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

STELLAR Study

Administered By
Pediatrics, Blood and Marrow Transplantation
Awarded By
Children's Healthcare of Atlanta
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

Ethical considerations of using a single minor donor for three bone marrow harvests for three HLA-matched siblings with primary immunodeficiency.

Allogeneic hematopoietic stem cell transplantation is curative for primary immunodeficiencies. Bone marrow from an unaffected human leukocyte antigen (HLA)-identical sibling donor is the ideal graft source. For minor donors, meaningful consent or assent may not be feasible, and permission from parents or legal guardians is considered acceptable. Adverse events, albeit extremely small, can be associated with bone marrow harvest in pediatric donors. Donor safety concerns potentially increase with multiple bone marrow harvests. Very little is known about multiple bone marrow harvests from pediatric donors. We describe the ethical considerations and clinical decision-making in an unusual clinical situation where three patients with the same primary immunodeficiency were HLA identical to one another and their younger sibling, who underwent bone marrow harvests three times between 1.3 and 4 years of age, resulting in successful transplantation for all three patients. We hope that this experience will provide guidance to providers and families in a similar situation.
Authors
Parikh, SH; Pentz, RD; Haight, A; Adeli, M; Martin, PL; Driscoll, TA; Page, K; Kurtzberg, J; Prasad, VK; Barfield, RC
MLA Citation
Parikh, Suhag H., et al. “Ethical considerations of using a single minor donor for three bone marrow harvests for three HLA-matched siblings with primary immunodeficiency.Pediatr Blood Cancer, vol. 66, no. 4, Apr. 2019, p. e27602. Pubmed, doi:10.1002/pbc.27602.
URI
https://scholars.duke.edu/individual/pub1364464
PMID
30609294
Source
pubmed
Published In
Pediatr Blood Cancer
Volume
66
Published Date
Start Page
e27602
DOI
10.1002/pbc.27602

Results of cord blood transplantation in children with nonmalignant hematologic conditions

This comprehensive volume discusses the current scope of umbilical cord blood transplantation (UCBT), including recent controversies and future developments for improving clinical outcomes.
MLA Citation
Page, K. M., et al. “Results of cord blood transplantation in children with nonmalignant hematologic conditions.” Umbilical Cord Blood Banking and Transplantation, edited by K. Ballen, Springer, 2014.
URI
https://scholars.duke.edu/individual/pub1259972
Source
manual
Published Date

Correction of chronic granulomatous disease after second unrelated-donor umbilical cord blood transplantation.

Allogeneic hematopoietic stem cell transplantation (HSCT) is curative for chronic granulomatous disease (CGD), but many patients lack a suitably matched related donor. We report successful outcomes after mismatched, unrelated-donor umbilical cord blood transplantation (uUCBT) in two boys with X-linked CGD. Both patients experienced autologous recovery after first transplants, required second transplants to achieve durable donor engraftment, and are alive 27 and 15 months post-transplant. Both had invasive fungal disease and received granulocyte transfusions. In conclusion, uUCBT is effective in children with CGD, but immunosuppression in the conditioning regimen may need to be increased to decrease the risk of graft rejection.
Authors
Parikh, SH; Szabolcs, P; Prasad, VK; Lakshminarayanan, S; Martin, PL; Driscoll, TA; Kurtzberg, J
MLA Citation
Parikh, Suhag H., et al. “Correction of chronic granulomatous disease after second unrelated-donor umbilical cord blood transplantation.Pediatr Blood Cancer, vol. 49, no. 7, Dec. 2007, pp. 982–84. Pubmed, doi:10.1002/pbc.21365.
URI
https://scholars.duke.edu/individual/pub703051
PMID
17941061
Source
pubmed
Published In
Pediatric Blood & Cancer
Volume
49
Published Date
Start Page
982
End Page
984
DOI
10.1002/pbc.21365

Hematopoietic Stem Cell Transplantation as Treatment for Patients with DOCK8 Deficiency.

BACKGROUND: Biallelic variations in the dedicator of cytokinesis 8 (DOCK8) gene cause a combined immunodeficiency with eczema, recurrent bacterial and viral infections, and malignancy. Natural disease outcome is dismal, but allogeneic hematopoietic stem cell transplantation (HSCT) can cure the disease. OBJECTIVE: To determine outcome of HSCT for DOCK8 deficiency and define possible outcome variables. METHODS: We performed a retrospective study of the results of HSCT in a large international cohort of DOCK8-deficient patients. RESULTS: We identified 81 patients from 22 centers transplanted at a median age of 9.7 years (range, 0.7-27.2 years) between 1995 and 2015. After median follow-up of 26 months (range, 3-135 months), 68 (84%) patients are alive. Severe acute (III-IV) or chronic graft versus host disease occurred in 11% and 10%, respectively. Causes of death were infections (n = 5), graft versus host disease (5), multiorgan failure (2), and preexistent lymphoma (1). Survival after matched related (n = 40) or unrelated (35) HSCT was 89% and 81%, respectively. Reduced-toxicity conditioning based on either treosulfan or reduced-dose busulfan resulted in superior survival compared with fully myeloablative busulfan-based regimens (97% vs 78%; P = .049). Ninety-six percent of patients younger than 8 years at HSCT survived, compared with 78% of those 8 years and older (P = .06). Of the 73 patients with chimerism data available, 65 (89%) had more than 90% donor T-cell chimerism at last follow-up. Not all disease manifestations responded equally well to HSCT: eczema, infections, and mollusca resolved quicker than food allergies or failure to thrive. CONCLUSIONS: HSCT is curative in most DOCK8-deficient patients, confirming this approach as the treatment of choice. HSCT using a reduced-toxicity regimen may offer the best chance for survival.
Authors
Aydin, SE; Freeman, AF; Al-Herz, W; Al-Mousa, HA; Arnaout, RK; Aydin, RC; Barlogis, V; Belohradsky, BH; Bonfim, C; Bredius, RG; Chu, JI; Ciocarlie, OC; Doğu, F; Gaspar, HB; Geha, RS; Gennery, AR; Hauck, F; Hawwari, A; Hickstein, DD; Hoenig, M; Ikinciogullari, A; Klein, C; Kumar, A; Ifversen, MRS; Matthes, S; Metin, A; Neven, B; Pai, S-Y; Parikh, SH; Picard, C; Renner, ED; Sanal, Ö; Schulz, AS; Schuster, F; Shah, NN; Shereck, EB; Slatter, MA; Su, HC; van Montfrans, J; Woessmann, W; Ziegler, JB; Albert, MH; Inborn Errors Working Party of the European Group for Blood and Marrow Transplantation and the European Society for Primary Immunodeficiencies,
MLA Citation
Aydin, Susanne E., et al. “Hematopoietic Stem Cell Transplantation as Treatment for Patients with DOCK8 Deficiency..” J Allergy Clin Immunol Pract, vol. 7, no. 3, Mar. 2019, pp. 848–55. Pubmed, doi:10.1016/j.jaip.2018.10.035.
URI
https://scholars.duke.edu/individual/pub1357421
PMID
30391550
Source
pubmed
Published In
J Allergy Clin Immunol Pract
Volume
7
Published Date
Start Page
848
End Page
855
DOI
10.1016/j.jaip.2018.10.035

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