia, Promyelocytic, Acute/drug therapy ; Leukemia, Promyelocytic, Acute/pathology ; Long QT Syndrome/chemically induced ; Long QT Syndrome/pathology ; Male ; Middle Aged ; Obesity/physiopathology ; Prognosis ; Retrospective Studies ; Young Adult
Chemical Substances	Antineoplastic Agents ; Arsenic Trioxide (S7V92P67HO)
Language	English
Publishing date	2019-07-11
Publishing country	United States
Document type	Letter ; Multicenter Study
ZDB-ID	1042374-6
ISSN	1029-2403 ; 1042-8194
ISSN (online)	1029-2403
ISSN	1042-8194
DOI	10.1080/10428194.2019.1639163
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Article ; Online: Acute undifferentiated leukemia: data on incidence and outcomes from a large population-based database.

Qasrawi, Ayman / Gomes, Victor / Chacko, Charles Andrew / Mansour, Akila / Kesler, Melissa / Arora, Ranjana / Wei, Sainan / Ramlal, Reshma / Munker, Reinhold

Leukemia research

2020 Volume 89, Page(s) 106301

Abstract: Acute undifferentiated leukemia (AUL) is rare and defined by the absence of bona fide myeloid and lymphoid markers. Little is known about its incidence, survival and optimal management in the recent time period. Based on a case observed in our clinic, we ...

Abstract	Acute undifferentiated leukemia (AUL) is rare and defined by the absence of bona fide myeloid and lymphoid markers. Little is known about its incidence, survival and optimal management in the recent time period. Based on a case observed in our clinic, we queried the Surveillance, Epidemiology, and End Results database between 2000 and 2016. A total of 1,888 cases of AUL were diagnosed (1.34 per million person-years). The incidence of AUL has significantly decreased over time. Compared to other acute leukemias, patients with AUL have the highest median age (74 years); in contrast to acute myeloid leukemia (AML, 65) and acute lymphoblastic leukemia (ALL, 12). Excluding patients with preexisting malignancies, 1,444 patients with AUL were analyzed for survival. Only 35% of AUL patients had received chemotherapy. Comparatively, 94% of ALL and 71% of AML cases received chemotherapy. Among AUL patients who received chemotherapy, the median survival was 12 months as opposed to 1 month in the group who did not receive chemotherapy (or unknown status). Among adults, AUL patients had the worst prognosis, with a median overall survival (OS) of 9 months, compared to 27 months in ALL and 13 months in AML. Among children, the median OS was superior for all three groups of leukemias, the OS of AUL patients being better than in AML and very similar to ALL. On multivariate analysis, older age and time period were associated with worse outcome. We describe here the largest series of cases with AUL published to date.
MeSH term(s)	Adolescent ; Adult ; Aged ; Biopsy ; Child ; Child, Preschool ; Databases, Factual ; Female ; Humans ; Immunohistochemistry ; Incidence ; Infant ; Infant, Newborn ; Leukemia, Myeloid, Acute/diagnosis ; Leukemia, Myeloid, Acute/epidemiology ; Leukemia, Myeloid, Acute/mortality ; Male ; Middle Aged ; Neoplasm Grading ; Patient Outcome Assessment ; Population Surveillance ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality ; Prognosis ; SEER Program ; Survival Analysis ; Young Adult
Language	English
Publishing date	2020-01-17
Publishing country	England
Document type	Journal Article
ZDB-ID	752396-8
ISSN	1873-5835 ; 0145-2126
ISSN (online)	1873-5835
ISSN	0145-2126
DOI	10.1016/j.leukres.2020.106301
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Article: Ten-year survival outcomes for patients with early stage classical Hodgkin lymphoma: An analysis from Kentucky Cancer Registry.

Myint, Zin W / Shrestha, Runa / Siddiqui, Salahuddin / Slone, Stacey / Huang, Bin / Ramlal, Reshma / Monohan, Gregory P / Hildebrandt, Gerhard C / Saeed, Hayder

Hematology/oncology and stem cell therapy

2019 Volume 13, Issue 1, Page(s) 17–22

Abstract: Objective/background: Early stage classical Hodgkin lymphoma (cHL) has an excellent outcome. Recent studies focus on decreasing toxicity related to the addition of radiation along with chemotherapy. Real-life reporting of the addition of radiation to ... ...

