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Article ; Online: Therapeutic plasma exchange as an intervention for gemtuzumab ozogamicin impaired hemoglobin scavenging: A case and systematic review.

Adkins, Brian D / Noland, Daniel K / Slone, Tamra / Sadanand, Arhanti

2024 Volume 39, Issue 3, Page(s) e22116

Abstract: Gemtuzumab ozogamicin (GO) is a CD33 monoclonal antibody-drug conjugate currently in use to treat myeloid malignancies. A unique adverse effect of this medication is destruction of CD33 positive macrophages resulting in reduced clearance of free ... ...

Abstract	Gemtuzumab ozogamicin (GO) is a CD33 monoclonal antibody-drug conjugate currently in use to treat myeloid malignancies. A unique adverse effect of this medication is destruction of CD33 positive macrophages resulting in reduced clearance of free hemoglobin leading to grossly red plasma. This build-up of free hemoglobin can potentially lead to end organ damage and prevent performance of clinically necessary laboratory evaluation. We present a case of a pediatric patient who developed this adverse effect and was successfully treated with therapeutic plasma exchange (TPE). We also present results from a systematic review of the medical literature and share data from a query of the United States Food and Drug Administration (FDA) Adverse Event Reporting system for GO-related hemoglobin scavenging impairment. Among reported cases, patients undergoing TPE and those receiving steroids had improved outcomes. Practitioners should be aware of this rare drug side-effect and the potential utility of TPE for these patients.
MeSH term(s)	Humans ; Gemtuzumab/therapeutic use ; Plasma Exchange/methods ; Hemoglobins/analysis ; Sialic Acid Binding Ig-like Lectin 3 ; Male ; Aminoglycosides/adverse effects ; Female ; Antibodies, Monoclonal, Humanized/therapeutic use
Chemical Substances	Gemtuzumab (93NS566KF7) ; Hemoglobins ; Sialic Acid Binding Ig-like Lectin 3 ; Aminoglycosides ; Antibodies, Monoclonal, Humanized
Language	English
Publishing date	2024-05-01
Publishing country	United States
Document type	Systematic Review ; Case Reports ; Journal Article
ZDB-ID	604912-6
ISSN	1098-1101 ; 0733-2459
ISSN (online)	1098-1101
ISSN	0733-2459
DOI	10.1002/jca.22116
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Article ; Online: Bartonella henselae Infection and Lymphadenopathy in a Patient With T Cell Acute Lymphoblastic Leukemia.

Sadanand, Arhanti / Patel, Pratik / Riedesel, Erica / Berkowitz, Frank / Keller, Frank G

Journal of pediatric hematology/oncology

2024 Volume 46, Issue 3, Page(s) e241–e243

Abstract: Patients undergoing therapy for T cell acute lymphoblastic leukemia are at risk of infections during their treatment course. Cat scratch disease caused by Bartonella hensalae can masquerade as leukemic relapse and cause systemic infection. Obtaining a ... ...

Abstract	Patients undergoing therapy for T cell acute lymphoblastic leukemia are at risk of infections during their treatment course. Cat scratch disease caused by Bartonella hensalae can masquerade as leukemic relapse and cause systemic infection. Obtaining a thorough exposure history may aid clinicians in making the diagnosis.
MeSH term(s)	Humans ; Cat-Scratch Disease/complications ; Cat-Scratch Disease/diagnosis ; Cat-Scratch Disease/drug therapy ; Bartonella henselae ; Lymphadenopathy/etiology ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/complications ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy ; T-Lymphocytes
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1231152-2
ISSN	1536-3678 ; 1077-4114 ; 0192-8562
ISSN (online)	1536-3678
ISSN	1077-4114 ; 0192-8562
DOI	10.1097/MPH.0000000000002844
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Zs.A 1537: Show issues

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Article ; Online: A single-center retrospective review of pediatric cases of progressive transformation of germinal centers.

Sadanand, Arhanti / Aljudi, Ahmed / Bergsagel, D John / Keller, Frank G

Pediatric blood & cancer

2023 Volume 70, Issue 6, Page(s) e30283

Abstract: Background: Progressive transformation of germinal centers (PTGC) is a rare diagnosis characterized by asymptomatic lymph node enlargement. It has previously been associated with lymphoma, autoimmune conditions, and lymphoproliferative diseases in small ...

