Raj Bajwa, MD
Disclosures: Nothing to disclose
398 Form Pages _

BIOGRAPHICAL SKETCH

NAME: Rajinder Pal Singh Bajwa

eRA COMMONS USER NAME (credential, e.g., agency login): BAJWARAJ

POSITION TITLE: Associate Professor of Pediatrics, MD

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable

INSTITUTION AND LOCATION

DEGREE

(if applicable)

 

Completion Date

MM/YYYY

 

FIELD OF STUDY

 

Government Medical College, Patiala, India

MBBS

1985

Medicine

Postgraduate Institute of Medical Education & Research, Chandigarh, Punjab University, India

MD

1989

Pediatrics

Royal College of Physicians of UK, England

Women and Children’s Hosp, Buffalo, NY

Women and Children’s Hosp. Buffalo, NY

 

MRCP(U.K)

Resident Peds

Fellow Ped/Onc

1997

2003

2006

Pediatrics

Pediatrics

Pediatric Hem/Onc

 

 

 

 

 

  1. Personal Statement

My role in this project is to provide support as a haematopoietic stem cell transplantation (HSCT) expert. After having completed my medical school degree and residency in India, I got further training in Hem/Onc/BMT in England and then in the USA. The diverse clinical and research exposure has helped me to establish myself as a clinical researcher in the field of HSCT. With a goal of “No child should die from veno-occlusive disease (VOD)”, I have been involved with a number of research projects about VOD, leading to extensive publications and presentations at national and international levelTo find a solution to a problem, one has to get to the root cause of the problem and with the help of an international survey of transplant and critical care providers I was able to find that “high variability in the diagnosis and treatment of VOD” is one of the major contributors to the increased morbidity and mortality from VOD in children. To help remove the inconsistencies in management of VOD, I took a leadership role to develop consensus guidelines for the supportive care of VOD in children which were completed and published in 2017.  While continuing my efforts about further research in VOD, I firmly believe that I have the expertise, leadership experience, motivation and above all the passion to support Dr Chan’s project.

 

  1. Skeens MA, McArthur J, Cheifetz IM, Duncan C, Randolph AG, Stanek J, Lehman L, Bajwa R; HSCT subgroup of the Pediatric Acute Lung Injury & Sepsis Investigators (PALISI). High Variability in the Reported Management of Hepatic Veno-Occlusive Disease in Children after Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2016 Oct;22(10):1823-8
  2. Bajwa RPS, Mahadeo KM, Taragin BH et al. Consensus Report by Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplantation Consortium Joint Working Committees: Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents, Part 1: Focus on Investigations, Prophylaxis, and Specific Treatment. Biol Blood Marrow Transplant. 2017 Nov;23(11):1817-1825. doi: 10.1016/j.bbmt.2017.07.021. Epub 2017 Jul 25. Review. PubMed PMID: 28754544
  3. Mahadeo KM, McArthur J, Adams RH,…Bajwa RPS. Consensus Report by the Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplant Consortium Joint Working Committees on Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents: Part 2-Focus on Ascites, Fluid and Electrolytes, Renal, and Transfusion Issues. Biol Blood Marrow Transplant. 2017 Dec;23(12):2023-2033. doi: 10.1016/j.bbmt.2017.08.014. Epub 2017 Aug 17. PubMed PMID: 28823876
  4. Ovchinsky N, Frazier W, Auletta JJ,…. Bajwa RPS. Consensus Report by the Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplantation Consortium Joint Working Committees on Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents, Part 3: Focus on Cardiorespiratory Dysfunction, Infections, Liver Dysfunction, and Delirium. Biol Blood Marrow Transplant. 2018 Feb;24(2):207-218. doi: 10.1016/j.bbmt.2017.08.035. Epub 2017 Sep 1. PubMed PMID: 28870776.

 

  1. Positions and Employment (USA only) 
  1. July 2006 to June 2007: Clinical Assistant Professor at Women & Children’s Hospital of Buffalo (WCHOB) & Roswell Park Cancer Institute (RPCI), Buffalo, NY.
  2. July 2007 –Dec 2015: Clinical Assistant Professor, Ohio State University, Division of Hem/Onc/BMT, Nationwide Children’s Hospital, 700 Children’s drive, Columbus, Ohio, 43205.
  3. Jan 2016 Onwards: Clinical Associate Professor Ohio State University, Division of Hem/Onc/BMT, Nationwide Children’s Hospital, 700 Children’s drive, Columbus, Ohio, 43205

 

Other Experience and Professional Memberships

2003 - present

Member  -Children’s Oncology Group

2006 - present

Member – American Society for Blood and Marrow transplantation

2007-  present

Member American Society of Hematology

2008– present

2013 – present

Member Pediatric Acute Lung Injury and Sepsis investigators (PALISI)

Executive member PALISI

2014 – present                   Member medical advisory board, Bone Marrow Foundation

 

Honors and Awards

2019 - Outstanding Patient & Family Centered Physician Award

 

  1. Contribution to Science

HSCT is now used as a curative treatment modality for a vast number of conditions, and the outcomes after transplant have improved over the last few decades, thanks to the improvement in better HLA typing and supportive care of patients. I have been involved in clinical research   in the field of supportive care  related to  HSCT.

