Browsing by Author "Isha Saini"

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Cytogenetic profile of aplastic anaemia in Indian children
(2013) Vineeta Gupta; Akash Kumar; Isha Saini; Ajit Kumar Saxena
Background & objectives: Aplastic anaemia is a rare haematological disorder characterized by pancytopenia with a hypocellular bone marrow. It may be inherited/genetic or acquired. Acquired aplastic anaemia has been linked to many drugs, chemicals and viruses. Cytogenetic abnormalities have been reported infrequently with acquired aplastic anaemia. Majority of the studies are in adult patients from the West. We report here cytogenetic studies on paediatric patients with acquired aplastic anaemia seen in a tertiary care hospital in north India. Methods: Patients (n=71, age 4-14 yr) were diagnosed according to the guidelines of International Agranulocytosis and Aplastic Anaemia Study. Conventional cytogenetics with Giemsa Trypsin Giemsa (GTG) banding was performed. Karyotyping was done according to the International System for Human Cytogenetics Nomenclature (ISCN). Results: Of the 71 patients, 42 had successful karyotyping where median age was 9 yr; of these 42, 27 (64.3%) patients had severe, nine (21.4%) had very severe and six (14.3%) had non severe aplastic anaemia. Five patients had karyotypic abnormalities with trisomy 12 (1), trisomy 8 (1) and monosomy 7 (1). Two patients had non numerical abnormalities with del 7 q - and t (5:12) in one each. Twenty nine patients had uninformative results. There was no difference in the clinical and haematological profile of patients with normal versus abnormal cytogenetics although the number of patients was small in the two groups. Interpretation & conclusions: Five (11.9%) patients with acquired aplastic anaemia had chromosomal abnormalities. Trisomy was found to be the commonest abnormality. Cytogenetic abnormalities may be significant in acquired aplastic anaemia although further studies on a large sample are required to confirm the findings.
Epidemiological features of aplastic anemia in Indian children
(Springer India, 2014) Vineeta Gupta; Raghvendra Pratap; Akash Kumar; Isha Saini; Jyoti Shukla
Objectives: To study the socio-demographic profile and clinico- hematological features of aplastic anemia in children presenting at a single institution over 5 y. Methods: Patients below the age of 15 y presenting with features of aplastic anemia were included in the study. Epidemiology, clinico-hematological features and treatment receivedwere recorded in all the cases. Serology for hepatitis A, B, C, E, EBV, parvovirus and HIV was carried out. Cytogenetic studies were available in approximately half of the patients. Results: One hundred eighty five patients were diagnosed with aplastic anemia. Ten patients with inherited bone marrow failure syndrome (IBMFS) were excluded. Median age was 8 y (range 4-14 y) with a male to female ratio of 2.4:1. Pallor (100%) followed by bleeding manifestations (83.8%) and fever (73.5%) were most common presenting symptoms. One hundred twenty patients (70%) were classified as severe, 36 (21%) very severe and 17 (9%) non-severe aplastic anemia. Viral markers for parvovirus, Epstein barr virus and hepatitis were positive in 25.8%, 20% and 6.7% patients respectively. Six patients had history of varicella infection in recent past (within 6 mo). Very few patients (30) could afford immunosuppressive therapy (IST) and had suboptimal response (29.7%). Conclusions: Majority of patients had idiopathic aplastic anemia. Very severe aplastic anemia and severe aplastic anemia were frequent. Few patients received IST and had suboptimal response. There is need to establish a national registry for aplastic anemia. © Dr. K C Chaudhuri Foundation 2013.
Immunosuppressive therapy in aplastic anemia
(2012) Vineeta Gupta; Akash Kumar; Vijai Tilak; Isha Saini; Baldev Bhatia
Objective: To assess the response to antithymocyte globulin based immunosuppressive therapy (IST) in pediatric patients with idiopathic aplastic anemia. Methods: Thirty patients (19 boys and 11 girls) with aplastic anemia received antithymocyte globulin and cyclosporine. Twenty-two patients had severe and 8 had very severe aplastic anemia. Results: Mean age of the patients was 9.19 ± 2.56 y. Three patients died within 1 mo of therapy, two due to sepsis and one due to intracranial hemorrhage. Twenty-seven patients were analyzed for response to therapy. Eight patients (29.7%) responded at 3 mo: 3 complete response (CR) and 5 partial response (PR). Six mo after the therapy, overall response (OR) was seen in 9/27 (33.3%), with one more patient in no response group achieving partial response. At 1 year, patients in CR maintained their status and 1 patient in PR group relapsed. He again achieved partial response with repeat course of ATG. Responders had significantly shorter duration of illness and higher absolute neutrophil count as compared to non responders to IST. None of the patients developed acute leukemia in the follow up. Conclusions: The treatment of aplastic anemia in pediatric patients is a challenging task. One third of the patients achieved overall response which included both complete and partial response. © 2012 Dr. K C Chaudhuri Foundation.
Prevalence of parvovirus B 19 infection in children with aplastic anemia
(Springer India, 2013) Vineeta Gupta; Isha Saini; Gopal Nath
We studied the prevalence of parvovirus B19 infection in pediatric patients with acquired aplastic anemia. Detection of parvovirus B19 DNA by PCR and IgM antibodies by ELISA was carried out in 66 pediatric patients with acquired aplastic anemia. 45 healthy children acted as controls. Parvovirus B19 DNA was detected in significantly higher number of patients in comparison to controls (27% vs 2%, P = 0.001). Similarly, parvovirus B19 IgM antibodies were detected in 17 (25.8%) patients as against one control (2.2%) (P<0.05). Clinical and hematological profile of the patients with or without parvovirus infection was comparable. © 2013 Indian Academy of Pediatrics.