Abstract	Background: Progressive transformation of germinal centers (PTGC) is a rare diagnosis characterized by asymptomatic lymph node enlargement. It has previously been associated with lymphoma, autoimmune conditions, and lymphoproliferative diseases in small pediatric case series. Procedures: We conducted a single-center retrospective review of pediatric cases of PTGC diagnosed at our institution by hematopathologists from 2000 to 2020. Results: We identified 57 primary cases and three recurrent cases of PTGC. Laboratory and imaging evaluations were obtained inconsistently. Nine patients (16%) saw a pediatric hematology/oncology (PHO) specialist prior to diagnosis, and 21 (37%) had follow-up with PHO after diagnosis. Conclusions: Patients with PTGC had similar age and involved lymph node sites to those from previous case series. Fewer patients underwent recurrent lymph node biopsy than previously described. PTGC has been linked to certain types of lymphoma, although never definitively associated with lymphoma. Follow-up with a PHO provider is indicated to ensure that close surveillance is performed.
MeSH term(s)	Humans ; Child ; Retrospective Studies ; Germinal Center/pathology ; Lymphoma/pathology ; Cell Transformation, Neoplastic/pathology ; Lymph Nodes/pathology
Language	English
Publishing date	2023-03-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.30283
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Zs.A 1131: Show issues

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Article: Safety of Probiotics Among High-Risk Pediatric Hematopoietic Stem Cell Transplant Recipients.

Sadanand, Arhanti / Newland, Jason G / Bednarski, Jeffrey J

Infectious diseases and therapy

2019 Volume 8, Issue 2, Page(s) 301–306

Abstract: Introduction: Increased diversity of the intestinal microbiome has been significantly associated with lower mortality after hematopoietic stem cell transplant (HSCT). Probiotics, such as Lactobacillus species with defined probiotic potential, may have ... ...

Abstract	Introduction: Increased diversity of the intestinal microbiome has been significantly associated with lower mortality after hematopoietic stem cell transplant (HSCT). Probiotics, such as Lactobacillus species with defined probiotic potential, may have beneficial properties including restoration of commensal species to the intestinal tract, anti-microbial effects, and healing of the intestinal mucosa. However, the use of probiotics in immune-compromised patients raises concerns, specifically regarding the risk for possible Lactobacillus bacteremia. Risk of bacteremia is an even greater concern in HSCT patients with breakdown of mucosal barriers, specifically patients with Clostridium difficile infection (CDI) or gastrointestinal graft-versus-host disease (GVHD). Minimal data have been reported on the safety of probiotics in these high-risk HSCT populations. Methods: We performed a retrospective study of allogeneic HSCT recipients at our institution between 2011 and 2016, and identified 14 patients (median age 7 years) prescribed probiotics, 10 of whom received probiotics prior to day 100 after HSCT. Results: Eight of ten patients were diagnosed with acute GVHD, four of whom (40%) specifically had acute GVHD involving the gastrointestinal tract. Five patients (50%) on probiotics prior to day 100 were diagnosed with CDI (median onset at day 13 post-transplant). There were no cases of Lactobacillus bacteremia, including in patients with GVHD or CDI. Conclusion: This small case series supports the safe use of probiotics in a high-risk population of pediatric HSCT patients with compromised intestinal mucosal integrity. Further studies are needed to determine if probiotics have benefit in preventing and treating gastrointestinal GVHD or CDI.
Language	English
Publishing date	2019-04-15
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2701611-0
ISSN	2193-6382 ; 2193-8229
ISSN (online)	2193-6382
ISSN	2193-8229
DOI	10.1007/s40121-019-0244-3
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Article ; Online: Case 1: Syncope in a 16-year-old Girl.

