Tulika Seth

Publications of Tulika Seth

• Eosinophilia: Rare cause of arterial thrombosis and cardioembolic stroke in childhood.

  Authors: Sanjeev Kumar Sharma, Suman Kumar, Tulika Seth, Pravas Mishra, Manoranjan Mahapatra

  World journal of cardiology. 04/2012; 4(4):128-9.

  Eosinophilia has been reported as a very rare cause of stroke in children. The thrombotic event may be either due to cardiac damage induced by eosinophils and their granular protein, that is, theEosinophilia has been reported as a very rare cause of stroke in children. The thrombotic event may be either due to cardiac damage induced by eosinophils and their granular protein, that is, the major basic protein, or the systemic hypercoagulable state induced by eosinophilia. We report here a case of eosinophilia whose initial presentation was recurrent strokes and cardiac and arterial thrombosis.

• Flow cytometry in myelodysplastic syndrome: analysis of diagnostic utility using maturation pattern-based and quantitative approaches.

  Authors: Anita Chopra, Haraprasad Pati, Manoranjan Mahapatra, Pravas Mishra, Tulika Seth, Suman Kumar, Saroj Singh, Sangita Pandey, Rajive Kumar

  Annals of hematology. 04/2012;

  Flow cytometry (FCM) is being increasingly evaluated for the diagnosis of myelodysplastic syndrome (MDS). We employed multiple FCM approaches to assess MDS. Five-color FCM, morphology blind, was doneFlow cytometry (FCM) is being increasingly evaluated for the diagnosis of myelodysplastic syndrome (MDS). We employed multiple FCM approaches to assess MDS. Five-color FCM, morphology blind, was done on bone marrow aspirates of 57 suspected MDS and 31 normal controls. Maturation pattern, quantitative FCM for low-grade MDS that awards FCM score, and expression of selected antigens on erythroid cells and CD34(+) blasts were evaluated. FCM results were correlated with clinical and laboratory workup. Patients (n = 57) included proven MDS (n = 14), suspected MDS (n = 13), and non-MDS (n = 30). By pattern-based approach, all proven cases were FCM positive. In suspected MDS, 11 (84.61 %) were positive including morphology-negative cases, and two (15.38 %) were intermediate. In non-MDS cases, 27 of 30 (90 %) were FCM negative, 2 of 30 (6.67 %) intermediate, and 1 of 30 (3.33 %) a hematinic-responsive case, positive. Quantitative parameters that characterized MDS included FCM score of >3, percentage CD34(+) B cells, and expression of CD11b, CD15, and CD56 on myeloblasts. CD71 MFI on CD235a(+) erythroblasts and CD38 MFI on myeloblasts were significantly lower in MDS. The former was present in FCM-intermediate suspected MDS but not FCM-intermediate non-MDS cases. Used in the overall clinical context, both maturation pattern recognition and quantitative approaches, the latter for low-grade MDS, are sensitive methods of diagnosing MDS, including cases negative by morphology and cytogenetics, especially if combined with evaluation of selected antigens, CD71 on CD235a(+) cells and CD38 on CD34(+) cells. The value of FCM in morphology-negative cases needs better definition of specificity through more extensive evaluation of secondary dyspoiesis.

• Clinical profile and outcome of patients of acute myeloid leukemia with high hyperdiploidy.

  Authors: Sanjeev Kumar Sharma, Monica Sharma, Tulika Seth, Pravas Mishra, Mohit Chowdhry, Manoranjan Mahapatra, Renu Saxena

  Leukemia research. 12/2011; 36(3):e60-1.

• Immune thrombocytopenic purpura following anti-rabies vaccines.

  Authors: Sanjeev Kumar Sharma, Tulika Seth, Narendra Agrawal, Manoranjan Mahapatra, Pravas Mishra

  Platelets. 10/2011;

• Enrichment of invariant natural killer T cells in the bone marrow of visceral leishmaniasis patients.

  Authors: A K Rai, C P Thakur, T Seth, D K Mitra

  Parasite immunology. 08/2011; 33(12):688-91.

