Top Ranking Haematology Departments in India

Haematology
DEPARTMENTS
IN INDIA
Editor
Dr M B Agarwal
From The Editor's desk
A frequently asked question by a student who completes his

postgraduate examination in medicine / paediatrics or
pathology relates to choosing a centre where he can pursue his
career in haematology. Often he is lost as he can't find many
institutions offering formal training / qualifications or even an
informal opportunity to learn the subject. Forty years ago, as a
student, I faced this problem. At that time, many outlets did not
exist and one had to look to the western world to achieve this
goal.
However, today, after 40 years, the situation has remarkably

changed. Today, one can be very proud of over 25 institutions in
India where top quality diagnostic and therapeutic haematology
is being practiced, taught and researched.
This booklet is a modest attempt to assemble information about

such centres of excellence and make it available to those who
need it most i.e. a student desirous of pursuing his career in the
field of haematology. I am grateful to the faculty of these
institutions for their authoritative write ups. The contributors have
done a marvelous job at a very short notice. I am sure that this
book will be a Bible for those who need and who will benefit from
this information.
Dr. M.B. Agarwal

November 2013
Contents
The list is arranged alphabetically as per city
Institute Contributed by Page No.
1. Gujarat Cancer Research Institute (GCRI), Ahmedabad Pankaj Shah 3

Sandip Shah
2. Narayana Health City, Bengaluru Sharat Damodar 5
3. Postgraduate Institute of Medical Education & Research Neelam Varma 6

(PGIMER), Chandigarh
4. S.C.B. Medical College, Cuttack Sudha Sethy 8

R.K. Jena
5. All India Institute of Medical Sciences (AIIMS), Delhi Renu Saxena 11
6. Army Hospital (Research & Referral i.e. R & R), Delhi Ajay Sharma 13
Sanjivan Sharma
Jasjeet Singh
7. Guru Teg Bahadur Hospital (GTB Hospital), Delhi Usha Rusia 15
8. Indraprastha Hospital Apollo Hospitals, Delhi Amita Mahajan 17
9. Maulana Azad Medical College (MAMC) & Tejinder Singh 20

Lok Nayak Hospital, Delhi Parul Sobti
10. Rajiv Gandhi Cancer Institute, Delhi Dinesh Bhurani 21

Gauri Kapoor
11. Sir Ganga Ram Hospital, Delhi Manorama Bhargava 23
12. Medical College, Kolkata Utpal Chaudhuri 29
13. NRS Medical College, Kolkata Maitreyee Bhattacharyya 33

Institute Contributed by Page No.
14. Tata Medical Centre (TMC), Kolkata Mayur Parihar 37

Deepak Mishra
Reena Nair
Mammen Chandy
15. Sanjay Gandhi Postgraduate Institute (SGPGI), Lucknow Soniya Nityanand 45
16. Christian Medical College (CMC), Ludhiana M. Joseph John 49

Naveen Kakkar
17. B.J. Wadia Hospital for Children, Mumbai Bharat Agarwal 54
18. KEM Hospital, Mumbai Farah Jijina 58

Chandrakala S.
19. LTMG Hospital, Sion, Mumbai Mamta Manglani 61
20. National Institute of Immuno-Haematology (NIIH), Mumbai K.Ghosh 64
21. P.D. Hinduja National Hospital, Mumbai Farah Jijina 68

Shanaz Khodaiji
22. Tata Memorial Hospital (TMH), Mumbai S.D. Banavali 70
23. Tata Memorial Centre, Mumbai Navin Khattry 73

S.D. Banavali
24. Armed Forces Medical College (AFMC), Pune AFMC Group 77
25. Sahyadri Hospital, Pune Shashi Apte 82
26. Shere-E-Kashmir Institute of Medical Sciences, Srinagar M. I. Quadri 87
27. Christian Medical College (CMC), Vellore Alok Srivastava 89

Contributed by
Bharat Agarwal, MD
Head of Department
Department of Pediatric Hematology & Oncology
B J Wadia Hospital for Children
Parel, Mumbai 400012
Narendra Agrawal, DM (Clin Haematology)

Consultant Haemato-Oncologist & BMT
Rajiv Gandhi Cancer Inst & Research Center,
Rohini Sector - 5
New Delhi 110085
Shashi Apte, MD
Head
Department of Haematology & BMT Unit
Sahyadri Speciality Hospital
Pune 411004
S.D. Banavali, MD
Professor & Head
Department of Medical Oncology
Tata Memorial Centre
Mumbai 400012
Manorama Bhargava, MD, FAMS

Senior Consultant & Chairperson
Department of Haematology
Sir Ganga Ram Hospital
Sir Ganga Ram Hospital Marg,
Rajinder Nagar,
New Delhi 110060
Maitreyee Bhattacharyya, MD (Gen Med), DM (Clinical Haematology)

Professor & Head
N.R.S Medical College
Kolkata 700014
Mammen Chandy, MD, FRACP, FRCPA, FRCP
Director
Tata Medical Center
New Town, Rajarhat
Kolkata 700156
Tathagat Chatterjee, MD, DM, FUICC, FISHTM

Professor & Head
Department of Immuno-Haematology & Transfusion Medicine
Armed Forces, Medical College
Pune 411040
Utpal Chaudhuri, MD
Director
Institute of Haematology & Transfusion Med
MCH Building, Medical College
3rd Floor, 88 College Street
Kolkata 700073
Sharat Damodar, MD, DNB, DM

Consultant Haematologist & BMT Physician
Narayana Hrudayalaya & Muzumdar Shaw Canver Centre
258 / A, Bommasandra Industrial Area, Anekal Taluk
Bengaluru 560099
K. Ghosh, MD
Director
Institute of Immuno-Haematology
13th Floor, Multi-storey Building
KEM Hospital, Parel
Mumbai - 400 012
Rabindra Kumar Jena, MD. PhD,FISHBT

Professor and Head
Dept. of Clinical Hematology
S.C.B. Medical College & Hospital
Cuttack 753007
Odisha
Farah Jijina, MD
Consultant Hematologist/Hemato-oncologist
PD Hinduja Hospital (Mahim) and Hinduja Heathcare (Khar)
Veer Savarkar Marg, Mahim
Mumbai 400 016
&
Professor Haematology
KEM Hospital
Parel
Mumbai 400012
M. Joseph John, MD, DM

Associate Professor & Head
Clinical Haematology, Haemato-Oncology & Bone marrow (Stem cell) Transplant Unit
Christian Medical College
Ludhiana 141088
Naveen Kakkar, MD
Professor of Pathology
In-charge of Special Tests Laboratory
Clinical Haematology, Haemato-Oncology & Bone marrow (Stem cell) Transplant Unit
Ludhiana 141088
Navin Khattry, MD, DM

Professor
Tata Memorial Centre
Mumbai 400012
Shanaz Khodaiji, MD
Consultant Hematology and Transfusion Medicine
Department of Laboratory Medicine
P.D. Hinduja National Hospital & MRC
Veer Savarkar Marg, Mahim
Mumbai 400016
Amita Mahajan, MD
Senior Consultant, Paediatric Haematology & Oncology,
Indraprastha Apollo Hospitals,
Delhi
Mamta V Manglani, Professor & Head, Department of Pediatrics
Chief, Div. of Hematology-Oncology
Programme Director, Paediatric Centre of Excellence for HIV Care
LTM Medical College & General Hospital,
Sion
Mumbai 400022
Deepak K Mishra, MD, MAMS, FICPath, FISHTM, FUICC, PDF

(Haematology - AIIMS)
Senior Consultant & Head (Haemato-Pathology)
Head, Department of Laboratory Sciences
Tata Medical Center
New Town, Rajarhat
Kolkata 700156
Reena Nair, MD
Senior Consultant
Clinical Haematology Department
Tata Medical Centre
New Town, Rajarhat
Kolkata 700156
Velu Nair, AVSM, VSM**

Dean & Deputy Commandant
Senior Consultant Medicine & Haematology
Armed Forces Medical College
Pune 411040
Soniya Nityanand, MD PhD

Professor & Head
Dept of Hematology
Sanjay Gandhi PG Inst. of Medical Sciences,
Rae Bareily Road
LUCKNOW 226014
Mayur Parihar, Associate Consultant

Department of Haemato-Pathology & Cytogenetics
Tata Medical Centre
New Town, Rajarhat
Kolkata 700156
M.I. Quadri, MD
Director
Dr. Quadri's Hematology Center & Clinical Laboratory
Srinagar
Usha Rusia, MD
Professor & HOD
Department of Pathology
University College of Medical Sciences and
Guru Teg Bahadur Hospital
Shahdara
Delhi 110095
Chandrakala S, MD, DM
Fellowship in Leukemia and BMT
Associate Professor. Dept of Hematology
KEM hospital, Parel
Mumbai 400012
Renu Saxena, MD, FNAMS, FIMSA

Professor & Head
Department of Hematology,
All India Institute of Medical Sciences,
Ansari Nagar,
New Delhi 110 029.
Sudha Sethy, MD
Assistant Professor
Department of Clinical Hematology
S.C.B. Medical College & Hospital
Cuttack 753007
Odisha
Pankaj M. Shah, MD
Vice President Gujrat Cancer Society
Advisor to Chairman
Gujarat Cancer & Research Institute
Ahmedabad 380016
Prof Emeritus Medical Oncology
Trustee : Sadvichar Parivar
Sandip A. Shah, MD
Consultant Haemato-Oncologist
Gujarat Cancer And Research Institute
Ahmedabad 380016
Ajay Sharma, MD
Prof & Sr Advisor
Dept of Hematology & Stem Cell Transplantation
Army Hospital( Research & Referral)
New Delhi
Sanjeevan Sharma, MD
New Delhi
Jasjeet Singh, MD
New Delhi
Tejinder Singh, MD, FICP, FISHTM

Director - Professor
Maulana Azad Medical College
Bahadur Shah Zafar Marg
New Delhi 110002
Parul Sobti, MD
Maulana Azad Medical College
Bahadur Shah Zafar Marg
New Delhi 110002
Alok Srivastava, MD, FRACP, FRCPA, FRCP

Professor & Head
Vellore - 632004
Neelam Varma, MD, FISHTM,

Professor & Head - Hematology,
V Floor, SS Anand Block (Research Block A),
Post-Graduate Institute of Medical Education & Research (PGIMER),
Chandigarh 160012
1
Gujarat Cancer & Research Institute, Ahmedabad
Hemato-oncology department
Pankaj Shah, Sandip Shah
Department of Medical & Pediatric Oncology, GCRI was established in 1972under the leadership of
Dr. Pankaj Shah (Founder Head of Medical Oncology Department). Other developments were
establishment of Pediatric Oncology Department in 1992 – first of it's kind in India and Haematopoietic
Stem Cell Transplant Unit in 2002. GCRI also has an active and dynamic Research division with state of
the art facilities even for molecular research since 1986.The Super Speciality DM Medical Oncology
Course started in 1991 with four students per year which has now increased to 10 students per year
since 2011. The Department of Medical and Paediatric Oncology renders services to Adult &
Paediatric patients, both solid tumours and Haematological malignancies.The indoor facility consists
of 127 beds for adults and 25 beds for Paediatric patients. Other facilities includes, Leukemia and
neutropenia ward with 22 beds, HSCT unit with 4 rooms and Medical ICU etc.
Team members
Dr. Pankaj M. Shah - Professor Emeritus and Former Hon. Director, GCRI.
Dr. Kirti M. Patel - Dean GCS medical college, Former HOD- Medical Oncology Dept. and Deputy
Director, GCRI.
Dr. Shilin N. Shukla - Former Hon. Director, GCRI and HOD – Medical Oncology Dept.
Dr. Asha S. Anand – Professor and Chief of medical oncology
Dr. Shailesh S. Talati – Professor and chief of medical unit III
Dr. Sandip A. Shah - Associate Professor(part time practicing)
Dr. Harsha P. Panchal - Associate Professor
Dr. Apurva A. Patel - Associate Professor
Dr. Sonia K. Parikh - Associate Professor
Dr. Bhavesh B. Parekh - Assistant Professor (practicing)
Adult hemato-oncology
The department of the Medical Oncology provides services to adult patients with cancer of which
apporx. 20% have haematological malignancy.
Pediatric hemato-oncology
The Paediatric Oncology centre has dedicat. The department of the Medical Oncology provides
services to paediatric patients. There are about 47 (25 Paediatric, 22 Leukemic) bedded indoor
facilities at Paediatric Oncology Centre.
3
Service Output of last year from April 2012 to March 2013
No. Details of Work Done Adult
1 New plus first time referred cases 10936
2 Follow-up cases 68055
3 Day care chemotherapy administration 40969
4 Minor Procedures - Bone marrow aspiration/biopsy Intrathecal, Pleural & 8638

Ascitic Fluid aspiration
5 Haematological Malignancies 1283
6 Benign Haematological Diseases – Aplastic anemia, ITP etc. >200
Service Output of last year from April 2012 to March 2013
No. Details of Work Done Nuber
1 New and referred cases 1079

2 Follow-up cases 15078
3 Day care chemotherapy administration 5700
4 Minor procedures - Bone marrow aspiration/biopsyIntrathecal, Pleural & 4100

Ascitic Fluid aspiration
5 No. Of Hemato-oncology cases 460

6 Benign Haematological Diseases – Aplastic anemia, ITP etc. >100
Bone marrow transplantation

The department of the Medical & Paediatric Oncology has an active HSCT unit under the able
leadership of Dr. Sandip Shah. They have performed 207 transplantations till date.They include
autologous, allogenic, umbilical cord transplantation, as well as 3 MUD HSCT. They were done for
variety of indications like haematological malignancies, solid tumors, thalassemias and others.
Financial Aid for Patients

GCRI has always strived to offer financial aid to economically backward patients with curable
malignancies. Various financial aids are MA Yojna for BPL patients, School health program for
children upto 18 yrs of age, LIG scheme for econimically backward patients, Adoption scheme
through which donors from society adopt a patient and give part of the expense (rest is borne by
GCS), partial reimbursement of bills by GCS etc.
Contact details
Phone (GCRI) : +91-79- 2268 8000 (Hunting)
Phone (GCS) : +91-79- 2268 1433 , 2268 8017
Fax : +91-79-2268 5490
E-mail: gcriad1@bsnl.in
Website: http://www.cancerindia.org
4
2
Narayana Health City, Bengaluru
Department Of Haematology
Sharat Damodar
The Department of Haematology was started in April 2004 as a one man unit in the Narayana
Hrudayalaya hospital. A three bedded bone marrow transplant unit was established in October 2004
and the first transplant for a child with thalassemia was conducted in November 2004.
Since then the department has steadily grown over a period of time to its current position and is
currently situated in the Mazumdar Shaw Cancer center in Narayana Health city. Over the last year the
OPD patients have crossed 7000/yr and in-patient admissions have crossed 1400/yr. The total
number of bone marrow transplants has crossed 280 till date which is the largest number in
Karnataka, of which 60 were done in the last year 2012. The new bone marrow transplant unit is a 14
bedded state of the art unit which is seen in the picture attached (jpg 35). The transplants conducted
till date includes autologous, allogeneic – matched sibling, cord blood, Matched unrelated and haplo-
identical transplants.
The department has a fellowship program in Haemato-oncology under the auspices of Rajiv Gandhi
University, running from 2010 and 9 students have joined till date. In addition we have been granted 4
seats in DNB Haematology starting Jan 2014 - students eligible are MD/DNB General medicine,
Paediatrics and Pathology.
Faculty
1. Dr Sharat Damodar MD,DNB,DM - Senior consultant and HOD
2. Dr Sunil Bhat MD, FPHO, Fellow Paed onc/BMT Univ Sydney - Paediatric consultant
3. Dr Nataraj KS MD, DM - Consultant
4. Dr Shoba Badiger MD, DNB, FHO - Paediatric consultant
5. Dr Akshatha MD - Fellow
6. Dr Shruthi Kodad DNB - Fellow
5
3
Postgraduate Institute of Medical Education &
Research (PGIMER), Chandigarh
Hematology Services
Neelam Varma
Hematology Service in PGIMER, Chandigarh comprises of 3 components: diagnostic service by

Hematology department, adult clinical hematology unit (of department of Internal Medicine) and
pediatric hematology-oncology unit (of department of Pediatrics).
Hematology section of the erstwhile Pathology department was upgraded to a full department in 1976.
Foundation of Hematology specialty was essentially laid by Dr. K. C. Das in 1964, who was appointed
as Lecturer. He rose to become the first Professor in Hematology in 1977. He has made great research
contributions in the field of B12-folate metabolism. Other faculty members also joined and contributed
immensely, namely, Dr. (Mrs.) A. Perkash, Dr. Swaroop, Dr. Dipika Mohanty, Dr. Sumitra Dash, Dr. G.
Garewal and Dr. Neelam Marwaha.
Several investigative sections were established focusing on coagulation disorders, nutritional anemia,
cytogenetics, radioisotopic studies and hemoglobinopathies. Ph.D. programme was introduced in
1970. Department was accorded the status of 'Advanced Centre for Hematology', by Indian Council of
Medical Research, in 1982. Departmental research activities concerning nutritional anemias,
hematological malignancies, hemoglobinopathies and coagulation/hemostasis have made a major
impact nationally and internationally.
The department was the first in India to start leukemia cytochemistry to classify leukemias.
Subsequently immunophenotyping of leukemias by immunofluorescence and APAAP was
established. Investigations for bleeding disorders and platelet function tests were also started.
Hematology department in association with the department of Pediatrics started investigations for
Genetic Disorders and the laboratory infrastructure was upgraded by the Department of
Biotechnology grant. Prof. G. Garewal started the Molecular Hematology Laboratory to establish
molecular analysis of Thalassemias. The data generated has been used for introducing prenatal
diagnosis of thalassemias. Mutational analysis of G6PD deficiency was started under a research
project. Dr. Neelam Varma has expanded leukemia cytogenetics, chromosomal breakage studies
and molecular genetic analysis of malignant and pre-malignant hematological disorders. These
investigations are being offered for diagnosis as well as therapy monitoring. Molecular tests for
mutations associated with venous thrombosis have been established through a grant by Department
of Biotechnology and this facility has been incorporated in patient care. Etiology of bone marrow
failure syndromes and the role of constitutional factors (Fanconi anemia and others) was studied by Dr
Neelam Varma under a DBT project. Flow cytometry for acute and chronic leukemias and paroxysmal
nocturnal haemoglobinuria (PNH) has been established since 1996 by Dr. Neelam Varma. Dr Reena
Das has extended the molecular analysis and gene sequencing for alpha thalassemia and
hemophilias. Dr Jasmina Ahluwalia has contributed to start new advanced investigations in the
Coagulation Laboratory which is now fully automated. Majority of the investigations performed by the
department are under quality surveillance and utmost care is taken by the faculty to maintain high
standards of the investigations as well as the teaching program. Dr. Man Updesh Singh Sachdeva, Dr.
Shano Naseem, Dr. Prashant Sharma and Dr. Narender Kumar are making excellent contributions in
6
the diagnostic and research activities of Hematology department. Department is presently pursuing
research projects concerning chronic myeloproliferative disorders, chronic lymphocytic leukemia, red
cell membrane diseases, stem cell transplantation, acute leukemia, coagulation/ platelet function
studies etc.
MSc Medical Technology (Hematology) course was started in 2010 and DM Hematopathology course
was started in July 2011. Department of Hematology also makes major contribution to the teaching
programmes of BSc MLT, MSc MLT and MD Pathology courses. MD Pathology residents are posted
for 11 months in Hematology department.
Adult clinical hematology service was started in 1978 by Dr. Juginder Kaur within department of
Internal Medicine. Dr. Subhash Varma joined in 1979 and has led the service since then. Stem cell
transplant (SCT) programme was started in 2005 and more than 100 autologous and allogeneic SCTs
have been performed so far. DM course in Clinical Hematology was started in July 2011. Adult clinical
hematology service is managed by 3 clinical hematology faculty members (Dr. Pankaj Malhotra, Dr.
Alka Khadwal, Dr. Gaurav Prakash), other faculty members of Internal Medicine unit I (Dr. Savita
Kumari, Dr. Sanjay Jain, Dr. Vikas Suri), DM Clinical Hematology fellows, senior and junior residents of
Internal Medicine.
Pediatric hematology-oncology unit (of department of Pediatrics) was started by Prof. RK Marwaha in
1982. Later Dr. Amita Trehan and Dr. Deepak Bansal have joined. DM in Pediatric hematology-
oncology was started in July 2009.
Hematology department, adult clinical hematology unit and pediatric hematology-oncology unit
conduct combined as well as individual sessions for the teaching programmes of DM
Hematopathology, DM Clinical Hematology and DM pediatric hematology-oncology courses.
Presently our institute has the capacity to provide state-of-the-art diagnostic services for patients with
hematological disorders, including investigations for cyto-morphological appraisal, flowcytometry,
cytogenetic/ molecular genetic analysis for malignant, pre-malignant and benign hematological
diseases, coagulations disorders, hemolytic anemias and nutritional anemias etc. Adult and pediatric
clinical services are geared to provide efficient management for patients with hematological
disorders.
Professor Sumitra Dash was the President of the Indian Society of Hematology and Blood Transfusion
for the year 2004. Prof. Subhash Varma is the current president of the society.
7
4
S.C.B. Medical College & Hospital, Cuttack
Sudha Sethy, R.K. Jena
General History
The department of Clinical Hematology has been created in this institute since 1972 as a Higher
specialty with sincere effort of Prof (Dr.) Janmejaya Nayak , M.D , Ph.D which is under broad specialty
of medicine. Initially it was provided with a post of register. One Graduate Lab. Technician and two
attendants with facilities of both out-door service twice a week and indoor beds. In 1984, one post of
Associate Professor was created and posted and since then it is functioning as an independent
department. The effort which has been started by Prof. Nayak was carried out by Prof. Upendra Nayak.
After the retirement of Prof. Upendra Nayak the department is being proudly headed by Prof. R.K.Jena
since 2003. In the year 2009 the State Govt. has been pleased to increase the number of beds from
existing 13 to 20 and also this year in 2013 the Govt. has sanctioned a separate Day Care Unit for the
department of Clinical Hematology with 10 sanctioned beds. Hence as on today 30 beds are
functioning in this department of Clinical Hematology at S.C.B.Medical College Cuttack. There is one
sanctioned post of Professor, one post of Associate Professor and one post of Assistant Professor in
the department of Clinical Hematology. In this department extra SR posts and two additional Assistant
professor posts and one Associate professor post are to be sanctioned during this financial year as
the BMT unit is to be functional in 2013-14. Already the proposal to open DM Course in the Department
of Clinical Hematology in this academic session 2013-14 with 2 seats of DM is for consideration by the
MCI and MCI will visit the department of Clinical Hematology, SCB Medical College, Cuttack this year.
Services Available
a) OPD : Monday & Friday's - 9am-5pm, (Closed on Govt. Holidays)
b) Indoor : Everyday including Holidays
c) Lab : Independent State of Art Equipments installed in the hematology laboratory :
i) Sebia Minicap Electrphoresis Machine
For both Hb Electrophoresis (Capillary Zone) and Serum Electrophoresis with Immuno-
fixation (IgG, A,M Kappa, Lambda for myeloma protein)
ii) Fully Automated Coagulometer
For Coagulation profile of Blood (PT, APTT, Sr. Fibrinogen, FDP etc. and factor Estimation
VIII/IX
iii) 5 Part Differential Fully Automated Cell Counter (Hematology Analyser)
For Blood parameters like CBC+diff+retics count.
iv) Flowcytometer
For Immunophenotyping of Acute Leukemia panel, BCR-ABL (Qualitative) and chronic
Leukemia panel study by CD Markers.
8
v) BM Study : BM Aspiration & Biopsy
d) Emergency : Day care centre functions from 9 AM to 5 PM on every working days. Regularly
doctors are on call to other specialties as and when required. One doctor is always in call in the
department of Clinical Hematology for indoor patients on daily basis and also attends emergency
calls of other patients admitted to other wards as and when required.
Chronicles of HOD's
1. Prof. Janmejaya Nayak, M.D, Ph.D 1972- 1995
2. Prof. Upendra Nayak, M.D , Ph.D,FISHBT 1995- 2003
3. Prof. (Dr.)Rabindra Kumar Jena, M.D., Ph.D, FISHBT 28th October 2003 to
Cont…
Prof. Janmejaya Nayak
Faculties
Prof. (Dr.) Rabindra Kumar Jena, M.D., Ph.D, FISHBT
28th October 2003 to Cont…

