Suhag Parikh

Overview:

Stem cell transplantation for a variety of disorders - ranging from malignant diseases such as leukemia, lymphoma and myelodysplastic syndrome to nonmalignant diseases such as sickle cell disease, thalassemias, aplastic anemia, histiocytosis and leukodystrophies. My clinical research interest is stem cell transplantation for children with primary immune deficiency disorders and hemoglobinopathies such as sickle cell anemia,thalassemia and other non-malignant disorders. In addition,I am interested in developing startegies, such as reduced intensity conditioning, to make transplant safer.

Positions:

Associate Professor of Pediatrics

Pediatrics, Blood and Marrow Transplantation
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.B.B.S. 1988

Nagpur University (India)

Grants:

Transfusion Medicine and Hematology

Administered By
Medicine, Hematology
Awarded By
National Institutes of Health
Role
Preceptor
Start Date
End Date

Prospective Study of SCID Infants who receive Hematopoietic Cell Therapy

Administered By
Pediatrics, Allergy and Immunology
Awarded By
University of California, San Francisco
Role
Principal Investigator
Start Date
End Date

BMT CTN 1507 RIC for Haplo BMT in Patients with Symptomatic SCD

Administered By
Pediatrics, Blood and Marrow Transplantation
Role
Principal Investigator
Start Date
End Date

Publications:

Chronic Granulomatous Disease-Associated IBD Resolves and Does Not Adversely Impact Survival Following Allogeneic HCT.

INTRODUCTION: Inflammatory bowel disease (IBD) affects approximately 1/3 of patients with chronic granulomatous disease (CGD). Comprehensive investigation of the effect of allogeneic hematopoietic cell transplantation (HCT) on CGD IBD and the impact of IBD on transplant outcomes is lacking. METHODS: We collected data retrospectively from 145 patients with CGD who had received allogeneic HCT at 26 Primary Immune Deficiency Treatment Consortium (PIDTC) centers between January 1, 2005 and June 30, 2016. RESULTS: Forty-nine CGD patients with IBD and 96 patients without IBD underwent allogeneic HCT. Eighty-nine percent of patients with IBD and 93% of patients without IBD engrafted (p = 0.476). Upper gastrointestinal acute GVHD occurred in 8.5% of patients with IBD and 3.5% of patients without IBD (p = 0.246). Lower gastrointestinal acute GVHD occurred in 10.6% of patients with IBD and 11.8% of patients without IBD (p = 0.845). The cumulative incidence of acute GVHD grades II-IV was 30% (CI 17-43%) in patients with IBD and 20% (CI 12-29%) in patients without IBD (p = 0.09). Five-year overall survival was equivalent for patients with and without IBD: 80% [CI 66-89%] and 83% [CI 72-90%], respectively (p = 0.689). All 33 surviving evaluable patients with a history of IBD experienced resolution of IBD by 2 years following allogeneic HCT. CONCLUSIONS: In this cohort, allogeneic HCT was curative for CGD-associated IBD. IBD should not contraindicate HCT, as it does not lead to an increased risk of mortality. This study is registered at clinicaltrials.gov NCT02082353.
Authors
Marsh, RA; Leiding, JW; Logan, BR; Griffith, LM; Arnold, DE; Haddad, E; Falcone, EL; Yin, Z; Patel, K; Arbuckle, E; Bleesing, JJ; Sullivan, KE; Heimall, J; Burroughs, LM; Skoda-Smith, S; Chandrakasan, S; Yu, LC; Oshrine, BR; Cuvelier, GDE; Thakar, MS; Chen, K; Teira, P; Shenoy, S; Phelan, R; Forbes, LR; Chellapandian, D; Dávila Saldaña, BJ; Shah, AJ; Weinacht, KG; Joshi, A; Boulad, F; Quigg, TC; Dvorak, CC; Grossman, D; Torgerson, T; Graham, P; Prasad, V; Knutsen, A; Chong, H; Miller, H; de la Morena, MT; DeSantes, K; Cowan, MJ; Notarangelo, LD; Kohn, DB; Stenger, E; Pai, S-Y; Routes, JM; Puck, JM; Kapoor, N; Pulsipher, MA; Malech, HL; Parikh, S; Kang, EM; submitted on behalf of the Primary Immune Deficiency Treatment Consortium,
MLA Citation
Marsh, Rebecca A., et al. “Chronic Granulomatous Disease-Associated IBD Resolves and Does Not Adversely Impact Survival Following Allogeneic HCT.J Clin Immunol, vol. 39, no. 7, Oct. 2019, pp. 653–67. Pubmed, doi:10.1007/s10875-019-00659-8.
URI
https://scholars.duke.edu/individual/pub1402389
PMID
31376032
Source
pubmed
Published In
J Clin Immunol
Volume
39
Published Date
Start Page
653
End Page
667
DOI
10.1007/s10875-019-00659-8

