Fouzia Na
Christian Medical College & Hospital
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Featured researches published by Fouzia Na.
Haemophilia | 2018
R. J. Liesner; M. Abashidze; Olga Aleinikova; Carmen Altisent; Mark J. Belletrutti; Annie Borel-Derlon; Manuel Carcao; Hervé Chambost; Anthony K.C. Chan; L. Dubey; Jonathan M. Ducore; Fouzia Na; M. Gattens; Yves Gruel; B. Guillet; N. Kavardakova; M. El Khorassani; Anna Klukowska; Thierry Lambert; S. Lohade; Marianne Sigaud; V. Turea; John K. Wu; Vladimir Vdovin; A. Pavlova; M. Jansen; L. Belyanskaya; O. Walter; S. Knaub; Ellis J. Neufeld
Nuwiq® (Human‐cl rhFVIII) is a fourth generation recombinant FVIII, produced in a human cell line, without chemical modification or protein fusion. No inhibitors developed in studies with Nuwiq® in 201 previously treated patients with haemophilia A (HA). The immunogenicity, efficacy and safety of Nuwiq® in previously untreated patients (PUPs) with severe HA are being assessed in the ongoing NuProtect study.
Clinical Pharmacology & Therapeutics | 2018
Ezhilpavai Mohanan; John C. Panetta; Kavitha M. Lakshmi; Eunice Sindhuvi Edison; Anu Korula; Fouzia Na; Aby Abraham; Auro Viswabandya; Biju George; Vikram Mathews; Alok Srivastava; Poonkuzhali Balasubramanian
A treosulfan (Treo)‐based conditioning regimen prior to hematopoietic stem cell transplantation (HSCT) has been successfully used in treating hematological malignant and nonmalignant diseases. We report Treo pharmacokinetics (PK) in patients with thalassemia major undergoing HSCT (n = 87), receiving Treo at a dose of 14 g/m2/day. Median Treo AUC and clearance (CL) was 1,326 mg*h/L and 10.8 L/h/m2, respectively. There was wide interindividual variability in Treo AUC and CL (64 and 68%) which was not explained by any of the variables tested. None of the Treo PK parameters were significantly associated with graft rejection or toxicity; however, Treo CL <7.97 L/h/m2 was significantly associated with poor overall (hazard ratio (HR) 2.7, confidence interval (CI) (1.09–6.76), P = 0.032) and event‐free survival (HR 2.4, CI (0.98–5.73), P = 0.055). Further studies in a larger cohort are warranted to identify the factors explaining the variation in Treo PK as well as to establish a therapeutic range of Treo for targeted dose adjustment to improve HSCT outcome.
Bone Marrow Transplantation | 2017
Ezhilpavai Mohanan; John C. Panetta; Kavitha M. Lakshmi; Eunice Sindhuvi Edison; Anu Korula; Fouzia Na; Asha Mary Abraham; Auro Viswabandya; Vikram Mathews; Biju George; Alok Srivastava; Poonkuzhali Balasubramanian
Although hematopoietic stem cell transplantation (HSCT) with a conditioning regimen consisting of fludarabine (F-araA) and cyclophosphamide (Cy) is associated with improved outcome in young patients with aplastic anemia (AA) and Fanconi anemia (FA), several factors limit the success of the procedure. We evaluated the population pharmacokinetics (POPPK) of F-araA and its influence on HSCT outcome in patients (n=53) with AA and FA undergoing HSCT. Patients carrying a 5′-UTR polymorphism in NT5E gene (rs2295890 G>C) exhibited significantly lower plasma F-araA clearance compared to those with wild-type genotype (7.12 vs 5.03 L/h/m2 (29%) P<0.05). F-araA clearance was significantly higher in patients with AA compared to FA (2.46 ×, P<1e−6). Of all the outcome parameters evaluated (engraftment, rejection/graft failure, GvHD, TRM, OS), high F-araA AUC (>29.4 μm*h) was the only significant factor associated with the development of aGvHD by both univariate and multivariate analysis (P=0.02). The influence of plasma F-araA levels need to be evaluated in a larger cohort of patients to propose the need for therapeutic drug monitoring.