Professor & Head : Clinical Hematology
Prof. Upendra Nayak, M.D., Ph.D, FISHBT
May - 2013 to Cont…

Professor : Clinical Hematology
Dr. Sudha Sethy, MD
17th February 2010 to Cont…

Assistant Professor: Clinical Hematology
Dr. Rajeeb Kumar Nayak, M.D.
2nd August 2007 to Cont…

Assistant Professor: Clinical Hematology
D.M. Course
Two seats of DM is to be opened in this academic year.
BMT unit
Is to be functional by the end of March -2014.
9
Research activities and project
I. International Trial of Glivec in Chronic Myeloid Leukemia. (Glivec) Imatinib is given free to newly
diagnosed cases of CML. Dept. of Clinical Hematology has been recognized as a nodal center for
this treatment Dr.R.K.Jena has been recognized as one of the Principal investigator .
2. Genetic Study- Study of interaction between Sickle Cell Gene and Beta-Thalassemia Gene with
resultant phenotypic expressions by Dr.R.K.Nayak.
3. Genetic Study- Study of Beta- thalassemia (Beta- globulin) gene mutation and different
phenotypes in Beta-Thalassemia and Sickle Beta-Thalssemia by Dr.Mishra.
4. Minimum Residual Disease (MRD)- Assessment in Acute Lymphoblastic Leukemia by
Flowcytometer- Dr.Sudha Sethy.
Ongoing with Collaboration with other Institutes
1. Identification of molecular markers in the Pathogenesis of Acute myeloid Leukemia from Indian
Population. Collaboration with Molecular pathology & clinical research service by super Religare
(SRL) Laboratories limited, Mumbai.
2. Identification of molecular markers in Pathogenesis of Acute Lymphoblastic Leukemia from Indian
Population Collaboration with Molecular pathology & clinical research service by super Religare
(SRL)Laboratories limited, Mumbai.
3. Computer based Acute lymphoblastic leukemia (ALL) diagnosis and prognosis collaboration with
Department of Electrical engineering National Institute of Technology Rourkela (NIT).
4. Improvement of L-Aspiration for treatment of Childhood (ALL) collaboration with KIIT university,
Bhubaneswar.
Research Activities and Conferences

Conference
1. 53rd Annual Conference of Indian Society of Hematology and Blood Transfusion (ISHBT), 9-11th
Nov.2012, Hotel Chariot, Puri, Odisha
2. VIII Annual Conference of Odisha Hematology to be held at IGH ,Rourkela on 11th – 12th May-2013
CME
1. International CME, Collaboration with European Hematology Association (EHA-ISHBT Joint CME):
8TH November, 2012, S.C.B Medical College & Hospital, Cuttack
2. CME on Flowcytometry in S.C.B. Medical College & Hospital on 11.08.2012
3. CME on Role of Engineering Science in the Development of Health Care system on 17.03.2013,
NIT Rourkela
Workshop
Pre Conference Workshop : 7th November 2012, S.C.B Medical College & Hospital, Cuttack
1. Diagnosis of Acute Leukemia by Flowcytometry
2. Capillary Zone Electrophoresis (both Hb, Serum)
3. Coagulation profile by Automated Coagulometer
National Hematology (ISHBT) Quiz

1. Rourkela IGH on 11th May-2013
2. MKCG Medical College & Hospital Berhampur on 24.07.2013
3. VSS Medical College Burla on 31.07.2013
4. SCB Medical College & Hospital, Cuttack on 24.07.2013
5. Final Selection (Odisha State) on 03.08.2013 at S.C.B. MCH, Cuttack
10
5
All India Institute of Medical Sciences (AIIMS), Delhi
Renu Saxena
The Hematology department, AIIMS, was created in 1989 with Prof A.K. Saraya as the first head of
department. It is a unique department, comprising both clinical and laboratory divisions for diagnosis
and management of patients with benign and malignant hematological disorders. After Dr Saraya's
retirement in 1994, Dr M Bhargav took over as Head till 2001 when Dr VP Choudhry became head till
2007. Dr. R Saxena took over Departmental headship from 2007 till date. The other faculty members
include Professor HP Pati, Professor Mahapatra, Dr. Seema Tyagi, (Addl. Professor), Dr. Tulika Seth,
(Addl. Professor) and Dr. Pravas Mishra, (Addl. Professor).
The department has the following facilities:
Hematopathology
a) Routine Services : The department offers state of the art services for hemogram, work up for
hemolytic anemia, detailed coagulation and thrombophilia work up.
b) Specialized tests
Molecular genetics of hematological disorders: The department performs PCR based tests for
prenatal diagnosis of hemophilia,thalassemias, acute and chronic leukemias.
Flow cytometry: This is currently is being used for Immunophenotyping of acute and chronic
leukemia, PNH, platelet function defects and hereditary spherocytosis.
Immunohistochemistry: Immunohistochemistry for diagnosis of lymphomas and CLPDs.
Platelet function studies: These include platelet aggregometry and VWD workup.
Quality Control: The department, along with ISHTM, runs a national external quality assessment
programme in hemogram. Currently it has approximately 1300 participant laboratories from all
over India.
Clinical hematology division
Wards: There 50-60 inpatients at any given time. These patients are spread out over general and
private and emergency wards.
Transplant: Blood and Marrow transplant: Our transplant program started in 2004. We have
performed 143 transplants till date. These include allogenic transplants for aplastic anemia,
leukemias and thalassemias.
Hematology Day care: The day care functions 24 hours a day, except Sundays. It experiences a
daily turnover of nearly 30–40 patients/day including chemotherapy, blood and blood component
transfusion and all routine OPD procedures like bone marrow aspirate and biopsy.
OPD Service:
The hematology outpatient clinic (OPD) is situated on the third floor of the Raj Kumari OPD block. It
runs six days per week (from Monday to Saturday). The main OPDs are on Monday, Wednesday
11
and Friday with each OPD serving 140 patients on an average with an additional load on Mondays
which also runs the chronic myeloid leukemia clinic in the mornings. The other days serve as
specialty clinics. New patients are registered on the main OPD days. The breakup of the OPD is as
follows:
1. Monday: Chronic myeloid leukemia and Hemato-Oncology clinic: This clinic looks after
patients of chronic myeloid leukemia and various other hematological malignancies including
acute leukemias, Myelomas, Lymphomas. The CML clinic runs in the mornings and the
remaining patients are seen in the afternoons.
2. Tuesday: Transplant Clinic: This clinic works up patients who have been planned for a
transplant and follows up transplanted patients.
3. Wednesday: This OPD looks after hemolytic anemias including thalassemics. It also looks
after Immune mediated hematological patients such as Immune thrombocytopenic purpura
and Autoimmune hemolytic anemia.
4. Thursday: Hemostasis clinic:This clinic looks after coagulation and bleeding problems. It
includes patients with deep vein thrombosis and also patients with various bleeding problems.
5. Friday: This OPD is devoted to patients with various marrow failure problems including aplastic
anemia which forms the bulk of patients attending this clinic.
6. Saturday: This clinic looks after Hemato-Oncology patients who have completed therapy.
Resident training
Department of Hematology, AIIMS provides two DM courses: DM Hematopathology and DM clinical
hematology and has a vibrant pHD program.The training in the department provides a comprehensive
laboratory and clinical training:
1. DM Hematopathology
DM Hematopathology started in 2001. This training includes training in highly sophisticated
technologies like molecular genetics, flow cytometry, detailed hemostatic and hemolytic anemia
work up alongwith clinical exposure. Our alumni are working in various parts of India and abroad.
Till date, 16 students have been awarded given DM hematopathology.
2. DM Clinical hematology
DM Clinical Hematology started in 2001. The training provides a comprehensive training in both
adult and pediatric hematology. Residents are trained to manage the complete gamut of benign
and malignant disorders. They receive a broad based training including stem cell transplant. Our
alumni are working in various parts of India and abroad. Till date, 22 students have been awarded
DM clinical hematology.
3. Ph.D.
The department has a vibrant Ph.D. programme pertaining to research on various aspects of
hematology. The Ph.D. entrance test is conducted by AIIMS six monthly. Till date, 13 Ph.D.
degrees have been awarded.
4. Miscellaneous
Training of MD Pathology students and basic scientists/technicians is also carried out.
Our alumni list is available at AIIMS website.
Research
Research remains one of the strong points of the department with publications in several high impact
journals. The department is engaged in research pertaining to molecular genetics, flowcytometry,
detailed hemostasis and prenatal diagnosis of genetic hematological disorders alongwith clinical
trials.
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6
Army Hospital, Delhi
Research & Referral
Ajay Sharma, Sanjivan Sharma & Jasjeet Singh
Army Hospital (Research & Referral) is a premier institution of armed forces medical services,
providing tertiary level medical care to serving and retired armed forces personnel and their families.
This institution has more than 30 super-speciality departments, with well equipped transplantation
facilitie in as many as seven departments (renal, cardiac, liver, orthopaedic, eye and hematology).
The department of hematology was established in 1994 and the facility of stem cell transplantation
started functioning since 1998.The department has all the essential components of various
hematology branches including clinical hematology, stem cell transplantation & research,
hematopathology, immunohematology, molecular hematology and transfusion department. The
hematology labs are well equipped and provide state of art investigative facilities for all kinds of
haematological problems.
The department offers benign as well as onco hematology services, has special outpatient clinics for
BMT and thalassemia and hemophilia patients. The centre has appx 100 male, female and pediatric
patient beds, providing comprehensive health care services for all kinds of hematological diseases.
It has an ultra-modern blood and marrow transplantation (BMT) unit. The first HSCT was undertaken
in 1998, for a patient of CML, and till Sept 2013, appx 400 transplants have been carried out. The
institute offers both autologous and allogeneic HSCT to its clientele which include serving and retired
armed forces personnel, and their families. Allogeneic transplants have been undertaken for almost all
types of benign and malignant haematological disorders, whereas, autologous transplants have
mainly been carried out mainly for multiple myeloma and acute myeloid leukemia. It is also worth
mentioning that AHRR has taken up a few autologous transplants for auto-immune disorders with
fairly satisfactory long term outcomes. This is the only centre in the country to do so. The 275 odd
allogeneic transplants have all been related donor transplants. This year we have started
haploidentical transplants as well. The matched unrelated transplants are also being taken up in our
institute soon. All patients post transplants are being followed up using DNA STR sequence based
chimerism studies done monthly for first six months and then on case to case basis.
Amongst the allogeneic transplants, 50 children with thalassemia major have undergone BMT with
more than 80% cure rates. The other disorders for which allogeneic transplants have been undertaken
include AML(55), CML(42), Aplastic anemia (31), ALL(27), MDS(9), and others including inherited
bone marrow failure syndromes, inherited metabolic disorders, PNH, and JMML. The overall survival
in most malignant conditions has been close to 50% at a median follow up of 18 months. The
department has an ultra modern well equipped stem cell lab, where a number of stem cell projects are
being carried out.
The department has been involved in a large number of research projects under aegis of armed forces
medical research council, dept of biotechnology, govt of India besides many departmental research
projects. Over 1000 papers have been published by various branches of the department.
13
The department imparts training to postgraduates and post doc research fellows. The department is
conducting PhD program, besides training postgraduates in clinical & lab hematology and stem cell
transplantation. The centre has obtained approval for DNB training in Hematology and will be taking
up students from next year.
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7
Guru Teg Bahadur Hospital (GTB), Delhi
Department of Hematology
Usha Rusia
The hematology section in the department of Pathology UCMS and GTB hospital was established in
1982 by Professor SK Sood, a known figure and a stalwart of hematology. Since then the department
has made considerable strides to position itself in the fore front as a premier department imparting
quality diagnostic workup of hematological disorders and educating post graduates under the
stewardship of Prof Nishi Madan who was heading the department for over a decade and has
superannuated a few years back.
The Department currently has a very dedicated and enthusiastic faculty in Prof Usha Rusia who heads
the department, Prof Meera Sikka, Prof Satendra Sharma, Dr Mrinalini Kotru, Assoc Prof, and Drs
Preeti Diwaker and Nadeem Tanwar, both Astt Professors who have joined the faculty last year. The
motto of the Department is Our Utmost for the Highest which each one is striving to achieve within the
prevailing circumstances and constraints .
Senior Faculty members have also held various offices in the Indian Society of Hematology and
transfusion medicine and Delhi society of Hematology and have been awarded the Fellowship of
ISHTM in recognition of their work and promotion of hematology as a discipline Currently and in the
past senior faculty members have been nominated to expert Task force panels constituted by ICMR
,DST, UGC, UNICEF and WHO in recognition of their experience in the field of hematology. The faculty
has won several awards and prizes in various National and International conferences and has
published extensively.
The department has developed expertise in some key fields such as Nutritional anemia, hemolytic
anemia and hematological malignancies especially CML in which pioneering work is being carried out
as evidenced by scientific papers published in these fields .
Iron deficiency has been the focus in nutritional anemia, not only because of its high prevalence in
India but also in the region where our institute is located. The department has been part of several
UNICEF and ICMR projects dealing with prevalence, diagnosis and prophylaxis in nutritional anemia .
High impact articles have been published in National and International journals in this field .
The Department is a nodal centre for Thalassaemia diagnosis and participates actively in antenatal
diagnosis and thalassaemia care projects of the Delhi Government. The Dept is also equipped for
molecular studies and was part of the multi centric projects conducted by ICMR. A project funded by
ICMR has mapped the Prevalence of beta thalassaemia mutations in northern India and HFE gene
mutations in beta thalassaemia. Besides this work on prevalence of genetic polymorphism in several
genes of interest in haematological and non-hematological related disorders such as e NOS
polymorphism in young patients with ischemic heart disease and type II DM and mitochondrial
mutations in CKD is being carried out .
In hematological malignancies , besides routine workup including immunophenotyping of leukemias
and lymphomas, a number of research projects some of them funded by UGC and DST have studied
the pathogenesis of myelofibrosis in CML and the effect of Imatinib on myelofibrosis. The ongoing
15
studies focus on the role of VEGF in neoangiogenesis in haematological malignancies including
Multiple myeloma and Acute and Chronic leukemia.
The Department is a nodal centre for Hemophilia diagnosis and care of Delhi Government. Besides
routine diagnostic tests the laboratory has facilities for a number of advanced tests such as Factor
assays, fibrinolysis and markers for Thrombophilia. The Department is well equipped for advanced
techniques such as Flow Cytometry, PCR, RT- PCR and HLA typing and is in process of setting up
cytogenetic and molecular diagnosis of leukemia.
Training is provided for the Degree of MD (Pathology) to 14 postgraduates annually under the
University of Delhi. It is a matter of pride that success rate is hundred percent year after year. Besides
PG training the Department is also involved in the training and teaching of 150 under graduate
students and laboratory technologists both from the institution and from other affiliated institutions of
the Government of Delhi.
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8
Indraprastha Apollo Hospitals, Delhi
Haematology Services
Amita Mahajan
The Hospital
Indraprastha Apollo Hospitals, New
Delhi is the First Hospital in India to be
Internationally Accredited by Joint
Commission International (JCI). It is a
tertiary care hospital with over 700
beds.
Clinical Hematology Services

The hospital is providing
multidisciplinary care for Malignant and non-malignant haematological diseases since its inception.
There are dedicated Adult Hematology and Oncology, Pediatric Hematology and Oncology, and
Blood & Marrow Transplant teams.
The Pediatric Hematology and Oncology division is an integral part of Apollo Centre of Advanced
Paediatrics. Treatment is delivered for both hematological cancers and solid tumors as per protocols
currently giving the best outcomes anywhere in the world. A team of pathologists, surgeons, and
radiation oncologists backs this service, as optimal treatment requires multi disciplinary involvement.
State of the art treatment is given in a patient friendly setting. There is a dedicated thalassemia unit for
patients with thalassemia major and a day care ward. Multidisciplinary managed is offered for
thalassemia at a subsidized cost.
Bone Marrow Transplant Unit

A six bedded HEPA-filtered laminar air flow unit and state of the art stem cell processing unit backed
up by excellent laboratory services compares with the best standard of care internationally. The Blood
& Marrow Transplant Department is offering allogeneic and autologous transplant to both adults and
children with malignant and non-malignant conditions. The Apollo group had performed more then
500 bone marrow transplant. Our outcomes are at par with international standard. The diseases
treated are leukemias, lymphomas, Multiple Myeloma, neuroblastoma, and some other solid
malignancy, thalassemia, Sickle cell anemia, aplastic anemia and other immune deficiency and
storage disorders. We are offering not only matched related allogenic transplant but matched
unrelated, cord blood and haplo-identical transplant as well.
Hemato-Pathology Services
The laboratory is equipped with completely automated instruments which include new generation cell
counters, coagulometers, flowcytometer, Real Time PCR. The Department carries out complete work
up Acute and Chronic Leukemias including Flowcytometry for Immunophenotyping and Molecular
Tests such as Multiplex PCR and Real Time PCR to detect the genetic abnormalities. Chimerism
17
studies are carried out to study monitor allogeneic bone marrow transplants.
The Department also carries out complete work up of Anaemia including Hemoglobinopathies.
Comprehensive workup for bleeding disorders and thrombotic disorders is available. The laboratory
is equipped with third generation Platelet Aggregometer which enables diagnosis of rare platelet
aggregation defects. A high degree of internal and external quality control is maintained.
Transfusion Medicine, Transplant immunology and molecular biology Services

The hospital offers state of art transfusion services which provide NAT tested, pre storage leuco-
depleted, irradiated blood components and apheresis services; including stem cell collection,
processing and storage. In addition the department performs regular screening for any irregular red
cell antibodies and the extended blood group phenotyping of Thalassemia patients, helping us in
providing the safest possible blood for them.
The aphresis lab is functional 24 hours, all days. It is equipped with fully automated cell separators,
which are flexible to produce various components. The various procedures undertaken include:
Plateletpheresis
Plasmapheresis
Granulocytapheresis
Besides these the department also performs special procedures such as:
Therapeutic Plasma Exchange
Peripheral Blood Stem Cell (PBSC) collection: Autologous and Allogenic
Red Cell Exchange
Our laboratory is equipped with the fully automated platform Galileo from Immucor for
Immunohaematology work up of donors & patients. Besides the fully automated system, the
laboratory also utilizes the gel technology by DIAMED. The ELISA based tests are performed on a fully
automated walk away system EVOLIS. Latest third/fourth generation kits are used for testing.
Individual Donor (ID)-NAT testing based on Transcription Mediated Amplification by ProcleixUltrio
Assay in the NAT Laboratory.
Voluntary blood donation program

The Department has initiated an in-house voluntary blood donation program wherein a list of hospital
employees willing to donate voluntarily is maintained. This also includes donors with rare blood
groups who can be called at the Eleventh hour for blood donation. These Voluntary Blood Donors play
a pivotal role in maintaining safe and adequate blood supply that forms the backbone of any Blood
Transfusion Service.
The Department also maintains the registration of Voluntary Blood Donors who are willing to donate
blood at the hospital. These Voluntary Blood Donors are encouraged to become regular repeat
Voluntary blood donors instead of just one-time voluntary blood donors. Voluntary donors at our
hospital are also provided with certain special incentives. As per the departmental policy that all
donors who have donated 4 times in a year or at least in 2 years are entitled for an Executive Apollo
Health Check up.
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Services provided by immunology & molecular biology
Prenatal & Postnatal Diagnosis
Chromosomal Analysis (GTG Banding) - Abortus Material
Amniotic Fluid - Karyotyping-GTG banding, FISH Ploidy for Chromosome 21,18,13,X and Y (5
probes analysis)
Chromosomal GTG Banding+ Ploidy analysis forCVS-Complete Analysis (Karyotyping
Chromosome 21,18,13,X and Y by FISH
Cytogenetics
Stress Cytogenetics for Aplastic Anaemia
Chromosomal Analysis (GTG Banding) -Peripheral Blood
Chromosomal Analysis (GTG Banding) -Bone Marrow
Couple Karyotype from peripheral blood samples
Fluorescence in situ Hybridization (FiSH) for Hematological malignancies
FISH FOR ALL PANEL, AML panel, CLL panel, CML, MDS PANEL MULTIPLE MYLOMA t(11;14),
t(14;18), 13q(del), p53(17p13)
FISH FOR 1q25,LSI19q13/LSI19p13, XY, CEP-12, N-myc, LSI D7S486(7q31)CEP-7q LSI 1p36/LSI
Her 2 Neu Gene Amplification by FISH with on Paraffin Embedded tissue Sections
HLA typing for Kidney, Liver and Bone Marrow Transplant
HLA CLASS –I/II PCR-SSP/SSOP
Hla Lymphocyte Cross-match & Hla Typing (Donor & Patient)
HLA B-27, HLA B-51, HLA B-17, HLA-B 15 (SSP-PCR)
Panel reactive antibody test
Donor specific antibody test
Infectious Marker Screening
HBV/HCV- Quantification/ Qualitative (PCR)
HCV genotype
HIV-Viral Load
MRD ASSESSMENT (Q-RT-PCR FOR BCR-ABL GENE)
HIV Proviral DNA
HIV Genotypic Drug Resistance
Molecular Genetics
Thalassemia - Alpha, Beta & Gamma Gene Mutation Analysis
Thrombophilia Profile(FAC V+MTHFR+Prothrombim gene).
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9
Maulana Azad Medical College & Lok Nayak Hospital,
New Delhi
Department of Hematology
Parul Sobti, Tejinder Singh
The Maulana Azad Medical College is situated in the capital city of Delhi. It straddles the historic old
city of Delhi on one side and the more modern Lutyen's Delhi on the other. The sprawling campus
includes the college and three of its major associated hospitals namely Lok Nayak Hospital, GB Pant
Hospital and the Guru Nanak Eye Centre. This institution is named after the great patriot and
educationist, Maulana Abdul Kalam Azad and has been in existence since 1959. The college made its
humble beginning in hospital block of Irwin (Lok Nayak) hospital 1958.
The Department of Hematology was established as a part of the Department of Pathology in 1978. The
Department is headed by Dr.Tejindar Singh and has four faculty members, two senior residents and six
junior residents (MD students) and seven technologists to man the laboratories. It processes 10,000
samples in a year including bone marrow aspirates and bone marrow trephine biopsies. The
laboratory has facilities for cytochemistry, immunohistochemistry, flowcytometry, HPLC and
Coagulation studies.
A hematology clinic is run in coordination with the Department of Medicine every Wednesday since
1978. Patients with various non Neoplastic and Neoplastic Hematological diseases give blood
samples in the morning and reports are dispatched by two pm, after which the patients attend the
Hematology clinic.
Dr.Naresh Gupta, Professor of Medicine, is running a Hemophilia centre in this campus. This centre
which has over 1,600 patients with Hemophilia and treats around 35 patients everyday. It was declared
the best facility in the field due to its excellent services by the World Federation of Hemophilia.
Established in 2008, HDCC has grown exponentially to become possibly the largest comprehensive
hemophilia care centre in India. The attached laboratory has facilities for coagulation studies, Factor
assay, and Factor VIII inhibitor assay. The centre provides factor VIII replacement therapy to patients.
The Department of Paediatrics under Dr.AP Dubey is running a Thallasemia day care centre which was
established in 1978, which has facilities for diagnosis and treatment of children suffering from
thallasemia and other haemoglobinopathies.
The Department of Hematology conducts teaching of undergraduate and post graduate students. It
has organised 16 CME and workshops on bone marrow biopsy interpretation, acute leukemia
diagnosis and flow cytometry etc attended by hundreds of delegates from all over India. It is involved
in various research activities including thallasemia, leukemia flow cytometry, multiple myeloma,
chronic lymphoproliferative
disorders, haematological
alterations in HIV infection
etc. The department is
running Fellowship in
Hematopathology of one
year duration under the
Indian College of
Pathologists.
20
10
Rajiv Gandhi Cancer Institute and Research Centre,
Delhi
Haematology services
Narendra Agrawal
Introduction
Rajiv Gandhi Cancer Institute and Research Centre (RGCI) was established in year 1996 by the
Indraprastha Cancer Society with a vision to provide best and comprehensive cancer care under one
roof at affordable cost to masses. As cancer patients often require multispeciality treatment like
medical, surgical as well as radiation, the hospital envisioned to provide medical oncology, surgical
oncology and radiation oncology services since its inception. Pediatric hemato-oncology department
was established in 1997 after Dr Gauri Kapoor joined the institute. A bone marrow transplant unit
(BMTU) was started in year 2001 and first autologous BMT was done in 2001. The services in the
hospital took a leap in 2007 when first haematologist, Dr Dinesh Bhurani, joined the institute. The
facility of allogeneic stem cell transplantation started soon after his arrival in the institute.
Facility
Currently the hospital is a renowned name in the field of cancer care and BMT. We have a separate unit
for adult and pediatric Hematology and Hemato-oncology services which is dedicated for patients
with all malignant as well as non-malignant haematological conditions and bone marrow/ stem cell
transplantation (both allogeneic and autologous). The BMT unit has 8 HEPA filtered rooms.
The Hematology services need a strong back up of blood bank and laboratory department. Without a
good laboratory and blood bank services, haematologist is just a crippled species. We at RGCI, are
fortunate to have a very strong laboratory and blood bank back up. The department of laboratory
services is headed by Dr Anurag Mehta. Hemato-pathology section of the lab is being looked after by
Dr Sonal Jain, DM Hematology from AIIMS Delhi. Our blood bank is providing NAT safe blood and
round the clock irradiated blood products. Our peripheral blood stem cell pheresis is also being done
regularly at blood bank of RGCI and the current volume of stem cell pheresis is approximately 150 per
year. Apart from pheresis, we also have cryopreservation facility at our blood bank. Overall the lab and
blood bank backup is very strong and efficient at RGCI and provides most of the services in house
The haematology team