Abstract	Objective/background: Early stage classical Hodgkin lymphoma (cHL) has an excellent outcome. Recent studies focus on decreasing toxicity related to the addition of radiation along with chemotherapy. Real-life reporting of the addition of radiation to chemotherapy is lacking. This study investigates the outcomes obtained from a statewide cancer registry for early stage cHL patients treated with chemotherapy alone (CT) versus patients treated with the combined modality of chemotherapy and radiation (CMT). Methods: A retrospective study of cHL patients diagnosed and treated was identified using a statewide cancer registry from 2005 to 2014. Patients with early stage disease (I, II) were then grouped on the basis of the presence of B symptoms into favorable and unfavorable groups. Baseline characteristics (age, gender, extranodal involvement, and histology) as well as overall survival were compared for both groups depending on whether they received CT or CMT as first line therapy for their cHL. Results: A total of 961 patients were identified; of those, 127 were excluded as they received only radiation or another form of treatment. Of the remaining patients, 293 were categorized as early stage favorable cHL (Group 1) and 130 adults were in the unfavorable cHL (Group 2). There were 335 patients with advanced stage cHL (Group 3) and 76 patients in an unknown stage. The 10-year overall survival for Group 1 was 81.3% versus 76.3% for Group 2 and 52.7% for Group 3. For Group 1, 10-year overall survival was 86.7% with CMT versus 75.1% for those receiving CT only (p = .004). For Group 2, there was no difference in 10-year overall survival between the CMT group (80.0%) and CT (72.5%) (p = .73). Conclusion: While radiation therapy might increase long-term toxicity in cHL, in our large data cohort, radiotherapy consolidation as part of the initial therapy for early stage disease provides superior survival at 10 years, especially in favorable risk cHL.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Hodgkin Disease/mortality ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Registries ; Retrospective Studies ; Survival Analysis ; Time Factors ; Young Adult
Language	English
Publishing date	2019-10-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2651893-4
ISSN	1658-3876
ISSN	1658-3876
DOI	10.1016/j.hemonc.2019.08.009
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Article ; Online: Efficacy and Toxicity of Induction Therapy with Cladribine, Idarubicin, and Cytarabine (IAC) for Acute Myeloid Leukemia.

Woelich, Susan K / Braun, James T / Schoen, Martin W / Ramlal, Reshma / Freter, Carl E / Petruska, Paul J / Lionberger, Jack M

Anticancer research

2017 Volume 37, Issue 2, Page(s) 713–717

Abstract: We report our single-center experience with cytarabine and idarubicin for induction therapy for acute myeloid leukemia (AML) with an additional 5 days of cladribine (IAC therapy). From July 2012 to September 2014, 38 patients completed a full course of ... ...

Abstract	We report our single-center experience with cytarabine and idarubicin for induction therapy for acute myeloid leukemia (AML) with an additional 5 days of cladribine (IAC therapy). From July 2012 to September 2014, 38 patients completed a full course of IAC induction. Median patient age was 61 years, 61% of patients were ≥60 years old, and 71% were male. The complete remission (CR) rate was 63% following a single induction course, three patients (8%) required a second induction course to achieve CR, for an overall response rate of 71%. The median duration of severe neutropenia was 30.5 days. Thirty-two percent of patients developed mucositis, 76% experienced diarrhea, and 61% developed a rash. Incidence of CR following IAC induction therapy for AML was comparable to historical data, but with frequent diarrhea, rash, and fungal infections. This study found IAC efficacy and toxicity was similar irrespective of age.
MeSH term(s)	Acute Disease ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Cladribine/administration & dosage ; Cladribine/adverse effects ; Cytarabine/administration & dosage ; Cytarabine/adverse effects ; Diarrhea/chemically induced ; Exanthema/chemically induced ; Female ; Humans ; Idarubicin/administration & dosage ; Idarubicin/adverse effects ; Induction Chemotherapy ; Leukemia, Myeloid/drug therapy ; Male ; Middle Aged ; Mucositis/chemically induced ; Neutropenia/chemically induced ; Remission Induction ; Retrospective Studies ; Treatment Outcome ; Young Adult
Chemical Substances	Cytarabine (04079A1RDZ) ; Cladribine (47M74X9YT5) ; Idarubicin (ZRP63D75JW)
Language	English
Publishing date	2017
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.11368
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