  Lipid antigens of Leishmania donovani like lipophosphoglycans are shown as a potent ligand for the activation of invariant natural killer T (iNKT) cells. It is reported that activation of iNKT cellsLipid antigens of Leishmania donovani like lipophosphoglycans are shown as a potent ligand for the activation of invariant natural killer T (iNKT) cells. It is reported that activation of iNKT cells augments the disease pathology in experimental visceral leishmaniasis (VL). In this study, we demonstrate the enrichment of iNKT cells in the bone marrow, one of the disease sites among patients with VL.

• Early activated Th-1 type and dominantly diverse natural killer T (CD3⁺CD161⁺Vα24⁻) cells in bone marrow among visceral leishmaniasis patients.

  Authors: Ambak Kumar Rai, Chandreshwar Prasad Thakur, Tulika Seth, Dipendra Kumar Mitra

  International journal for parasitology. 08/2011; 41(10):1069-77.

  Lipid antigens of Leishmania donovani-like lipophosphoglycans (LPG) are demonstrated to be a potent ligand for natural killer T (NKT) cell activation. Little is known about the phenotype or functionLipid antigens of Leishmania donovani-like lipophosphoglycans (LPG) are demonstrated to be a potent ligand for natural killer T (NKT) cell activation. Little is known about the phenotype or function of these cells and their trafficking pattern to the bone marrow (BM) of visceral leishmaniasis (VL) patients. Their precise role in humans still requires pathological validation. The study included 42 parasitologically confirmed patients (mean age 24.80±16.26 years; range 3-70 years; 25 males and 17 females), 33 healthy contact subjects (family/non-family members) and normal BM specimens (NBM; n=9). Enumeration of NKT cells and quantification of parasites (before and after therapy) were performed for the recruited patients. Results established that non-CD1d restricted, diverse cells are the dominant population among resident but not enriched NKT (CD3⁺CD161⁺) cells at the disease site (BM). Expression profiles for various markers are indicative of their early activated (CD69⁺, CD62L(low), CD11a(high)) CCR5⁺ phenotype at the BM. Functionally, BM-derived NKT cells were dominantly producing IFN-γ in response to L. donovani antigen in vitro. Given these observations, these data indicate that CD3⁺CD161⁺ diverse NKT cells are heterogeneous in function and of the dominant Th-1 phenotype at the disease site.

• Rituximab in Steroid Refractory Autoimmune Hemolytic Anemia.

  Authors: Nitin Gupta, Sanjeev Sharma, Tulika Seth, Pravas Mishra, Manoranjan Mahapatra, Suman Kumar, Rajan Kapoor, Narendra Agarwal

  Indian journal of pediatrics. 08/2011;

  Autoimmune hemolytic anemia is rare in children and infants and steroids are the corner stone of therapy. Management of the patients with steroid refractory/dependent disease is difficult .RituximabAutoimmune hemolytic anemia is rare in children and infants and steroids are the corner stone of therapy. Management of the patients with steroid refractory/dependent disease is difficult .Rituximab is being used in the treatment of a variety of autoimmune diseases including Autoimmune hemolytic anemia (AIHA),especially in adults but there is scarce data regarding the use of this agent in pediatric AIHA patients.The authors report two cases of steroid refractory AIHA, who responded to rituximab with review the literature of its use in pediatrics.

• Successful management of refractory chronic immune thrombocytopenia with intracranial hemorrhage by emergency splenectomy.

  Authors: Sanjeev Kumar Sharma, Nitin Gupta, Tulika Seth, M Srinivas, Pravas Mishra, Manoranjan Mahapatra

  Indian journal of pediatrics. 07/2011; 79(3):397-8.

• Treatment of acute myeloid leukemia in children: experience from a tertiary care hematology centre in India.

  Authors: Nitin Gupta, Tulika Seth, Pravas Mishra, Manoranjan Mahapatra, Shyam Rathi, Rajan Kapoor, Narendra Agarwal, Suman Kumar, Renu Saxena

  Indian journal of pediatrics. 05/2011; 78(10):1211-5.