Dr Dinesh Bhurani: First haematologist who joined RGCI was Dr Dinesh Bhurani. He is a graduate from
GR medical college Gwalior and MD from Pt JLN medical college Raipur. He joined department of
Hematology at CMC vellore and became first DM Hematology student of India. After completing DM,
he joined FRCPA (Australia) for next 4 year. He came to RGCI in 2007 and started developing and
improving Hematology services at the institute. Soon after his arrival at RGCI, his activities came into
full swing when he performed first allogeneic BMT of the institute and gave a new hope to the patients
who needed this treatment.
He strived hard to expand Hematology services and ran the department single handed for next 3 years
21
till a second person, Dr Shishir Seth DM Hematology, Fellow Leukemia/BMT VGH Vancouver Canada,
joined the department in Jan 2011. The team of both haematologists took the Hematology services at
the institute to a substantially high level.
Dr Narendra Agrawal: Soon the Hematology unit needed third person to handle the rapidly expanding
work and patient load. Dr Narendra Agrawal came to institute in January 2012. He studied MBBS and
MD from RNT medical college Udaipur and JLN medical college Ajmer, Rajasthan and DM
Hematology from AIIMS, Delhi.
Dr Shishir Seth left the institute in June 2013 and went to Apollo Hospital Delhi.
Dr Rayaz Ahmed: Dr Rayaz Ahmed joined the institute in July 2013. He is a medical graduate from Pt
JLN medical college Raipur and MD from Dr V M Medical College Solapur. After MD, he went to CMC
Vellore to join the department of Hematology as senior resident and DM student. He gave his services
at CMC vellore for full 8 years as senior resident/ DM student, then assistant professor and thereafter
associate professor.
The Pediatric hemato-oncology team

Dr Gauri Kapoor, Director of pediatric hemato-oncology: She joined the institute in 1997. She is a
graduate and postgraduate in pediatrics from Lady Hardinge Medical College Delhi and PhD in
molecular oncology from University of Delhi with a post graduate clinical experience of 24 years. Her
experiences include fellowships at Tata Memorial Hospital Mumbai for 3 years and in USA (including St
Jude Children's Research Hospital, Memphis). She was awarded Heinz fellowship by Royal College of
Pediatrics and Child Health, London in 2001.
Dr Sandeep Jain: He is a graduate from medical college Surat, Gujrat and DNB pediatrics from Mata
Chanan Devi Hospital Delhi. He was awarded Indian Academy of Pediatrics Fellowship in pediatric
hemato-oncology in 2009. He is serving at the institute since 2006, initially as fellow and thereafter as
consultant.
Dr Anshul Gupta: He is a graduate and MD pediatrics from JLN medical college Aligarh. He has been a
Fellow of National Board of Examinations (FNB Pediatric hemato-oncology) and is presently working
as clinical associate in department of pediatric hemato-oncology.
Dr Silky Jain: She is a graduate and MD pediatrics from Maulana Azad medical college Delhi and is
currently pursuing fellowship of national board of examinations.
Achievements: Academic
National board of examinations recognized the pediatric hemato-oncology and started post
doctoral fellowship in pediatric hemato-oncology since 2008. Four fellows have completed their
training so far in pediatric hemato-oncology.
DNB oncology program in medical oncology/ hemato-oncology with 3 candidates coming in every
year.
Achievements: bone marrow/stem cell transplantation

Performed nearly 300 stem cell transplants so far till Oct 2013 including 80 transplants in last one
year.
12 haplo-identical stem cell transplants so far (for acute leukemia, CML in blast phase, aplastic
anemia and a rare tumor blastic plasmacytoid dendritic cell neoplasm) with 75% survival.
Got registered with NMDP this year and became first NMDP transplant centre of India
To conclude, RGCI is a leading Hematology and stem cell transplant centre of north India, providing all
forms of advanced Hematology services as well as involved in research and academics.
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11
Sir Gangaram Hospital, Delhi
Manorama Bhargava
From a relatively small Haematology laboratory about 10 years ago, to a composite Department of
Haematology, with clinical and laboratory faculty working together under one roof for better service,
resident training and research activities, we indeed have come a long way. Our mission is to provide
state of the art investigative facilities for the comprehensive diagnosis of haematologic diseases and
the highest quality of clinical care for our patients with the latest therapeutic tools. In addition, to impart
training and mentor the next generation of academic hematologists, through our Diplomate of
National Board (DNB) programme, is a high priority. For Ph.D, Guru Gobind Singh Indraprastha
University has accorded the status of Approved Research Centre to Sir Ganga Ram Hospital and the
head of the department is an approved PhD guide. Department has its own SOPs and protocols and
has accreditation for the laboratory services from the National Accreditation Board for Testing
Laboratories (NABL).
I. Staff, faculty and Residents

Faculty
1. Prof. Dr. Manorama Bhargava, Senior Consultant & Head, Former Professor and Head of
Haematology, All India Institute of Medical Sciences.
2. Dr. Amrita Saraf, Consultant.
3. Dr. Jasmita, Consultant.
4. Dr. Sabina Langer, Consultant.
5. Dr. Vandana Arya, Scientist.
Ex-Head
1. Prof. Dr. S.K. Sood.
Residents
Non-DNB Senior residents - 2
DNB Senior Residents - 6
Teaching on Multihead Microscope
Technologists
24-Highly trained and competent senior technicians man the various stations for bench work.
II. Education
Department of Hematology, SGRH started the DNB course in Hematology of the National Board of
Examinations in 2008, the first such course in the country in the superspeciality of Hematology. It is
equivalent to DM in Hematology.
23
Eligibility for the examination and admission procedure is as per the National Board of Examinations
(http://www.natboard.edu.in/).
No. of seats: 02 per year
The department participates in and holds many CME programmes and conferences.
III. Hematology Services

A. Clinical Hematology services
Outpatient services are being run six days a week including general OPD once a week. Indoor
admissions are done in SGRH and City Hospital affiliated to SGRH. The department has a unique
opportunity to provide services to patients of Hematological malignancies as well as benign
hematological disorders. The spectrum includes acute and chronic leukemias, lymphomas,
MDS, myeloproloferative neoplasms, multiple myeloma, deep vein thrombosis, ITP, various
hemolytic anemias including hemoglobinopathies. Bleeding disorders covering coagulation
factor deficiencies as well as qualitative platelet disorders are covered in detail.
The department works in close association with Departments of Medical Oncology, Paediatric
Hematology-Oncology and Internal Medicine both for clinical service and education.
SGRH is a center of excellence for both autologous and allogeneic stem cell transplants including
the umbilical cord blood transplants.
B. Hematopathology services
The laboratory is widely known as a centre of excellence for providing diagnostic facilities for a
wide spectrum of hematologic disorders using cutting edge technology. It is recognized as a
referral centre for second opinion on difficult and rare cases by hospitals and institutions
nationwide.
Equipments:
Beckman LH 780, two DxH 800 analysers, Excyte ESR equipment, Chronolog platelet
aggregometer, Biorad variant II, coagulometers-ACL TOP 500, Elite Pro, ACL 7000,
Electrophoresis equipment Chorus, ELISA system, Flowcytometers BD Canto II and Beckman
Coulter FC 500.
Routine and special investigations

Complete blood counts
24
Haemorrhagic disorders
PT, APTT, TT, assays of factor VIII, IX,
vWF. Platelet count, Fibrinogen
estimation, Quantitative D-dimer, Clot
retraction test, clot solubility test,
APTT mixing, PT mixing, factor Xa
assays.
Platelet Aggregometry
Platelet function tests for qualitative
platelet defects, von Willebrands
disease, Drug resistance to aspirin
and clopidogrel.
Thrombophilia
Tests for antiphospholipid syndrome
and lupus anticoagulants: APTT with
lupus sensitive reagent, APTT–
dependent inhibitor screen, dRVVT,
KCT, Anti-cardiolipin antibodies
(ACA), b 2 GPIG, b 2 GPIM, Anti-ds-
DNA antibodies; Protein C, Protein S
& Antithrombin, Factor V leiden (APC-
R) estimation.
Molecular assays
Mutations of Factor V (Leiden),
Prothrombin gene mutation, MTHFR
genes, JAK2V617F.
HPLC and Hemolytic disorders
The Chronolog Dual-Channel Platelet Aggregometer.
Screening/testing for beta-
thalassemia & hemoglobinopathies
by HLPC and hemoglobin
electrophoresis at alkaline & acid pH
are routinely done. More than 30,000
antenatal screens have been
analysed to date. Other tests are G-6-
PD screening, Osmotic fragility test,
Heat instability test for unstable
haemoglobin, Heinz bodies,
Haemoglobin F Cytochemistry
(Kleihauer test), Haemosiderin in
urine, Methaemoglobin estimation,
sickling test for Hb S.
Leukemias & lymphomas
Detailed work-up by CBC, bone
marrow examination, Cytochemistry and flow cytometry on acute and chronic leukemias,
myelodysplastic syndromes, Multiple myeloma and lymphoproliferative disorders.
25
Flowcytometry
BD FacsCanto II and FC 500
Leukemia and lymphoma
immunophenotyping (Acute
leukemia panel,
CLL panel, Lymphoma panel).
MRD assay
Multiple myeloma
Myelodysplastic syndrome
Four color single tube CD4 & CD8
counts (HIV panel).
Enumeration of B-, T-& NK cells.
PNH panel extended panel
Flowcytometric HLA Cross-Match
(Donor specific).
Stem cell enumeration based on
ISHAGE protocol.
Molecular Haematology
Qualitative and quantitative assays for
BCR-ABL. TEL-AML1, PML-RARa, JAK2,
FLT-3 (D835 & ITD) mutations, NPM-1
mutation, RUNX1-RUNX1T1, CBFB-
MYH11, MTHFR, Factor V Leiden and
Prothrombin gene mutations.
Autoimmune Markers
ANA-3 (Western blot), ds-DNA, p-ANCA, c-ANCA by ELISA
Electrophoresis
Serum protein electrophoresis, Immunofixation electrophoresis, Urinary protein electrophoresis.
Free light chain assay
by minineph.
IV. Research projects

1. Completed
1. b
-Thalassemia mutations in subjects with borderline Hb-A2 values: a pilot study in North India.
2. A comparative study of bone marrow flowcytometric immunophenotyping, bone marrow aspirate
and biopsy in evaluation of involvement by non Hodgkins lymphoma.
3. Cytogenetic and molecular profile of Acute Myeloid Leukemia in India.
4. Safety and efficacy of Bortezomib+dexamethasone in newly diagnosed patients of multiple
myeloma.
5. Clinicomorphologic spectrum of myelodysplastic syndrome.
26
2. Ongoing projects
1. Clopidogrel and Aspirin Resistance in Indian Patients with Coronary Artery Disease and their
associations with CYP2C19, CYP3A5 and GPIIa/GPIIIa gene polymorphisms (ICMR grant
approved).
2. To assess the role of prothrombotic genetic markers in Ischemic Cerebrovascular stroke.
3. Evaluation of association between Thrombophilia and Unexplained Pregnancy Loss.
4. Multiparametric flowcytometric determination of minimal residual disease in multiple myeloma.
5. Flowcytometric and molecular studies of apoptotic and proliferative markers in Myelodysplastic
syndromes.
V. Some Recent Publications

1. Sharma P, Bhargava M, Sukhachev D, Datta S, Wattal C. LH750 hematology analyzers to identify
malaria and dengue and distinguish them from other febrile illnesses. Int J Lab Hematol. 2013 Jun
15. doi: 10.1111/ijlh.12116. [Epub ahead of print]
2. Khan AA, Saraf A, Bhargava M, Kumar V. Role of flow cytometry in the diagnosis of acute
promyelocytic leukemia. Am J Clin Pathol. 2013 Jun; 139(6):829.
3. Kumar J, Bhargava M, Aggarwal S. Bevacizumab-induced reversible thrombocytopenia in a
patient with adenocarcinoma of colon: rare adverse effect of bevacizumab. Case Rep Oncol Med.
2012; 2012:695430.
4. Sharma P, Bhargava M. Degenerative Changes in t(9;22)-positive Precursor B-lineage ALL: A
Potential Diagnostic Pitfall. J Pediatr Hematol Oncol. 2012 Dec 13. [Epub ahead of print]
5. Khan AA, Siraj F, Bhargava M, Aggarwal S. Successful treatment of multicentric Castleman's
disease accompanying myeloma with bortezomib. BMJ Case Rep. 2012 Dec 20;2012.
6. Sharma P, Gogia S, Sadaqat M, et al. Glanzmann Thrombasthenia in pregnancy: The value of a
probing bleeding history. Clin Appl Thromb Hemost. Clin Appl Thromb Hemost. 2012 Jan-
Feb;18(1):110-2.
7. Rangan A, Dadu T, Sharma P, et al. b -Thalassemia Mutations in Subjects with Borderline HbA2
Values: A Pilot Study in North India. Clin Chem Lab Med.2011; 49:1-4.
8. Bhargava M, Sindhuri U, Saluja S, et al. Volume, conductivity and scatter properties of Leucocytes
(VCS technology) as a highly sensitive and specific predictor of blood culture proven neonatal
sepsis. Int. J. of Lab. Hematology vol 33 (suppl 1), May 2011.
9. Bhargav M, Sharma P, Sukhachev. Discriminant value of volume, conductivity and scatter
properties of leucocytes (VCS Technology) for rapid and reliable diagnosis of malaria and dengue
fever.(Abstract). Blood on line at http://bloodjournal.hematologylibrary.org/site/misc/ASH
Meeting Abstracts Info.xhtml.
10. Bhargava M, Sindhuri U, Saluja S et al. Volume, Conductivity and Scatter properties of leucocytes
(VCS Technology) is a highly sensitive and specific predictor of blood culture proven neonatal
sepsis. Published online in Blood, December 2010
(http://bloodjournal.Hematologylibrary,org/misc/ASH_meeting_Abstracts_info.dtl).
11. Rangan A, Sinha S, Handoo A, Bhargava M. Ascitic fluid cytology and flow cytometry in the primary
diagnosis of lymphoma – a case Report. Indian J Hematol Blood Transfus.2010; 26:15-18.
12. Dadu T, Rangan A, Bhargava M. CD4+/NKa+/CD8dim+ T-Cell large granular lymphocytic
leukaemia: a rare entity. J Postgrad Med. 2010;56(3):223-224.
27
13. Gogia A, Kakar K, Byotra SP, Bhargava M. Aggressive natural killer cell leukemia. JAPI. 2010;
58:704-706.
14. Rangan A, Arora B, Rangan P, Dadu T. Florid plasmacytosis in a case of acute myeloid leukemia: A
diagnostic dilemma. Indian J Med Paediatr Oncol.2010;31:36-38.
15. Rangan A, Handoo A, Sinha S, Saxena R, Verma I.C., Kumar S., Sood S.K. and Bhargava M. Utility
of Family Studies in Diagnosing Abnormal Hemoglobins.Thalassemia states. Indian J.
Pediatrics.2009;76:615–21.
16. Dadu T, Rangan A, Handoo A, Bhargava M. Primary non-secretory plasma cell leukemia with
atypical morphology – a case report. Indian J Hemat Blood.Tranfus.2009;25:81-83.
17. Rangan A, Choudhry D.R., Sinha S., Handoo A., Bhargava M. Secondary Myelofibrosis in a case
of Aplastic Anemia. J Clin Diagn Res.2009;3:1587-96.
Accreditation
The laboratory is NABL accredited.
Quality assurance
Quality assurance is a major concern of the department. It covers all aspects of laboratory functioning
i.e. pre-analytical, analytical and post-analytical; turn around time; maintenance of equipment;
selection of tests & reagents; standardization & validation of tests before they are introduced; and
training of personnel.
28
12
Medical College, Kolkata
Institute of Haematology & Transfusion Medicine
Utpal Chaudhuri
Prior to 1968, Haematology in West Bengal existed only at Calcutta School of Tropical Medicine, the
birthplace of Haematology in India. The need for additional centre for management of haematological
disorders was long been felt. But it was not until 1968, when Government of West Bengal took the
decision to start a haematology unit under the department of Medicine at Medical College, Kolkata. A
small unit with one consultant, a small lab and about 10 beds started its journey in a small room at the
famous MCH building of Medical College. Dr. Sandhya Ghose took the charge. Later on Prof. R.N.Roy,
another eminent haematologist was associated with this unit. Suffering humanity in west Bengal at
least got another place to get specialised opinion on haematology. The academic activity was mostly
limited to undergraduate teaching.
Dr. Sandya Ghose nurtured the unit just like her child and struggled untiringly to make improvement
which was palpable. With an army of two technician and three resident house physician, she delivered
the best treatment available at that time to the patients who flocked to the haematology OPD in
increasing numbers. With little support from the authority, she started the basic haematological
investigations. Her struggle continued till 1988 when she decided to call it quit. In these years, many
students blossomed under her some of them became well known haematologists in the country and
abroad.
It continued till 1990s when Dr. Utpal Chaudhuri joined as a consultant in the unit and inherited the
struggle from his mentor. In late 90's the health department decided to upgrade the small unit to a
separate department of Haematology freeing it from the clutches of Medicine. A slow but steady
improvement was going on with introduction of automated cell counter, electrophoresis apparatus
with densitometry facilities.
However, the load of haematology
patients, especially thalassaemias
are increasing by leaps and bounds
and it was also felt that people should
be trained in haematology to provide
better diagnostic and treatment
facilities. With objective in mind, the
government of West Bengal
upgraded the existing haematology
department of Medical College to a
centre of excellence leading to the
formation of Institute of Haematology
& Transfusion Medicine (IHTM) in
October 2002 covering an area of
about 15000 sq.ft on the third floor of
MCH Building. Prof. Utpal Chaudhuri
was appointed as the first director of
29
the institute. Besides the
t r a t m e n t f a c i l i t y, a n
elaborate laboratory
complex was set up with
facilities to diagnose
various haematological
disorders.
The indoor facility
consisted of 40 beds
including a 10 bedded day
care. The day care facility
is available six days a
week and transfusion
dependent thalassaemia
patients get blood
transfusion free of cost.
The indoor beds are
mostly occupied by
patients suffering from haematological malignancies and were offered treatment following latest
international protocols.
The institute has small stem cell transplantation unit where it has carried out a number of autologous
stem cell transplantation for multiple myeloma patients. Very soon it will have state of the art stem cell
transplantation unit.
OPD Service
IHTM runs regular haematology OPD twice a week where all patients suffering from
haematological disorders are attended. Besides this, the institute runs special clinics as follows:
Thalassaemia Clinic once in a week every Monday. IHTM has more than 1500 registered
thalassaemia patients.
Special Thalassaemia clinic every Monday attending limited number of thalassaemia patients who
are examined thoroughly for other problems like endocrine, growth, psychological etc.
Acute Leukaemia Clinic every Monday to follow up acute leukaemia patients who are in remission.
Haemophilia Clinic every Friday to cater over all management of haemophilia patients. IHTM has
about five hundred registered haemophilia patients.
Chronic Leukaemia Clinic every Saturday to attend patients suffering from CML and CLL.
The diagnostic services provided by IHTM include
General Haematology Service like CBC etc.
Haemolytic Anaemia Lab provides facility for HPLC, Mutation Detection and other related facilities.
Flow Cytometry Lab instituted with the help of FIST program of DST, Govt. of India regularly carry
out immunophenotyping of Acute and Chronic Leukaemias at surprisingly low cost in the interest
of poor patients.
Haemostasis Lab deals with coagulation studies including factor assays and platelet function
tests.
Molecular Biology Lab does the mutation detection of beta thalassaemia patients of the institute. It
also successfully runs pre natal diagnostic services for beta thalassaemia.
30
Academic activity
While IHTM is trying to provide state of the art diagnostic and treatment facilities it is not lagging behind
in the academic front. The institute started DM (Clinical Haematology) course in 2006 and was one of
the three recognized centres to run this course (the other two being AIIMS, New Delhi and CMC,
Vellore). The course is run successfully and students qualified from this institute are occupying
important positions in various parts of the country. The DM course originally started with one seat was
later increased to three seats every year. Many of the DM students earned compliments by presenting
research papers in various academic forum in the country and abroad.
Regular academic programs includes seminars, journal clubs, CME The students undergoing
DM(Clinical haematology) course are thoroughly trained in both laboratory and clinical haematology.
IHTM also organizes Dr. Sandhya Ghose Memorial Oration which over the years are addressed by
haematologists of international repute.
The present faculty includes persons who well aclaimed both in and outside the country.
Prof. Utpal Chaudhuri, Director, almost single handed transformed the scenario of haematology in
the Government Hospital in West Bengal.
Prof. Prantar Chakrabarti, a very bright and very active person who are trying to put the institute in
the international field.
Dr. S.S. Ray, Assoiciate Professor, very sincere and academic person.
Dr. Uttam Nath, Assistant Professor, very energetic and devoted haematologiist.
Dr. Arnab Chattopadhyay, Assistant Professor plays the pivotal role in the flow cytometry lab.
Dr. Sambit samanta, Assistant Professor, an upcoming haematologist with good administrative
capabilitiy.
Research activity
IHTM also plays a significant role in the research in Haematology. With funding from various central
agency like DST, DBT, it conducted basic researches on platelets and other fields. The institute can
boast of a number of international and national publication to its credit.
Completed projects
1. “Evaluation of the mechanism
of the synergism between
Purinergic and Adrenergic
receptors and search for
Platelet based markers of
ACS (Acute Coronary
Syndrome”
Funding Agency - Department
of Science & Technology,
Govt. of India
2. "Jai Vigyan Mission" Project on
Community Control of
Thalassaemia Syndromes
Funding Agency - Indian
Council of Medical Research
31
3. Rapid and Economic Sampling of red cell disorder using photodetector aided multipurpose set up
– CP-STIO project
Funding Agency - Department of Science & Technology, Govt. of India
4. Targeted therapy and drug resistance in Multiple Myeloma : a nanotechnology based approach
Funding Agency - Department of Bio-Technology, Govt. of India
Ongoing Project
1 “A study of genotypic characterization of Beta Thalassaemia and the causes of the phenotypic
diversity of haemoglobin E - Beta Thalassaemia in West Bengal”.
Funding Agency - West Bengal State Health & Family Welfare Samiti under State Thalassaemia
Control Program
2. Jeevan Asha Project on quality of care of thalassemics in a center with limited resources
Funding Agency - ONGC Officers' Wives Mahila Samiti
3. Molecular study of Oral Squamous Cell Carcinoma samples with respect to micro RNA,
prevalence of HPV infection and P53 gene expression status and its relevance in determining the
resection margin
Funding Agency - Department of Science & Technology, Govt. of India
In the year 2000, ICMR started its Jai Vigyan Mission Project on Thalassaemia, a multicentric project
and IHTM was one of the centres. Later on with the starting of State Thalassaemia Control Program,
IHTM has become one of the nodal centres for screening of thalassaemia carriers throughout the state
of West Bengal and till date screened about 30000 people. It also monitors activities of another 11
centres entrusted with the job of thalassaemia carrier screening. The thalassaemia Unit consists of
Medical Officers, Counsellors, Medical Technologists and Data Entry Operators. All the data about the
screening program is stored using a software named "Thalamon" though which activities of all the
centres are monitored. The thalassaemia Unit also organises cultural and academic program on 8th
May every year on the occasion of World Thalassaemia day.
32
13
N.R.S. Medical College, Kolkata
Maitreyee Bhattacharyya
Today the haematology department of N.R.S Medical College has made his position in the
haematology map of India. The journey started long back in 1974.
The humble beginning