Hematology/Oncology and Stem Cell Therapy | 2017
Meenu Angi; Vandana Kamath; S. Yuvarani; J. Meena; Usha Sitaram; Marie Therese Manipadam; Sukesh C. Nair; Abhijeet Ganapule; Fouzia Na; Aby Abraham; Auro Viswabandya; Balasubramanian Poonkuzhali; Biju George; Vikram Mathews; Alok Srivastava; Vivi M. Srivastava
BACKGROUND The t(8;14)(q24.1;q32) and its variants - the t(2;8)(p12;q24.1) and t(8;22)(q24.1;q11.2) are associated with B-cell neoplasia and result in MYC/immunoglobulin (IG) gene rearrangement. PATIENTS AND METHODS We correlated the cytogenetic, molecular and clinico-pathological findings of patients with 8q24 translocations seen in the Department of Haematology, Christian Medical College, Vellore, from January 2003 to December 2015. RESULTS There were 34 patients with 8q24 translocations (31, ALL and three myeloma). The t(8;14) was seen in 25 patients, t(8;22) in seven and t(2;8) in two. The salient findings were as follows: 85% males; 79% adults, median age 37 years; L3 morphology in 61%; mature B immunophenotype in 77%; extra-medullary disease in 41%; additional abnormalities in 28 (85%), notably, structural abnormalities of chromosome 1q (41%) and 13q (9%) and monosomy 13 (15%); complex karyotypes in 68%. There were two double-hit lymphoma/leukemia, one with a t(14;18)(q32;q21) and the other with a t(3;14)(q27;q11.2), associated with nodal high grade B cell lymphoma and dermal leukemic infiltrates respectively. Only 13 samples were processed for DNA PCR and all these samples were positive for MYC-IgH (c-gamma type) rearrangement. Only in one patient, in addition to c-gamma, c-alpha rearrangement was also detected. CONCLUSION The frequency (1.7%) and distribution of these translocations in our series and the association with 1q and 13q abnormalities is similar to the literature. Trisomies 7 and 12 were seen in less than 10% of our patients.
Transfusion Medicine | 2018
Ajay Abraham; M. P. Chacko; Fouzia Na; Alok Srivastava; Dolly Daniel
The transfusion of platelets is an important therapeutic strategy in bleeding patients with thrombocytopenia. However, some chronically transfused patients fail to achieve the appropriate platelet count increment following transfusion due to the presence of platelet alloantibodies.
Journal of Clinical Pathology | 2018
A Kumar Arun; Anandan Senthamizhselvi; Suresh Hemamalini; Eunice Sindhuvi Edison; Anu Korula; Fouzia Na; Biju George; Vikram Mathews; Poonkuzhali Balasubramanian
Aims Congenital and cyclical neutropenia are rare inherited diseases that result in recurrent life-threatening bacterial infections due to a deficiency of mature neutrophils. Cyclical neutropenia is usually caused by heterozygous ELANE mutations while congenital neutropenia is genetically heterogeneous with mutations in genes like ELANE, HAX-1, G6PC3 and GFI1. The presence of ELANE mutation aids in the establishment of diagnosis and rules out other secondary causes of neutropenia such as autoimmune cytopenia and evolving aplasia. Further, patients with ELANE mutations are also at a high risk of developing myelodysplasia or acute myeloid leukaemia. Hence it is important to screen for these mutations in patients presenting with neutropenia early in life. Methods The study included 52 patients who were evaluated for inherited neutropenia. Genomic DNA was extracted from peripheral blood leucocytes and mutation analysis was done by bidirectional Sanger sequencing. Results Ten different missense, frameshift or splice site variants in ELANE gene were identified in 11 patients: c.125C>T (p.Pro42Leu), c.164G>A (p.Cys55Tyr), c.169G>A (p.Ala57Thr), c.179T>C (p.Ile60Thr), c.770C>T (p.Pro257Leu), c.367–8C>A, c.597+1G>A along with three novel mutations c.302T>A (p.Val101Glu), c.468G>T (p.Try156Cys) and c.596delT (Phe199Ser fs*13). Family studies were available for three patients and, in all three instances, the mutation had a de novo origin. Conclusion The widespread distribution of mutations suggests the need to screen all the exons in ELANE gene for proper characterisation of the genotype.