Outcomes and Treatment Strategies for Autoimmunity and Hyperinflammation in Patients with RAG Deficiency.

BACKGROUND: Although autoimmunity and hyperinflammation secondary to recombination activating gene (RAG) deficiency have been associated with delayed diagnosis and even death, our current understanding is limited primarily to small case series. OBJECTIVE: Understand the frequency, severity, and treatment responsiveness of autoimmunity and hyperinflammation in RAG deficiency. METHODS: In reviewing the literature and our own database, we identified 85 patients with RAG deficiency, reported between 2001 and 2016, and compiled the largest case series to date of 63 patients with prominent autoimmune and/or hyperinflammatory pathology. RESULTS: Diagnosis of RAG deficiency was delayed a median of 5 years from the first clinical signs of immune dysregulation. Most patients (55.6%) presented with more than 1 autoimmune or hyperinflammatory complication, with the most common etiologies being cytopenias (84.1%), granulomas (23.8%), and inflammatory skin disorders (19.0%). Infections, including live viral vaccinations, closely preceded the onset of autoimmunity in 28.6% of cases. Autoimmune cytopenias had early onset (median, 1.9, 2.1, and 2.6 years for autoimmune hemolytic anemia, immune thrombocytopenia, and autoimmune neutropenia, respectively) and were refractory to intravenous immunoglobulin, steroids, and rituximab in most cases (64.7%, 73.7%, and 71.4% for autoimmune hemolytic anemia, immune thrombocytopenia, and autoimmune neutropenia, respectively). Evans syndrome specifically was associated with lack of response to first-line therapy. Treatment-refractory autoimmunity/hyperinflammation prompted hematopoietic stem cell transplantation in 20 patients. CONCLUSIONS: Autoimmunity/hyperinflammation can be a presenting sign of RAG deficiency and should prompt further evaluation. Multilineage cytopenias are often refractory to immunosuppressive treatment and may require hematopoietic cell transplantation for definitive management.
Authors
Farmer, JR; Foldvari, Z; Ujhazi, B; De Ravin, SS; Chen, K; Bleesing, JJH; Schuetz, C; Al-Herz, W; Abraham, RS; Joshi, AY; Costa-Carvalho, BT; Buchbinder, D; Booth, C; Reiff, A; Ferguson, PJ; Aghamohammadi, A; Abolhassani, H; Puck, JM; Adeli, M; Cancrini, C; Palma, P; Bertaina, A; Locatelli, F; Di Matteo, G; Geha, RS; Kanariou, MG; Lycopoulou, L; Tzanoudaki, M; Sleasman, JW; Parikh, S; Pinero, G; Fischer, BM; Dbaibo, G; Unal, E; Patiroglu, T; Karakukcu, M; Al-Saad, KK; Dilley, MA; Pai, S-Y; Dutmer, CM; Gelfand, EW; Geier, CB; Eibl, MM; Wolf, HM; Henderson, LA; Hazen, MM; Bonfim, C; Wolska-Kuśnierz, B; Butte, MJ; Hernandez, JD; Nicholas, SK; Stepensky, P; Chandrakasan, S; Miano, M; Westermann-Clark, E; Goda, V; Kriván, G; Holland, SM; Fadugba, O; Henrickson, SE; Ozen, A; Karakoc-Aydiner, E; Baris, S; Kiykim, A; Bredius, R; Hoeger, B; Boztug, K; Pashchenko, O; Neven, B; Moshous, D; Villartay, J-PD; Bousfiha, AA; Hill, HR; Notarangelo, LD; Walter, JE
MLA Citation
Farmer, Jocelyn R., et al. “Outcomes and Treatment Strategies for Autoimmunity and Hyperinflammation in Patients with RAG Deficiency..” J Allergy Clin Immunol Pract, vol. 7, no. 6, July 2019, pp. 1970-1985.e4. Pubmed, doi:10.1016/j.jaip.2019.02.038.
URI
https://scholars.duke.edu/individual/pub1375660
PMID
30877075
Source
pubmed
Published In
J Allergy Clin Immunol Pract
Volume
7
Published Date
Start Page
1970
End Page
1985.e4
DOI
10.1016/j.jaip.2019.02.038