  To assess the treatment and outcome of children with acute myeloid leukemia. The Primary objectives were to assess remission rates, treatment related toxicity and disease free survival. SecondaryTo assess the treatment and outcome of children with acute myeloid leukemia. The Primary objectives were to assess remission rates, treatment related toxicity and disease free survival. Secondary objective was to assess prognostic factors associated with poor outcome. A retrospective analysis of all treated patients with acute myeloid leukemia, less than 18 year of age from Sept 2005 to Aug 2009 was done. Clinical laboratory, treatment and follow up records retrieved to calculate remission rate, treatment related toxicity, disease free survival and poor prognostic factors. This analysis included thirty five patients (male : female; 23:12), twenty seven (77.1%) achieved remission after one 3 + 7 induction and seven required two inductions. High dose cytosine arabinoside consolidation was given in thirty one patients while one underwent allogenic stem cell transplantation. Two patients died during chemotherapy (TRM- 5.7%), two did not complete the therapy, seventeen relapsed (48.5%) with 80% of relapses occurring within first year of remission and no relapse occurred after 2 years. Fourteen patients are in remission (40%, follow up 5-54 months) and cumulative median disease free survival is of 13 months. The present data suggests that 3 + 7 induction, followed by high dose cytarabine consolidation has low treatment related toxicity and resource utilization; however, relapse free survival is inferior to more intensive regimens, highlighting the need to intensify chemotherapy regimen once the treatment related mortality has been minimized.

• Acute renal failure following antithymocyte globulin therapy for aplastic anaemia-report of two cases and review of literature.

  Authors: Nitin Gupta, Manoranjan Mahapatra, Shyam Rathi, Rajan Kapoor, Avinash Singh, Tulika Seth, Pravas Mishra

  Annals of hematology. 02/2011; 90(2):239-41.

• Ileal ulceration during all-trans-retinoic acid therapy for acute promyelocytic leukemia.

  Authors: Sanjeev K Sharma, Pravas Mishra, Tulika Seth, Manoranjan Mahapatra

  Leukemia research. 02/2011; 35(6):e89-90.

• Coexisting pulmonary tuberculosis and mucormycosis in a patient with aplastic anemia post allogenic stem cell transplantation.

  Authors: Sanjeev Kumar Sharma, Narendra Agarwal, Anjan Mukherjee, Tulika Seth, Pravas Mishra, Immaculata Xess, Manoranjan Mahapatra, Sanjay Sharma

  Mediterranean journal of hematology and infectious diseases. 01/2011; 3(1):e2011036.

  Infections are the most common cause of morbidity and mortality in allogenic stem cell transplant recipients. Survival of the patient depends on the accurate diagnosis of the infectious agents andInfections are the most common cause of morbidity and mortality in allogenic stem cell transplant recipients. Survival of the patient depends on the accurate diagnosis of the infectious agents and prompt and effective management of the infection alongwith maintenance of adequate immunosuppression post transplantation. We here reported a case of aplastic anemia who developed left upper lobe consolidation post allogenic stem cell transplantation and was found to have combined infection with tuberculosis and mucormycosis. This is the first case of combined infection with tuberculosis and mucormycosis reported in such a host, with a favourable outcome.

• Clinical profile of dengue infection in patients with hematological diseases.

  Authors: Sanjeev Kumar Sharma, Tulika Seth, Pravas Mishra, Nitin Gupta, Narendra Agrawal, Shobha Broor, M Mahapatra, Renu Saxena

  Mediterranean journal of hematology and infectious diseases. 01/2011; 3(1):e2011039.

  Managing hematological disorders in a tropical country presents several unique diagnostic and management problems. Apart from the disease process, we need to be aware of infections that canManaging hematological disorders in a tropical country presents several unique diagnostic and management problems. Apart from the disease process, we need to be aware of infections that can exacerbate or mimic serious hematological problems. We present here a series of five patients with pre-existing hematological diseases who were infected by dengue virus. These cases highlight the need to keep a strong suspicion of common endemic diseases in tropical countries before considering extensive workup for the basic hematological disease. There was no mortality and all patients recovered without any significant impact on their pre-existing hematological condition inspite of their low baseline blood counts. There was no excessive bleeding, prolonged stay in the hospital or relapse of underlying hematological disease in these patients and the only major concern was the increased anxiety among both the patient and treating physician regarding the relapse/progression of pre-existing hematological disease.

