Abhijeet Kumar

Interests

Research

Immunotherapy and resistance to immune checkpoint inhibition in lymphoid malignancies, modalities to overcome late relapses in patients with localized DLBCL, clinical trials using combination of aurora kinase inhibition and BTK or downstream signaling inhibition as an modality for relapsed refractory double hit double protein or ABC subtype DLBCL; Mechanisms Resistance to immune checkpoint inhibition is sarcomas.

Courses

No activities entered.

Scholarly Contributions

Chapters

• Korde, N., Kumar, A., Agarwal, A. B., & Sundararajan, S. (2016). MGUS, Smoldering Myeloma and Plasmacytoma. In Handbook of Hematologic Malignancies 1st Edition.
• Kumar, A., Krishnadasan, R., & Sundararajan, S. (2016). T-cell Prolymphocytic Lymphoma. In Handbook of Hematologic Malignancies 1st Edition.

Journals/Publications

• Menghani, S. V., Diaz-Hanson, J. P., Heimbigner, A., Wakefield, C., Fuchs, D., Reveles, C. Y., Spier, C., Amaraneni, A., & Kumar, A. (2023). Peripheral T-Cell Lymphoma in a Patient Previously Diagnosed With Sarcoidosis. Journal of hematology, 12(6), 272-276.
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  Sarcoidosis is a multisystem disorder characterized by granulomatous inflammation on histopathological evaluation. Diagnosis of sarcoidosis requires thorough elimination of malignancy and alternative causes of noncaseating granulomatous inflammation. Sarcoidosis and several subtypes of lymphoma have similar clinical presentations and can potentially have similar histopathological findings. Patients with a histopathology-confirmed diagnosis of sarcoidosis are at higher risk of developing malignancies. In this report, we present a case of a 64-year-old male diagnosed with sarcoidosis 2 years before presenting to the emergency department with a 4-month history of generalized weakness, cough, and very high fever. After a thorough workup involving cervical lymph node biopsy and bone marrow biopsy, he was diagnosed with peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS). Due to the patient's current lymphoma diagnosis and features noted on pathology, a retrospective review of the prior biopsy specimen was performed, finding similar hematopathological features on both initial lymph node biopsy diagnosing sarcoidosis and current biopsies diagnosing lymphoma. Given these findings, our patient likely had early manifestation of PTCL misdiagnosed as sarcoidosis. In summary, lymphoma should be considered in all patients with suspected sarcoidosis, especially those who do not respond to treatment or who present with persistent hematological abnormalities.
• Davids, M. S., Roberts, A. W., Kenkre, V. P., Wierda, W. G., Kumar, A., Kipps, T. J., Boyer, M., Salem, A. H., Pesko, J. C., Arzt, J. A., Mantas, M., Kim, S. Y., & Seymour, J. F. (2021). Long-term Follow-up of Patients with Relapsed or Refractory Non-Hodgkin Lymphoma Treated with Venetoclax in a Phase I, First-in-Human Study. Clinical cancer research : an official journal of the American Association for Cancer Research, 27(17), 4690-4695.
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  We previously reported a 44% overall response rate (ORR) with the oral BCL-2 inhibitor venetoclax in a phase I study of relapsed/refractory non-Hodgkin lymphoma (NHL). Complete response (CR) was observed in patients with mantle cell lymphoma [(MCL), 21%, = 6/28] and follicular lymphoma [(FL), 17%, = 5/29], and partial response (PR) noted in several patients with Waldenström macroglobulinemia (WM), and marginal zone lymphoma (MZL). Here, we report the long-term outcomes of these four cohorts.
• Moore, L., Bartels, T., Persky, D. O., Abraham, I., Kumar, A., & McBride, A. (2021). Outcomes of primary and secondary prophylaxis of chemotherapy-induced and febrile neutropenia in bendamustine plus rituximab regimens in patients with lymphoma and chronic lymphocytic leukemia: real-world, single-center experience. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 29(8), 4867-4874.
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  To examine the outcomes associated with granulocyte colony stimulating factors (G-CSFs) administered as primary versus secondary prophylaxis in setting of bendamustine plus rituximab (BR) regimens.
• Smith, J., Kumar, A., Stanton, N. A., & Katsanis, E. (2021). Concurrent application of blinatumomab and haploidentical donor leukocyte infusions for refractory primary mediastinal large B-cell lymphoma. Therapeutic advances in hematology, 12, 2040620721994348.
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  Primary mediastinal large B-cell lymphoma (PMBCL) is a rare hematologic malignancy with distinct clinical and immunopathological features. We report a case of a young male with disease refractory to multiple lines of therapy, including chimeric antigen receptor-T cells, who achieved his first complete remission after haploidentical bone marrow transplantation (haplo-BMT), following donor leukocyte infusions (DLIs) given concurrently with blinatumomab. While DLI has been used after T-replete haplo-BMT with post-transplant cyclophosphamide, there are no reports on its use for PMBCL. Similarly, blinatumomab is active against B-cell lymphomas, but literature is lacking in patients with PMBCL. Our experience illustrates that blinatumomab can be used concurrently with DLI in a haploidentical setting to achieve disease response in PMBCL. Despite our encouraging experience with this case, we would not recommend this approach outside of a clinical trial as blinatumomab may exacerbate the graft host disease risks of DLI, especially in a haploidentical setting. Evaluating this treatment combination in high-risk patients in the setting of a clinical trial may be meaningful.
