Vimarsh Raina

• MD
• Research Director at Chimera Transplant Research Foundation

Background To study the prevalence of genetic mutations in patients with gastrointestinal stromal tumors (GIST) using next-generation sequencing at a tertiary care center in northern India. Methods We performed genotypic analysis of histologically and immunohistochemically diagnosed GIST using Ion AmpliSeq Cancer Hotspot Panel v2 to identify mutat...

Introduction: Hematopoietic stem cell transplantation (HSCT) is a crucial treatment for various blood disorders. However, the scarcity of matched related donors has led to the establishment of stem cell donor databases, commonly known as stem cell registries. These registries aim to streamline the identification of unrelated volunteer stem cell don...

Objectives Ankylosing spondylitis (AS) is a type of spondylitis in which the spine and other joints are largely affected. A strong association of HLA-B*27 with AS has been observed. However, the exact mechanism underlying this association and the pathogenesis of the disease remains unclear. As the diversity of HLA varies among populations, our obje...

Introduction: Numerous studies have concentrated on specific populations to explore the extensive polymorphism of class I and II HLA genes. This genetic diversity is crucial for various applications, such as advancing transplantation immunology, understanding genetic population patterns, and uncovering the pathways of different diseases. Objective:...

Histocompatibility testing is pivotal in any renal transplantation workup, aimed at enhancing prospective donor recipient compatibility and improving transplant outcomes. The evolution and advancement of histocompatibility testing, particularly HLA typing, have significantly improved its precision. This study outlines the historical progression fro...

Our capacity to recognize and manage allosensitized transplant recipients and optimize organ allocation has been greatly improved by the development of single-antigen bead tests for detecting human leukocyte antigen antibodies. The main drawbacks of this technology have been thoroughly discussed in the literature, covering problems like artifacts t...

Introduction: India has a huge disease burden of thalassemia major with an estimated 40 million carriers and over a million thalassemia major patients. Very few patients are optimally treated, and the standard of care “hematopoietic stem cell transplant” (HSCT) is out of reach for most patients and their families. The cost of HSCT is significant, a...

ISO15189:2012 is a formal recognition by an authorized national accreditation body that a testing laboratory is competent to carry out specific tasks according to the standard. This article aims to share the experience of reaching ISO 15189:2012 accreditation at Chimera labs. A gap analysis was performed, followed by the preparation and implementat...

Numerous HLA allele relations with various diseases have been observed all over the world, including leukemia, aplastic anemia, and thalassemia. The current study looked at the frequency of HLA A, B, C, DRB1, and DQB1 loci with thalassemia to see if there was a correlation between the HLA allele and the disease. The study involved a total of 200 pa...

Introduction: Since HLA-B*15:02 is a biomarker for carbamazepine-induced Stevens- Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in certain Asian populations, the United States food and drug administration (USFDA) recommends HLA-B*15:02 screening before carbamazepine administration in Asian and other communities. Several published repo...

The occasion is when there is discordance between the results of the cell‑based and virtual crossmatch and requires further workup before considering a patient for renal transplant. A case of the positive single‑antigen bead (SAB) with donor‑specific antibodies (DSA) against HLA‑A*33:01 with negative complement‑dependent cytotoxicity crossmatch and...

Background Allogeneic hematopoietic stem cell transplantation activity is growing globally as one of the curative treatment options for many hematological diseases. A stem cell transplant registry plays an important role in such treatment. Setting up a functional stem cell donor registry is quite challenging with several issues such as resources, d...

BACKGROUND: Human leukocyte antigen (HLA) is a major determinant in deciding upon solid organ histocompatibility. Donor-specific anti-HLA antibodies (Donor-specific anti-HLA antibodies (DSAs)) are always a contraindication for solid organ transplantation, and identification of DSA becomes very crucial before transplantation to provide long-term gra...

Background: The understanding of transplant acceptance or rejection derives directly from knowing human leukocyte antigen (HLA) involved in the immune response. The HLA of the major histocompatibility complex contains a numerous family of genes located on the short arm of the chromosome number 6 and divided majorly into two classes, Class I (HLA‑A,...

The short tandem repeats (STRs) or microsatellites are used for paternity testing and these sequences mutate more rapidly than bulk DNA sequences. A total of 746 paternity cases were analysed to understand the mutation rate of 21 autosomal STR loci. We identified 41 mutations in 11 STR Loci with a maximum at SE33. No mutations occurred in the remai...

