Vasudeva Bhat K

Manipal Academy of Higher Education | MAHE · Division of Pediatric Hematology and Oncology

Introduction L-asparaginase is an essential chemotherapeutic agent in the therapy of acute lymphoblastic leukemia (ALL), which has led to improvement in survival. In low- and middle-income countries like India, the outcomes in ALL are inferior compared with the published literature, one of the causes of which is believed to be due to the inferior q...

Introduction: L‑Asparaginase is an essential chemotherapeutic agent in the therapy of Acute Lymphoblastic Leukemia (ALL), which has led to improvement in survival. In low and middle-income countries like India, the outcomes in ALL are inferior compared to the published literature, one of the cause of which are believed to be due to the inferior qua...

Corticosteroids and L-asparaginase used in the treatment of pediatric acute lymphoblastic leukemia (ALL) can cause drug-induced diabetes mellitus (DIDM). DIDM can lead to dyselectrolytemia, a higher risk of infections including cellulitis, bacteremia, fungemia, and a higher incidence of febrile neutropenia and may have an impact on the outcome of A...

Clinicopathologic profile and outcome of 15 children (15 years or above) with diffuse large B-cell lymphoma treated with MCP-842 protocol are reported. Eleven of 15 presented with advanced (stage-III/IV) disease. Post-2 cycles of chemotherapy, complete metabolic and morphologic response was documented in 10 (66%) and rest 5 (33%) with partial respo...

Palatal involvement in mucormycosisis mostly secondary to rhino-orbito-cerebraldisease, but rarely can be a primary disease of the oral mucosa.This report presents two rare cases of the isolated palatal mucormycosis in neutropenic children and highlights some of the peculiar features of the primary palatal disease and management-related issues in c...

Corticosteroids and L-asparaginase used in the treatment of pediatric acute lymphoblastic leukemia (ALL) results in Drug induced Diabetes Mellitus (DIDM). Literature on the management of DIDM among children with ALL is sparse and the diagnostic criteria for pediatric diabetes should be carefully applied considering the acute and transient nature of...

Objectives Early integrated palliative care has shown to improve the quality of life in patients with cancer. During the past decade, pediatric palliative care has become an established area of medical expertise, however due to scant information available regarding the triggers for referral and referral practice very few children receive a formal p...

Introduction Renal infiltration by leukemia causing massive bilateral nephromegaly is an extremely rare presentation of T-cell acute lymphoblastic leukemia(T-ALL). Case report 18-month-old female toddler presented with fever and progressive abdominal distension of 4-6 weeks duration. Imaging revealed bilateral massively enlarged kidneys with norma...

BACKGROUND: Outcomes in childhood cancer has dramatically improved in the West due to intensification of chemotherapy along with improved supportive care, however in LMIC like ours, deaths in remission secondary to MDR sepsis and viral infections is alarming and has drastically reduced cure rates. Very few IV antibiotics have been FDA approved late...

Objectives: To study vitamin C levels in children with transfusion-dependent b-thalassemia and correlate with age, transfusions received and iron overload; and to study the effect of administering vitamin C on its levels and Malondialdehyde (MDA) in deficient patients. Methods: This case-control study enrolled 100 children with transfusion-depen...

Purpose: To assess the safety and efficacy of concurrent carboplatin during craniospinal irradiation (CSI) in high-risk/metastatic medulloblastoma defined as either residual tumor >1.5 cm2 or leptomeningeal metastases. Methods: This single-arm combined prospective (2005-2011) and retrospective (2011-2019) study was undertaken at a tertiary care...

Coronavirus disease-19 was declared a pandemic and global emergency in March 2020. Oncology education and training has been on a rollercoaster ride ever since. Despite major changes in the work environment, training for postgraduates in oncology has continued with various challenges. We discuss the changes brought about in education, training and a...

Background and Aims: Outcomes in childhood cancer has dramatically improved in the west due to intensification of chemotherapy and improved supportive care. In LMIC like India, infections related deaths brings down the overall childhood cancer outcome. Also, there is an alarming rise in MDR infections among pediatric cancer patients in India and th...

B-cell acute lymphoblastic leukemia is the clonal proliferation of B-lymphoblasts, primarily in the blood and bone marrow. The morphology of these cells is largely of L1 or L2 type according to French-American-British (FAB) classification. Molecular cytogenetic testing remains the gold standard technique for genetic classification of ALL along with...

Background: Outcomes of childhood hematolymphoid malignancies have improved several fold because of immunosuppressive chemotherapy and broad-spectrum antibiotics for managing febrile neutropenia. An apparent trade-off has been an increase in invasive fungal disease (IFD), affecting multiple organs. We report the diagnostic and therapeutic challeng...