 

  1. Supportive care of patients with VOD

While training at Newcastle upon Tyne when we published our experience with treatment of VOD using recombinant tissue plasminogen activator. Since then  I have  planned and performed a number of studies  related to i) the clinical presentation of VOD (like anicteric VOD), ii)  high variability in the diagnosis and management of VOD  and have published extensively  about VOD.  Further I have taken a leadership role in developing consensus guidelines for management of VOD in children.  Refractory thrombocytopenia (RT) is one of the new diagnostic criteria as per the EBMT diagnostic criteria. We presented our research related to RT at ASBMT annual meeting in 2018 and showed that it is a valid diagnostic criteria.  Along with my colleagues I was involved in planning of an international conference about VOD in Feb 2019 at MD Anderson Cancer Center, Houston, TX.

    1. Richardson PG,  Riches ML, Kernan NA,…. Bajwa R, D'Agostino RB Sr, Massaro J, Warren D, Miloslavsky M, Hume RL, Iacobelli M, Nejadnik B, Hannah AL, Soiffer RJ. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood. 2016 Mar 31;127(13):1656-65.

 

  1. Supportive care during transplant 

During my fellowship I was involved in a translation research project and showed that Ganciclovir Inhibits Lymphocyte Proliferation by Impairing DNA Synthesis". With this knowledge foscarnet is the preferred treatment of CMV reactivation before engraftment and is switched to ganciclovir after engraftment. Multicenter collaborative research is important for the successful out of any project and in addition leads to establishment of a good network of   researchers. As a member of the HSCT subgroup of the Pediatric acute lung injury and sepsis investigators (PALISI), I have been involved in multiple research projects and collaborative publications. Chimeric antigen receptor T cells therapy is the used to treatment of patients with relapsed leukemia and lymphoma and is associated with a few potentially life threatening complications.  The HSCT subgroup of PALIS published Management guidelines for patients receiving CAR-T cell therapy

  1. Mahadeo KM, Khazal SJ, Abdel-Azim H,….. Bajwa R, Kebriaei P, Martin PL,  et al. PALISI Network. Management guidelines for paediatric patients receiving chimeric antigen receptor T cell therapy. Nat Rev Clin Oncol. 2019 Jan;16(1):45-63. doi: 10.1038/s41571-018-0075-2. Review. PubMed PMID: 30082906
  2. M Battiwalla, Y Wu, RPS Bajwa, M Radovic, NG Almyroudis, BH Segal, PK Wallace, R Nakamura, S Padmanabhan, T Hahn, PL McCarthy, Jr., "Ganciclovir Inhibits Lymphocyte Proliferation by Impairing DNA Synthesis". Biology of blood and marrow transplantation. Vol. 13, no. 7: 765-770. 2007

 

  1. Long term complications after HSCT 

Myeloablative transplants are associated with a number of long term complications. I am the director of the comprehensive survivorship clinic for such patients. In our cohort of patients we have identified metabolic syndrome, endocrine dysfunctions and psychosexual issues as common long term complications. 

  1. Vicky Lehmann, Marrit A. Tuinman, Madelaine C. Keim, Adrien M. Winning, Randal S. Olshefski, Rajinder P.S. Bajwa, Mariet Hagedoorn and Cynthia A. Gerhardt. Psychosexual Development and Satisfaction in Long-Term Survivors of Childhood Cancer: Neurotoxic Treatment. Cancer. 2017 Feb 6. doi: 10.1002/cncr.30513

 

  1. Bajwa R, Skeens M, Garee A, et al.Metabolic syndrome and endocrine dysfunctions after HSCT in children. Pediatr Transplant. 2012 Dec;16(8):872-8. doi: 10.1111/petr.12002. PubMed PMID: 23131056

  1. Treatment of rare and complicated conditions

Over the years I have performed a number of successful transplants in many high risk conditions by customizing the conditioning regimen. These have included patients with Diamond Blackfan anemia with cirrhosis of the liver (from iron overload), patients with congenital amegakaryocytic thrombocytopenia, glycogen storage disease type 1b and severe congenital neutropenia to name a few.

  1. Asquith JM, Copacia J, Mogul MJ, Bajwa RPS, "Successful use of reduced-intensity conditioning and matched unrelated hematopoietic stem cell transplant in a child with Diamond-Blackfan anemia and cirrhosis". Pediatric Transplantation. Vol. 19, E157-E159. 2015.,
  2. Woods G, Bajwa RPS, Rose MJ. “Reduced intensity transplantation for congenital amegakaryocytic thrombocytopenia: Report of a case and review of the literature.” Pediatr Transplantation 2014: 18: E31–E34
  3. Lubna S. Mehyar, Rolla Abu-Arja, Hemalatha G. Rangarajan, Vinita Pai, Dennis W. Bartholomew,  Melissa J. Rose, Rajinder P. S. Bajwa. Matched unrelated donor transplantation in glycogen storage disease type 1b patient corrects severe neutropenia and recurrent infections. Bone Marrow Transplantation, https://doi.org/10.1038/s41409-018-0147-z 2018.