• Acute lymphoblastic leukemia presenting as non-oliguric renal failure and hypertension.

  Authors: Nitin Gupta, Sanjeev Kumar Gupta, Shyam Rathi, Sanjeev Kumar Sharma, Manoranjan Mahapatra, Tulika Seth, Pravas Mishra, Renu Saxena

  Leukemia research. 07/2010; 34(7):e150-1.

• Expression of CD13/aminopeptidase N in precursor B-cell leukemia: role in growth regulation of B cells.

  Authors: Ankit Saxena, Ambak Rai, Vinod Raina, Tulika Seth, Dipendra Mitra

  Cancer immunology, immunotherapy : CII. 07/2009;

  Expression of cell surface CD13 in acute B-cell leukemia (ALL-B) is often viewed, as an aberrant expression of a myeloid lineage marker. Here, we attempted to study the stage specific expression ofExpression of cell surface CD13 in acute B-cell leukemia (ALL-B) is often viewed, as an aberrant expression of a myeloid lineage marker. Here, we attempted to study the stage specific expression of CD13 on ALL-B blasts and understand its role in leukemogenesis as pertaining to stage of B-cell ontogeny. A total of 355 cases of different hematological malignancies were diagnosed by immunophenotyping. Among 68 cases of early B-cell ALL, 22 cases with distinct immunophenotype was identified as immature B-cell ALL. Blasts from these ALL-B patients demonstrated prominent expression of CD10, CD19, CD22, but neither cytoplasmic nor surface IgM receptors. This strongly indicates leukemogenesis at an early stage of B-cell development. We also identified, the existence of a subpopulation of cells with remarkably similar phenotype in non-leukemic marrow from healthy subjects (expressing CD10, CD19, CD22, CD24, Tdt together with the co-expression of CD13). This sub-population of B cells concomitantly expressing CD13 appeared to be a highly proliferating group. By blocking their cell surface CD13 in leukemic blasts with monoclonal antibody we were able to inhibit their proliferation. We hypothesized that neoplastic transformation at this stage may be facilitated by CD13. CD13 may thus be an important target for novel molecular therapy of early stage acute B-cell leukemia.

• SUCCESSFUL USE OF TERBUTALINE IN PERSISTENT PRIAPISM IN A 12-YEAR-OLD BOY WITH CHRONIC MYELOID LEUKEMIA.

  Authors: Ajay Gupta, Tulika Seth, Anuradha Gupta

  Pediatric hematology and oncology. 02/2009; 26(1):70-73.

  A 12-year-old boy had been suffering from intermittent episodes of penile erection for 2 weeks. For the last 2 days, however, the patient had been having sustained priapism and had to be admitted inA 12-year-old boy had been suffering from intermittent episodes of penile erection for 2 weeks. For the last 2 days, however, the patient had been having sustained priapism and had to be admitted in a private hospital for management. Investigations revealed high total leukocyte counts. He was referred to the authors' hospital where a diagnosis of chronic myeloid leukemia was made. He was started on intravenous hydration, hydroxyurea, and allopurinol. Imatinib was added 2 days later. The parents refused surgical intervention. Despite a reduction in the counts the priapism persisted and the pain was unresponsive to opioids. Administration of terbutaline was associated with a successful outcome resulting in relief from pain within 20 min. The priapism also resolved completely in 1 day.

• Clinical and hematological profile of HbE/Ggamma(Agammadeltabeta)(0) and Ggamma(Agammadeltabeta)(0)/beta(0) patients.

  Authors: Vineeta Sharma, Tulika Seth, Renu Saxena

  Clinica chimica acta; international journal of clinical chemistry. 05/2008;

• Imaging findings in hepatic Langerhans' cell histiocytosis.

