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KING EDWARD MEMORIAL HOSPITAL
SETH GORDHANDAS SUNDERDAS MEDICAL COLLEGE

बृहन्मुंबई महानगरपालिका रुग्णालय

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Hematology

First Floor Multi storeyed building Seth GS Medical College & KEM Hospital Mumbai 400012!

J.C. Patel Department of Clinical Hematology

In 1961, Dr.J.C. Patel, Hon. Physician, Seth GS Medical College and KEM Hospital, obtained a grant of Rs.30, 000.00 from Glaxo Laboratories Ltd. to start work in Haematology.  A full-time medical officer and technician were appointed to work under the guidance of Dr. J.C. Patel and Prof.N.M. Purandare.  Over a period of six months, they established most of the laboratory tests necessary for diagnosis of various haematological disorder that were encountered in practice.
The department was named after Dr. J.C Patel in 1977. Medical Council of India (MCI) gave permission to super speciality course in start DM Clinical Haematology in 2001 and first batch of students got admission from 2002. Then MCI recognized DM course in 2012.
The department is located on 10th floor of multistorey building of this hospital and has dedicated state of art haematology day care centre on 11th floor, specialized haematology laboratory.  There is facility of clean and well-maintained ward with total capacity of 25 beds.  The day care facility has started to cater patients of Thalassemia, haemophilia and blood cancer such as leukaemia and lymphoma both in adults and paediatric patients.  It was inaugurated by honourable Dean and director, Dr. Avinash Supe in December 2016 and is funded by NATCO Trust.
The Dr. J. C. Patel Department of Haematology provides haematooncology services to the patients that are referred to the King Edward Memorial VII Hospital and caters to the lower strata of the society. This is one of the oldest and most prestigious Medical Colleges in India, with 1820 bed capacity & century old record of superlative patient care in all Departments. It has got one of the biggest Haematology Departments in Mumbai, with the monthly O.P.D. attendance of almost 350 to 500 patients coming from all over India.
The haematology department has easy access to the two main libraries,i.e., the central library of the hospital& the more specialized library of the IIH which is housed in the same building as the department. Besides these the department has its own collection of reference books.

Milestones –

Department started in 1961
DM Clinical Hematology course started in 2002
Dedicated Hematology Day care center started in 2015 with 10 beds and 5 reclining chairs with facility for day care chemotherapy, blood transfusion, regular blood transfusion and factor replacement therapy, rehabilitation therapy.

Section

J C Patel Hematology ward

Dedicated Hematology ward with 25 beds where blood cancer patients both adult and pediatric patients are admitted in this ward. Patients with hemophilia and thalassemia, other blood disorders patients are admitted in ward. There are 7 separate cabins for admission of blood cancer patients. In this ward we have dedicated medical social worker, psychologists and dedicate nutritionist.Here all types of blood cancer patients including acute leukemia, chronic leukemia and lymphoma are admitted

Hematology laboratory

There is dedicated lab on 10 th floor. Bone marrow examination is done for both adults and pediatrics. We usually do around 800 – 900 bone examinations in a year. Bone marrow reporting is done in the lab. We have a 5-part cell counter where all patients CBC done prior to chemotherapy. We have a fully automated coagulometer where coagulation tests are done. We have hemoglobin electrophoresis HPLC Machine where the diagnosis of thalassemia and sickle anemia diagnosis is done

Hematology day care center

Located on 11 th floor of the new MSB in KEM. 10 beds and 4 reclining chairs with seating arrangements for the patients and relatives with dedicated play area. There is dedicated rehabilitation area with all the equipment such as cycle, pulleys and CPM and others. Dedicated hemophilia multidisciplinary OPD conducted every Wednesday and CML OPD is conducted on every Wednesday morning in Hematology Day care. In day care chemotherapy, PICC line care and intrathecal chemotherapy procedures are done. Regular blood transfusion for thalassemia and supportive, chelation therapy. Round the clock services for the hemophilia patients.

We have more than 1300 Hemophilia patient registered with us and we also a International Hemophilia Training center where we conduct training programs for doctors, nurses, technicians in the care of Hemophilia. We do all types of surgeries in hemophilia including joint replacement and pseudotumor.