Umbilical Cord Blood Transplantation for Cartilage Hair Hypoplasia: A Single Center Experience Demonstrates Excellent Outcomes Using Myeloablative Preparative Regimens

Authors
Allewelt, HB; Patel, S; Prasad, VK; Kurtzberg, J; Driscoll, TA; Martin, PL; Page, K; Parikh, S
MLA Citation
Allewelt, Heather B., et al. “Umbilical Cord Blood Transplantation for Cartilage Hair Hypoplasia: A Single Center Experience Demonstrates Excellent Outcomes Using Myeloablative Preparative Regimens.” Biology of Blood and Marrow Transplantation, vol. 22, no. 3, Elsevier BV, 2016, pp. S235–S235. Crossref, doi:10.1016/j.bbmt.2015.11.646.
URI
https://scholars.duke.edu/individual/pub1125825
Source
crossref
Published In
Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Volume
22
Published Date
Start Page
S235
End Page
S235
DOI
10.1016/j.bbmt.2015.11.646

Umbilical Cord Blood: A Reliable Source of Stem and Progenitor Cells for Human Transplantation

MLA Citation
Parikh, S. H., and J. Kurtzberg. “Umbilical Cord Blood: A Reliable Source of Stem and Progenitor Cells for Human Transplantation.” Rossi’s Principles of Transfusion Medicine: Fourth Edition, 2009, pp. 559–65. Scopus, doi:10.1002/9781444303513.ch36.
URI
https://scholars.duke.edu/individual/pub1151471
Source
scopus
Published Date
Start Page
559
End Page
565
DOI
10.1002/9781444303513.ch36

Survival Trends in Infants Undergoing Allogeneic Hematopoietic Cell Transplant.