Indian Journal of Hematology and Blood Transfusion | 2018
Uday Kulkarni; Anup J. Devasia; Anu Korula; Fouzia Na; Nisham Pn; Yasir J. Samoon; Kavitha M. Lakshmi; Aby Abraham; Alok Srivastava; Vikram Mathews; Biju George
There is paucity of data from developing countries on the clinical outcomes in myeloma post-autologous transplantation. In this retrospective study, we used hospital records to retrieve data of patients with multiple myeloma undergoing autologous stem cell transplantation (ASCT) from January 1995 to December 2014 at our centre. During the study period, 245 patients underwent ASCT for myeloma. Of these, 19%, 37% and 37% were in complete response, very good partial response and partial response respectively at the time of ASCT. Only in 14 (5.7%) patients, the stem cells were cryopreserved. The transplant related mortality was 2.86%. The median follow up was 40.7 months (range 0–237.4 months). The 5-year overall survival (OS) and progression-free survival (PFS) for the entire cohort was 61.6% ± 3.8% and 37.2% ± 3.9% respectively. Independent predictors of OS included mononuclear cell dose infused, pre- and post-transplant response; and the use of maintenance therapy. Independent predictors of PFS included age at diagnosis, pre- and post-transplant response; and the use of maintenance therapy. In a resource limited setting, ASCT for myeloma is associated with low transplant related mortality. Pre- and post-transplant response and maintenance therapy are predictors of survival.
Haemophilia | 2018
S. Elayaperumal; Fouzia Na; A. Biswas; S. C. Nair; A. Viswabandya; Biju George; Asha Mary Abraham; J. Oldenburg; Eunice Sindhuvi Edison; Alok Srivastava
Type 3 von Willebrand disease (VWD) is the rare and most severe form of VWD which results from a near‐complete deficiency of the von Willebrand factor (VWF). This study evaluates in detail the molecular pathology of type‐3 VWD in India. One hundred and two patients from 90 families were evaluated.
Bone Marrow Transplantation | 2018
Fouzia Na; Eunice Sindhuvi Edison; Kavitha M. Lakshmi; Anu Korula; S R Velayudhan; Poonkuzhali Balasubramanian; Asha Mary Abraham; Auro Viswabandya; B George; Vikram Mathews; Alok Srivastava
Mixed chimerism (MC) occurs frequently after allogeneic hematopoietic stem cell transplantation (HSCT) for thalassemia major (TM) and may be associated with rejection. We report the outcome of MC in 132 TM patients conditioned with Busulphan/Cyclophosphamide, who had successful engraftment and had ⩾1 year follow-up. Chimerism was first assessed at day +28, then every 3–9 months or more frequently if there was MC. If rejection was suspected, immunosuppression was stopped and donor-lymphocyte infusion (DLI) was given if there was no response. Among 132 patients, aged 7 years (range: 2–24), 46/132 (34.8%) had MC in the first year, 32/46 (69.6%) at day +28 and another 14 (30%) between day +28 and 1 year post HSCT. MC was quantified at level 1 (residual host chimerism (RHC) <10%) in 20 (43.5%), level II (RHC 10–25%) in 14 (30.4%) and level III (RHC >25%) in 12 (26.1%). On tapering immunosuppression, 15 (32.6%) developed acute GvHD and 8 (17.4%) had chronic GvHD with reversal to complete chimerism (CC). DLI was administered to 5/46 (10.9%), 1 evolved to CC but 4 rejected the graft. At median follow-up of 60 months (range: 16–172), 20/46 (43.5%) had CC, 18/46 (39.1%) had persistent MC with hemoglobin of 11.5 g/dL (range: 8.4–13.6), whereas 8 (17.4%) rejected the graft. Close monitoring and early intervention is needed with increasing recipient chimerism. Novel strategies are required for preventing graft rejection.
Blood | 2016
Ezhilpavai Mohanan; John C. Panetta; Kavitha M. Lakshmi; Anup J. Devasia; Nisham Pn; Anu Korula; Fouzia Na; Aby Abraham; Biju George; Alok Srivastava; Vikram Mathews; Poonkuzhali Balasubramanian