• Kumar, A., & Persky, D. O. (2020). Treatment of Early (Limited)-Stage DLBCL. Clinical lymphoma, myeloma & leukemia, 20 Suppl 1, S34-S36.
• Kumar, A. (2019). Abstract CT028: Drug-drug interaction potential of EZH2 inhibitor tazemetostat (TAZ). American Association for Cancer Research, 79(13 Supplement), CT028-CT028. doi:10.1158/1538-7445.AM2019-CT028
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  AACR Annual Meeting 2019; March 29-April 3, 2019; Atlanta, GA
• Kumar, A. (2019). Outcomes of Primary and Secondary Prophylaxis of Chemotherapy Induced and Febrile Neutropenia (CIN/FN) in Bendamustine Plus Rituximab (BR) Regimens in Patients with Lymphoma and Chronic Lymphocytic Leukemia (CLL): Real-World, Single-Center Experience. Blood, 134(Supplement_1), 5353.
• Kumar, A. (2019). The efficacy of ibrutinib-based combination therapy for mantle cell lymphoma: A systematic review.. Journal of Clinical Oncology, 37(15_suppl), e19043-e19043.
• Kumar, A., Fraz, M. A., Usman, M., Malik, S. U., Ijaz, A., Durer, C., Durer, S., Tariq, M. J., Khan, A. Y., Qureshi, A., Faridi, W., Nasar, A., & Anwer, F. (2018). Treating Diffuse Large B Cell Lymphoma in the Very Old or Frail Patients. Current treatment options in oncology, 19(10), 50.
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  R-CHOP has been the standard of care for diffuse large B cell lymphoma (DLBCL), curing approximately 60% of patients for more than 2 decades. However, the optimal treatment of patients who are too frail to tolerate this regimen and/or are not candidates for anthracycline therapy continues to be debated. MInT and GELA trials established addition of rituximab to CHOP in DLBCL but excluded patients older than 80 years. Multiple regimens have been tried with varying success in the very elderly, including R-mini-CHOP, R-mini CEOP, R-split CHOP, pre-phase strategies, and R-GCVP. However, there has not been a randomized trial among these strategies. Although addition of novel agents including ibrutinib, brentuximab vedotin, lenalidomide, and many others on the horizon holds promise in this population, none have been tested in a randomized setting or have results awaited. There is also a lack of a validated and easy to use clinical tool in this population to predict patients who will not tolerate R-CHOP. Identifying patients who will not tolerate R-CHOP early with the help of tools like CGA, along with integrating biology-based treatment (ibrutinib, lenalidomide in activated B cell type DLBCL) is being investigated in this population.
• Puvvada, S. D., Guillen-Rodriguez, J., Kumar, A., Inclán, L., Heard, K., Rivera, X. I., Anwer, F., Schatz, J. H., Mahadevan, D., & Persky, D. O. (2018). Phase 2 Open-Label Study of Bortezomib, Cladribine, and Rituximab in Advanced, Newly Diagnosed, and Relapsed/Refractory Mantle-Cell and Indolent Lymphomas. Clinical lymphoma, myeloma & leukemia, 18(1), 58-64.
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  Mantle-cell lymphoma (MCL) and indolent non-Hodgkin lymphoma (iNHL) are incurable heterogeneous diseases characterized by relapse. There is a need for newer treatments in MCL and iNHL, especially in the relapsed/refractory (R/R) setting. We therefore investigated the novel combination of bortezomib (Velcade), cladribine, and rituximab (VCR) in front-line and R/R settings in MCL and iNHL (NCT00980395).
• Naing, A., Heist, R., McClay, E., Richards, D., Mita, M., Kumar, A., Mahadevan, D., & Sundararajan, S. (2017). Phase I single dose, two-period and two-sequence cross-over trial to evaluate the relative bioavailability of two oral pimasertib formulations in advanced cancer patients. Cancer Chemotherapy and Pharmacology.
• Pulluri, B., Kumar, A., Shaheen, M., Jeter, J., & Sundararajan, S. (2017). Tumor microenvironment changes leading to resistance of immune checkpoint inhibitors in metastatic melanoma and strategies to overcome resistance. Pharmacological research, 123, 95-102.
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  Immunotherapy with checkpoint inhibitors targeting CTLA-4 and/or PD-1 receptors independent of the BRAF mutational status and targeted therapy with BRAF and MEK inhibitors in BRAF V600 mutated patients have taken the forefront of advanced melanoma treatment. The main advantage of immunotherapy is its ability to provide durable responses in a subset of patients. However, significant proportions of patients either do not respond or have progression after initial response to immunotherapies. Multiple changes in the tumor microenvironment, such as down regulation of immune checkpoint ligands by tumor, alteration in interferon signaling, and activation of alternate immune suppressive pathways, have been identified as possible reasons for failure of immune checkpoint therapy. Here, we review the resistance mechanisms adopted by cancer cells to checkpoint inhibitor therapy and targeted therapy. In addition, we focus on the available and emerging evidence on tumor microenvironment modulation by BRAF/MEK inhibitor therapy and its role in improving responses to checkpoint inhibitor therapy.