Wayback in 1974, hematology wing, at N.R.S. Medical College started as a unit under department of
medicine to cater the needs of hematology patients exclusively. It was then housed in a single room
with a very tiny space for laboratory. The unit comprised of a faculty (teacher) trained in hematology,
who was posted under the department of medicine, along with one technician & a group D staff. The
unit in this initial phases was headed by Dr Sandhya Ghose, Dr Manju Duttachaudhuri & Dr M.M.
Rakshit sequentially. A total of ten beds were provided from the department of medicine. Two house
physicians (from the department of medicine) were allotted to the unit. Activities included-outpatient
clinic-twice in a week, indoor admission & attending referred cases. Basic instruments were scanty -
1-2 monocular microscopes, a water bath, few wintrobe & westergren tubes, couple of centrifuge
machines, few bone-marrow aspiration needles. The faculty in-charge of the unit, had to work
overtime single handedly to provide adequate hematology services as well as teaching students. After
about a decade, the unit was provided additional space, better ward facilities and some additional
essential items. In spite of repeated efforts nothing substantial was achieved.
Begining of a new era

Dr. M. K. Ghosh joined the department in mid nineties, he was fortunate enough to visit few established
hematology setups in the country. He got inspired & could realize that to sustain in this speciality, it
needs to transform the existing set-up into a comprehensive hematology department, outside the
prevailing domain of medicine. Dr Ghosh was a post-graduate in medicine with exclusive hematology
training under Prof. Sandhya Ghosh besides training in general medicine. He was also fortunate
enough to be posted as a clinical tutor in the prestigious hematology department of Calcutta School of
Tropical Medicine (first time in the history of hematology in West-Bengal).
Bolstering of the department by younger generation

Dr. Maitreyee Bhattacharya, present head of the department, joined as a clinical tutor in late nineties
when only a post of clinical tutor was sanctioned by the health department. With her intense
involvement, both Dr. Ghosh and Dr. Bhattacharyya embarked upon an intense drive for upgradation
of the hematology service and academic activities. In the beginning of 2000, it was officially declared
an independent department of its own-one dream fulfilled. In 2002 Dr. Maitreyee was selected for D.M
(CLINICAL HEMATOLOGY) in hematology department of AIIMS (New Delhi). Infact she is the first DM
(Clinical Haematology) from the East & North East India. During this time the hematology department
gradually started its journey for induction into the national field. With the initiative of Prof. Ghosh N.R.S.
Medical College became the principal centre for ICMR sponsored multicentric - JAY VIGYAN MISSION
PROJECT for assessing the most recent status of thalassaemia burden in the country. After
33
Dr. Maitreyee, another highly talented boy Dr. Tuphan Kanti Dolai, joined as clinical tutor in the
department. He also got selected at AIIMS- D.M. (clinical hematology).
During this period, the relentless persuasion for the upgradation continued ceaselessly. New posts
were created for professor, associate professor, assistant professor & clinical tutors along with non-
academic Senior Residents.
D.M. course in Clinical Hematology was permitted to start from 2009 and got recognised in 2012 at the
time of the final examination of the first batch. Presently the department has three seats for DM (Clinical
Hematology). Dr M.K. Ghosh retired from the service on 28th February, this year.
Prof. Maitreyee Bhattacharyya took the reins from Dr Ghosh.
Glorious present
The faculty of great pride
Prof. Maitreyee Battacharya, D.M.

Clinical Haematology (AIIMS),
H.O.D.
Dr. Tufan Kanti Dolai, D.M.

Clinical Haematology (AIIMS),
Associate Professor
Dr. Shaymali Dutta, D.M.

Haemato-pathology (AIIMS),
Associate Professor
Dr Rajib De, D. M.

Clinical Haematology. (WBUHS, Kolkata),
Assistant Professor
Dr. Sanjay Misra, M.Sc, PhD,

Biochemist
Dr. Aditi Sen, M. Sc, PhD Molecular

Biologist
Instruments of vital importance

Automated cell counters of various parameters

HPLC machines for thalassaemia diagnosis

Platelet aggregometer

Advanced coagulometer for full coagulation

Serum protein electrophoresis system

-80 centrigrade refrigerator, Blood bank refrigerator

Chemiluminiscence

Semiautoanalysers for departmental biochemistry

Apheresis machine

PCR , gel doc, nanodrop spectra

34
Facilities available
Clinics
Twice a week general OPD, 3 special clinic - Thalassaemia, Haemostasis & Leukemia
52 indoor beds with day care facilities
Laboratoray
All basic haematological investigations
Haemostasis : Coagulation profile, Factor assay, Fibrinogen, Protein C, Protein S, ProC globe,
Lupus anti-coagulant, Platelet aggregation
Leukemia : Cytochemistries, Immunophenotyping
Haemoglobinopathy work up
Serum protein electrophoresis
Iron & Vit B12
Molecular study for thalasseamia mutation
Prenatal diagnostic services for thalassaemia
Achievements
i) D.M. – Clinical Haematology course – students from different parts of India come for training
ii) This department has the unique credit of the first successful BMT venture by a state govt
35
institution. As of now, more than 25 successful BMT (both auto and allogenic) have been carried
out by the department
iii) Nodal centre for the control of thalassaemia in the state
iv) Fully equipped with molecular diagnosis of thalassaemia which is under the charge of a molecular
biologist.
v) International updates : Thalassaemia update in 2011 - attended by Sir David J Weatheral, Nancy
olivieri, Anuj Premawardhena, Suthat Futcheron among others. 2013 international confernce
attended by- Neil Youmg, Antonio palumbo, Anuj Premawardhena besides national stalwarts
Academic schedules
Seminars - weekly
Grand round - weekly
Case presentation (both-clinical & lab) - weekly
Journal club - fortnightly
Comprehensive examinations - at three months interval
Thesis review - at six monthly interval
The department periodically arranges guest lecture by eminent hemologists, both from the country as
well as from abroad. Various projects are undertaken by the faculties sponsored by ICMR, DBT & other
academic funding bodies
We aspire to be a super speciality department of repute with all our endeavours, God willing.
36
14
Tata Medical Centre (TMC), Kolkata
Mayur Parihar, Deepak Mishra, Reena Nair, Mammen Chandy
Tata Medical Center (TMC), Kolkata is a

philanthropic initiative from the House of Tata.
Its mission is to promote Prevention, Early
Diagnosis, Treatment, Rehabilitation, Palliation
and Research for cancer patients.
The Tata Medical Center is a comprehensive
cancer care centre with well-trained
professional staff and equipped with modern
facilities and the most contemporary medical
equipment. The centre provides a wide
spectrum of services from Diagnosis and
Therapy, to Rehabilitation and Palliative
support in cancer. Efforts are on to add STRATEGIC PARTNERSHIPS:
Preventive services in the near future. This
state-of-the-art Hospital has been set up with Tata Memorial Centre, Mumbai
strategic alliance and assistance from the Tata CMC, Vellore
Memorial Centre, Mumbai, which is one of the Duke Cancer Center, US
premier national institutions for cancer
American Cancer Society
prevention, treatment, education and research
with nearly 70 years of experience. British Council
NGO Partners
TMC is a not-for-profit initiative that is aimed
specifically at helping cancer patients from the
East and North East of India and also from the
neighbouring countries like Bangladesh, Bhutan and Nepal. The Hospital, with a capacity of 167 beds,
serves all sections of the Society, with 50% of the infrastructure earmarked for free or subsidized
treatment for the underprivileged sections. The Institution's objective is to excel in service, education
and research. In its 2nd phase it will add another 242 beds to cater to the growing number of patients
visiting the hospital for treatment.
Haemato Oncology Services

The department of Clinical Hematology in TMC is involved in the treatment of malignant blood
disorders (Acute & Chronic Leukemias and Lymphomas), Myeloma and some benign blood
disorders.
TMC possesses a state-of-the-art bone marrow transplant unit with 9 beds, another first for this part of
the country.
This unit has been designed based on international standards, with definitive measures for asepsis
including HEPA filtered air. The unit is capable of autologous and allogeneic transplants, matched
37
unrelated donor transplants, haplo as well as
cord blood transplants. The unit has a separate
area for management of donors and collecting
peripheral blood stem cells. The unit also
boasts of a stem cell cryopreservation
laboratory (-180°C, in vapour phase of liquid
nitrogen).
The Stem Cell Cryopreservation laboratory is
equipped with a Planar Control Rate Freezer
with liquid nitrogen system to aid in stem cell
transplantations. The CHART 800 Series LN2
cryopreservation System with attached two
liquid nitrogen tanks aid in long term storage of
stem cells. The lab is complete with Thermo
Class-II bio-safety cabinet, sterile connecting
device, water baths, electronic balance, heavy HAEMATOLOGY FACULTY::
duty and table-top centrifuges for stem cell
Prof Mammen Chandy
processing and cryo-preservation. The BD
FACS Canto II flow cytometer performs the Prof Vaskar Saha
CD34 enumeration and viability studies for Dr. Reena Nair
stem cell harvests. Dr. Anupam Chakrapani
Bone Marrow Transplant Unit Dr. Arpita Bhattacharya
Dr. Saurav Bhave
Nine transplant beds in the first unit of its kind in
eastern India. Care has been taken to ensure Dr. (Col ) Deepak K Mishra
the most suitable environment for the patient Dr. Mayur Parihar
during his/her immunologically vulnerable Dr. Neeraj Arora
period. The hospital started transplantation in Dr. Sabita Biswas
December 2011 and has performed more than
65 transplants in the last 18 months, primarily
allogeneic. A couple of MUD transplants from
the DKMS Registry, Germany have also been done. The transplant numbers are steadily going up and
the results are comparable to the best centres in the west.
Laboratory Services
The Hospital has state-of-the-art laboratory services compliment the highly superior clinical services,
offering patients the widest range of investigations which include all subspecialties, i.e., Haematology,
Clinical Chemistry including drug assays, Clinical Pathology, Microbiology, Virology, Serology, Tumour
Histopathology & Cytopathology, Molecular Pathology, Cytogenetics and Histo-compatibility.
The Haematology laboratory is completely automated with state-of-the-art equipments. Beckman
Coulter LH780, the fully automated 5–part differential cell counter with auto slide-maker and stainer
38
is the work-horse in this lab.
FELLOWS:
Coagulation is fully automated with IL
Elite PRO analyser. Cytochemical Dr. Sumit Goyal, (BMT)
staining is automated using a Dr. Vishvadeep Khushoo, (Clinical Haematology)
Thermac auto-staining system. There Dr. Damodar Das, (Clinical Haematology)
is an advanced platelet
aggregometer, both for whole blood Dr. Sriram Ravichandran, (Clinical Haematology)
and PRP (Chronolog Model 700) for Dr. Monali Gupta (Haemat-Path)
platelet function defects as well as a Dr. Aroonima Mishra (Haemat-Path)
ROTEM for rotational Dr. Subhosmito Chakravarty (Bio-Chemistry)
thromboelastometry study during Dr. Neelesh Jain (Transfusion Medicine)
prolonged & complicated cancer
surgery. The 3-Laser BD FACS Canto Dr. Supriya Dhar (Transfusion Medicine)
II performs 8 colour flowcytometric Dr. Sonal Dalvi Mitra (Pediatric Hematology
analyses in leukaemia / lymphoma Dr. Ranjan Tiwari (Pediatric Hematology
diagnosis, MRD detection, Dr. Debjani Ghosh
haematopoietic stem cell
enumeration and cell cycle studies.
The Sebia HYDRASIS II automated
electrophoresis platform performs the
haemoglobin & protein
electrophoresis including immuno-
fixation electrophoresis in diagnosis
of plasma cell disorders and
haemoglobinopathies. The
nephelometer from Binding Site
supplements further by doing the FLC
assays and Ig quantifications. Though
a cancer hospital, the lab houses a
BIORAD HPLC system for Hb variant
analysis in thalassaemias /
haemoglobinopathies. In addition the
lab has spectrophotometer for kinetic
red cell enzyme assays (G6PD),
automated ESR equipment and
performs all kinds of special stains
(NAP, Esterases, AP, TRAP etc.)
employed in haematology. Besides
the sophisticated blood and bone
marrow testing, the bone marrow
biopsies have access to all possible
IHC markers. The in-house facilities
for molecular haematology and
cytogenetic tests for hematological
malignancies encompass the entire
diagnostic algorithm.
The Molecular Genetics laboratory is comprehensive equipped with Applied Biosystems 7500
Real Time PCR System, Rotorgene RQ-PCR system, ABI 3500 8-capillary DNA sequencer and
Luminex automated SSOP HLA testing platform. Besides there are 3 thermal cyclers, 8
electrophoresis systems, automated BIORAD gel documentation facility and a Nano-Drop. The
laboratory has a QIACUBE, which fully automates DNA/RNA extraction. Besides this, the
39
laboratory houses all other standard
systems to support molecular diagnostic
work. The lab offers molecular diagnostic
and monitoring facilities in haematological
malignancies (AML, ALL, CML, HCL, etc.)
including post-BMT chimerism analysis.
The HLA lab performs HLA-A, B & DR typing
by low to intermediate resolution SSOP
technique in an automated Luminex
platform. It also does the SSP technique to
cross- validate results & resolve
ambiguities. The molecular lab also
supports the entire spectrum of molecular
virology assays that is so important for a
comprehensive cancer centre including a
busy BMT facility.
The Cytogenetics laboratory is involved in
chromosomal analysis of tumour cells by
both conventional cytogenetics
(karyotyping) and molecular cytogenetics
(Fluroscent in situ hybridization, FISH). An
automated karyotyping system
(MetaSystems GmbH, Germany) along with
Carl Zeiss capturing station is used for
analyzing and reporting the cytogenetic
abnormalities. The laboratory also does stress cytogenetic analysis for chromosomal breakage
syndromes (Fanconi Anemia) that are premalignant conditions and may evolve into leukemias.
Besides it has many other probes applied on tissue sections to diagnose Lymphomas. The
department shall soon be acquiring an automated cytogenetic scanning system of Carl Zeiss with
a digital slide (V-SLIDE) software that should help in automated metaphase scanning, spot
counting, mutlicolour FISH and digital archiving of slides for entire pathology laboratory.
The Biochemistry laboratory offers biochemical diagnostic support through Vitros 5600®
integrated system (J&J); providing routine chemistry, immunoglobulin quantification and special
chemistry tests. Vitros 250 (J&J) serves as the back-up analyzer. Therapeutic Drug Monitoring
(TDM) also uses the Vitros 5600 platform with assays for Methotrexate and Cyclosporine.
Advanced HPLC system from BIORAD allows us to detect various haemoglobin abnormalities and
glycated haemoglobin. Acquisition of a Mass Spectrometer is in the pipeline for TDM and
pharmacokinetic studies.
The Microbiology laboratory aims to
provide a timely, clinically relevant, and
quality assured diagnostic test results in
Bacteriology, Virology, Mycology, and
Parasitology for in-patients, out-patients at
an affordable price. The diagnostic facilities
in the Microbiology laboratory are state-of-
the-art. The department also provides
Environmental Microbiology service, which
is so important in a cancer hospital with
BMT facility. This involves using the
Airborne Particle Counter (Ergo Touch Pro
40
and RCS High Flow Microbial Air Sampler
from Biotest), and doing water microbiology
using the membrane filtration technology
from Millipore.
The Histopathology laboratory provides
comprehensive anatomical pathology
services on Leica fully automated
histopathology workstations, which include
fully automated tissue processing (Leica
Peloris II & ASP), embedding, microtomy,
slide staining and cover-slipping. Immuno-
histochemistry is performed on fully
automated Leica Bondmax / Roche Ventana immunohistochemistry systems and more than 120
IHC markers are available to make comprehensive histopathological diagnosis. The
Cytopathology Laboratory provides a wide range of diagnostic cytology services that include
FNACs, exfoliative and liquid based cytology. Immuno-cytochemistry is employed routinely to
smears, so as IHC on cell-blocks. A Thermac cytospin prepares smears. A fully automated thin-
prep system (Hologic) has been acquired for thin-prep cytology.
The hospital, being an academic medical institution, has all the facilities to perform clinical
autopsies. The reporting room houses a top-end Leica Binocular triple-head microscope along
with a high fidelity camera / 46'' LED Monitor system for teaching, slide seminars and consensus
reporting. The Multi Disciplinary Team board room also has facility of microscope with high fidelity
camera / 46'' LED Monitor system for Multi Disciplinary Team meetings. A digital pathology system
is also in the offing for slide archiving and digital consultations.
Transfusion Medicine
The Department of Transfusion Medicine at TMC offers a comprehensive range of services unique to
the requirements of oncology and hematology. The mission of the department is to save lives of
people who need blood and blood components.
Blood is collected from voluntary and family replacement donors. 800 units of blood, on an average,
are collected every month and its rising. All blood units are tested using a highly sensitive testing
protocol for infection markers to make transfusion safe for all patients. All units are separated into
components, with leucocytes removed for cancer patients. Almost 1500 component units are issued
to patients every month.
TMC has the first 'blood irradiator' in the whole of Eastern India, essential for transfusion in
immunocompromised patients. The department is an integral part of the bone marrow transplant
program where stem cells are collected for autologous and allogenic transplant program by
automated apheresis machines (Cobe
Spectra, Hemonetics).
Robotic machines and bar codes are used for
routine operations to avoid clerical mistakes
and precision performance.
The Department has a unique distinction of
being the first Blood Bank to be accredited by
the NABH (National Accreditation Board for
Hospitals and Healthcare Providers) within the
first year of its operations.
41
Infection Control at Tata Medical Center
The Infection Control system at Tata Medical Center, Kolkata, comprises of
a coordinated set of policies, procedures, strategic goals and operational
initiatives that are planned, administered, delivered and evaluated through
a multi-disciplinary team effort for prevention, surveillance, diagnosis, and
treatment of infections.
Information Technology
The Tata Consultancy Services (TCS) has a legacy of managing healthcare
IT needs of users and addressing their challenges (e.g., rising costs,
improvement in the quality of treatments, patient safety and availability and
collaboration of information). The systems and workflows in Tata Medical
Center are aided by a comprehensive Hospital Management System,
developed by Tata Consultancy Services (TCS), running on a state-of-the-
art IT infrastructure designed and implemented by TCS.
TMC is currently using the
software for all patient records;
outpatient, inpatient and
operation theatre. A team of
software and network
professionals from TCS are
posted at TMC for operational
support as well as new innovative
additions to the HMS. Currently a
software package for Pathology
reporting is being developed for
India with inputs from TMC and
Duke University in the United
States.
EDUCATION AT TATA
MEDICAL CENTER
Currently, there are 2 year
Fellowship Programs in Surgical
Oncology ( GI, GU, Breast,
Gynaecologic, Head & Neck,
Plastic & Reconstructive ),
Clinical Haematology, Bone
Marrow Transplantation, Medical
Oncology, Radiation Oncology,
Pa e d i a t r i c H a e m a t o l o g y /
Education Block
Oncology, Anaesthesiology,
Diagnostic Imaging, Nuclear
Medicine, Onco-Pathology,
Haemato-Pathology, Molecular
Pathology, Cytogenetics, Clinical
Chemistry, Clinical Microbiology
& V i r o l o g y, C l i n i c a l
Pharmacology and Transfusion
Medicine. It will be upgraded to
42
University recognized courses once the Hospital finishes 3 years of operations, as required by MCI.
The Hospital has been recognised for MSc in Oncology Nursing by the West Bengal University of
Health Sciences, the State Government and the Indian Nursing Council (INC). The hospital will soon
induct 5 nursing students for the M.Sc. program.
An Education Block is being planned as part of the Phase II Expansion Plan. This will offer the
infrastructure to conduct multiple education programs.
Collaborations
In keeping with its thrust for excellence, TMC is partnering with many international organizations to
maintain the highest standards of service, education and research.
RESEARCH AT TATA MEDICAL CENTER

The Tata Medical Center is committed to research and development in all aspects of cancer and its
management. Our aim is to develop a solid platform for clinical, laboratory and translational research
in oncology.
The ambit of research at Tata Medical Center will cover phase I/II/II clinical trials as well as laboratory
and technical studies on a wide range of subjects. Collaborative research and developmental
activities with some of the best academic hospitals are planned. A memorandum of understanding
(MoU) has already been signed with Duke University in the United States for collaboration in a wide
range of activities, including clinical research as well as health information technology.
TMC is uniquely equipped for research of the highest standards. The hospital has state of the art
infrastructure in all clinical and laboratory departments. Clinical information storage and flow is entirely
electronic, with excellent search and retrieval facilities. The faculty has an excellent academic
background and research experience. A large fellowship program has been initiated in all
departments to foster new research and developmental activities under faculty supervision.
In our endeavour to win the battle over cancer we have invested heavily in research and development.
Whilst clinical research is currently active in our centre, we would like to establish the translational
research facilities at the earliest. The hospital close to its current location is setting up the Tata
Translational Cancer Research Centre (TTCRC).
The Mission Statement for the TTCRC will be that the TATA Translational Cancer Research Centre in
Kolkata will create a vibrant interactive environment for clinicians, scientists and industry to work
together to deliver a better future for cancer patients in India. Our aim is to integrate scientific enquiry
into routine clinical practice; bridging the translational gap between inquiry, investigation and
application for patients with cancer.
All this cannot be done within the
working structure of a busy hospital.
Thus the TATA Translational Cancer
Research Centre (TTCRC) has been
created to act as the research and
implementation arm of the TATA
Medical Centre. It is important to
appreciate that this centre will serve not
only TMC/TTCRC but Kolkata in the first
instance, spreading out to the North
East in due course.
43
University Subject
Duke University, USA Radiation Oncology, Molecular Genetics,