Sadanand, Arhanti / Ladell, Meagan / Fischer, Kayleigh

Pediatrics in review

2018 Volume 40, Issue 1, Page(s) 37–39

MeSH term(s)	Adolescent ; Antineoplastic Agents/therapeutic use ; Diagnosis, Differential ; Electrocardiography ; Female ; Heart/diagnostic imaging ; Heart Neoplasms/diagnosis ; Heart Neoplasms/pathology ; Heart Neoplasms/therapy ; Hemangiosarcoma/diagnosis ; Hemangiosarcoma/pathology ; Hemangiosarcoma/therapy ; Humans ; Lung/diagnostic imaging ; Lung/pathology ; Lung Neoplasms/secondary ; Radiosurgery/methods ; Syncope/etiology ; Tomography, X-Ray Computed
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2018-11-22
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	774515-1
ISSN	1526-3347 ; 0191-9601
ISSN (online)	1526-3347
ISSN	0191-9601
DOI	10.1542/pir.2018-0028
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Zs.B 2595: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 53: Show issues

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Article: Burkitt Lymphoma Presenting as a Paraneoplastic Demyelinating Disorder in a Child

Sadanand, Arhanti / Jain, Juhi / Elkins, Kathryn / Bergsagel, Daniel John

Journal of Pediatric Neurology

2021 Volume 20, Issue 02, Page(s) 113–114

Abstract: In adults, lymphomas have been associated with paraneoplastic syndromes that cause cranial nerve palsies, polyneuropathies, and paraplegias. These have been less frequently reported in children. We described a pediatric patient who initially presented ... ...

Abstract	In adults, lymphomas have been associated with paraneoplastic syndromes that cause cranial nerve palsies, polyneuropathies, and paraplegias. These have been less frequently reported in children. We described a pediatric patient who initially presented with palsy of her left third cranial nerve and bilateral ptosis. Initial diagnosis was concerning for myasthenia gravis, but after additional diagnostic evaluation, she was found to have acute motor axonal neuropathy. Cerebrospinal fluid studies were consistent with a diagnosis of Burkitt lymphoma. In this article, we discussed the importance of considering primary oncologic diagnoses in acute neurologic disorders with unusual presentations.
Keywords	paraneoplastic ; demyelinating ; lymphoma
Language	English
Publishing date	2021-06-26
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ISSN	1875-9041 ; 1304-2580
ISSN (online)	1875-9041
ISSN	1304-2580
DOI	10.1055/s-0041-1731398
Database	Thieme publisher's database

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Article ; Online: A phase 1 study of simvastatin in combination with topotecan and cyclophosphamide in pediatric patients with relapsed and/or refractory solid and CNS tumors.

Cash, Thomas / Jonus, Hunter C / Tsvetkova, Maya / Beumer, Jan H / Sadanand, Arhanti / Lee, Jasmine Y / Henry, Curtis J / Aguilera, Dolly / Harvey, R Donald / Goldsmith, Kelly C

Pediatric blood & cancer

2023 Volume 70, Issue 8, Page(s) e30405

Abstract: Background: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) can inhibit tumor proliferation, angiogenesis, and restore apoptosis in preclinical pediatric solid tumor models. We conducted a phase 1 trial to determine the ... ...

Abstract	Background: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) can inhibit tumor proliferation, angiogenesis, and restore apoptosis in preclinical pediatric solid tumor models. We conducted a phase 1 trial to determine the maximum tolerated dose (MTD) of simvastatin with topotecan and cyclophosphamide in children with relapsed/refractory solid and central nervous system (CNS) tumors. Methods: Simvastatin was administered orally twice daily on days 1-21, with topotecan and cyclophosphamide intravenously on days 1-5 of a 21-day cycle. Four simvastatin dose levels (DLs) were planned, 140 (DL1), 180 (DL2), 225 (DL3), 290 (DL4) mg/m Results: The median age of 14 eligible patients was 11.5 years (range: 1-23). The most common diagnoses were neuroblastoma (N = 4) and Ewing sarcoma (N = 3). Eleven dose-limiting toxicity (DLT)-evaluable patients received a median of four cycles (range: 1-6). There were three cycle 1 DLTs: one each grade 3 diarrhea and grade 4 creatine phosphokinase (CPK) elevations at DL1, and one grade 4 CPK elevation at DL0. All patients experienced at least one grade 3/4 hematologic toxicity. Best overall response was partial response in one patient with Ewing sarcoma (DL0) and stable disease for four or more cycles in four patients. Simvastatin exposure increased with higher doses and may have correlated with toxicity. Plasma interleukin 6 (IL-6) concentrations (N = 6) showed sustained IL-6 reductions with decrease to normal values by day 21 in all patients, indicating potential on-target effects. Conclusions: The MTD of simvastatin with topotecan and cyclophosphamide was determined to be 100 mg/m
MeSH term(s)	Humans ; Child ; Infant ; Child, Preschool ; Adolescent ; Young Adult ; Adult ; Topotecan ; Sarcoma, Ewing ; Simvastatin/adverse effects ; Interleukin-6 ; Cyclophosphamide ; Neoplasms/drug therapy ; Central Nervous System Neoplasms/drug therapy ; Central Nervous System Neoplasms/etiology ; Neuroectodermal Tumors, Primitive, Peripheral ; Maximum Tolerated Dose ; Antineoplastic Combined Chemotherapy Protocols/adverse effects
Chemical Substances	Topotecan (7M7YKX2N15) ; Simvastatin (AGG2FN16EV) ; Interleukin-6 ; Cyclophosphamide (8N3DW7272P)
Language	English
Publishing date	2023-05-09
Publishing country	United States
Document type	Clinical Trial, Phase I ; Journal Article
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.30405
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Zs.A 1131: Show issues