• Kumar, A., & Le, D. T. (2016). Hepatocellular Carcinoma Regression After Cessation of Immunosuppressive Therapy. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 34(10), e90-2.
• Kumar, A., Sundararajan, S., Puvvada, S., & Persky, D. O. (2016). Limited Stage Aggressive Non-Hodgkin Lymphoma: What Is Optimal Therapy?. Current treatment options in oncology, 17(9), 45.
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  The seminal SWOG trial S8736 trial established the success of a short course of chemotherapy followed by involved field radiation in treating limited stage aggressive NHL lymphoma. Addition of rituximab offered a surprisingly modest improvement in this disease subset. Radioimmunotherapy could hold a slight advantage over rituximab, but that should be investigated in a randomized trial setting. The role of radiation therapy continues to be widely debated, with interpretation complicated by different trial populations, methods of assessing risk, as well as by differences in timing and dose of radiation. Prolonged course of chemotherapy followed by radiation is certainly not justified in all patients with limited stage disease. Three to four cycles of R-CHOP followed closely by IFRT/ISRT, or six cycles of R-CHOP chemoimmunotherapy (based on the MInT trial) are acceptable options. PET/CT scans may further limit radiation to minority of patients who have residual PET-positive masses. PET/CT-directed treatment strategy is being tested in a US intergroup trial. There is evidence that localized DLBCL has a different biology as compared to advanced stage disease. This relates to propensity of limited stage disease to be proportionately more germinal center B-cell like (GCB) and to have late relapses beyond 5 years. Both biology and imaging need to be integrated in the study of limited stage disease without presumption that it should be approached the same as advanced stage disease.
• Mahadevan, D., Mita, M., Richards, D., McClay, E., Heist, R. S., Kumar, A., Sundararajan, S., & Naing, A. (2017). Phase I single dose, two-period and two-sequence cross-over trial to evaluate the relative bioavailability of two oral pimasertib formulations in advanced cancer patients. Cancer chemotherapy and pharmacology, 79(4), 681-688.
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  A phase I two-period two sequence cross-over study compared the bioavailability of two pimasertib (MSC1936369B/AS703026) formulations (capsule versus tablet) in advanced cancer patients.
• Sundararajan, S., Chen, H., Kumar, A., Tus, K., Yeager, A., & Puvvada, S. (2016). Donor-derived marginal zone lymphoma following reduced-intensity allogeneic peripheral blood stem cell transplant. Leukemia & lymphoma, 57(7), 1735-8.
• Sundararajan, S., Kumar, A., Korde, N., & Agarwal, A. (2016). Smoldering Multiple Myeloma: Emerging Concepts and Therapeutics. Current hematologic malignancy reports, 11(2), 102-10.
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  Smoldering multiple myeloma (SMM) is a pre-malignant condition with an inherent risk for progression to multiple myeloma (MM). The 2014 IMWG guidelines define smoldering multiple myeloma as a monoclonal gammopathy disorder with serum monoclonal protein (IgG or IgA) ≥30 g/L or urinary monoclonal protein ≥500 mg per 24 h and/or clonal bone marrow plasma cells 10-60 % without any myeloma-defining events or amyloidosis. The risk for progression of SMM to MM vary based on clinical, laboratory, imaging, and molecular characteristics. Observation, with periodic monitoring is the current standard of care for SMM. Over last few years, research advances in SMM have led to the delineation of newer risk factors for progression and identification of a "high-risk" group that would potentially benefit from early treatment. This review focuses on advances in the SMM risk-stratification model and recent clinical trials in this patient population.
• Sundararajan, S., Kumar, A., Poongkunran, M., Kannan, A., & Vogelzang, N. J. (2016). Cardiovascular adverse effects of targeted antiangiogenic drugs: mechanisms and management. Future oncology (London, England), 12(8), 1067-80.
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  Anticancer treatment has evolved enormously over the last decade. Drugs targeting receptor tyrosine kinases, VEGFR and EGFR have changed the treatment landscape of certain cancers and have shifted the theme of anticancer therapy toward personalized care. However, these newer agents also come with unique side-effect profiles not seen with conventional chemotherapy including serious cardiovascular adverse effects. Hence, meticulous understanding of the adverse effects is crucial in maximizing clinical benefits and minimizing detrimental effects of these newer drugs. We have reviewed the cardiovascular adverse effects of anti-VEGF therapy in this article.
• Kumar, A., & Puvvada, S. (2015). Mantle cell lymphoma presenting as cardiac tamponade. Blood, 126(10), 1255.
• Kumar, A., Dagar, M., Herman, J., Iacobuzio-Donahue, C., & Laheru, D. (2015). CNS involvement in pancreatic adenocarcinoma: a report of eight cases from the Johns Hopkins Hospital and review of literature. Journal of gastrointestinal cancer, 46(1), 5-8.
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  CNS metastasis of pancreatic cancer is extremely rare, although systemic metastasis is very common. We present eight such cases with various forms of nervous system involvement.