Background: Timeline is a key factor for hematopoietic stem cell transplant (HSCT) recipient. HSCT by matched unrelated donor (MUD) is a standard definitive therapeutic approach for many hematological disorders which are not amenable to chemotherapy and other conventional treatment. Aims and Objectives: The aim of the present study was to compare t...

Several HLA allele associations with aplastic anemia have been reported around the world. However, due to a lack of such association studies in the Indian population, the current study looked at the frequency of HLA class I (A, B, and C loci) and II (DRB1 and DQB1 loci) with aplastic anemia to see if there was an association between the HLA allele...

Introduction Anti-neutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis (AAV) is a small vessel vasculitis with insufficient epidemiological estimates in India. We aimed to determine demographic, clinical features, and laboratory diagnosis of AAV patients presenting to a large tertiary care centre in India. Material and methods 1289 p...

To describe the essential backend services required CONCLUSION for a successful EQAS program.

Since the pandemic occurred due to the emergence of SARS-CoV-2, there has always been a demand for a simple and sensitive diagnostic kit for detection of SARS-Cov-2 infection. In January 2020, WHO approved the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for detecting the presence of Covid-19 genetic material in individuals. Till date m...

Background and Objective: Increment in voluntary stem cell donor registrations has led to an increase in the chances of a patient finding a perfect match for matched unrelated donor (MUD) hematopoietic stem cell (HSC) transplant.However, it has been seen multiple times that the donor’s passion to donate HSCs is short lived. They register with a str...

The study of allele frequency and analysis of statistical parameters of 21 STR markers was done among 437 unrelated individuals representing different parts of India using the GlobalFiler™ Express PCR Amplification Kit (Thermo Fisher Scientific, USA). All the tested 21 STR loci were tested for Hardy- Weinberg equilibrium and all of them were fall u...

Background: With only 25% chances of finding a human leukocyte antigen matched stem cell donor within the family, in case of minimal residual disease, the dependence on matched unrelated donor (MUD) is inevitable. With increasing awareness about the MUD stem cell registries, the numbers of registrations for voluntary stem cell donations are also in...

Introduction Hematopoietic stem cell transplant (HSCT) is the definite treatment for acute leukemia but considering HSCT is challenging for the patients. There are many studies that have described the patients’ experience after HSCT but very few studies have reported their experience before going for HSCT and there is no published report in India o...

Background The diverse polymorphism among human leukocyte antigen (HLA) and its association with genetic population structure, transplantation immunology and with different disease pathology has been the objective of several studies. Since, HLA-B shows various polymorphic forms in comparison to others among the HLA class I molecules, therefore, stu...

HLA and childhood acute lymphoblastic leukemia (cALL) association has been reported by a number of studies and amongst varied populations. However the same has not yet been reported in Indian population. We undertook a study to analyze the Human Leukocyte Antigen (HLA) Class I (−A, B, C) and HLA class II (-DRB1, -DQB1) frequency in Indian cALL pati...

Background HLA-B gene is reported to have the highest number of allelic variants among the other HLA class I genes. It is suggested that the HLA-B gene has a particular ability to affect the activity of some immune responses mainly those related to lymphoproliferative neoplasia triggered by intracellular pathogens. Although, several studies have be...

Context: A range of instruments based on the absorbance principle are available in the market for DNA quantification. This study compares the statistically significant difference between three different instruments based on the same principle but different in operational technology, allowing users to make an informed choice. Aims: DNA extraction an...

ARTICLE INFO ABSTRACT Context: A range of instruments based on the absorbance principle are available in the market for DNA quantification. This study compares the statistically significant difference between three different instruments based on the same principle but different in operational technology, allowing users to make an informed choice. A...

Background: Autoantibodies (AAbs) are important biomarkers for the diagnosis of Autoimmune Diseases (ADs). The detection of AAbs performed by current methods (indirect immunofluorescence test (IIFT)/Immunoblot (dot/line)/enzyme-linked immunosorbent assay ELISA) which have limitations in terms of performing multiple assays to arrive at laboratory di...

Human leukocyte antigen (HLA) and its association with diseases have been studied extensively for many decades, with the prime focus on the underlying mechanism(s) involved in various diseases including ankylosing spondylitis (AS), insulin dependent diabetes mellitus (IDDM), rheumatoid arthritis (RA), leukemia, HIV, multiple sclerosis, etc. Alarmin...