  Authors: Alka Chaudhary, Jyotindu Debnath, Sanjay Thulkar, Tulika Seth, Anindita Sinha

  Indian journal of pediatrics. 12/2006; 73(11):1036-8.

  We describe ultrasonographic and computed tomographic features of hepatic lesions in two cases of disseminated Langerhans' cell histiocytosis affecting children. In the first case, hyperechoic bandWe describe ultrasonographic and computed tomographic features of hepatic lesions in two cases of disseminated Langerhans' cell histiocytosis affecting children. In the first case, hyperechoic band like periportal lesions were observed at ultrasonography, which on computed tomography was found to be hypodense admixed with fatty attenuation (HU@23 to - 57) at places. In addition, the caudate lobe was very prominent. In the second case, the hepatic parenchyma showed predominantly hyperechoic diffusely heterogeneous echogenicity. There were features of cirrhosis of liver with portal hypertension in the form of atrophy of right lobe with hypertrophy of left lobe of liver with lobulated outline, prominent main portal vein and splenoportal axis, splenomegaly and gastroesophageal varices. Both the patients were put on chemotherapy as per schedule (Protocol: DAL HX - 83) and are on follow up.

• Midterm results with hepatectomy after preoperative chemotherapy in hepatoblastoma.

  Authors: Minu Bajpai, K Pal, S Agarwala, Tulika Seth, Arun K Gupta

  Pediatric surgery international. 06/2005; 21(5):364-8.

  We evaluated the results of surgical treatment for hepatoblastoma in infants and children after intensive preoperative chemotherapy, with special reference to histology and extent of liverWe evaluated the results of surgical treatment for hepatoblastoma in infants and children after intensive preoperative chemotherapy, with special reference to histology and extent of liver involvement. The clinical features of 10 children with hepatoblastoma were reviewed regarding response to neoadjuvant chemotherapy, histological subtypes, extent of hepatectomy, operative complications, and prognosis. Response to chemotherapy was measured by volumetric assessment of tumour size by computed tomography scan. Cisplatin and Adriamycin (PLADO regime) up to three cycles markedly reduced the tumour volume on computed tomography (mean regression rate 65.9%); alpha-foetoprotein (AFP) levels also decreased from an initial mean of 16,116.4 ng/ml to 2,050.9 ng/ml. Five patients underwent right hepatectomy, two had right trisegmentectomy, two had left hepatectomy, and one had left trisegmentectomy. Histopathology of resected specimens revealed foetal histology in four patients, poorly differentiated (anaplastic) subtype in three, and mixed histology with mesenchymal components and osteoid formation in three. There was 100% resectability including six unresectable tumours (prechemotherapy). Moreover, hepatic resection tended to be less invasive in patients whose tumours had been much reduced after preoperative chemotherapy. Preoperative administration of cisplatin and Adriamycin reduces the tumour size significantly so that a safe radical hepatectomy can be performed. It also allows early administration of postoperative chemotherapy. Although overall good results were obtained with the current protocol, we also document our experience of unfavourable outcomes in patients with bilobar tumours (despite trisegmentectomy), patients with tumours showing poor response to neoadjuvant chemotherapy, and patients with anaplastic histology. Overall, at a 60-month follow-up we report an 80% survival rate by a combined approach.

• Acute basophilic leukemia with t(8;21).

  Authors: Tulika Seth, Amish Vora, Manisha Bhutani, K Ganessan, Paresh Jain, Vinod Kochupillai

  Leukemia & lymphoma. 04/2004; 45(3):605-8.

  Acute basophilic leukemia (ABL) is a rare form of leukemia. The diagnostic criteria have recently been described. Morphological evidence for basophilic lineage is required for its classification.Acute basophilic leukemia (ABL) is a rare form of leukemia. The diagnostic criteria have recently been described. Morphological evidence for basophilic lineage is required for its classification. However the criteria for remission status and standard therapy is not established. Here we have described an atypical case of ABL and reviewed the literature to high light issues regarding diagnosis and management, which need further discussion.