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

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

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

Outcomes of unrelated umbilical cord blood transplantation for X-linked adrenoleukodystrophy.

Adrenoleukodystrophy (ALD) is an X-linked disorder caused by a defect in the metabolism of long chain fatty acids leading to demyelination, neurodegeneration, and death. The disease typically presents in young boys and adolescent boys. Allogeneic bone marrow transplantation has been used to halt progression of the disease. However, many patients lack suitable HLA- matched related donors and must rely on unmatched donors for a source of stem cells. The purpose of this study was to evaluate outcomes of unrelated donor umbilical cord blood transplantation after chemotherapy-based myeloablative conditioning and retrospectively determine if baseline studies correlate and help predict outcome. Between November 22, 1996, and November 3, 2005, 12 boys with X-linked ALD who lacked HL- matched related donors were referred to Duke University Medical Center for transplantation. These children were conditioned with myeloablative therapy including busulfan, cyclophosphamide, and antithymocyte globulin before receiving umbilical cord-blood transplants from unrelated donors. Baseline studies of neurophysiologic, neuroimaging, and neurodevelopmental status were performed and patients were subsequently evaluated for survival, engraftment, graft-versus-host disease, and neurodevelopmental outcomes. A substudy evaluated whether baseline neuroimaging and neurophysiologic studies correlated with cognitive and motor function and if these studies were predictive of posttransplantation outcomes. The umbilical cord blood grafts had normal levels of very long chain fatty acids. They delivered a median of 6.98 x 10(7) nucleated cells per kilogram of recipient body weight and were discordant for up to 4 of 6 HLA markers. Neutrophil engraftment occurred at a median of 22.9 days after transplantation. Three patients had grade II-IV acute graft-versus-host disease; 2 had extensive chronic graft-versus-host disease. Cumulative incidence of overall survival of the group at 6 months is 66.7% (95% confidence interval 39.9-93.3%). Median follow-up was 3.3 years (range 12 days to 6.3 years). As previously reported with bone marrow transplantation, symptomatic patients faired poorly with lower survival and rapid deterioration of neurologic function. This study included 3 patients transplanted at a very young age (2.6-3.5 years) before the onset of clinical symptoms who continue to develop at a normal rate for 3-5 years posttransplant. Although baseline Loes scores correlated with cognitive and motor outcome, neurophysiologic studies failed to show statistically significant differences. Transplantation of boys with X-linked ALD using partial HLA-matched umbilical cord blood yields similar results to those previously reported after bone marrow transplantation. Superior outcomes were seen in neurologically asymptomatic boys less than 3.5 years of age at the time of transplantation. Baseline Loes scores were a strong predictor of cognitive and motor outcome.
Authors
Beam, D; Poe, MD; Provenzale, JM; Szabolcs, P; Martin, PL; Prasad, V; Parikh, S; Driscoll, T; Mukundan, S; Kurtzberg, J; Escolar, ML
MLA Citation
Beam, Donald, et al. “Outcomes of unrelated umbilical cord blood transplantation for X-linked adrenoleukodystrophy.Biol Blood Marrow Transplant, vol. 13, no. 6, June 2007, pp. 665–74. Pubmed, doi:10.1016/j.bbmt.2007.01.082.
URI
https://scholars.duke.edu/individual/pub703057
PMID
17531776
Source
pubmed
Published In
Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Volume
13
Published Date
Start Page
665
End Page
674
DOI
10.1016/j.bbmt.2007.01.082

Practice pattern changes and improvements in hematopoietic cell transplantation for primary immunodeficiencies.

Authors
Marsh, RA; Hebert, KM; Keesler, D; Boelens, JJ; Dvorak, CC; Eckrich, MJ; Kapoor, N; Parikh, S; Eapen, M
MLA Citation
Marsh, Rebecca A., et al. “Practice pattern changes and improvements in hematopoietic cell transplantation for primary immunodeficiencies..” J Allergy Clin Immunol, vol. 142, no. 6, Dec. 2018, pp. 2004–07. Pubmed, doi:10.1016/j.jaci.2018.08.010.
URI
https://scholars.duke.edu/individual/pub1353907
PMID
30170121
Source
pubmed
Published In
The Journal of Allergy and Clinical Immunology
Volume
142
Published Date
Start Page
2004
End Page
2007
DOI
10.1016/j.jaci.2018.08.010

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