Facilities and procedure available in the department

  • Hemophilia comprehensive care.
  • Treatment of Hematolymphoid malignancies
    • Intravenous Chemotherapy
    • Intrathecal Chemotherapy
  • Thalassemia comprehensive care
  • Hemogram Retic count, ESR, HPLC
  • Bone marrow aspiration and biopsy
  • Bone marrow transplant
  • PT/APTT/Fibrinogen
  • Education and rehabilitations program for our patients
  • Procedure and tests done in Hematology dept
  • Bone marrow examination
  • PICC insertion and line care
  • Hemoglobin electrophoresis

Future outlook –

Bone marrow transplant tis the need of the hour in Mumbai for adults in public hospital. At present there is no BMT facility for adults with benign hematologic condition in any of the Public Hospital. We would like to have a dedicated BMT unit with 8 beds.

 Staff Nurse giving chemotherapy

PICC line care by nursing staff

Blood transfusion to Thalassemia patient.

Community activity - Counseling session of relatives and staff by dietitian and psychologist respectively.

PICC line care by nursing staff

Blood transfusion to Thalassemia patient.

Community activity - Counseling session of relatives and staff by dietitian and psychologist respectively.

Patient Feedback

Courses offered –

  • DM in Clinical Hematology.
  • Training for nurses, doctors and technicians in hemophilia management.

CME AND CASE CONFERENCE
2021 -CME on Hemophilia Basics and management
CME – On advances in Hemophilia
2022 – Case conference on thrombosis
Projects

  • Principal investigator in RESPONSE II trial in POLYCYTHEMIA VERA
  • Principal investigator in Guardian X trial.
  • Principal investigator in STASEY trial
  • PI in a Prospective multicenter randomized doble blind study to coampare the efficacy and safety of ENZ10 versus innovator Romiplostim in patients with Chronic ITP
  • PI Frontier 2,3, and 4 trials in Hemophilia
  • PI study on Luspatercept in TDT

In collaboration with ICMR

  • Defining immunological markers for response to therapy in patients with aplastic anemia.
  • Cytogenetic and molecular study of Myelodysplastic syndrome in Indian Population
  • Telomerase activity and telomere gene mutations in aplastic anemia.

  1. Chandrakala.S, Jijina Farah,K.Ghosh, Diffuse Alveolar Hemorrhage with severe hemophilia - letter to the editor ; Hemophilia 2010 ,1-3
  2. Khushnooma Y. Italia, Farah F. Jijina, S. Chandrakala, Anita H. Nadkarni, Pratibha Sawant, Kanjaksha Ghosh, and Roshan B. Colah., Exposure to hydroxyurea during pregnancy in sickle-beta thalassemia: a report of 2 cases; J Clin Pharmacol. 2010 Feb; 50(2):231-4. Epub 2009 Oct 1.
  3. Chinmay B. Dalal, MD1*, Chandrakala Shanmukhaiah, MD1*, Thomas J. Nevill, MD, FRCPC1, et al 4132 Factors Predictive for Graft Failure Following Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia in a Population-Based Provincial  transplant cohort .Program: Oral and Poster Abstracts
  1. M P Jadhav; Farah Jijina; B Arora; S Chandrakala; P A Kurkure; H Menon; P M Parikh; V M Shinde; N A Kshirsagar A randomized comparative trial evaluating the safety and efficacy of liposomal amphotericin B (Fungisome) versus conventional amphotericin B in the empirical treatment of febrile neutropenia in India. 2012:  Indian journal of cancer 2012; 49(1):107-13.
  2. Desai Nayan, S. Bhagyalakshmi, Karnik Nitin, Jijina Farah, chandrakala. Hemophagocytic Lymphohistiocytosis in a 19 Year Old Critically III Patient.  Indian J Hematol Blood Transfus. 2011
  1. Preethi S Nair, Shrimati D Shetty, S Chandrakala, Kanjaksha Ghosh. Mutations in intron 1 and intron 22 inversion negative haemophilia a patients from Western India. PLoS ONE 01/2014; 9(5):e97337.
  1. Khushnooma Italia, Harshada Kangne,Chandrakala Shanmukaiah2,Anita H. Nadkarni1 Kanjaksha Ghosh1and Roshan B. Colah. Variable phenotypes of sickle cell disease in India with the Arab-Indian haplotype. British Journal of Haematology Volume 168, Issue 1, pages 156–159, January 2015.
  1. Dolly Joshi, S Chandrakala, Seema Korgaonkar, Kanjaksha Ghosh, Babu Rao Vundinti.  Down-regulation of miR-199b associated with imatinib drug resistance in 9q34.1 deleted BCR/ABL positive CML patients. Gene 2014 Jun 27; 542(2):109-12.
  1. Madhavi Sawant, Chandrakala S., Roshan Colah, Kanjaksha Ghosh, Anita Nadkarni. Does HBF induction by hydroxycarbamide work through MIR210 in sickle cell anaemia patients. 2015, British Journal of Haematology.