Objective: Acute lymphoid leukemia (ALL) and acute myeloid leukemia (AML) are neoplastic blood disorders in which the cancerous white blood cells accumulate, resulting in a significant morbidity and mortality. Human leukocyte antigen (HLA) association is observed as one of the factors in the development of leukemia. The objective of the present stu...

Introduction Anti-neutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis (AAV) is a small vessel vasculitis with insufficient epidemiological estimates in India. We aimed to determine demographic, clinical features, and laboratory diagnosis of AAV patients presenting to a large tertiary care centre in India. Material and methods 1289 p...

Background: In order to improve the success rate for transplantation the combination of assays has been used in which the flow-based methods carry a high degree of sensitivity but the significance of positive B Cell Flow crossmatch (FCXM) remains controversial.

The aim of present study is to determine and analyse the frequencies of Human Leukocyte Antigen (HLA)-B allele in North India population.

Presented a case of pre-transplant workup, where the importance of the sensitivity of the Flow Cytometry Crossmatch (FCXM) for detection of Donor Specific Antibodies (DSA) was highlighted over the other tests and also showed that a combination of assays is important to perform for understanding the DSA identification and graft survival. The patient...

Background and Objectives Timely detection of human leucocyte antigen (HLA) antibodies plays a key part in transplant outcome. Conventionally, several cell‐based assays are available for detection of HLA antibodies upgrading to virtual crossmatch in which single‐antigen bead (SAB) assay is widely used for characterization of pre‐formed HLA donor‐sp...

BACKGROUND: Hematopoietic progenitor cell transplantation (HPCT) is used as a definitive treatment in hematological malignancies. For a successful HPCT, the donor and recipient should have matching human leukocyte antigens (HLAs). About 25% of patients have a chance of finding matching HLA within family, while rests 75% are dependent on voluntary s...

Introduction: In India, 90% kidneys for transplantation are obtained from living donor while only 10% come from deceased donors. Since the rate of living organ donors is high, it therefore leads to the problem of organ trafficking.To minimize the chances of organ trafficking, the Transplantation of Human Organ Act (THOA) 2014 was enacted in India...

Objectives: Testing for antinuclear antibodies (ANA) facilitates the diagnosis of autoimmune diseases (ADs). Here, we report an incidence of ANA positivity and its patterns by indirect immunofluorescence (IIF) and specific autoantibodies through immunodot assay. Methods: Sera from 993 patients presenting with various ADs were tested by IIF and immu...

Introduction Currently, more than 10,000 matched unrelated donor transplants (MUDT) are performed annually worldwide. India has recorded a significant increase in the number of hematopoietic progenitor cell transplantation (HPCT) centers reporting transplants. The number of HPCTs increases by approximately 10% every year, with 1878 transplants repo...

Introduction: Human leukocyte antigen (HLA)-matched unrelated donor (MUD) is the source of MUD transplantation (MUDT) for about 70% of patients who do not have matched related donor. To facilitate MUD search globally, there are 75 stem cell registries with more than 28 million donors registered (as of January 2017). Out of these donors, India has a...

Background: Hematopoietic progenitor cell transplantation (HPCT) is used as a definitive treatment in hematological malignancies. For a successful HPCT, the donor and recipient should have matching human leukocyte antigens (HLAs). About 25% of patients have a chance of finding matching HLA within family, while rests 75% are dependent on voluntary s...

Autoimmune diseases (ADs) are the outcome of a malfunctioning immune system in which the immune system attacks self-antigens. These diseases are grouped into organ-specific and non-organ-specific types. Autoantibodies are important biomarkers used for confirming the diagnosis of ADs. Disease-specific autoantibodies are detected at a very early stag...

In complicated cases proposed a cost-effective algorithm for pre-transplant workup using flow-based techniques

Abstract Introduction: Human leukocyte antigen (HLA)‑matched unrelated donor (MUD) is the source ofMUD transplantation (MUDT) for about 70% of patients who do not have matched related donor.To facilitate MUD search globally, there are 75 stem cell registries with more than 28 million donors registered (as of January 2017). Out of these donors, Indi...

Stem cell transplant (SCT) is the “standard of care” for several malignant disorders such as leukemia as well as nonmalignant disorders such as thalassemia and aplastic anemia. In SCT, family (usually a sibling) is screened for human leukocyte antigen (HLA)-matched related donor (MRD), and failing this, matched unrelated donor (MUD) transplants are...

Voluminous number of patients suffering from blood related diseases need lifesaving stem cell transplant with handful of them is lucky to find suitable related family donors. Most of these individuals need to find voluntary matched unrelated donors. The ultimate purpose of the adult stem cell registry is to evolve a database of matched unrelated do...