Introduction: Juvenile myelomonocytic leukaemia (JMML) is a clonal haematopoietic disorder occurring in pediatric age group usually characterized by uncontrolled granulocytic and monocytic lineage proliferation and a poor outcome. JMML is characterised by aberrant signal transduction of the RAS signalling pathways, usually manifesting in molecular...

Background/Objectives: Presence of minimal residual disease (MRD) at End-of-Induction (EoI) for acute lymphoblastic leukemia (ALL) is an important prognostic marker at levels ≥0.01%. However, value of Minimally Detectable Disease (MDD) <0.01% is being increasingly highlighted. We evaluated the impact of EoI MRD & MDD on outcomes of a uniformly-trea...

Background/Objectives: NAVYA is a clinically validated online cancer informatics solution that combines artificial intelligence (AI) and rapid review by Multi-Disciplinary Tumor Board (MDTB) experts at Academic Medical Centers (AMC) to deliver comprehensive multidisciplinary expert treatment plans to patients within 24 hours. This has significant i...

Background/Objectives: Increasing understanding of cancer biology and cytogenetic based-refinement of risk stratification are linked to improvement in childhood acute lymphoblastic leukemia (ALL) survival. The evolution of Minimal Residual Disease MRD) at End-of-Induction (EoI) assessment response-based therapy adaptation has impacted prognostic va...

Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) constitute 10-20% of pediatric Non-Hodgkin Lymphomas (NHL), with better prognosis than when occurring in adults. We report the clinico-demographic profile and outcomes of pediatric DLBCL treated with a uniform protocol at our center- a large tertiary cancer institute in India. Design/Meth...

Background/Objectives: Background: In Childhood Acute Lymphoblastic Leukemia (ALL), chemotherapy-associated toxicities occur maximally during Induction.We analyzed the distribution of severe toxicities (≥Grade 3) in children with ALL treated uniformly on a risk-adapted protocol at a tertiary cancer institute in India. Design/Methods: Methods: Child...

Background/Objectives: In India, with comprehensive pediatric cancer units being located in major cities, many families travelling from far off places for treatment have to refuse or abandon therapy because of lack of accommodation. SJICC (http://www.stjudechild.org) run by an NGO came forward to bridge this gap and provide along with free accommod...

Background/Objectives: Acute promyelocytic leukemia (APML), is a distinct subtype of acute myeloid leukemia (AML) characterized by a tendency to bleed and respond very well to differentiating agents.We studied the baseline characteristics, toxicities and outcome of children with APML at a tertiary cancer Institute in India. Design/Methods: Patients...

BACKGROUND Incidence of intracranial germ cell tumors (ICGCT) in Western literature is low (0.3–0.6 %) as compared to East Asia (3–4 %), & their clinicopathological features are well documented. However, there are scant studies on ICGCT from India. MATERIAL AND METHODS Retrospective observational study of all ICGCT histologically diagnosed in our...

Objectives: B-cell acute lymphoblastic leukemia is the clonal proliferation of B-lymphoblasts, primarily in the blood and bone marrow. The morphology of these cells is largely of L1 or L2 type according to French-American-British (FAB) classification. Molecular cytogenetic testing remains the gold standard technique for genetic classification of A...

Background/Objectives: Lack of access to evidence based multidisciplinary expertise is an under-recognized cause of suboptimal outcomes in pediatric cancers in low middle income countries (LMIC) (unlike well recognized financial and psychosocial barriers). Imbalanced general oncologist:patient ratio (∼1600:1.8 Million,India, ∼23,000:15 Million, USA...

METHODOLOGY A retrospective analysis of children less than 3 years diagnosed with malignant brain tumors was conducted from January 2011 to December 2016. Children with malignant brain tumors were treated with cyclophosphamide, etoposide and carboplatin (CEJ) upto 36months of age or till disease progression. Low grade gliomas were excluded from the...

OBJECTIVE We retrospectively reviewed the efficacy and feasibility of COMBAT metronomic chemotherapy in high risk and relapsed medulloblastoma from April 2011 to December 2016. METHODS Post-surgery high risk medulloblastoma or relapsed medulloblastoma who were started on COMBAT regimen after completion of conventional therapy were included in this...

Background/Objectives: Dengue Infection has varied manifestations from minor self limiting illness to shock and is a common cause of morbidity in children in tropical countries. There is very little knowledge about its clinical presentation and outcome in immunocompromised patients with cancer. Design/Methods: Aim: To study the clinical profile, di...