 

  1.    Hashem H, Abu-Arja R, Auletta JJ, Rangarajan HG, Varga E, Rose MJ, Bajwa RPS. Successful second hematopoietic cell transplantation in severe congenital neutropenia. Pediatr Transplant. 2018 Feb;22(1). doi: 10.1111/petr.13078. Epub 2017 Oct 26. PubMed PMID: 29076228

 

  1. Novel interventions

Secondly steroid refractory acute graft versus host disease (SRaGvHD) is a potentially life threatening complication after HSCT and there are not many successful treatments available. I developed an investigator initiated prospective multi-center study using infliximab and basiliximab for the treatment of SRaGvHD with intramural funding support and pharmaceutical support for supply of free basiliximab.  Unfortunately the pharmaceutical company withdrew support and the study could not be completed. However encouraged with the positive outcome of the few patients we have adopted this approach for all patients with SRaGvHD.

 

Calcineurine inhibitors commonly used for GVHD prophylaxis, are usually administered via a dedicated central venous line (CVL) and trough levels drawn from the unexposed lumen. Being an oil-based medication, it may be adsorbed to the inner lumen of the CVL and result in falsely high levels drawn from an inadvertently exposed lumen. There is no treatment for decontamination of such CVLs, and natural decay occurs over months before the CVL can be used to draw reliable trough levels. In a first ever prospective study we concluded that a 2-hour 70% ethanol lock is effective for decontamination of CVLs exposed to tacrolimus.

 

  1. Copacia JA, Taylor K, Laudick M, Rangarajan HG, Abu-Arja R, Auletta JJ, Pyle-Eilola A, Stanek J, Pai VB, Bajwa R. 70% Ethanol for Decontamination of Central Venous Lines Exposed to Calcineurin Inhibitors. Ann Pharmacother. 2018 Jan;52(1):32-39. doi: 10.1177/1060028017709289. Epub 2017 Aug 24. PubMed PMID: 28838253

 

  1. Additional Information: Research Support and/or Scholastic Performance

 

Ongoing Research

Grant                                                                        Rajinder Bajwa (PI)                                          2016 - present

A Retrospective Study of Vitamin D Levels and its Correlation with Patient Outcomes after Hematopoietic Stem Cell Transplantation in Children

 


Grant                                                                       Rajinder Bajwa (site PI)                            2017 -  present

Harmony Study (15-007) phase 3 randomized adaptive study  comparing the efficacy and safety  of defibrotide vs best supportive care in prevention of hepatic veno –occlusive disease in adult and pediatric patients undergoing hematopoietic stem cell transplantation.

 

Grant                                                                       Rajinder Bajwa    (Co-PI)                        2016- present

Paracentesis in stem cell transplant recipients with ascites due to veno-occlusive disease is associated with favorable outcomes.

 

Grant # 82259917                                                      Rajinder Bajwa   (site PI)                              2017 – present

Noninvasive Positive Pressure Ventilation in the Pediatric Allogeneic Hematopoietic Cellular Transplant Recipients.

 

Grant # 82259917                                                 Rajinder Bajwa (site PI)                               2017- present

Retrospective Study of Acute Pulmonary Hemorrhage following HSCT.

 

Grant #  720095-1117-00                                          Rajinder Bajwa  (site PI)                              2015 – present

Pathogen Identification in Pediatric Hematopoietic Stem Cell Transplant Patients with

Suspected Lower Respiratory Tract Infection (PBMTC Study SUP1601).

 

Completed research

  1. Outcome of children who experience disease relapse following allogeneic hematopoietic stem cell transplantation. 2012. Role - PI
  2. Infliximab and Basiliximab for treatment of Steroid refractory acute graft versus host disease. 2012. Role –PI
  3. Metabolic Syndrome and Endocrine dysfunction after hematopoietic stem cell transplantation in children at NCH. 2012 Role-PI
  4. Outcome of Children who Experience Disease Relapse Following Allogeneic Hematopoietic Stem Cell Transplantation for Hematologic Malignancies. 2012. Role -PI
  5. Diagnosis treatment and outcome of Anicteric Hepatic veno-occlusive disease after HSCT. 2013. Role -PI
  6. Variations in the practice for management of Hepatic veno-occlusive disease in children. 2014, Role – PI
  7. 70% Ethanol for decontamination of CVL exposed to calcineurine inhibitors. 2014, Role –PI

 

Complete List of Published work in My Bibliography

https://www.ncbi.nlm.nih.gov/sites/myncbi/1XataCoxdgLk4/bibliography/10299572/public/?sort=date&direction=ascending

 

 

 

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