Palliative Care, Nursing, Information Technology
King's College London, UK Nursing Education
Manchester University, UK Medical Technologist Training
Medical Research Council, UK Epidemiology
Christie Hospital Manchester, UK Radiation Oncology, Laboratories, Translational
Research
INDOX Cancer Research Network, UK Anti Cancer Therapeutics
International Nosocomial Infection Control Infection Monitoring
Consortium (INICC)
Tata International Social Entrepreneurship Economic and Social Studies
Scheme (Tata ISES)
44
15
Sanjay Gandhi Post-Graduate Institute of
Medical Sciences (SGPGIMS), Lucknow
Soniya Nityanand
After the initiation of clinical services in SGPGI in 1988, hematology patients were initially managed in
the Department of Immunology and under the Headship of Prof SS Agarwal, the Dept. developed two
major streams- autoimmunity and immune malignancies (hematological malignancies). Further, Prof
SS Agarwal after visiting the BMT Unit of the Fred Hutchinson Cancer Centre at Seattle, USA, for 3
months, got approvals from the Institute and the State Govt. for establishing a BMT unit at SGPGIMS.
When Dr Soniya Nityanand, joined as an Assistant Prof in Immunology in 1993, she was deputed for
the Hematology patient care services and for teaching/training in hematology. She was also deputed
to develop the BMT Program at the Institute. Later when Dr Sunil Dabadghao, joined as an Asst Prof in
the Dept of Immunology in 1998, he was Took care of hematology patients, till he left in 2002. Over the
years there was a consistent increase in the number of hematological patients being treated in the
Dept of Immunology and in the year 1999 a Bone Marrow/Hematopoietic Stem Cell Transplantation
(BMT/HSCT) program was successfully established by Dr Soniya Nityanand. Noting this significant
increase in the hematology and BMT/HSCT patients, the Institute decided to have a separate Dept. of
Hematology which was established in 2003 with Dr Soniya Nityanand as its head and is a composite
Dept. with both clinical and laboratory components. It was the first Dept. of Hematology to have been
established in the State of U.P. and is the only centre in UP performing BMTs.
Faculty of the Dept

Dr. Soniya Nityanand, Prof. & Head (Clinical Hematology/BMT): from 2003 till date
Dr. Rajesh Kashyap, Addl. Prof. (Clinical Hematology): from 2003 till date
Dr. Ritu Gupta, Asst. Prof. (Lab Hematology): from 2003-2005
Dr. Shawji Sukumuran, Asst Prof (Clinical Hematology/BMT): from 2003-2004
Dr. Ruchi Gupta, Asstt Prof (Lab Hematology): from 2011 till date
Dr. Khaliqur Rahman, Asst Prof (Lab Hematology): from 2013 till date
Stem Cell Research Scientists

Dr. Naresh Tripathy: from 2005 till date
Dr. Sachin Jadhav: from 2005 till date
Dr. Leena Rastogi: from 2012 till date
Dr. Yamunna Mohanram: from 2012 till date
Dr. Ramalingaswami Fellow:
Dr. Chandra Chaturvedi: from Oct 3, 2013
45
Department Facilities
A. Clinical Facilities
Ward: 24 general beds, 05 Private Rooms
Pre-BMT/Hematology ICU: 07 beds, for management of patients with severe neutropenic
complications, induction phase of acute myeloid leukemia, as a step-up and step-down unit for
BMT/HSCT patients
BMT: 02 beds
OPD: Consultation Rooms, Procedure Room, and an OPD chemotherapy room
Stem Cell Harvesting Facility: 02 apheresis machines (Spectra Optia Apheresis System,
Caridian BCT, USA)
B. Laboratories
Advanced Flow Cytometry and Sorting
Lab
Bone Marrow/Hematopoietic Stem Cell
Transplantation (HSCT) Lab
Drug Assay & Coagulation Lab
Platelet Aggregation Studies Lab
Molecular Hematology Lab
Morphology Lab
Myeloma Lab
C. Stem Cell Research Facility (SCRF)
The SCRF has Culture Labs for normoxic and hypoxic culture of stem cells, Stem Cell Biology Lab,
Molecular Biology Lab. In addition the SCRF has the following unique facilities.
Current Good Manufacturing Practice (cGMP) Facility:
This facility has been established under a Program Support Project, entitled “Mesenchymal stem cell
therapy in myocardial infarction, stroke, renal failure and diabetes”, funded by DBT, Govt. of India, New
Department staff
46
Delhi (PI: Dr Soniya Nityanand). This facility is meant for generation/processing of stem cells for
clinical trials and therapy.
Small Animal Imaging Facility (SAIF):
The Small Animal Imaging Facility (SAIF) presently has a small animal SPECT/CT (Bioscan, USA),
procured from an Indo-Denmark bilateral collaborative research project funded by DBT, Govt of India,
New Delhi (PI: Dr. Soniya
Nityanand). This is the
second small animal SPECT-
CT equipment in the country
and is open for use to all
scientists of the country.
Teaching Program
The Dept runs
i) MCI recognized DM
Hematology course
ii) MCI registered
PDCC course in
Hemato-Oncology
iii) PhD Program
Research
Since its inception, the Dept. is deeply engaged in basic and translational research work. The areas of
research interest of the faculty are as follows:
Dr Soniya Nityanand
Stem Cell Research and Therapy: (i) Basic biology and therapeutic applications of human
mesenchymal stem cells (MSC), with special interest in fetal MSC from different sources; (ii)
Cardiovascular and renal regenerative potential of different populations of MSC in pre-clinical
animal models using animal CT-SPECT and 2-D ECHO; (iii) Clinical trials with mesenchymal stem
cells and bone marrow stem cells; (iv) Biology and characterization of human bone marrow
derived multipotent adult progenitor cells (MAPC).
Aplastic anemia: Immunopathogenesis and newer therapeutic strategies.
Biology and epigenetics of Acute Lymphoblastic Leukemia in India.
Immune mechanisms in Takayasu's arteritis
Dr Rajesh Kashyap
Clinical presentation and management of Extra-nodal lymphomas
Dr Ruchi Gupta
Multiparametric Flow Cytometry in MDS, immunophenotyping of acute leukemias and chronic
lymphophroliferative disorders in peripheral blood, bone marrow, body fluids and fine needle
aspiration samples.
Platelet aggregation studies.
Dr Kaliqur Rahman
Molecular analysis of CML
47
Awards and Honors
Dr Soniya Nityanand
2009 - Prof. SR Naik Award, for Outstanding Research Investigator, SGPGIMS, Lucknow
2009 - Fellowship of the Indian Academy of Sciences, Bangalore. India
2006 - Fellowship of the National Academy of Sciences, Allahabad, India
2005 - Rajib Goel Young Scientist Award, Kurukshetra University, Kurukshetra
2004 - Pratima & Sucharu Stree Shakti Award for the Best Woman Scientist of the Year
2003 - DBT National Biosciences Career Award, New Delhi
Dr Rajesh Kashyap
2013 - Member of National Academy of Medical Sciences, India
Sister Madhuri Smith, Specialist Nurse, Bone Marrow Transplantation
2011 - National Florence Nightingale Nurses Award
Dr Sunil Chauhan, PhD student
2006 - Prof SS Agarwal award for excellence in research, SGPGIMS, Lucknow
Future Plans
The Dept. plans to expand its faculty strength, which is a burning need of the Dept. The new building of
the Dept. is near completion. It has 02 Blocks- the Academic Block and the Clinical Block. The
Academic Block which consists of Offices, Labs and Teaching Facilities, is currently being handed
over. The Clinical Block consisting of OPD day, day care ward, in patients-ward and a 10-bed BMT Unit
will be handed over in the next few months. Once the new BMT ward is functional, the Dept. will start a
01 year post-doctoral Fellowship in Bone Marrow Transplantation.
A new building of Stem Cell research Center with a (i) cGMP facility having 04 productions suites, (ii) In
vitro stem cell research labs, (iii) Cryo-facility, is near completion. In this Centre, clinician-scientists and
basic research scientists will closely work together in stem cell research and therapy. The Centre also
plans to run MD/PhD and MSc/PhD programs in stem cell research and therapy.
48
16
Christian Medical College, Ludhiana
Clinical Haematology,
Haemato-Oncology & Bone Marrow (Stem cell) Transplant services
M Joseph John and Naveen Kakkar
'The Past, Present and Future’
A brief look into our history: (The past)

Christian Medical College, Ludhiana was established in the year 1894 by Dame Edith Mary Brown and
this year we are celebrating 119 years of service to the nation. It is a non-profit organization which
envisions providing quality medical care from primary to tertiary level in India, with an emphasis on
serving the needy and downtrodden. Health outreach in the country is done by training of medical
personnel specifically to reach out to needy areas of the country after graduation and post-graduation.
The college was upgraded to MBBS course in 1953 and more than 2500 MBBS students have
graduated from the portals of this institution and many of these graduates and post graduates are
working in some of the most backward areas of India. At the same time others have moved on to
research and have pioneered innovation and quality health care across the world.
The institution has grown over the years into 700 bed multispecialty, tertiary health care center. It has
pioneered as well as developed many initiatives in the field of medicine and has had a major
contribution to health care particularly in North India, as a major referral center.
Haematology-Oncology services
The pioneering and legendary work on Clinical Hematology was started by Dr. Betty Cowan a Scottish
Physician, in the 1960's. She established assays for vitamin B12 and folate in the Medical Research
laboratory in the days when this was done by a very labor intensive method using the growth of
lactobacillus bacteria and her work is internationally recognized which earned her MBE (Member of
British Empire). The pioneering Medical Oncology and Hemato-Oncology work was started by Dr Alex
Zachariah since the 70s (As recorded with International Union against Cancer Directory). Dr. William
Robinson MD spent a year with in CMC in 1970s to help develop the Medical Oncology Unit. Dr. Sewa
Legha MD has been helping CMC in medical oncology and Haem-Onc since 1974 while he was with
National Cancer Institute in USA and ever since he has been giving his time and talent to help CMCL in
Medical Oncology.
Dr. Edward B Crowell MD did excellent Clinical Hematology work during 1976-1990 and treated
patients with leukaemia, lymphoma and myeloma. His wife Dr Susan Crowell, took over the medical
research laboratory and established chromatographic assay for haemoglobin, G6PD assay and tests
to support multiple myeloma evaluation and treatment. Dr. Anna Mani continued his excellent work in
Clinical Haematology and did initial work on Haemophilia in Punjab. Dr. Reginald Britt came from UK
several times in the 70s right up till 2006 and helped in the Clinical Hematology work and laboratory up
gradation. For his work in India, he was awarded the MBE.
Current work: (The present)

Christian Medical College, Ludhiana (CMCL) established a dedicated Clinical Haematology,
49
Haemato-Oncology and Bone Marrow Transplant Unit in Punjab in 2007. Bone Marrow (Stem Cell)
Transplant programme was started in October 2008 and subsequently CMCL has done 57 transplants
till now. (45 allogeneic and 12 autologous transplants) over the last 5 years for various haematological
conditions like, aplastic anemia, multiple myeloma, acute lymphoblastic leukemia, chronic myeloid
leukemia and genetic diseases like thalassaemia and Wiskott Aldrich syndrome (WAS). However, the
major area of focus remains thalassaemia transplants.
Vision statement of our unit
To meet the haematological, oncological and stem cell transplant needs of patients through ethical
high quality patient care by constant innovation towards premium personalized patient care and
specialized training of the health professionals.
Mission statement of our unit
To create an outstanding Department of Clinical Haematology, Haemato-oncology & Bone Marrow
(Stem cell) Transplant Unit, which is worthy of the healing ministry of Christ. This we will do through
service, education and training, with the aim of producing professionally excellent, ethically sound
individuals who will go out as servant leaders of health teams and healing communities.
Motto of our unit
“Quality, Competency and Research”
Major focus of services at present
1. Diagnosis and treatment of benign and malignant haematological diseases.
2. Bone Marrow (Stem cell) Transplantation services of haematological diseases (benign and
malignant).
Staff pattern and table of organization
Clinical Wing Laboratory wing
Clinical Haematology and Medical Oncology Unit Special Tests Lab in-charge
Bone Marrow Transplant Unit Professor in pathology
Associate Professor & Head Assistant Professor & Head
Lab technicians
Assistant Professors Assistant Professor*
Medical officers Medical officers*
Physician assistants Physician assistant*
Ward 6 Oncology nurses BMT unit nurses Day Care nurses
Office secretary and clerks Clinical Trial co-ordinator
BMT co-ordinator Ancillary staff, helpers, sanitation workers
50
3. Stem cell transplantation for thalassaemia.
4. Haemophilia care.
Facilities available related to haematology, oncology and stem cell transplant services
1. Full-fledged blood bank
2. Dedicated irradiator for blood and platelets.
3. Comprehensive laboratory support from biochemistry, haemato-pathology and microbiology
4. Special tests laboratory for coagulation work and stem cell analysis
5. Stem cell cryopreservation facility
6. Haematology - Oncology ward
7. Day care center
8. Bone marrow transplant unit (with HEPA filter) - 5 bedded
Training programmes:
1. Haematology-Oncology and stem cell transplant Physician assistant/technician course. (Recently
accredited by Baba Farid University of Health Sciences)
Collaborative work:
1. Haemophilia twinning programme with Henry Ford Hospital through the World Federation of
Haemophilia.
2. Center of Excellence in Comprehensive hemophilia care
Developments over the last few years

1. New 5 bedded Bone Marrow Transplantation Unit: Recently opened, this would be meet need to
conduct multiple bone marrow transplants at a given time and reduce the waiting periods for
transplant.
2. Day care unit: Inaugurated in 2102, this has provided more space and improved significantly the
care given to patients who come to haematology and oncology units.
3. Matched Unrelated Donor (MUD) Stem cell transplant: (MUD) transplant is now being extended to
patients with thalassaemia apart from leukemia patients.
Our new BMT unit – 5 bedded
51
Our new Day Care center
4. Centre of Excellence (COE) in Haemophilia care: Clinical Haematology Unit started the first
comprehensive haemophilia care centre in this part of the country with a multi-disciplinary
approach. We have also signed a memorandum of understanding with Baxter India Private,
Limited for the COE. As part of this collaboration, we have organized training workshops for
doctors and technicians to disseminate information regarding hemophilia diagnosis and training.
5. World Federation of Haemophilia (WFH) Twinning Programme with Henry Ford Hospital, Detroit:
CMC, Ludhiana has tied up with Henry Ford hospital, Detroit, USA as part of the twinning
programme through the World Federation of Haemophilia. We have been able to streamline many
aspects of haemophilia care and improve our existing facilities. We have also been able to
conduct workshops for doctors as well as patients. We have become a referral centre for
hemophilia care in Northern India for a population of 40 million.
6. Haemophilia Clinic: Started a comprehensive haemophilia clinic from May 2012 as part
comprehensive haemophilia programme to provide appropriate care for patients with
haemophilia who are suffering from joint problems. Specialists from 8 different units come
together to discuss and make the treatment plans for patients with joint problems. Every 2nd
Wednesday, Haemophilia meetings are attended by four to five patients.
7. SIR RATAN TATA TRUST support of transplant patients: Under the Individual grants programme,
for patients undergoing bone marrow transplant at Christian Medical College, Ludhiana, Sir Ratan
Tata Trust has been supporting us for the last 3 years. The existing grant has been extended for the
next 3 years till 2016.
Further plans (The future)

1. Molecular laboratory to support the haematology/oncology and stem cell transplant services.
2. To work towards establishing DM/Fellowship programmes by the year 2014 – 15.
3. Further training for laboratory technicians (BSc MLT/MSc/PhD)
4. To develop a dedicated research wing to support and initiate active research in the unit.
5. Capacity development: empowerment of Physician assistants and nurses by training and
workshops to take on specific areas of independent responsibilities.
6. To establish a state of the art primary immunodeficiency evaluation laboratory.
7. Establish outreach programmes for thalassaemia, haemophilia and haematological
malignancies. Awareness activities towards thalassaemia transplants.
52
8. To work towards definite data base management systems in place for audit, analysis and future
research.
Summary
We have been blessed to have many people who paved the way over the years to help us reach till
now. The goal of our team is “Quality, Competency and Research”. We firmly believe that with the God
almighty at the helm of affairs and a spirited team, CMC Ludhiana will be able to fulfill the vision of
providing excellent care for the people of India.
Our team:
“Coming together is the beginning,
staying together is progress, working
together is success” - Henry Ford
53
17
B. J. Wadia Hospital for Children, Mumbai
Department of Pediatric Hematology & Oncology
Bharat Agarwal
The Department of Pediatric Hematology & Oncology (DPHO) has been rendering its services for
outpatients, ambulatory and indoor care of children with blood disorders and cancer since 1984.
Dr. Zinet Currimbhoy started this service with a vision and zeal that inspires us even today. She was the
driving force for the growth and expansion of the unit from 1984 until 1996 when Dr. Rashmi Dalvi took
over as the head of this program until 2001. Dr. Bharat Agarwal has been leading the unit since 2001
until date. The department has witnessed an exponential growth over the years, and today our staff &
service have a good standing not only with the patients but also the fraternity.
The beginnings
In 1984, Dr. Currimbhoy started using the pathology laboratory as the base for all hematology /
oncology activities. She believed in the adage “Hematology / Oncology consultation is incomplete
without a thorough clinical examination of the patient and the review of his / her peripheral blood
smear”. Hence she had to establish herself next to the microscope that was available only in the
pathology laboratory. During this period, hematology consultations were not many; and all oncology
patients were referred to Tata Hospital. Today we have more than 1500 new referrals each year; of
these more than 100 new cases are for pediatric oncology. Dr. Sunil Abhyankar joined the DPHO as
the “first part time fellow” in 1984. He is now a very Senior Bone Marrow Transplant (BMT) Consultant
in the U.S.
In 1986 a section of the pathology laboratory : the far end corridor was cordoned to create the physical
space for DPHO. We had a small procedure room attached for out patient interventions. The number
of patients / referrals kept rising and we had to move to a much bigger space on the first floor. Half of
the ward 13 with its side room was allocated to DPHO in 1992-93. We created a 'state of the art'
department with 3 consulting rooms, a specialized hematology laboratory, a well equipped procedure
room and a twelve bed “Day Care Service” unit. This was one of its kind in the whole country in that era.
We were very proud of the new setup ! We have never looked back since then….
The aim of department is to provide
holistic care to children who have
debilitating illness in the prime of
their life.
The department receives
around 1,500 new patients in
OPD and 5000 patients come
for follow-up/treatment thus
making around 7,000 OPD
references in a year
B J Wadia Hospital for Children
54
Day care attendance of about 3,000 on yearly basis for procedures like transfusion, chemotherapy,
bone marrow aspiration and blood sampling
In-door admissions are about 1,000 per year
The department receives patients from various off-site locations across the country for expert
opinion and treatment
The centre is affiliation by National Board and IAP for training and teaching post graduate students
and fellows in this specialised field. Over the years, the department has produced highly
competent and experienced professionals
The department includes seasoned physicians working as honorary consultants and staff
Department Structure
Honarary Faculty
1. Dr. Bharat Agarwal,
Head of the Department
2. Dr. Mukesh Desai,
Hon. Consultant and
Immunology In-charge
3. Dr. Nitin Shah, Hon.
Consultant and Hematology
In-charge
4. Dr. Archana Swami, Hon.
Consultant and Oncology
In-charge
5. Dr Sangeeta Mudaliar, Hon.
Project officer
The Honarary Doctors are
supported by a dedicated Department of Pediatric Hematology & Oncology,
Support Team. All members of the Division of Immunology
Wadia Hospital PCU work together
in order to provide treatment, care
and support for children with
cancer and their families.
Out Patient Services