 

  1. Pallavi R.Mehta, Dipti S.Upadhye, Pratibha M.Sawant, Manju S.Gorivale, Anita H.Nadkarni, Chandrakala Shanmukhaiah, Kanjaksha Ghosh, Roshan B.Colah.Diverse phenotypes and transfusion requirements due to interaction of B-thalassemias with triplicated  -globin genes. Ann Hematol (2015) 94:1953-1958.
  1. Swati Garg, Chandrakala Shanmukhaiah, Supreet Marathe, Prashant Mishra, Vunditi Babu Rao, Kanjaksha Ghosh, Manisha Madkaikar.  Differential antigen expression and aberrant signaling via PI3/AKT, MAP/ERK, JAK/STAT, and Wnt/B catenin pathways in Lin-/CD38-/CD34+ cells in actue myeloid leukemia.2015 European Journal of Haematology.

 

  1. Shantashri Vaidya, Babu Rao Vundinti, Chandrakala Shanmukhaiah, Prantar Chakrabarti, Kanjaksha Ghosh. Evolution of BCR/ABL Gene Mutation in CML Is Time Dependent and Dependent on the Pressure Exerted by Tyrosine Kinase Inhibitor. PLOS ,0114828, January 28, 2015.
  1. Khushnooma Italia, Harshada Kangne, Chandrakala Shanmukaiah2, Anita H. Nadkarni1 Kanjaksha Ghosh1and Roshan B. Colah. Variable phenotypes of sickle cell disease in India with the Arab-Indian haplotype. British Journal of Haematology 
Rajesh Patil, Chandrakala S, Farah F. Jijina, Shailesh Bamborde, Nilesh Wasekar, Manoj Toshniwal, Aniket Mohite and Vinod Patil. Wiskott –Aldrich syndrome presenting with jmml like blood picture and normal sized platelets. Case Reports in Hematology. Volume 2016 (2016), Article ID 8230786,
  1. Aniket B. Mohite, Nilesh Wasekar, Vinod Patil, Rajesh Patil, Shailesh Bamborde and Chandrakala S Nilotinib induced rash in CML patient. European journal of Biomedical and Pharmaceutical Sciences; 2016.Vol – 3, Issue – 5, 598-600.

 

  1. Vinod R. Patil, Chandrakala S., Nilesh P. Wasekar, Farah Jijina, Aniket B. Mohite.Ruxolitinib associated tuberculosis – a rare complication of a novel drug!   International Journal of Medical Science and Public Health.
  1. Patil VR, Chandrakala S, Mantri S, Patil R, Wasekar N, Jijina F. Mutation profile in Indian primary myelofibrosis patients and its clinical implications. South Asian J Cancer. 2019 Jul-Sep;8(3):186-188. doi: 10.4103/sajc.sajc_276_18. PMID: 31489296; PMCID: PMC6699232.

 

  1. Patil RK, Ghosh KK, Chandrakala S, Shetty S. A possible need for routine screening for Strongyloides stercoralis infection in Indian haemophilia patients. Indian J Med Res. 2018 Mar;147(3):315-317. doi: 10.4103/ijmr.IJMR_1236_16. PMID: 29923523; PMCID: PMC6022374.
  1. Shabrish S, Kelkar M, Chavan N, Desai M, Bargir U, Gupta M, Mehta P, Chichra A, S C, Taur P, Saxena V, Vundinti BR, Madkaikar M. Natural Killer Cell Degranulation Defect: A Cause for Impaired NK-Cell Cytotoxicity and Hyperinflammation in Fanconi Anemia Patients. Front Immunol. 2019 Mar 21;10:490. doi: 10.3389/fimmu.2019.00490. PMID: 30949167; PMCID: PMC6438155.

 

  1. Patil, Vinod & S, Chandrakala & Wasekar, Nilesh & Jijina, Farah & Mohite, Aniket. (2017). Ruxolitinib-associated tuberculosis - A rare complication of a novel drug! International Journal of Medical Science and Public Health. 6. 1. 10.5455/ijmsph.2017.0846912092016.
  1. Shanmukhaiah, C, Jijina, F, Kannan, S, et al. Efficacy of emicizumab in von Willebrand disease (VWD) patients with and without alloantibodies to von Willebrand factor (VWF): Report of two cases and review of literature. Haemophilia. 2022; 1- 6.