Genebandhu stem cell registry has been actively recruiting matched unrelated hematopoietic stem cell donors since May 2012. Matched Unrelated Donor (MUD) Hematopoietic stem cell transplantation (HSCT) is one of the options for about 70% of patients who do not have a Matched Related Donor (MRD).

This presentation describe about the unrelated donor search experience for hematological disorder in Indian patients

Stem cell transplant (SCT) is the “standard of care” for several malignant disorders such as leukemia as well as nonmalignant disorders such as thalassemia and aplastic anemia. In SCT, family (usually a sibling) is screened for human leukocyte antigen (HLA)-matched related donor (MRD), and failing this, matched unrelated donor (MUD) transplants are...

Gastrointestinal stromal tumors (GIST) commonly harbour oncogenic mutations of the proto-oncogene KIT tyrosine kinase. A subset of GIST, called ‘wild type’ possess mutations in Platelet derived growth factor receptor alpha (PDGFRA), most of which are resistant to the tyrosine kinase inhibior (TKI) imatinib. GIST having PDGFRA mutations are found m...

Background and Objectives: Various methods have been reported for the detection of antibodies in recipient sera, which can be human leukocyte antigens (HLAs) or non-HLA specific, complement- or noncomplement fixing, as well as donor T (HLA-Class-I) and/or B cell (HLA-Class-I and II) specific. These alloantibodies play a pivotal role in antibody-med...

Background: Blood centers in India have published individual donor nucleic acid testing (ID-NAT) data based on an algorithm (Algorithm A) where serologically negative, NAT reactive sample was subsequently tested with discriminatory NAT (d-NAT), and on the basis of d-NAT, initial reactive samples were classified as “NAT yield” or inconclusive. We fo...

Background: Bead based flow cytometry and Luminex play a major role in identification of alloantibodies in renal transplant work-up. Strong sensitization events may lead to prozone phenomenon that can affect single antigen bead (SAB) assay and result in false negativity. However, this can also be due to high titer of other blocking antibodies. Whi...

Background and Objectives: The US Food and Drug Administration and American Association of Blood Banks approved the type and screen approach in 1980s, long after antibody screen (AS) was introduced in 1950s. The present study omits conventional anti-human globulin (AHG) crossmatch and replaces it with immediate-spin (IS) crossmatch as part of pretr...

Background: Blood donor experiences both immediate adverse reactions (IAR) and delayed adverse reactions (DAR). With limited published data available on the incidence of DAR, a study was conducted to estimate incidence and profile of DAR through telephonic interview. Materials and methods: Study was conducted over a 45-day period for consecutive...

Hepatosplenic T-cell lymphoma is a rare haematopoietic malignancy that comprises less than 1% of Non-Hodgkin lymphomas. We are reporting a case of a 26-year-old female, who presented with pallor, weight loss, jaundice, pancytopenia and hepatosplenomegaly. The bone marrow examination showed infiltration by lymphoid cells. These cells on flow cytomet...

Background: CD71 is a marker that has been usually used for identifying dysplasia in the erythroid series. We have tried to evaluate the expression of CD71 in various types of acute leukemias. Materials and methods: We studied 48 patients of acute leukemia, of which 25 were acute myeloid leukemia (AML), 13 were precursor B-acute lymphoblastic le...

Background: Hematopoietic progenitor stem cell transplantation (HPSCT) is used as a standard treatment option to improve outcome in hematological and nonhematological disorders. It is important for new HPSCT program to look at its patient outcome data and compare it with the published data to evaluate the efficacy of program. Aims: The aim was to c...

Five years five month old male child diagnosed with aplastic anemia required blood and platelet support regularly. He was advised bone marrow transplant (BMT) and had 6/6 match with a younger sibling (11 months old). He was admitted for planned BMT and was put on preparatory regimen five days prior to BMT. GCSF-primed bone marrow (BM) harvest was d...

Introduction: As per the 2008 World Health Organization (WHO) classification, Myeloproliferative neoplasms (MPN) are subclassified into eight clinicopathological groups.1 The discovery of activating JAK2 mutations revolutionized the approach to diagnosis of MPN. Recently there have been studies suggesting an increasing number of mutations distinct...

Background Many centres provide D‐mismatched platelet transfusions. Platelet concentrates may contain enough red cells leading to the formation of anti‐D antibody in D‐negative recipient. In resource‐poor settings, random donor platelet concentrate ( RDPC ) is used often and carries higher risk of alloimmunization. At our institution, platelets are...