Importance: Studies demonstrating improved survival after allogeneic hematopoietic cell transplant generally exclude infants. Objective: To analyze overall survival trends and other outcomes among infants who undergo allogeneic hematopoietic cell transplant. Design, Setting, and Participants: In this cohort study, we used time-trend analysis to evaluate 3 periods: 2000 through 2004, 2005 through 2009, and 2010 through 2014. The study was conducted in a multicenter setting through the Center for International Blood and Marrow Transplant Research, which is made up of a voluntary working group of more than 450 transplant centers worldwide. Two groups of infants aged 1 year or younger in 2 cohorts were included: those with malignant conditions, such as leukemia, and those with nonmalignant disorders, including immunodeficiencies. Data analysis was conducted from July 2017 to December 2018. Exposures: Allogeneic hematopoietic cell transplant. Main Outcomes and Measures: Survival trends, disease relapse, and toxicity. Results: A total of 2498 infants with a median age of 7 months (range, <1-12 months) were included. In the nonmalignant cohort (n = 472), survival rates improved from the first to the second period (hazard ratio, 0.77 [95% CI, 0.63-0.93]; P = .007) but did not change after 2004. Compared with infants with nonmalignant diseases (n = 2026; 3-year overall survival: 2000-2004, 375/577 [65.0%]; 2005-2009, 503/699 [72.0%]; and 2010-2014, 555/750 [74.0%]), those with malignant conditions had poorer survival rates, without improvement over time (3-year overall survival: 2000-2004, 109/199 [54.8%]; 2005-2009, 104/161 [64.6%]; and 2010-2014, 66/112 [58.9%]). From 2000 through 2014, relapse rates increased in infants with malignant conditions (3-year relapse rate: 2000-2004, 19% [95% CI, 14%-25%]; 2005-2009, 23% [95% CI, 17%-30%]; 2010-2014, 36% [95% CI, 27%-46%]; P = .01). Sinusoidal obstruction syndrome was frequent, occurring with a cumulative incidence of 13% (95% CI, 11%-16%) of infants with nonmalignant diseases and 32% (95% CI, 22%-42%) of those with malignant diseases. Generally, recipients of human leukocyte antigen-identical sibling bone marrow grafts had the best outcomes. Conclusions and Relevance: Survival rates have not improved for infants with malignant diseases over the 15-year study period. Infants with nonmalignant diseases had improved survival rates in the earlier but not the later study period. Higher relapses for the malignant cohort and toxicities for all infants remain significant challenges. Strategies to reduce relapse and toxicity and optimize donor and graft selection may improve outcomes in the future.
Authors
Parikh, SH; Satwani, P; Ahn, KW; Sahr, NA; Fretham, C; Abraham, AA; Agrawal, V; Auletta, JJ; Abdel-Azim, H; Copelan, E; Diaz, M-A; Dvorak, CC; Frangoul, HA; Freytes, CO; Gadalla, SM; Gale, RP; George, B; Gergis, U; Hashmi, S; Hematti, P; Hildebrandt, GC; Keating, AK; Lazarus, HM; Myers, KC; Olsson, RF; Prestidge, T; Rotz, SJ; Savani, BN; Shereck, EB; Williams, KM; Wirk, B; Pasquini, MC; Loren, AW
MLA Citation
Parikh, Suhag H., et al. “Survival Trends in Infants Undergoing Allogeneic Hematopoietic Cell Transplant..” Jama Pediatr, vol. 173, no. 5, May 2019. Pubmed, doi:10.1001/jamapediatrics.2019.0081.
URI
https://scholars.duke.edu/individual/pub1375661
PMID
30882883
Source
pubmed
Published In
Jama Pediatr
Volume
173
Published Date
Start Page
e190081
DOI
10.1001/jamapediatrics.2019.0081

Research Areas:

Adolescent
Adrenoleukodystrophy
Anemia
Anemia, Hemolytic, Autoimmune
Blood Platelets
Bone Marrow Transplantation
Cause of Death
Cell Division
Central Nervous System Neoplasms
Child
Child, Preschool
Cognition
Common Variable Immunodeficiency
Cord Blood Stem Cell Transplantation
DiGeorge Syndrome
Disease-Free Survival
Drug Evaluation, Preclinical
Female
Follow-Up Studies
Graft vs Host Disease
Granulocytes
Granulomatous Disease, Chronic
HLA Antigens
Hematologic Neoplasms
Hemoglobinopathies
Humans
Immunologic Deficiency Syndromes
Infant
Infant, Newborn
Kaplan-Meier Estimate
Leukemia
Leukodystrophy, Globoid Cell
Leukodystrophy, Metachromatic
Lymphoproliferative Disorders
Male
Metabolic Diseases
Metabolism, Inborn Errors
Mucopolysaccharidoses
Multivariate Analysis
Mycophenolic Acid
Neoplasm Transplantation
Neutrophils
Pancytopenia
Quality of Life
Risk Factors
Severe Combined Immunodeficiency
Sickle Cell Trait
Stem Cell Transplantation
Stem Cells
Survival Rate
Thalassemia
Tissue and Organ Harvesting
Transplantation Chimera
Transplantation, Homologous
Treatment Outcome
Umbilical Cord
United States
Unrelated Donors
Whole-Body Irradiation