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Article ; Online: Development of a Medical Spanish Curriculum for Fourth-Year Medical Students.

Sadanand, Arhanti / Ryan, Mark H / Cohen, Steven / Ryan, Michael S

PRiMER (Leawood, Kan.)

2018 Volume 2, Page(s) 17

Abstract: Introduction: The US Latino population is projected to double over the next 50 years while the proportion of Latino physicians is expected to decrease over the same interval. Spanish curricula within medical schools are common but rarely assess learners ...

Abstract	Introduction: The US Latino population is projected to double over the next 50 years while the proportion of Latino physicians is expected to decrease over the same interval. Spanish curricula within medical schools are common but rarely assess learners for proficiency and are often not incentivized. Family physicians are well positioned to promote the effective delivery of culturally and linguistically appropriate care to Latino patients with limited English proficiency (LEP). Our aim was to develop a replicable, incentivized, medical Spanish curriculum to promote fluency. Methods: We developed a peer-taught, interactive, case-based medical Spanish curriculum for fourth-year medical students at a single medical school. All fourth-year medical students were eligible to enroll. Seventeen students completed pre- and postintervention questionnaires to rate their self-efficacy in medical Spanish comprehension and vocabulary. At the end of the course, students were also assessed for oral Spanish language skills by a standardized patient (SP). Results: Students rated themselves as having improved at completing nearly all components of the medical interview and physical in Spanish after completing the course (15/16 tasks, Conclusion: This peer-led medical Spanish course shows promise as a feasible and sustainable curriculum for teaching medical Spanish and assessing fluency among fourth-year medical students. Establishing a cohort of peers as teachers addresses concerns about cost and reduces the need for faculty support.
Language	English
Publishing date	2018-09-11
Publishing country	United States
Document type	Journal Article
ISSN	2575-7873
ISSN (online)	2575-7873
DOI	10.22454/PRiMER.2018.738688
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Teaching scripts via smartphone app facilitate resident-led teaching of medical students.

Zessis, Nicholas R / Dube, Amanda R / Sadanand, Arhanti / Cole, Jordan J / Hrach, Christine M / Daud, Yasmeen N

BMC medical education

2021 Volume 21, Issue 1, Page(s) 331

Abstract: Background: Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The ... ...

Abstract	Background: Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app). Methods: Prior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships. Results: 44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention. Conclusions: Residency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.
MeSH term(s)	Child ; Clinical Clerkship ; Curriculum ; Humans ; Internship and Residency ; Smartphone ; Students, Medical ; Teaching
Language	English
Publishing date	2021-06-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-021-02782-w
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Article ; Online: Non-Neural (S-100 Negative) Bronchial Granular Cell Tumor Causing Acute Respiratory Failure.

Chen, Stephanie Y / Sadanand, Arhanti / Dillon, Patrick A / He, Mai / Dehner, Louis P / Leonard, David S

Fetal and pediatric pathology

2019 Volume 39, Issue 1, Page(s) 85–89

Abstract: ... ...

Abstract	Introduction
MeSH term(s)	Bronchi/pathology ; Bronchoscopy/methods ; Child ; Female ; Granular Cell Tumor/diagnosis ; Granular Cell Tumor/pathology ; Humans ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/pathology
Language	English
Publishing date	2019-07-09
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2165508-X
ISSN	1551-3823 ; 1551-3815 ; 1522-7952
ISSN (online)	1551-3823
ISSN	1551-3815 ; 1522-7952
DOI	10.1080/15513815.2019.1636431
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