 

  1. Kulkarni BP, Ghargi K, Shanmukhaiah C, Shetty SD. Rare Occurrence of Inhibitors in Von Willebrand Disease: A Case Report. Front Med (Lausanne). 2022 Jan 11;8:807664.
  1. George M, Solanki A, Chavan N, Rajendran A, Raj R, Mohan S, Nemani S, Kanvinde S, Munirathnam D, Rao S, Radhakrishnan N, Lashkari HP, Ghildhiyal RG, Manglani M, Shanmukhaiah C, Bhat S, Ramesh S, Cherian A, Junagade P, Vundinti BR. A comprehensive molecular study identified 12 complementation groups with 56 novel FANC gene variants in Indian Fanconi anemia subjects. Hum Mutat. 2021 Dec;42(12):1648-1665.

 

  1. John, M. J., Chakrabarti, P., Apte, S., Bhattacharyya, M., S, C., Hansen, T., Kolla, R., Ross, C., Seth, T., Siddharthan, N., & Abraham, A. (2020). Turoctocog alfa is safe for the treatment of Indian patients with hemophilia A: Guardian 10 trial results. Research and practice in thrombosis and haemostasis, 4(8), 1324–1330.
  1. Shabrish, S., Kelkar, M., Chavan, N., Desai, M., Bargir, U., Gupta, M., Mehta, P., Chichra, A., S, C., Taur, P., Saxena, V., Vundinti, B. R., & Madkaikar, M. (2019). Natural Killer Cell Degranulation Defect: A Cause for Impaired NK-Cell Cytotoxicity and Hyperinflammation in Fanconi Anemia Patients. Frontiers in immunology, 10, 490. https://doi.org/10.3389/fimmu.2019.00490
  2. Shanmukhaiah C, Jijina F, Kannan S, Pai NG, Kulkarni B, Khuba SV, Shaikh M, Joshi A, Phatale R, Apte S. Efficacy of emicizumab in von Willebrand disease (VWD) patients with and without alloantibodies to von Willebrand factor (VWF): Report of two cases and review of literature. Haemophilia. 2022 Mar;28(2):286-291.
  3. Kulkarni BP, Ghargi K, Shanmukhaiah C, Shetty SD. Rare Occurrence of Inhibitors in Von Willebrand Disease: A Case Report. Front Med (Lausanne). 2022 Jan 11;8:807664.
  4. George, Merin & Solanki, Avani& Chavan, Niranjan & Rajendran, Aruna& Raj, Revathi & Mohan, Sheila &Nemani, Sandeep &Kanvinde, Shailesh &Munirathnam, Deendayalan& Rao, Sudha & Radhakrishnan, Nita &Prasada, Harsha &Ghildhiyal, Radha & Manglani, Mamta & Shanmukhaiah, Chandrakala & Bhatt, Sunil & Ramesh, Sowmyashree& Cherian, Anchu&Junagade, Pritesh &Vundinti, Babu Rao. (2021). Comprehensive molecular study identified 12 complementation groups with 56 novel FANC gene variants in Indian Fanconi anemia subjects. Human Mutation. 42. 10.1002/humu.24286.
  5. Dhangar S, Ghatanatti J, Shanmukhaiah C, Vundinti BR. Sequential acquisition of tyrosine kinase domain mutations in a case of chronic myeloid leukemia: A dormant clone war against TKI. Research Square; 2022.
  6. Chakrabarti P, George B, Shanmukhaiah C, Sharma LM, Udupi S, Ghanima W. How do patients and physicians perceive immune thrombocytopenia (ITP) as a disease? Results from Indian analysis of ITP World Impact Survey (I-WISh). J Patient Rep Outcomes. 2022 Mar 18;6(1):24.
  7. Maurya N, Mohanty P, Dhangar S, Panchal P, Jijina F, Mathan SLP, Shanmukhaiah C, Madkaikar M, Vundinti BR. Comprehensive analysis of genetic factors predicting overall survival in Myelodysplastic syndromes. Sci Rep. 2022 Apr 8;12(1):5925.
  8. Kedar P, Dongerdiye R, Chandrakala S, Bargir UA, Madkaikar M. Targeted next-generation sequencing revealed a novel homozygous mutation in the LRBA gene causes severe haemolysis associated with Inborn Errors of Immunity in an Indian family. Hematology. 2022 Dec;27(1):441-448.
  9. Jiménez-Yuste V, Peyvandi F, Klamroth R, Castaman G, Shanmukhaiah C, Rangarajan S, García Chavez J, Martinez R, Kenet G, Alzahrani H, Robson S, Schmitt C, Kiialainen A, Meier O, Ozelo M. Safety and efficacy of long-term emicizumab prophylaxis in hemophilia A with factor VIII inhibitors: A phase 3b, multicenter, single-arm study (STASEY). Res PractThrombHaemost. 2022 Nov 14;6(8):e12837.

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