New Patients : Everyday at 9.00 a.m.
Hematology / Oncology Follow up OPD : Tuesday & Friday 9.00 a.m. onwards
Thalassemia Transfusion OPD : Mon, Wed, Thurs, Sat 9.00 am onwards
Thalassemia Followup OPD : Monday, Wednesday, Thursday, Saturday
9.00 a.m. onwards
Long term follow up of cancer : Friday at 11.00 a.m.
Out patient service is open from 8 a.m. to 5 p.m. every day (Monday to Saturday). Particularly we have
2 large follow up OPDs, on Tuesday and Friday morning, while emergencies are received at any
time.
55
On a busy outpatient day !!!!
Post Doctoral Fellowship training : PHO
56
Day Care Ward
Ambulatory care is provided between 8 a.m. to 5 p.m. Monday to Saturday in a 12 bedded facility. In
this Day Care Service ward the thalassemia and oncology patients receive blood transfusion, the
oncology patients receive intrathecal and infusion chemotherapy, the hemophiliacs receive factor
replacement etc. A number of investigations and therapeutic procedures are also carried out in the
procedure room.
In-Patient Service
Indoor patients from medical and surgical units and intensive care areas are opined on and managed
by the department in various wards on a daily basis. On an average 15-25 such indoor patients are
directly under the care of this unit at any given time. These patients require specialized hematological
investigations, procedures and therapy (chemotherapy) which is carried out in the ambulatory care
facility. Since 2007 a separate 10 beds indoor unit was created exclusively for pediatric oncology
inpatients.
Hematology Laboratory
The department runs a specialized hematology laboratory where the following investigations are
done: CBC, Hemolytic anemia profile, coagulation profile, bone marrow aspiration and biopsy,
cytochemical stains etc.
Oncology nursing
Administration of chemotherapy is a very specialised service. The daily activities of the department
are managed by our Oncology nurse. She is the backbone of our Day Care Service. Our nurses are
also encouraged to present papers in international conferences to highlight the work done by them.
Academic Activities
The Department of Pediatric Hematology & Oncology has initiated a “Post doctoral fellowship”
training program of 2 years in Pediatric Hematology and Oncology at B.J. Wadia Children's Hospital in
February 2007, under the auspices of National Board of Examination, Delhi (www.natboard.nic.in).
This is one of the first centre in the country to start this course. The first two students for this course
were selected by merit on the basis of a National level entrance examination conducted by National
Board of Examination, Delhi. The first batch of successful specialists in Pediatric Hematology and
Oncology has passed in April 2009 (Dr. Priti Mehta & Dr. Nirav Buch). Two new students were enrolled
in 2009 (Dr. Priyanka Sharma & Dr. Purvi Kadakia) & 2010 (Dr. Pinky Shah & Dr. Asruti Kaccha). Regular
academic sessions are conducted for this fellowship course with additional sessions for preparing the
candidates for their exit exams.
Collaboration with Jiv Daya Foundation & Cankids
In January 2010 the Trustees of JDF visited the department & proposed to financially support our unit
with the salaries of 6 staff members. Two oncology fellows, two oncology nurses & two social workers
have joined the department under the collaboration with JDF /Cankids. This has been a major boost
to the level of services provided by our department. The social workers dedicated to the unit have
been a great asset in providing the much required psycosocial support to our patients and their
families.
Improvement in Treatment Statistics
Percentage of Children abandoning treatment: Overall Survival Rate:
2009: 37% (25/68) 2009: 43%
2010: 25% (23/91) 2010: 47%
2011: 14% (12/84) 2011: 62%
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18
KEM hospital, Mumbai
Dr. J.C. Patel Hematology Department
Farah Jijina, Chandrakala S
The Dr. J.C. Patel Hematology Department is one of the biggest hematology departments in Mumbai.
It provides hemato-oncology services to patients referred to the KEM Hospital. Diagnostic and
therapeutic procedures are performed on patients suffering from various hematological disorders
such as anemia, leukemia, lymphomas, myelomas, bleeding disorders etc.
The center is affiliated to the Hemophilia Society of Mumbai, and caters to the therapeutic needs of
about 650 hemophilia patients in and around Mumbai. The Department has many collaborative
research projects in the field of hemophilia, hemoglobinopathies, thrombophilia, myelodysplasia etc
with the National Institute of Immunohaematology (ICMR). There is also a regular exchange of ideas
and experiences with the Tata Memorial Hospital.
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 Hematology. 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 many of the laboratory tests necessary for diagnosis of
various hematological disorders that were encountered in practice. Data of the hematological cases
seen over a period of ten years was compiled, analyzed and presented to the administration with a
suggestion that the Municipal Corporation should start a hematology department. The MCGB was
thus persuaded to start a hematology department and appointed a Hon Asst Hematologist.
Gradually, with the help of a generous donation of Rs.600, 000.00 from Dr. J C Patel, grants and
assistance from BARC and ICMR, the diagnostic and therapeutic range for various hematological
diseases was expanded. These resulted in reference of cases from various hospitals in the city as well
as from all over the country.
Since its inception, 5-15 scientific papers were published in Indian and international journals over the
next 25 years. Several monograms were published. The Department organized several national and
international conferences and staff members of the department held important offices in various
national and international societies as well as in WHO advisory committee. Several postgraduate
students (in general medicine and pediatrics) carried out work on various hematological topics in the
department to write their dissertations. Staff members of the department received various prestigious
awards and orations from various national societies and institutions. Staff members of the department
acted as editor, sectional editor, referee and judge for medical journals and textbooks, and also
contributed chapters to books of the stature of Oxford Textbook of Medicine.
The department was named after Dr. J C Patel, in view of his immense contribution to the field of
Hematology in 1977. The department was headed by one of our prominent hematologists of Mumbai
Dr B C Mehta till his retirement in 1991.
In 2001, The Medical Council of India (MCI) gave permission to start DM Clinical Hematology. The
teachers appointed for the super specialty course were Dr Dipika Mohanty, Dr K Ghosh and Dr Farah
Jijina. This was and still is the only center in Maharashtra to have a DM Clinical Hematology. The first
batches of students were admitted from 2002.
58
Subsequently, the MCI recognized our DM Clinical Hematology course in 2012, with full retrospective
effect. To date, fourteen students have completed their DM degree from our department and
practicing Hematology in India and other countries.
In a year, we see about 4000 - 4500 patients on an outpatient basis and about 1000 - 1500 in hospital
patients. We also run a specialized laboratory where about 7000 samples are processed annually. Our
Department works in close collaboration with the National Institute of Immuno Hematology where
majority of the specialized investigations including molecular research is done, at very economical
rates. This ensures that patients are well worked up, without incurring crippling expenses.
The Comprehensive Hemophilia Care Centre has been started in the department from 1993 where
hemophilia patients from all over the country are managed. The center is also recognized by WHF as
an international hemophilia training center. The ward is attended by qualified personnel from the
occupational therapy and orthopedic departments, to ensure complete care of all major problems of
Hemophilia under one roof.
A number of complicated cases of hemophilia are taken care of in the ward, including referrals from
other hospitals and states from all over the country. This Department has been a Centre of Excellence
for hemophilia care.
The first autologous bone marrow transplant was successfully done in a multiple myeloma patient in
2013.
Departmental Services
The Dr. J C Patel Hematology Department provides the following services at the KEM Hospital for all
hematology related disorders:
1. Indoor and outdoor patients' services
2. Referral call services for all the departments.
3. Bone Marrow Aspiration and biopsy.
4. Comprehensive Hemophilia Care.
5. Hemato-oncological malignancies: Diagnostic and therapeutic.
6. Hematological emergencies: Diagnostic and therapeutic.
7. Hematological laboratory services: Diagnostic.
8. Hemostatic laboratory services: Diagnostic
Our Patient Department Service
The outpatient department service is provided twice a week to old and new patients. All interesting
cases and patients with a hematological diagnosis are systematically examined and investigated;
separate proforma files are prepared which give complete details of examination and investigations
and are maintained in the department for future follow-up and reference.
Day - care services
All patients with thalassemia and transfusion dependent anemias are given transfusions on a day care
basis. Bleeding disorders like hemophilia and vWD are treated regularly with factor and component
therapy. Patients requiring chemotherapy for malignancies are likewise treated in the day care.
Indoor Patients Service
Indoor patient service is provided around the clock to patients suffering from hematological disorders,
both benign and malignant, such as megaloblastic anemia, myelodysplastic syndrome, leukemias,
multiple myeloma etc that require inpatient management.
59
Intensive / Emergency Hematology Services
Serious patients with bleeding manifestations such as hemophilia, bleeding disorders, acute
leukemia's etc are admitted round the clock for their diagnosis and management. The hematological
laboratory provides the backing for handling these emergency cases.
Faculty members:
Dr. Farah Jijina M.D
Honorary Professor
Dr. Chandrakala.S. M.D., D.M
Fellowship in Leukemia and BMT
Assoc. Professor
Just another day in our ward !!!
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19
Lokmanya Tilak Municipal Medical College &
General Hospital
Division of Pediatric Hematology
Department of Pediartics
Mamta Manglani
The Division of Pediatric Hematology-Oncology was established in the year 1976 by Dr. M. R.
Lokeshwar, then Honorary Asst Professor of pediatrics due to his passion for the subject. Dr. Mamta
Manglani joined him in the year 1987. This was the first of its kind in the city of Mumbai in a municipal
medical college affiliated hospital.
Presently, we are a unit with Professor and Head, and an Assistant Professor, fellows and resident
doctors. We also have staff appointed through collaboration with the Jiv Daya Foundation, Dallas,
Texas, USA. This includes 4 staff nurses, one field worker, one data manger and a social worker
besides a staff nurse through Municipal Corporation, for looking after indoor patients and, one staff
nurse to look after Thalassemia Day Care Centre.
The Division caters to patient care (outdoor and indoor), teaching and research. The unit consists of a
15 bedded ward with 5 isolation cubicles (centrally air conditioned) for high risk oncology patients.
Besides, we have a pediatric intensive care unit, where any of the children requiring intensive
management are transferred and managed. We are in the process of establishing a new state-of-the-
art ward for children with hematologic and oncologic disorders with help from a donor. This will be a 15
bedded ward with the latest equipment and 2 beds for stem cell transplantation likely to be installed in
June 2014.
The Pediatric Hematology-Oncology OPDs run on every Tuesday and Friday with almost 3000 to 4000
patients per year. There are about 80 to 100 new Oncology patients registered per year and about 750
to 800 new Hematology patients registered every year. The palliative care OPD is held on Tuesdays
The Hematology-Oncology Ward Pediatric Oncology Cubicles with Isolation
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and Thursdays in the Pediatric OPD complex. This is managed by volunteers along with one of the
Assistant Professors in the department and resident doctors.
There is a centrally air-conditioned laboratory under the department which performs various tests
including complete blood counts with five part differential (on a particle cell counter), reticulocyte
counts, sickling, ESR, bleeding profile including PT, PTT, TT, plasma fibrinogen, Factor XIII assay,
HPLC on Variant II for hemoglobinopathies, serum iron studies, DCT, ICT, qualitative G6PD estimation
etc. Peripheral blood smears and bone marrow aspirate smears are reported by the resident doctors
and fellows and are confirmed by faculty. We are in the process of procuring flowcytometer for
oncology patients and for stem cell transplant.
The Thalassemia Day Care Centre has now been upgraded to a state-of-the-art centre with 15 recliner
chairs and 8 beds and can cater to 23 to 25 patients daily and 280-300 patients monthly. We also
extend our expertise to all Thalassemia Day Care Centres in the vicinity in and around Mumbai. We
conduct mentoring workshops for staff of these day care centres as well as for patients and parents
from time to time. We conduct annual check-up for every thalassemic registered at our centre. This
includes evaluation for bone disease, cardiac iron overload by an MRI, endocrine evaluation done by a
visiting endocrinologist in the OPD.
Thalassemia Day Care Centre with 15 Recliners

We now run one year post
doctoral Fellowship courses in
Pediatric Hematology–Oncology
(post MD/DNB/DCH) under
Maharashtra University of Health
Sciences. Till date, 6 students
have availed of these courses
and have been awarded the
Fellowship.
The Department has organized
various local, regional, national
and international conferences,
workshops and seminars. The
faculty and postgraduate
students participate in various
national and international
conferences and CMEs.
Some of the research activities
undertaken in the division include
the following:
1. NESTROFT (Naked Eye
Single Tube Red Cell Osmotic
Fragility Test) as a screening
test for beta-thalassemia trait
in population.
2. Effect of L-Carnitine in
multiply transfused
thalassemic children.
3. Psychological impact in
children with thalassemia
major. The New Thalassemia Day Care Centre with 8 beds
62
4. Prevalence of lead poisoning in children.
5. CD4, CD8 and Immunoglobulin levels in multi-transfused thalassemic patients.
6. Prevalence of Vitamin C deficiency in multi-transfused thalssemic patients.
7. Antenatal screening of mothers and their spouses for thalassemia minor and prevention of births
of thalassemia major children.
8. SIPPET International multicentric trial on “(Inhibitor Development in Previously Untreated Patients
(PUPs) or Minimally Blood Component-Treated Patients (MBCTPs) when Exposed to plasma-
derived von Willebrand Factor-Containing Factor VIII (VWF/FVIII) Concentrates and to
Recombinant Factor VIII (rFVIII) Concentrates: An Independent, International,
Multicentre,Prospective, Controlled, Randomised, Open Label, Clinical Trial.
63
20
National Institute of Immunohaematology, Mumbai
A Mecca for Haematologists and Transfusion Experts in India
K Ghosh
National Institute of
Immunohaematology is an unique
Institute in India dedicated to
research and service in
Haematology and Transfusion
Medicine. This Institute originally
started as the Blood Group
Reference Centre (BGRC) of ICMR
in 1957 with the mandate of
developing transfusion medicine
research and human resource
development in Transfusion
Medicine. However, during the last
56 years under the able guidance
of Dr.H.M.Bhatia, Dr.S.V.Apte,
D r. D i p i k a M o h a n t y a n d
Dr.K.Ghosh, the Institute has
developed into a leading centre for
Haematology and Transfusion Medicine service in the country.
In one of the scientometric publications, the Institute has been rated as one of the top Institutes with
highest research output for Research in Genetic Haematology Disorders. (Gupta BM, Journal of
Blood Disorders and Transfusion, 2012;4:3) In addition to transfusion medicine,
haemoglobinopathies, red cell enzymopathies and membranopathies, cytogenetics and molecular
genetics of hematological disorders, cellular and experimental immunology, pediatric immunology
and immunodeficiencies, thrombosis and hemostasis, haemato - virology, HLA and transfusion
transmitted viral infections, are some of the areas of service, research and human resource
development. The centre has been a support not only to all the government and municipal medical
colleges in and across Mumbai metropolis, but hospitals like Tata Memorial Hospital and many other
corporate and government hospitals in Mumbai and the rest of India also regularly take advantage of
the services provided by the Institution.
This centre is a WHO recognized Blood Group Testing Laboratory, International Hemophilia Training
Centre, Thrombosis and to Haemostasis training centre of International Society of Thrombosis and
Haemostasis (ISTH) and National Reference Laboratory for HIV infection. As a result the Institute not
only trains national trainees but also international trainees from various countries.
The Institute is recognized by Mumbai University as well as Maharashtra University of Health Sciences
and West Bengal University of Health Sciences, for the Ph.D programme and by Mumbai University for
the M.Sc programme by research. The Institute imparts training for MD (Transfusion Medicine) and
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DM (Clinical Haematology) students of KEM Hospital and Seth GS Medical College, Mumbai.
There are many seminal contributions made by the Institute in the field of haematology and
immunohaematology.
1. Discovery of Bombay (Oh) and Indian (In) blood groups.
2. Discovery of first case of G6PD deficiency in the country.
3. Discovery of several unique haemoglobins and coagulation proteins like Hb D Agri, Hb M
Ratnagiri, Fibrinogen - Mumbai, Prothrombin Mumbai to name a few.
4. Discovery of a family with Co(a - b-) blood group.
5. Seminal work on various lectins found in India which are useful as reagents for blood group
systems.
6. Discovery of association of HLA B-27 with haemophilia associated chronic synovitis.
7. Demonstration of several molecular variants of Fanconi's anemia in this country.
8. d - thalassemia carriers in the country.

globin mutations as a cause of normal HbA2 b
9. Thombophilia as a cause of recurrent pregnancy loss and salvaging the pregnancy with LMW -
heparin.
10. Thromophilia as an important modulator of bleeding in severe inherited bleeding disorders.
11. Molecular pathology of many haemoglobinopathies, red cell enzymopathies, congeniatal
bleeding disorders, leukemias, immuno deficiency disorders as well as many new HLA antigen
polymorphisms.
12. Hydroxyurea as an important iron chelating agent in addition to its effect on fetal hemoglobin
induction in sickle cell anemia and b
- thalassemia.
13. Factor V Leiden as an important cause of Budd Chiari Syndrome in this country.
14. Developing various strategies to reduce factor concentrate usage in severe haemophilia.
15. Developing prenatal diagnostic technologies in various inherited severe haemoglobinopathies,
red cell eyzymopathies, coagulation disorders.
16. Developing techniques and methodologies to treat severe iso immunization and neonatal
isoimmune thrombocytopenia.
17. Diagnosing fetal pathology from circulating fetal DNA in mother's blood.
18. Direct effect of EACA in reducing the effect of inhibitors in haemophilia.
The above mentioned list is indicative but not all inclusive. The Institute has several patents to its credit
and some of these techniques are already in routine use.
One of the unique features of the Institute is its ability to train and transfer advanced technologies to
various medical colleges in this country. Medical college - Kolkata, Govt.Medical College - Nagpur,
NRS Medical College - Kolkata, St John's Medical College - Bangalore, Christian Medical College,
Ludhiana are few of the medical colleges benefitted from this technology transfer. Strengthening of
centres in the north-eastern region in immunohaematology and other areas as well as other regions
under the tribal health research forum of ICMR is an on-going activity.
The Institute is now looking forward to working in the backward areas of the country. The Institute plans
to start a National Centre for Hemoglobinopathy Research and Training (NCHRT)” in Chandrapur
town of Vidarbha region and 4 acres of land has already been acquired for this purpose. The Institute
65
is also looking forward towards substantial expansion of its activities and areas of research once the
Center for Molecular Haemtology and Transfusion Medicine (CMHT) is ready in the recently acquired
land at Nahur in Mumbai. Blood Group Reference Centre (BGRC) was the early dawn of this illustrious
Institute with more than 2000 research papers to its credit. Its progress towards the service of
humanity through patient service, translational research, twinning programmes and training for
manpower development and basic research has created a unstoppable momentum. This momentum
is created by the dedicated scientists, staff and students of the Institute as also the goodwill and help
of innumerable doctors and scientists in the country who in some way have contributed to its present
development.
Tribal Health Research Activities
Trainings/Workshops Conducted
66
State of the art laboratories
67
21
P.D. Hinduja National Hospital and
Medical Research Centre, Mumbai
Hematology Division
Shanaz Khodaiji, Farah Jijina
The Hematology Division of P.D. Hinduja National Hospital and Medical Research Centre consists of
laboratory hematology and clinical hematology manned by specialists in both fields.
Hematology - Laboratory Medicine

The Hematology section of the department of Laboratory Medicine caters not only to in-patients but to
a large number of out-patients as well. Since Hinduja Hospital is a multi-specialty tertiary care hospital,
the hematology lab serves as a reference centre for patients from Mumbai and other parts of
Maharashtra and India.
The Hematology lab offers an exhaustive menu of investigations
Complete blood counts (CBC) are done on top of the line hematology analyzers which give multiple
parameters for each blood cell in every sample within a minute along with flags and signals which
serve as a warning for abnormalities of red cells, white cells and platelets. All such 'flagged' samples
are reviewed by the hematologist and a descriptive report with advice is issued to the patient.
A large variety of tests for characterizing complex bleeding and thrombotic disorders are available.
These include coagulation factor assays, tests for thrombophilia and platelet function tests. Reliable
monitoring of oral anticoagulation is made possible with the help of high quality reagents. Recently
introduced tests are anti-Factor Xa assay for monitoring of low molecular weight heparins and gel
particle immunoassay for diagnosing heparin-induced-thrombocytopenia (HIT)
Other specialized investigations include study of abnormal hemoglobins by high performance liquid
chromatography (HPLC) and tests to diagnose cause of hemolytic anemias.
Acute leukemias, chronic lymphoproliferative disorders and other benign conditions are diagnosed
from examination of the peripheral blood, bone marrow aspirates/biopsies and flow cytometry.
The flow cytometry lab is equipped with a FacCanto II flow cytometer (BD) which is capable of
performing 8 - colour analysis simultaneously. This is a powerful tool for diagnosis, monitoring, staging
and prognosis of a large number of hematological malignancies and in the work-up of immunological
disorders (HIV). We have introduced a number of other tests after due validation. These are PNH by
FLAER and MRD in acute B-cell leukemias, primary immunodeficiency screening, CD34 stem cell
counts, platelet antigen assay and rituximab monitoring by flow. Other applications in the pipe line
include flow for MDS and platelet function disorders
Molecular tests for diagnosing thrombotic disorders such as Factor V Leiden mutation and
myeloproliferative diseases (JAK-2 mutations) are also available to facilitate diagnosis of these
conditions.
The department undertakes 3 to 4 research projects a year for MSc, PhD and DNB students under the
aegis of the National Health and Education Society which is the in-house research body. Many of
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these studies have been published in national and international journals.
The department added a feather in the cap by collaborating with BD to become the first clinical Centre
of Excellence (PDHNH-BD COE) in the country. Under this tie-up, many training programs are
conducted which benefit the aspiring as well as experienced flow cytometrists.
The department has applied for and is certain of being recognized as a centre for PDCC fellowship in
Hematopathology.
The lab follows a strict policy of quality control. We are accredited by the College of American
Pathologists (CAP) and are in the process of acquiring NABL accreditation.
Consultants: Dr Shanaz Khodaiji, Dr Kunal Sehgal
Clinical Associate: Dr Dia Mansukhani
Clinical Hematology
The clinical hematology division has two hematology consultants
Dr. Farah Jijina is full time Consultant Clinical Haematologist & Hemato Oncologist at P. D. Hinduja
Hospital, Mahim, Mumbai.
Her prior experience includes, Professor & Head of Dept. of Hematology, KEM Hospital, Mumbai, till
2012 (total 20 years at KEM hospital, Hematology). She is also a Postgraduate teacher for super
specialty, DM Clinical Hematology, MUHS.
Dr. Balkrishna Padate is a full time Consultant in Haematology, Haemato-Oncology and Bone Marrow
Transplantation (BMT) in Mumbai, at P. D. Hinduja National Hospital and Research Center, Mahim.
He trained in Hematology in the UK. He was associated with The Royal Free Hospital, London for
Haemato-oncology and BMT/SCT. He has also worked as a consultant Haematologist NHS, UK.
Both consultants have daily OPDs, and all haematological disorders, both benign and malignant are
seen by them. Day care, short stay and indoor facilities are all available for patient care! Both
consultants also work in close collaboration with the laboratory, facilitating patient care.
Both consultants are actively involved in academic activities such as teaching students and junior
doctors, presenting papers at conferences and publications.
A state of the art Bone Marrow Transplant Unit has been constructed and is ready. Autologous
transplants in the hematology division have already started and the hospital will start offering allogenic
transplant facilities very soon, under Dr Padate.
A close synergy exists between the lab and clinical hematologists resulting in excellent patient care.
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22
Tata Memorial Hospital (TMH), Mumbai
Haematology Services
Shripad D. Banavali
History
Tata Memorial Hospital (TMH), inaugurated on February 28, 1941, was founded by the house of Tata,
one of the leading industrialist families of India. It was later given to the Government of India, and since
1962 has been operated by the Department of Atomic Energy. TMH was merged with the Cancer
Research Institute (CRI, Est. 1952) in 1966, under the banner of Tata Memorial Centre (TMC). TMC's
third arm was a Clinical Research Center (CRC) established in 2005 at Kharghar, New-Mumbai. TMC
is the national comprehensive cancer centre for prevention, treatment, education and research in
cancer and is recognized as one of the leading cancer centre in this part of the world. In order to fulfill
its objective of providing the highest standards of patient care, the center has been continuously
upgrading its administrative structure and constantly upgrading its use of technology in order to
deliver optimal cancer care as well as conduct research and education at a globally competitive level.
As the premier cancer center in the country, TMC provides leadership for the national strategy for
cancer control. Last year more than 50,000 new patients were registered at TMC.
Clinical Care
Surgery remains the basic approach to treatment, especially for patients with solid tumors. Nearly
6300 major surgical procedures are performed annually in 20 state-of-the-art operating theatres at
TMC. Wherever possible, conservative organ-sparing surgery is performed. Nearly 6000 patients are
treated with radiotherapy each year with equipment that includes state-of-the-art technology. At TMC
there are 5 cobalt units, 6 linear accelerators, 2 high dose brachytherapy units, several treatment
planning systems with computerized tomographic (CT) stimulators, and two Image Guided
Radiotherapy units with Helical Tomotherapy (IGRT). The radiology department is equipped with
ultrasonography, mammography, CT-Scanners, MRI equipment and has excellent interventional
radiology facilities. The nuclear medicine department has access to the latest isotopes for nuclear
imaging and possesses three Positron Emission Tomography-CT units. Since this year, TMC has gone
paper-less. All the clinical data and reports are directly entered into the Hospital Information System
and so are immediately available. The radiology films can be accessed on computers in the clinics
through the standard system for transmitting high quality images, known as PACS system. This on-
line data can also be accessed from home by the staff. TMH is equipped with an excellent
microbiology laboratory, a pathology laboratory with immuno-histochemistry facilities, a hematology
lab (with automated cell counters and flow cytometers), a cytogenetics laboratory and molecular
biology laboratory. All the laboratories are accredited by an autonomous body established by the
Indian Government called the National Accreditation Board for Testing and Calibrating laboratories.
TMH was the first to introduce the concept of joint (multidisciplinary)-clinics in India in the 1980s, and in
2009, TMH was the first oncology facility in the country to introduce the concept of Disease
Management Groups (DMGs). The groups presently include adult Hemato-Lymphoid neoplasms,
Bone & Soft Tissue tumors, Breast cancer, Gastro-Intestinal tumors, Gynecological cancer, Head &
Neck cancers, Neuro-oncological tumors, Thoracic cancers, Urological cancers, Pediatric
Hematological and lymphoid tumors and Pediatric Solid Tumors. The aim of this “division of labor” was
70
to ensure a team approach and provision of care in accordance with evidence-based standards and
access to the full range of potential therapies for all patients, together with involvement of patients in
decisions about their care, aiming for better outcomes and increased patient satisfaction. At the
same time, this will also help in the advancement of science.
The strategy for early diagnosis, treatment, rehabilitation, pain relief and palliative care has been
established in a comprehensive and multidisciplinary approach for a total cancer care programme.
There is an active medical social worker department which looks after the social, financial, travel and
accommodation needs of the patients. Additionally, several voluntary non-governmental
organizations (NGOs) have been working with TMH to help patients deal with the implications of the
successive stages of their disease management.
Adult Hemato-Lymphoid DMG

In the year 2012, 3037 new patients were registered in the Adult Hemato Lymphoid Division. Of these
390 patients were registered in Acute Leukemia Clinic; 909 in Lymphoma Clinic; 240 in the BMT clinic;
and, 129 in the Myeloma clinic. The total work load can be gauged by 54,769 OPD visits and 1957
admissions. The emphasis of the division was to improve the early results for leukemia and lymphoma
patients by decreasing the early treatment related mortality and morbidity. Through a process of
triage and constant OPD and ward supervisions, the division was successful in substantially bringing
down the 100 day mortality from 222 in 2010 to 157 in 2011. The division started the first 'Registry for
Epidemiology and End Result Analysis – Lymphoma (REAL_L)” initially at Mumbai level and later
expanded the same at National level. 1361 patients have been registered by end of 2011. This would
be very valuable in generating India related data in the future. The division has partially shifted from
TMH to ACTREC in 2011 and presently has 17 in-patient beds and CML follow-up OPD there. The aim
is to shift the entire Adult Hemato-Lymphoid unit to ACTREC in a new wing in the near future. The Bone
Marrow Transplant (BMT) unit is already functioning at ACTREC since November 2007. About 70
transplants are done every year. Results here are amongst the best in the world with a 100 day
mortality of <5% and 365 day mortality of about 25% (80% of deaths due to relapse).
Presently there are 14 new DM (Medical Oncology) seats and 1 BMT Fellow-ship at TMH. All these
residents rotate through this DMG. Classes for all students (residents and nurses) are conducted
thrice a week. Registrars are also encouraged to participate in research projects with consultants,
which include clinical studies and laboratory based projects, retrospective analysis and are also
encouraged to publish during their training period.
The DMG undertook a total of 54 research studies in recent years. Out of 54, 11 were student research
(6 completed), 25 studies were initiated by investigators (10 completed) and 18 studies were
sponsored clinical trials. In 2012 the DMG published 20 articles related to its research activity and
members also contributed 8 chapters to various books
Pediatric Hemato-Lymphoid DMG