The revolution of internet and specifically mobile internet has occurred at a blinding pace over the last decade. With the advent of smart phones, the hand held device has become much more than a medium of voice calling. Healthcare has been catching up with the digital revolution in the form of Hospital Information System and Laboratory Information...

Introduction: Lab-diagnosis of hepatitis C virus (HCV) is based on detecting specific antibodies by enzyme immuno-assay (EIA) or chemiluminescence immuno-assay (CIA). Center for Disease Control reported that signal-to-cut-off (s/co) ratios in anti-HCV antibody tests like EIA/CIA can be used to predict the probable result of supplemental test; abov...

Background: The present study addressed the interesting findings of supplemental evaluation of hepatitis B "seroyield" donors. Materials and methods: Each blood donor sample was tested for anti-human immunodeficiency virus type I (HIV-I)/HIV type II (HIV-II), HBsAg, and anti-hepatitis C virus (HCV) antibody by enhanced chemiluminescence method a...

Background In India variable rate of “NAT yield” has been demonstrated in several published reports. This study was performed with the objective to know the rate of “true NAT yield” in blood donors by confirmation with supplementary tests and follow up of initial “NAT yield” donors Materials and methods 48441 blood donors were tested for HIV, HBV...

Defective hepatitis B virus (dHBV) particles contain genomes corresponding to singly-spliced HBV RNA. A limited number of studies show that dHBV is present in all chronic HBV patients. Clinical studies have linked dHBV and dHBV gene products to high virus loads and liver damage. The replication characteristics of dHBV genomes remain poorly understo...

EBV-associated PTLD is increasingly recognized as an important cause of morbidity and mortality in both solid organ and hematopoietic stem cell transplant recipients. Mortality rates due to PTLD and virus-induced HLH are reported to be quite high. We report a case of EBV-associated PTLD and HLH in a child after liver transplantation who was success...

Background: In any task, human error is almost always a constant component. Impact of an error in hospital blood bank is sometimes so profound that it can even result in patient’s death. To detect incorrectly drawn sample i.e. wrong blood in tube [WBIT]; two independent samples for blood group was in place. This policy mandated doing blood groups o...

Background: Platelet transfusion therapy has made significant contributions in several patient categories and many centres provide non-ABO and Rh matched platelets due to prolific demand and limited availability. Though Rh antigens are not present on platelet surface but platelet concentrates may contain enough red cells leading to formation of anti-...

A 44-year-old male presented with fever, progressive weight loss, and anorexia for 6 months. The laboratory results showed deranged renal function tests. Serum adrenocorticotropic hormone was high at 252 pg/mL (normal limit: <46 pg/mL), suggestive of primary adrenal insufficiency. Serum free light chains were elevated, kappa at 87.97 mg/L (referenc...

IntroductionPrimary breast lymphomas are a rare entity and constitute less than 1 % of all the non-Hodgkin’s lymphomas, 1]. The predominant type of primary breast lymphoma is Diffuse Large B cell Lymphoma (DLBCL), while Follicular Lymphoma (FL) is a still rarer entity. In the study conducted by International Extranodal Lymphoma Study Group (IELSG),...

The eosin-5'-maleimide (EMA) binding test using flow cytometry is a common method to measure reduced mean channel fluorescence (MCF) of EMA-labeled red blood cells (RBCs) from patients with red cell membrane disorders. The basic principle of the EMA-RBC binding test involves the covalent binding of EMA to lysine-430 on the first extracellular loop...

Chronic Lymphocytic Leukemia (CLL) is one of the commonest leukemias that has been reported extensively throughout the literature. The characteristic phenotype includes co-expression of CD5 and CD23, along with dim expression of light chain and CD22/CD79b, with lack of FMC7. The immunophenotypic scoring system given by Matutes has been used to diff...

American society for apheresis (ASFA) publishes guidelines for therapeutic apheresis (TA) and physicians ordering TA procedures should be aware of the appropriate indications based on scientific evidence. Transfusion Medicine specialists (apheresis physicians) can steer physicians in right direction through CME on right indications, duration of the...

Liver transplantation is an important modality of treatment for end-stage liver disease. Liver biopsy evaluation has been an important aspect of the donor evaluation protocol. With the advent of newer modalities of donor evaluation such as high resolution CT scan, fibroscan and NMR spectroscopy, the relevance of the liver biopsy appears to be dimin...