Christian Medical College, Vellore
BMT and Leukemia Unit, Washington University, St.Louis, USA
Christian Medical College, Vellore
Having completed my medical school training at Christian Medical College I spent two years in primary care hospitals which included a rural hospital where I was the one of two physicians. This exposure helped me get a realistic perspective of the challenges that face medical care delivery in our country. I subsequently completed my post graduation in General Medicine from the same institution where I had done my under graduate training. During this training period I was fortunate to meet some of the pioneers of Clinical Hematology in our country, namely Dr. Mammen Chandy and Dr. Alok Srivastava. They gave me the opportunity to work in this department during my post graduate training program. Dr. Alok Srivastava asked me to join the department of Hematology soon after I completed my General Medicine course, which I did. While the clinical work load in this department was heavy it was also extremely challenging and very fulfilling. I was impressed with the hard work, commitment and scientific pursuit of my mentors who were extremely encouraging for all research related activities. The high standards set by Dr. Chandy and Dr. Srivastava both in the clinical area and in basic science research was stimulating. The confidence and high expectations that they placed on me were very important factors in my development. Working in haematology, as with my rural hospital experience, it was clearly evident to me that for a number of hematological conditions, especially acute leukemia's, a major challenge was the cost of therapy and supportive care. The majority of our patients in a self paying system could not afford such expensive therapies. I felt it was important for focus on cost effective therapy rather than to blindly apply algorithms that had evolved in a developed country setting. Research, both clinical and basic science, was critical for us to develop strategies that were effective and relevant to us.
After completion of my specialty training in Clinical Haematology in the Department of Haematology at Christian Medical College, Vellore in 2001 I looked for opportunities to develop my basic science research skills further. With the help of Dr. Ajit Varki I was fortunate to get a postdoctoral fellowship at the 'Stem Cell and Leukemia Unit' in Washington University, St. Louis, MO, USA. My mentor at this institution was Dr. Timothy Graubert. I am extremely grateful Dr. Graubert for taking the risk and accepting a person with relatively low level experience and expertise in basic science research. Over the next two year under his guidance I learnt a number of aspects of basic science research. My project involved studying the potential for stem cell plasticity to cure a mouse model of diabetes mellitus. I was also involved in generation and characterization of transgenic mouse models of leukemia and generation of chemotherapy induced mouse models of myelodysplastic syndrome and leukemia. Most importantly Dr. Graubert taught me the fundamentals of the language of science, how to ask a basic science question and how to persevere and address a research question against the odds.
In my last year at Washington University I did a clinical bone marrow transplant fellowship. Here my mentor was Dr. John F. DiPersio who was involved in a number of clinical trials in the field of stem cell transplantation. He was also leading basic science research in various aspects leukemia and stem cell mobilization. Dr. Graubert and Dr, DiPersio continue to encourage me in all my research activities even though it has been almost a decade since I left there.
I returned to India in 2004 and rejoined the Department of Haematology at Christian Medical College. Prior to leaving Vellore I had initiated work in acute promyelocytic leukemia using arsenic tioxide and with the help of my colleagues I restarted my clinical work in this area. I also started my basic science work in this area and started addressing the question of cause of relapse in a proportion of cases and methods to improve the clinical outcome and prevent such relapses. The work in the clinical area in this field has progressed well and included a multi-center clinical trial in India. Getting adequate funds to do the basic science research was a bigger challenge. Most funding agencies were unwilling to fund a comprehensive study in this field. It was at this stage that I was offered the fellowship by the DBT/Wellcome India Alliance. The funding was generous but more important was the prestige and the facilitation provided by the organization to interact and carry research forward with the best in the field both at the national and the international level. I am truly grateful to the Alliance for this fellowship and hope to utilize the opportunity to the best of my ability.