The important function of Pediatric Hemato-lymphoid DMG is to provide service of international
standards to patients, conduct research in to novel locally-relevant therapeutic strategies and educate
trainees to expand the treatment net for Pediatric hemato-lymphoid cancers in India.
A total of 694 new patients were registered in 2012. There were 400 new cases of acute leukemias and
123 new cases of lymphomas which are among the highest seen by any Pediatric cancer unit in the
world. However this number does not give justice, as majority of these require intense, curative and
prolonged therapies with multiple outpatient and inpatient visits. This is reflected by the nearly 34,718
OPD visits in 2012 (average OPD of 150 patients every day). The division treated more than 400 acute
leukemia patients and 123 new cases of lymphoma in 2012, which is the largest number by any one
center throughout the world.
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PHLG has set up an organized psychosocial-economic support group to provide holistic care of
children and their families during treatment consisting of social workers, data managers, counselors,
psychologists, and multiple NGOs to ensure accommodation, travel support, emotional & nutritional
help, transfusion support and education etc. The establishment of social support group has
dramatically decreased the abandonment rates (TR&A) from >20% in 2009 to 9.5% in 2010. This has
further reduced to 5% in 2012. This highly successful model of support won the international society of
Pediatric Oncology (SIOP) award at London meeting in 2012. The overall induction mortality rates in
leukemias have reduced from 8% in 2010 to 4.5% in 2012 by a process of triage, constant supervision
& aggressive management of treatment related complications. Number of patients being treated as
per standard TMH protocols has improved from 79% in 2010 to 89% in 2012 with reduction in the rates
of TR&A and second opinions. The Pediatric cancer registry maintains details of epidemiology and
outcomes of all Pediatric hemato-lymphoid cancers. The disease free survival amongst BMT patients
is 70% and transplant related mortality is 6%.
The division has developed locally relevant, risk stratified, cost effective protocols and all pediatric
cancer patients are uniformly treated on protocols. The overall survival has improved up-to 70% to
90% for most childhood hematological cancers at TMH.
Presently there are 2 new DM (Pediatric Oncology) seats and 1 Pediatric Oncology Fellow-ship at
TMH. All these residents rotate through this DMG. Classes for all students are conducted thrice a
week. Registrars are also encouraged to participate in research projects with consultants.
The DMG undertook a total of 43 research studies in recent years. Out of 43, 10 were student research
(7 completed), 30 studies were initiated by investigators (9 completed) and 3 studies were sponsored
clinical trials. In 2012 the DMG published 15 articles related to its research activity and members also
contributed 6 chapters to various books.
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23
Tata Memorial Centre, Mumbai
Overview of BMT Programme in ACTREC
Navin Khattry, S D Banavali
The Bone Marrow transplant (BMT) unit of Tata Memorial Centre started in 1983 at Tata Memorial
Hospital (TMH), being the first hospital in the country to perform bone marrow transplant. Since then
approximately 660 transplants have been performed both in adult and pediatric patients of which 55%
have been allogeneic transplants. Though most transplants have been performed in patients suffering
from hematological malignancies such as acute myeloid leukemia (AML), acute lymphoblastic
leukemia (ALL), chronic myeloid leukemia (CML) and lymphomas, approximately 10% of transplants
have been performed for benign diseases such as aplastic anemia and thalassemia.
The transplant unit shifted from TMH to our new research center at ACTREC, Kharghar, Navi Mumbai
and was commissioned on 14th November 2007. This is a six bedded BMT unit, with each room
having terminal HEPA filter. Approximately 320 allogeneic (45%) and autologous (55%) transplants
have been performed in our new centre. Since last 4 years, more than 50 transplants are done each
year as shown in Fig.1.
Encouraged by the initial success and in order to cater to the needs of those who do not have an HLA-
matched sibling, an ambitious program of Matched Unrelated Donor Transplant was successfully
initiated in November 2009, using HLA matched stem cells from international Unrelated Donor
Registries. Similarly unrelated cord transplant programme was started in April 2010. And recently we
have begun doing haplo-identical transplants for patients who do not have a fully matched related or
unrelated donor. Similarly a new review and funding mechanism was initiated in 2009 for offering free
or greatly subsidized BMT as a life saving measure for deserving poor patients. More than 60 such
autologous and allogeneic transplants have been done since 2009 under this scheme.
The BMT unit is also involved in training of DM students as part of their 3 year Medical Oncology
curriculum. Each student spends approximately 4-6 months in this unit and gets acquainted with
Figure 1: Number of autologous and allogeneic transplants per year since March 1983.
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various conditioning protocols used and post transplant care of patients. They are also encouraged to
do research projects during their rotation. BMT Fellowship of 1 year for post DM students of Medical
Oncology and Hematology has also been recently initiated.
Various research protocols have been initiated over the last few years in ACTREC. Transplant
medicine has moved to the next level with various methods of graft engineering being attempted to
reduce toxicity and improve disease free survival. The unit plans to initiate several translational
research studies that will lead to clinical benefits to our patients in future.
Outcome data in various diseases since November 2007- May 2013

Since November 2007 – May 2013 approximately 294 transplants have been done in ACTREC as
shown in Fig 2. AML and ALL comprise majority of allogeneic transplants while Hodgkin's disease and
multiple myeloma comprise the majority of autologous transplants.
Figure 2. No. of transplants in various diseases from November 2007- May 2013
At a median follow up of 24 months, the overall survival (OS) and relapse free survival (RFS) of all
patients is shown in Fig 3.
Figure 3: OS and RFS of all patients and according to type of transplant.
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The OS and RFS of patients with AML and ALL are shown in Fig 4.
Figure 4: OS and RFS of patients undergoing allogeneic transplant for AML and ALL
Similarly the OS and RFS of patients with Hodgkins and Non- Hodgkins lymphoma, multiple myeloma
and aplastic anemia undergoing autologous and allogeneic transplants are shown in Fig. 5 and Fig. 6
respectively.
Figure 5: OS and RFS of patients undergoing autologous transplants for lymphomas.
Figure 6: OS and RFS of patients undergoing autologous transplants for multiple myeloma and OS and
graft failure free survival of patients undergoing allogeneic transplant for aplastic anemia.
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Mortality and Relapse
Since 1983, there has been a steady decrease in the 100 day and 365 day mortality of patients in each
decade in our center. The mortality has decreased from approximately 50% in the first decade to less
than 10% from November 2007 onwards. This is shown in Figure 7.
Figure 7: Decade wise 100 and 365 day mortality since March 1983- May 2013.
The overall transplant related mortality (TRM), autologous and allogeneic TRM respectively, relapse
rate and cause of death in all patients undergoing transplant in ACTREC is shown in Fig 8.
Figure 8: Incidence of Transplant Related Mortality, Relapse and cause of Death
The Way Forward

After reestablishing itself in ACTREC, The BMT Programme of Tata Memorial Center is poised to
venture into more sophisticated cellular therapies and do meaningful clinical research to further
improve outcomes of transplant and also improvise ways to decrease cost of transplants.
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24
Armed Forces Medical College (AFMC), Pune
Hematology Services
Armed Forces Hematology Group
The Armed Forces Medical Services (AFMS) is the largest Haematology network in the country
providing comprehensive medical care to almost one crore people comprising of, all serving and ex-
servicemen along with their families belonging to the triservices from the Army, Navy and Air force. At
present Hematology centres are fully functional at Army hospital Research and Referral (AHRR), New
Delhi, Command Hospital Southern command (CHSC),Pune, Armed forces medical college
(AFMC),Pune, Indian Naval Hospital Ship (INHS Asvini), Bombay, Command Hospital Eastern
command (CHEC),Kolkata and Command Hospital(Air Force), Bangalore. The centres at Delhi and
Pune are the larger Haematology centres comprising of 4-5Clinical Haematologist and two
Haematopathologist besides a back-up of Molecular lab and state-of-the art Transfusion centres
providing component and stem cell apheresis. The centre at Bombay is a medium sized one having 2-
3 Clinical Haematologist besides a Haematopathologist where-as the centres at Kolkata and
Bangalore are smaller with the facility of a Clinical Haematologist and back-up of Haematopathology
and molecular set-up. BMT centres are available in both large and medium sized centres.
A humble beginning was made In Nov 1993 when Lt Col Velu Nair first started the Department of
Clinical Haematology at the Army Hospital Delhi Cantt. It was started with 10 beds situated in acute
medical ward. However over a period of three years the number of beds was increased to thirty and the
Clinical Haematology Department became fully functional with both in-patient and out-patient
departments, under his stewardship; The center had a Single Consultant till 1997.Presently he is a Maj
Gen and the Dean of the prestigious AFMC.Initially patients of Acute Leukaemias, Bone marrow failure
syndrome (including patients of MDS and Aplastic anaemia), those suffering from deep vein
thrombosis and other thrombotic disorders, bleeding diathesis including Haemophilia, ITP as well as
various haemolytic disorders were managed in this centre. Intensive chemotherapy for Acute
Leukemia was also initiated as also immunomodulatory treatment for hypoplastic anaemias.The Dept
was functional in the new location in May 1997 at Army Hospital(R&R). A second Consultant, Lt Col
Rajat Kumar, was posted in late 1997. He too made a significant contribution to the Dept and took
Maj Gen Velu Nair
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premature retirement in 2003
and joined AIIMS, New Delhi
as Professor of Haematology.
Lt Col Ajay Sharma joined the
Dept in 2003. He is presently
Head of the Dept of
Haematology at Army
Hospital(R&R) in the rank of a
Brigadier and has strived hard
to upgrade various facilities in
the department. Presently Col
Jasjit Singh and Lt Col
Sanjeevan Sharma are posted Army Hospital (Research& Referral) Delhi Cantt
as Clinical Haematologist.
Surg/Capt Satya Ranjan Das, Lt Col Rajan Kapoor, Col Tarun Varma and Lt Col Vinod Raghavan have
all worked in this dept. Majority of these clinical Haematologists have been trained at CMC Vellore
while three have trained at AIIMS New Delhi.
Transfusion support was catered by Armed Forces Transfusion Centre (AFTC), where, in the
beginning, a V50 hemonitics instrument was used for platelet apheresis. State-of-the-art component
therapy was the backbone of the Haematology center and AFTC provided a round-the-clock 24hrs
service. Some of the prominent Haematopathologist in this center during that period included Rear
Admiral Monisha Jaiprakash who was then a Lt Col, Brig PS Dhot, Brig Khetrapal, Col Saha and Brig
Salopal and Col Aloke Sen.
During Dengue epidemic in 1996 Department of Clinical Haematology AHRR firmly established itself
as a leader in Haematological practices in Delhi with successful management of more than five
hundred cases of Dengue including a large number of Dengue hemorrhagic fever. An advanced MCP
3P Hemonetics and several horizontal platelet agitators were procured and installed at AFTC, Blood
bank at AH(R&R) as also in the transplant unit. In 1997 AHRR became fully functional in the new
hospital location. Forty five beds were allotted for Haematology patients which included thirty male,
ten female and five paediatric beds. At the same time a neutropenic unit was also created. In the same
year planning for high efficiency particulate air (HEPA) filtered three bedded Bone Marrow
Transplantation (BMT) with six bedded step-down unit was initiated which fruitified in 2002. Additional
equipments in form of apheresis machine (, Kobe, Baxter Haemonitics) and cryopreservation facilities
(liquid nitrogen and -86 C deep freezers) were installed. Till date approximately 400 transplants (65%
allogeneic) have been performed with 69 - 70% overall survival. This included allogeneic, autologous
as well as cord transplants. BMT initially was started with autologous transplantation in Multiple
Myelomas and Lymphomas and subsequently, allogeneic BMT was started in diseases like AML,
CML, Thalassemia Major and Aplastic Anemia. Allogeneic BMT has also been performed for some
rare genetic disorders including Fanconi anaemia, Diamond Blackfan anaemia and
Adrenoleucodystrophy.
Haematopathology Lab at the erstwhile Army Hospital Delhi Cantt, located near Kirby Place was
popularly known as the A-4 lab. This was set up in the early 1990s by Lt Col Ramji Rai who later retired
as the Director General Medical Services in the rank of a Lt Gen. This lab functioned as a Leukemia
diagnostic lab employing morphological and cytochemical approach to the diagnosis of Acute
Leukaemias. This lab had all the facilities for haemolytic and coagulation work-up by manual method.
The lab was amalgamated with Command Pathology Laboratory of Western Command in 1999. The
last Pathologist to be posted at A-4 lab was Maj T Chatterjee who is currently Professor and Head Dept
of Immunohaematology, AFMC, Pune in the rank of Col.
The Haematopathology Lab at Army Hospital (Research& Referral) was set up in 1996. Lt Gen Ramji
Rai, Col VK Kumar, Col DK Mishra, Col Jyoti Kotwal, Col T Chatterjee, Col B Asthana and Col Prosenjit
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Ganguli are some of the Haematopathologist who have contributed to the excellent growth of this fine
dept. Lt Col Velu Nair and Lt Col Mishra initiated flowcytometry in early 2000 which was further
expanded by Col J Kotwal and Col T Chatterjee. Flow cytometry contributed significantly to augment
diagnostic accuracy and estimations for MRD in hematological malignancies. The state-of-the-art
Molecular lab was set up in 2003 under the guidance of then Professor and Head of AH(R&R), Col GS
Chopra who is a renowned Transplant Pathologist and presently holding the appointment of Lt Gen in
the Army Medical Corps. Col Jasmeet Kaur who joined the Dept in 2006 helped to establish chimerism
study for BMT. Latest techniques in Molecular Haematology like BCR-ABL, JAK2 Mutation, PML-RARA
RQ-PCR analysis as well as MRD were set up subsequently by Col DK Mishra, Col Jyoti Kotwal and
Col T Chatterjee. Col Prosenjit Ganguli was instrumental in setting the stem cell lab in the Dept.Today
this lab is considered one of the finest Haematopathology Labs in the country.
The AH(R&R) imparts training to all Post-graduate students in Medicine. Regular courses are carried
out for paramedics to make them multifaceted and proficient in apheresis, care of PICC, Hickman,
administration of chemotherapy and blood products as well as skilled assistants in bone marrow
aspiration, biopsy and intrathecal therapy. The team of paramedics is also trained in Bone Marrow
harvest for transplantations. To start with there were only 3 paramedics, which has steadily increased
to a panel of of 30 Haematology trained paramedics who are invaluable to the organization. DM
students in hematology were rotated in AHRR BMT centre and students from other centers also visited
this unit. Research has been a key thrust area of work and multiple projects funded by various
agencies including Armed Forces Medical Research Council (AFMRC), DBT and ICMR have been
successfully undertaken for projects on Aplastic Anaemia, Acute Leukemia, conditioning protocol in
BMT, thrombosis including thrombosis in high altitude areas and published in peer-reviewed journals.
Haematologist from armed forces who were “Presidents of the Indian Society of Haematology and
Blood Transfusion” include Brig (Retd) PS Dhot, Maj Gen Velu Nair and Col (Retd) DK Mishra. They
also have contributed significantly to Delhi Society of Haematology in all its academic and
organizational activities. Brig PS Dhot and Maj Gen Velu Nair were its past Presidents and the present
designate is Brig Ajay Sharma. Col T Chatterjee is currently an Executive Body Member of the ISHTM.
He has also been the Secretary of DSH as well as its Treasurer.
Maj Gen Velu Nair, AVSM, VSM** is a Co-Chairperson of the stem cell task force of DBT and has been
instrumental in raising the standards of research in armed forces by being part of various multi centric
trials. He is also a member of the ICMR stem cell task force and a part of the ICMR group which
formulated the guidelines for stem cell research in the country. He and the armed forces team has
undertaken numerous collaborative projects with ICMR, DBT, DRDO including numerous multi center
projects and trials in the field of stem cells, leukaemia and Bone marrow failure syndrome.
The Dept of Haematology at Armed Forces Medical College (AFMC) & Command Hospital Southern
Command (CHSC) Pune has been functional since 1996 and includes a BMT unit. AFMC is a premier
medical college and has been consistently ranked as one of the best medical colleges in India (India
Today survey on top medical colleges). The department is expected to expand with the construction of
new ultra-modern Hematology centre, construction of which has already been started. Department of
Hematology is involved in training of undergraduates (UG) and postgraduates (PG) in Medicine, many
of them who have gone on to do their thesis on hematology topics. Our UG and PG have consistently
made a mark in various local and national hematology quiz programmes. Col VD Charan, Col H
Motwani and Brig Ajay Sharma are some of the prominent Haematologists who have served in Pune
complex. Currently Lt Col Rajan Kapoor is posted at this centre with Lt Col Vishal Sondhi as Paediatric
Haematologist. Brig Ajay Sharma performed the first allogeneic transplant in a Thalassaemic child in
this center in 2002.
The Dept of Immunohematology & Blood Transfusion, AFMC, Pune is a unique Institution by itself. It is
the oldest Dept of AFMC and has started a MD course in Immunohaematology& Transfusion Medicine
since 2008.
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In April 1942, two British Base
Transfusion Units with their
associated field transfusion
services were made available
to India. These transfusion
units were responsible for the
production of Crystalloid
solutions and providing blood
transfusion. Soon after the
World War II was over, the
Blood Transfusion Units were
disbanded and a centralized
Army Transfusion Centre was
established in Poona to cater
to the transfusion
requirements of the Army.
The Department of
Transfusion Medicine was
formed on 01 May 1948 by incorporation of the Army Transfusion Centre with Armed Forces Medical
College (AFMC). The first HOD was Padmashri Lt Col GWG Bird, who discovered Lectins. Lectins are
seed extracts which are very useful in blood banking.
The department manufactured and supplied all resuscitation fluids. It ran a blood bank for Military
Hospitals located in Poona and even extended its services to civilians in times of need. It
manufactured dry plasma and blood grouping sera for the Armed Forces, which was discontinued in
1972. It was also responsible for the preparation and assembly of all transfusion sets for supply to
hospitals and field units. Since 1997 the manufacture of Crystalloids at has been completely stopped.
Today it has a state-of-the art licensed Blood Bank with component & apheresis facilities. In addition, it
regularly undertakes plasma exchange therapy, prepares single donor platelet concentrates, and
harvests haematopoietic stem cells for stem cell transplantation in various haematological and non-
haematological conditions. This dept. also runs a state of the art coagulation & thrombophilia
laboratory. Eighty registered Thalassemic patients routinely take blood transfusions from the blood
bank. To facilitate detection of haemoglobinopathies, HPLC facility for hemoglobin assay is available.
The department has the unique distinction of conducting a three year MD course in the subject
Immunohematology and Blood Transfusion since April 2008. In addition this department has been
nominated as the center for conducting DNB practical examination consecutively for the last three
years. It is the only center in the country which conducts DNB examination for the subject in
Immunohematology & blood transfusion. Presently Col Tathagata Chatterjee is the Professor& Head
of this Dept with Col Joseph Philip and Surg/Cdr RS Mallhi as faculties.
Approx. 40 blood donation camps are organized every year. These include both voluntary blood
donation camps organized in civil institutes /firms/organizations, & in army establishments.
The department is focused on advancing the science and practice of transfusion medicine and
cellular therapies by implementing complete automation and computerization, setting up pathogen
inactivation facilities, nucleic acid testing for screening for infectious diseases, stem cell research
capabilities, and long term storage of frozen RBCs. Some of the prominent Haematopathologist to
have headed the Dept includes Brig Rathin Dutta, Maj Gen Octania, Col AK Dutta, Brig Hassan,
Col GLN Swamy, Rear Admiral Monisha Jaiprakash, Col Harsh Kumar, Brig RS Sarkar, Col Lahiri and
Col Machwe.
Department of Hematopathology AFMC is well equipped with diagnostic facilities which include multi-
80
color flow cytometry, cytogenetics and molecular diagnostics for various benign and malignant
hematology disorders. Col DK Mishra, Col Jyoti Kotwal, Col T Chatterjee and Surg Capt Manu have all
worked in this Dept and helped train UGs, PGs and paramedical staff.
The Dept of Haematology at INHS Asvini has Surg/Capt Satya Ranjan Das who is credited with starting
the first Autologous BMT in that centre. Surg/Capt Gaurav Narula, a Paediatric Haematologist was
posted in this unit and has currently retired and is a Professor of Haematology at TMH Bombay. Lt Col
Suman Kumar Parmanik is the Clinical Haematologist at Command Hospital, Kolkata and is
consolidating the pioneering works of Maj Gen Velu Nair, Col H Mothwani and Col T Chatterjee who
had all served in that Hospital earlier.Lt Col Tarun Verma is the Haematologist at Command Hospital,
Lucknow and he has also performed Autologous Stem cell transplants both at Lucknow as well as at
Northern Command Hospital at Udhampur.
Over the years many hematologists have contributed towards growth of hematology in Armed Forces.
Maj Gen Velu Nair, AVSM, VSM** who is presently Dean of AFMC has been the father figure to all
hematologists of AFMS. The frequent change in appointments as a result of the transferrable job in the
armed forces has been perceived as the limiting factor by the environment. On the contrary we in the
armed forces feel strongly that this “change is the pillar of our strength”. Change invariably invites new
ideas, policies and research areas, hitherto, untread. The unique quality of networking,
communication and registry within the armed forces has ensured mainstream continuity of all policies.
Lt Col GWG Bird
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25
Sahyadri Speciality Hospital, Pune
Shashi Apte
From a relatively small Haematology laboratory and OPD in 1999, to a composite Department of
Haematology, at SSH with clinical and laboratory faculty working together under one roof for better
service, resident training and research activities, we indeed have come a long way. Sahyadri group
has now 8 hospitals in Pune with 950 beds.
Our mission is to provide state of the art investigative facilities for the comprehensive diagnosis of
haematologic diseases and the highest quality of clinical care for our patients with the latest
therapeutic tools.
To impart training and mentor the next generation of academic hematologists, Diplomate of National
Board (DNB) program started in 2012. Even before DNB program started we trained 9 candidates at
the dept.
Dept works in close liaison with premier institutes like NCCS, IISER and Pune University in field of basic
research.
SSH got NABH accreditation and Laboratory got NABL accreditation.
Staff, faculty and Residents

Clinical Hematologists
1) Dr. S. Apte , MD ( Int Medicine ), FRCPA ( Australia )
2) Dr. S .Melinkeri, MD ( Int Medicine ), DM ( CMC, Vellore )
3) Dr. S. Kannan , DNB ( Int Medicine ), DM ( CMC, Vellore )
4) Dr. Akash Kalro, MD ( Int Medicine ), FRCPA ( Australia )
DNB ( Hematology ) Residents, Started in 2012
1) Dr. Abhishek Dudhatra - 2nd Year
2) Dr. Girish Kamath - 1st Year
3) Dr. Nidhi Chaturvedi - 1st Year
Non DNB Hematology Residents, working for more than 4 years
1) Dr. Sneha Kurhade
2) Dr. Aditi Joshi
Hemato - Pathologist
1) Dr. Vijaya Gadage, MD ( Path )
2) Dr. Sushil Agarwal, MD ( Path )
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3) Dr. Shital Joshi , MD ( Path )
Past Faculty : Dr. Anjali Kelkar ( 1999 - 2012 )
Dr. V. Melinkeri ( 2008 - 2012 )
Histopathologist
1) Dr. Sudhir Kambale, MD ( Path )
2) Dr. P. Kanitkar, MD ( Path )
3) Dr. V. Ingale, MD ( Path )
Molecular Biologist
1) Dr. Sonali Sanghavi, MD PhD
Clinical Geneticist
1) Dr. Chaitanya Datar, MD ( Pead )
Cytogentecist
1) Mrs. S. Vaidya, MS
2) Dr. A. Babarekar, PhD
Transfusion Medicine
1) Dr. Smita Joshi, MD
2) Dr. Purnima Rao, PhD
MIcrobiology / Mycology
1) Dr. M. Kavathekar, MD
Physiotherapy
1) Dr. Rohini Dange
Clinical Trial Co-ordinators
1) Dr. Anagha Parakhi
2) Dr. Sucheta Wakekar
Data Manager
1) Mrs. Dipti Khedekar
Dept Secretaries
1) Amruta Sane
2) Ajit Wanjale
Total Technicians : 112
24-Highly trained and competent senior technicians man the various stations in the laboratory and
transfusion services for bench work.
II. Education
Department of Hematology, SSH started the DNB course in Hematology of the National Board of
Examinations in 2012, the second such course in the country in the superspeciality of Hematology. It is
equivalent to DM in Hematology.
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Eligibility for the examination and admission procedure is as per the National Board of Examinations
(http://www.natboard.edu.in/).
No. of seats: 02 per year
The department participates in and holds many CME programmes and conferences.
III. Hematology Services