Presentations

• Kumar, A. (2022, July/Summer). Lymphoma. ASCO Direct Hematological Malignancies. Las Vegas, NV: ASCO.
• Kumar, A. (2022, November/Winter). Critical Reviews. Introduction to Clinical and Translational Research "Fellows Boot Camp". Tucson, AZ: UACC.
• Kumar, A. (2020, October/Fall). Lymphoma 101 for Newly Diagnosed Patients/Caregivers. 25th annual North American Educational Forum on Lymphoma / Lymphoma Foundation. virtual.
• Kumar, A. (2020, October/Fall). Lymphoma. PRIME: Oncology Program. virtual: PRIME.
• Kumar, A. (2016, December/Winter). A Phase II, Open-Label Study of Bortezomib (Velcade), Cladribine and Rituximab (VCR) in Advanced, Newly Diagnosed and Relapsed/Refractory Mantle Cell and Indolent Lymphomas. American Society of Hematology (ASH) Annual Meeting. San Diego, CA: ASH.

Poster Presentations

• Abraham, I. L., Kumar, A., Persky, D. O., & Anwar, F. (2017, December/Winter). 4678 Economic Evaluation for the US of Venetoclax Versus Allogeneic Hematopoietic Stem-Cell Transplantation for Patients with Relapsed or Refractory Chronic Lymphocytic Leukemia with 17p Deletion. ASH Annual Meeting. Atllanta, GA: ASH.
• Abraham, I. L., Kumar, A., Persky, D. O., & Anwar, F. (2017, December/Winter). 4679 Economic Evaluation for the US of Ibrutinib Versus Allogeneic Hematopoietic Stem-Cell Transplantation for Patients with Relapsed or Refractory Chronic Lymphocytic Leukemia with 17p Deletion. ASH Annual Conference. Atlanta GA: ASH.
• Kumar, A. (2016, January/Winter). Epidemiology and survival of metastatic gastrointestinal stromal tumor: A Surveillance, Epidemiology, and End Results (SEER) database review. GI ASCO Symposium. San Francisco, CA: ASCO.
• Kumar, A. (2016, January/Winter). Epidemiology and survival of small cell carcinoma of gastrointestinal tract: A Surveillance, Epidemiology, and End Results (SEER) database review. GI ASCO Symposium. San Francisco, CA: ASCO.
• Kumar, A. (2014, April/Spring). Retrospective Analysis of CML treated at St. Agnes Hospital. ACP. Orlando, FL: American College of Physicians.
• Kumar, A. (2012, April/Spring). Miliary BCG Pneumonitis: A Rare Complication of a common therapy. ACP Annual Meeting. New Orleans, Louisiana: ACP.
• Kumar, A. (2012, April/Spring). Systemic mastocytosis: The mystery of a 89 year old with chronic loose stools.. ACP Annual Meeting. New Orleans, Louisiana: ACP.

Others

• Rivera, X., Ayala, A., Inclan, L., Schatz, J., Guillen-Rodriguez, J., Anwer, F., Kumar, A., Puvvada, S. D., Persky, D. O., Mahadevan, D., & Sundararajan, S. (2016, December). A phase II, open-label study of bortezomib (Velcade®), cladribine, and rituximab (VCR) in advanced, newly diagnosed and relapsed /refractory mantle Cell and indolent Lymphomas.