IIIA. Clinical Hematology services
Outpatient services are being run six days a week involving 3 consultants, around 16000 patients
attended Hemat OPD in 2012. Indoor facility is in SSH, 4000 patients were treated on IPD basis. The
department has a unique opportunity to provide services to patients of Hematological malignancies
as well as benign hematological disorders. The spectrum includes acute and chronic leukemias,
lymphomas, MDS, myeloproloferative neoplasms, multiple myeloma, deep vein thrombosis, ITP,
various hemolytic anemias including hemoglobinopathies. Bleeding disorders covering coagulation
factor deficiencies as well as qualitative platelet disorders are covered in detail.
We are a referral center for bleeding disorders. 902 various congenital bleeding.
Disorder patients are SSH is a center of excellence for both autologous and allogeneic stem cell
transplants including the umbilical cord blood transplants. We are a non network unit status
sanctioned by NMDP, USA
IIIB. Hematopathology services

The laboratory is widely known as a centre of excellence for providing diagnostic facilities for a wide
spectrum of hematologic disorders using cutting edge technology. It is recognized as a referral centre
for second opinion on difficult and rare cases by hospitals and institutions nationwide.
Equipments
Beckman LH 780, two DxH 800 analysers, Excyte ESR equipment, Chronolog platelet aggregometer,
Biorad variant II, coagulometers-ACL 10000, Elite Pro, ACL 7000, Electrophoresis equipment Chorus,
ELISA system, Flowcytometers FC 500.
Routine and special investigations

Complete blood counts
Haemorrhagic disorders
PT, APTT, TT, All Factor assays, vWF studies, Platelet function studies including platelet receptor
studies, Fibrinogen estimation, Quantitative D-dimer, Clot retraction test, clot solubility test, APTT
mixing, PT mixing, factor Xa assays.
Platelet Aggregometry
Platelet function tests for qualitative platelet defects, von Willebrands disease, Drug resistance to
aspirin and clopidogrel.
The Chronolog Dual-Channel Platelet Aggregometer

Thrombophilia
Tests for antiphospholipid syndrome and lupus anticoagulants: APTT with lupus sensitive reagent,
APTT– dependent inhibitor scree, dRVVT, KCT, Anti-cardiolipin antibodies (ACA), b 2 GPIG, b 2 GPIM,
Anti-ds-DNA antibodies; Protein C, Protein S & Antithrombin, Factor V leiden (APC-R) estimation.
84
Molecular assays
Mutations of Factor 5(Leiden), Prothrombin gene mutation, MTHFR genes, JAK2V617F, F12 mutation
HPLC and Hemolytic disorders
Screening/testing for beta-thalassemia & hemoglobinopathies by HLPC and hemoglobin
electrophoresis at alkaline & acid pH are routinely done.
Very busy Beta Thal screening program involving schools, colleges and pre employment program
with companies
Other tests are G-6-PD screening, Osmotic fragility test, Heat instability test for unstable haemoglobin,
Heinz bodies, Haemoglobin F Cytochemistry (Kleihauer test), Haemosiderin in urine,
Methaemoglobin estimation, sickling test for Hb S.
Running B thal screening program for schools/colleges and industry
Leukemias & lymphomas
Detailed work-up by CBC, bone marrow examination, Cytochemistry and flow cytometry on acute and
chronic leukemias, myelodysplastic syndromes, Multiple myeloma and lymphoproliferative
disorders.
Flowcytometry
FC 500
Leukemia and lymphoma immunophenotyping (Acute leukemia panel,
CLL panel, Lymphoma panel).
MRD monitoring
Multiple myeloma
Myelodysplastic syndrome
Four color single tube CD4 & CD8 counts
Enumeration of B-, T-& NK cells.
PNH panel extended panel
CD34 enumeration based on ISHAGE protocol.
CD4/CD8/CD25-FOXP3 analysis
Foetal RBC in maternal circulation - Project
Molecular Haematology
Qualitative and quantitative assays for BCR-ABL. TEL-AML1, PML-RARa, JAK2, FLT-3 (D835 & ITD)
mutations, NPM-1 mutation, FLT 3ITD RUNX1-RUNX1T1, CBFB-MYH11, MTHFR, Factor V Leiden and
Prothrombin gene mutations.
Started Telomere length assays.
Autoimmune Markers: ANA-3 (Western blot), ds-DNA, p-ANCA, c-ANCA by ELISA.
Electrophoresis: Serum protein electrophoresis, Immunofixation electrophoresis, Urinary protein
electrophoresis.
85
IV. Research projects
1. Completed
1. MRD for acute Leukemia by TCR gene rearrangement and Heavy chain
2. A comparative study of bone marrow flowcytometric immunophenotyping and molecular
technique for APML MRD
3. Fludarabine in SAA
4. Arsenic Trioxide in APML
5. Joint replacement surgery in Hemophilia
6. Low dose factor replacement for surgery in PWH
7. Endurance v/s Muscle strength in PWH
8. Coronary artery diseases in congenital bleeding disorders
9. Flu Cy conditioning in SAA SCT
2. Ongoing projects
1. RQ PCR BCR ABL major at 0,3,6,12,24 months and comparison with EUTOS and Sokalscore
2. Drop in CD4/CD8 conts and rise in Neutrophils and outcome of Acute ITP in adults
3. Day 8 steroid response and co relation of D14 and D35 MRD by Flow in ALL
4. Flu Cy conditioning and Post Transplat Cy in SAA SCT
5. Auto PBSCT in Auto Immune diseases
6. Impact of Telomere length in CML and response to TKI therapy
3. Clinical global trials
Hematology dept is involved in 18 global trials for Hematological disorders
Clinical Trial unit of the dept successfully passed the audit by US FDA in 2012
Accreditation:
The laboratory is NABL accredited
The Dept and Sahyadri Speciality Hospital is NABH accredited
Quality assurance:
Dept and laboratories participate in EQAS programs
JACIE accreditation is on way
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26
Sher-i-Kashmir Institute of Medical Sciences,
Sri Nagar
Department of Clinical Hematology
M. I. Quadri
Ex-HOD/Prof Clinical Hematology & Transfusion Medicine
This institute was conceived with the objective of providing facilities of specialized medical care and to
develop super specialties that would provide tertiary health-care. Also to provide need oriented
education in medical sciences and clinical research.
The construction of the Institute commenced in the year 1976. The Institute was partially
commissioned on 5th December 1982. By an Act of Legislature on 19th August 1983, Sher-i-Kashmir
Institute of Medical Sciences was granted a Deemed University status.
The department of Clinical Hematology was one among the earliest departments which were
commissioned & operational in 1982. I had a distinction of being first faculty member of the Institute.
Initially for few months we started hematology laboratory work by manual techniques. Within 6-8
months automation started. This department was first to have Hematology Analyzers (Coulter Hemo
W, Thrombocounter, S7 & so on) in India. Within 2 years of commissioning of Institute, the department
of Clinical Hematology had complete automation in all its sub-specialties.
The department was running 2 OPDs in a week. As per policy, faculty positions were open to any body
having MD Pathology, MD Medicine & MD Pediatric with 2 years experience in Hematology/Clinical
Hematology. The department was so attractive that 4 Senior Residents with MD Medicine, MD
Pediatrics & MD Pathology joined the department. We had 12 beds for admission & these were always
full & there was need for expansion. We started treating all Leukemias/lymphomas who were
otherwise travelling to Delhi & Mumbai (Bombay then). 3 of our ALL patients are living with children
(>25 years survival).
Among various reasons for quick recognition & advancement of Department was the trust of
Administration especially Prof. A.M Jan (Vice-chairman Governing Body) on our abilities & talent. We
had first CME on Nutritional Anemia in 1984. We published more than 30 research papers in first 10
years. We were able to secure a very interesting project from ICMR also. One among best senior
residents & later on faculty member was DR. Ramesh Pandita. He contributed immensely to the
department.
The department suffered maximum during militancy & my senior residents & faculty migrated. I had to
look after many departments in addition to my own department during those days. Finally I also had to
leave in 1994.
In spite of this loss, the department got new faculty & they are working with zeal. They have regained
the trust & confidence. Presently the treatment of hematological diseases at this department is at par
with other reputed centers in India. The faculty is working towards establishing the facility of Bone
Marrow transplantation. Stem Cell Transplant is available in sister department of Medical Oncology.
Dr. Samoon Jeelani (retired recently), Dr. Javeed Rasool, Dr. Aleem Jan & Dr. Geelani have enriched
the department as faculty members. Faculty with hemato-pathology background will be soon joining
the department.
87
Clinical Hematologists/Hematologists were almost non-available 10 years back but now there are
more than half a dozen of Hematologists in the state.
I am sure that Department of Hematology will be one of the excellent centers for Blood Diseases in
coming years.
88
27
Christian Medical College, Vellore
The Department of Haematology
Alok Srivastava
The beginning
The department of Haematology was created in its current form in this institution in the late 1980s.
However, hematology services and research have existed in the institution from the 1950s.
Starting in the late 1950s and early 1960s, there was significant interest in two aspects of hematology -
nutritional anemias and hemostasis along with transfusion services. These were the areas that were
relatively easily recognized clinically and for which there were major needs for services at that time.
Starting with Dr. Selwyn J. Baker, who joined the institution in 1955 and set up the beginnings of the
transfusion service as well as laboratory hematology, it was Dr. Robert Carman who joined in 1963 and
truly expanded this service. The detailed and systematic evaluation of disorders of hemostasis that
was done at that time was indeed remarkable. CMC was one of the few places in the country where
factor assays could be done in those days. Later on, further clinical services were developed under the
guidance of Dr. B.M Pulimood from the 1970s, including the treatment of hematological malignancies,
while Dr. Baker went on to research nutritional anemias along with Dr. Sheila Pereira of the pediatrics
department. In the laboratory, it was the combination of Dr. Ramani Pulimood, Dr. Annie Sudarsanam
and Dr. Uma Khanduri who created one of the most advanced and high quality laboratory hematology
and transfusion medicine service available in the country at that time. They not only provided
diagnostic services but also advised general physicians and pediatricians on the evaluation of
patients with difficult to diagnose anemias and bleeding disorders. Questioning what was in the
literature and research was also an integral part of this service.
The department and its development
On this background and heritage of a fairly wide spectrum of laboratory and clinical hematological
services being provided by a variety of extremely good and committed team in different departments,
it was Dr. Mammen Chandy, who then tried to bring all the clinical services together from1983, after
completing his training in hematology. This also included a lot of the pediatric hematology services,
some of which were managed in conjunction with colleagues from the child health services for very
small children (less than 2 years). After functioning for a few years from the general medical
department, in the late 1980s, a separate department of Haematology was created, as it stands today.
He was joined by Dr. David Dennison in 1986 while I joined the team in 1987. In the first 10 years or so,
we concentrated on developing the highest quality of clinical services. The aim was to consolidate the
work that had already been done and add to it in a way that would build and provide for a complete
hematology service. We initiated contemporary protocols for acute leukemias, started a systematic
clinical service for bleeding disorders, particularly with respect for surgery for those patients, which at
that time was hardly done anywhere else in the country. The first bone marrow transplantation was
done in 1986. Even though there were very few people, the emphasis on research continued.
We have always believed that our main strength will be the people we have. By the early 1990s, we had
three full time trained faculty in the department but the numbers of patients were increasing all the time.
We were very fortunate to have some excellent people who worked in the department at that time for
89
their training and in the process helped our services as well. These include, Major Velu Nair and Dr.
Shashi Apte, both of whom have subsequently gone on to play major roles in hematology in India.
Current faculty
Recognizing our own need for qualified clinical faculty and that in the country, we initiated the first DM
training program in Clinical Haematology in the country in 1999 after overcoming several challenges.
Three people who had joined the department in the mid to late 1990s, Dr. Vikram Mathews (1996),
Dr. Biju George (1997) and Dr. Auro Viswabandya (1999), then went on to complete their DMs in 2001,
2002 and 2004, respectively, in the first three batches. They now form the pillars of the clinical service.
The team has grown further with Dr. Aby Abraham joining the faculty after completing his training in
2009. Other junior colleagues work in the department for shorter periods. Dr. Mammen Chandy retired
from the institution in 2011.
It was our aim to not only develop clinical services but also molecular genetics for these services and
research, so as to cover all aspects of hematology to contemporary standards. With our first major
research grant in 1993, we established a genetics and flow-cytometry laboratory in 1994. Around that
time, we also initiated a PhD program in the department. Dr. B. Poonkuzhali and Dr. R.V. Shaji who had
joined the department from the basic science stream were the first two PhD candidates. They
completed their PhD in 1999 and 2001, respectively and became faculty in the department after that.
The scientific faculty grew further when Dr. Eunice Sindhuvi and Dr. Jayandharan G.R. joined after
completing their PhD in 2006 and 2008, respectively. Together, these faculty have helped consolidate
and expand the molecular genetics platform into what today is the largest such service in the country
in a medical institution.
Supported by laboratory hematology colleagues from the Department of Immunohematology and
Transfusion Medicine, Dr. Dolly Daniel, Dr. Sukesh Nair, Dr. Joy Mammen and Dr. Usha Sitaram as well
as other colleagues in that department, we form a fairly large group of people who now provide the
largest comprehensive hematology service in the country. Given these numbers of faculty and the
infrastructure that we have, indeed, anything less would be unacceptable! The close collaboration that
was established more than 50 years ago between faculty in the various clinical departments and
laboratory, continues today. Apart from our services and teaching programs, another example of this
collaboration is the joint external quality assessment program that we provide to the country for tests of
hemostasis, transfusion medicine and molecular genetics. (www.cmc-eqas.net)
Clinical services
The clinical services provided by the department of Hematology are indeed very wide, covering all
aspects of adult and pediatric hematological diseases. We cater to about 30000 patients in the out-
patient clinics and about 3000 in-patients every year. We run the largest hematopoietic stem cell
transplant (SCT) program in the country performing about 150 allogeneic and 50 autologous SCTs
every year. Unfortunately, this is still inadequate for the demands that exist as our waiting list for
elective transplants is nearly 2 years. There are comprehensive clinical services for hematological
malignancies with a special focus on the treatment of acute promyelocytic leukemia with arsenic
trioxide, an extremely cost-effective treatment with excellent results.The department has spearheaded
this work in the country with colleagues from other institutions in what is perhaps the only multicenter
clinical trial in acute leukemia in the country so far. This led to local manufacture of this drug making it
rapidly available in the country at very affordable costs. We have also developed a multidisciplinary
comprehensive care team for the management of hereditary bleeding disorders which are particularly
common in southern India due to consanguineous marriages, including carrier detection and prenatal
diagnosis. This work also has major international recognition. For hemoglobin disorders, we provide
the full range of care from prenatal diagnosis to stem cell transplantation. The details of all the clinical
and laboratory services are available on our website. (www.cmchaematology.org)
90
Laboratory services
The clinical service is backed by a very wide range of molecular genetics, cytogenetic and
flowcytometric laboratory services that have been developed within the department of Hematology.
These include genetic diagnosis for a wide range of hemoglobin disorders, hereditary bleeding
disorders as well hematological malignancies such as acute and chronic leukemias, lymphomas and
plasma cell dyscrasias as well allogeneic transplant related services. Without this support from
molecular hematology laboratories, we would not be able to provide the quality of clinical care that we
wish to provide. These services have been developed over the last two decades by the clinical and
laboratory faculty of the department as mentioned above. Given the importance of cytogenetics in the
management of hematological malignancies, we have also established a cytogenetcis laboratory in
the department for karyotyping and fluorescent in-situ hybridization (FISH). Dr. Vivi Srivastava from the
Cytogenetics unit helps the department for this service.
Training
Given the paucity of trained personnel in the country in hematological sciences, we have considered it
our responsibility to develop appropriate training programs for different needs. As mentioned above,
we initiated a PhD program in basic medical sciences with a focus on hematological diseases in the
mid 1990s. After a prolonged pursuit through the approval systems in the country, we finally initiated
the first DM (Clinical Hematology) training program in India in 1999. We now take four students every
year. In addition, we have a post-doctoral fellowship program for those wanting to acquire expertise in
diagnostic molecular genetics after an MD in Pathology or related subjects. We also have a technical
training program for graduates in life sciences to acquire skills for techniques in molecular genetics.
Apart from these certified training courses, we have also trained a large number of physicians in
different aspects of clinical and laboratory hematology. They now provide these services across the
country. To help familiarize MD (Medicine, Pediatric s and Pathology) students in the country with the
scope of hematology, we conduct an annual CME program for these students. To help secondary
hospitals develop basic hematology services or enhance them, we have an annual program where we
encourage small teams of clinical and laboratory physicians / technologists (including blood bank) to
come together for training for a week. A more focused training program on comprehensive care for
people with hemophilia and other hereditary bleeding disorders is also conducted one a year. The
department is also recognized as an International Hemophilia Training Center of the World Federation
of Hemophilia (http://www.wfh.org/en/page.aspx?pid=831) since 1998.
Research
We believe that we will only be able to improve and maintain the quality of our service that we provide if
we are continuously engaged in research - both clinical and laboratory. Towards clinical research, we
have two approaches. The first is to conduct or participate in prospective clinical trials. The second is
to audit and analyze our own data. For this, we have established an elaborate system of maintaining
data bases of individual patient outcomes for many of the common conditions that we treat. This
allows us to review our own data from time to time and not only report them in the literature but also
assess our own quality. Bench research involves many areas such as genetics of leukemias and
mechanisms or drug resistance, with particular reference to acute myeloid leukemia, acute
promyelocytic leukemia and chronic myeloid leukemia. There is significant work also going on with
genetics of hemoglobin disorders and iron metabolism, hemostasis disorders and certain
constitutional bone marrow failure syndromes. In recent years, we have also invested in developing a
gene therapy for hematological diseases. This includes work related to the adeno associated virus
(AAV) as vectors for gene therapy. Novel forms of AAV have been created in different serotypes with
modifications of capsid proteins that are meant to increase their efficiency of transduction. These
vectors could be used for clinical trials in hemophilia B, hematological malignancies and even non-
hematological diseases. We have also just initiated some work with lentiviral vectors for transferring
the globin genes into hematopoietic stem cells as a prelude to our planned attempts at developing
91
gene therapy for thalassemia. The details of the work being done in all these areas and the faculty
responsible are mentioned on our website: www.cmchaematology.org and www.cscr.in. The faculty
have obtained research grants worth more than 25 crores in the last 20 years and published more than
200 original papers.
Multidisciplinary team
We need to recognize that our clinical and laboratory services are now supported by a large number of
multidisciplinary staff. We have between 15-20 senior registrars at any time who are an integral part of
the clinical services. There are also a large number of nurses, led by Ms. Selva Titus Chacko, who
make up the team. They are indeed critical to both our out-patient and in-patient services. Starting in
the mid-1990s, we have developed a team of nurses to take care of all central IV lines, blood sampling
from them, chemotherapy and transfusions. The laboratory work is supported by nearly twenty five
technical staff, led by Ms. Shankari Devi. We have a data management team led by our biostatistician,
Ms. M.L. Kavitha. There is a clinical research management team that helps with all clinical trials led by
Mr. Christopher Benjamin. There are several secretarial and other support staff who help in so many
ways to make the department what it is. Without their dedication and work, we would not be what we
are.
It is a privilege to have been a part of this story and building up this team and department over the last
25 years. While drawing some satisfaction from the contributions that we make to hematology in India
through the services and education that we provide and the research that we do, we are also very
conscious of the many challenges ahead.
92
We accept that this, by no means, is a complete list. Due to various reasons, certain hospital department names from
the field of haematology in India may have been missed and we regret for the same.

Top Ranking Haematology Departments in India

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Top Ranking Haematology Departments in India

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Haematology

A frequently asked question by a student who completes his

However, today, after 40 years, the situation has remarkably

This booklet is a modest attempt to assemble information about

Dr. M.B. Agarwal

Institute Contributed by Page No.

1. Gujarat Cancer Research Institute (GCRI), Ahmedabad Pankaj Shah 3

2. Narayana Health City, Bengaluru Sharat Damodar 5

3. Postgraduate Institute of Medical Education & Research Neelam Varma 6

4. S.C.B. Medical College, Cuttack Sudha Sethy 8

5. All India Institute of Medical Sciences (AIIMS), Delhi Renu Saxena 11

7. Guru Teg Bahadur Hospital (GTB Hospital), Delhi Usha Rusia 15

8. Indraprastha Hospital Apollo Hospitals, Delhi Amita Mahajan 17

9. Maulana Azad Medical College (MAMC) & Tejinder Singh 20

10. Rajiv Gandhi Cancer Institute, Delhi Dinesh Bhurani 21

11. Sir Ganga Ram Hospital, Delhi Manorama Bhargava 23

12. Medical College, Kolkata Utpal Chaudhuri 29

13. NRS Medical College, Kolkata Maitreyee Bhattacharyya 33

14. Tata Medical Centre (TMC), Kolkata Mayur Parihar 37

15. Sanjay Gandhi Postgraduate Institute (SGPGI), Lucknow Soniya Nityanand 45

16. Christian Medical College (CMC), Ludhiana M. Joseph John 49

17. B.J. Wadia Hospital for Children, Mumbai Bharat Agarwal 54

18. KEM Hospital, Mumbai Farah Jijina 58

19. LTMG Hospital, Sion, Mumbai Mamta Manglani 61

20. National Institute of Immuno-Haematology (NIIH), Mumbai K.Ghosh 64

21. P.D. Hinduja National Hospital, Mumbai Farah Jijina 68

22. Tata Memorial Hospital (TMH), Mumbai S.D. Banavali 70

23. Tata Memorial Centre, Mumbai Navin Khattry 73

24. Armed Forces Medical College (AFMC), Pune AFMC Group 77

25. Sahyadri Hospital, Pune Shashi Apte 82

26. Shere-E-Kashmir Institute of Medical Sciences, Srinagar M. I. Quadri 87

27. Christian Medical College (CMC), Vellore Alok Srivastava 89

Narendra Agrawal, DM (Clin Haematology)

Manorama Bhargava, MD, FAMS

Maitreyee Bhattacharyya, MD (Gen Med), DM (Clinical Haematology)

Tathagat Chatterjee, MD, DM, FUICC, FISHTM

Sharat Damodar, MD, DNB, DM

Rabindra Kumar Jena, MD. PhD,FISHBT

M. Joseph John, MD, DM

Navin Khattry, MD, DM

Deepak K Mishra, MD, MAMS, FICPath, FISHTM, FUICC, PDF

Velu Nair, AVSM, VSM**

Soniya Nityanand, MD PhD

Mayur Parihar, Associate Consultant

Renu Saxena, MD, FNAMS, FIMSA

Tejinder Singh, MD, FICP, FISHTM

Alok Srivastava, MD, FRACP, FRCPA, FRCP

Neelam Varma, MD, FISHTM,

Pankaj Shah, Sandip Shah

4 Minor Procedures - Bone marrow aspiration/biopsy Intrathecal, Pleural & 8638

Service Output of last year from April 2012 to March 2013

No. Details of Work Done Nuber

1 New and referred cases 1079

3 Day care chemotherapy administration 5700

4 Minor procedures - Bone marrow aspiration/biopsyIntrathecal, Pleural & 4100

5 No. Of Hemato-oncology cases 460

Bone marrow transplantation

Financial Aid for Patients

Hematology Service in PGIMER, Chandigarh comprises of 3 components: diagnostic service by

Sudha Sethy, R.K. Jena

Prof. (Dr.) Rabindra Kumar Jena, M.D., Ph.D, FISHBT

28th October 2003 to Cont…

Prof. Upendra Nayak, M.D., Ph.D, FISHBT