Browsing by Author "Gujral, S"
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Item Agreement between arm circumference, weight for age, and weight for height measures of malnutrition in children.(1990-03-01) Anderson, M A; Gopaldas, T; Abbi, R; Gujral, SAgewise agreement between mid-upper arm circumference (AC), weight for age and weight for height assessment of nutritional status was analyzed for 5,509 Indian children 1 to 5 years of age. Sensitivity specificity and positive predictive value of AC are presented. The sensitivity of AC for detecting moderate malnutrition by weight for age or weight for height was found to be low, except in children 13-24 months of age. From 25-58% of the severely malnourished children by weight for age in the age group 25-60 months were misclassified as normal by AC. Specificity of AC was high across the age range indicating that most of the children identified as not malnourished by weight for age or weight for height also had normal AC. The positive predictive value of AC was low for severe malnutrition but high for moderate to mild malnutrition compared to weight for age and weight for height. The findings indicate that AC is not constant over the age range 1 to 5 years, and use of fixed cut-off points for assessing malnutrition from 1 to 5 years is inappropriate. Sensitivity of AC using a fixed-cut-off point clearly decreases with age, and specificity increases with age. Where possible, weight of children is preferable to AC for nutritional status assessment, due to large number of moderately or severely malnourished children likely to be wrongly classified as normal by AC.Item Altered lipid profile in liver amoebiasis and its emendation with metronidazole treatment.(1982-07-01) Gujral, S; Patel, N; Chaudhuri, S K; Seth, DLiver amoebic abscess was produced by introducing 16,000 trophozoites of Entamoeba histolytica directly into the livers of growing hamsters. A group of the infected animals received orally 64 mg metronidazole/kg body weight for 5 days from the day of the infection. The treated group was autopsied 7 or 14 days after the treatment. Histologically, liquefaction of large parenchymal areas and biochemically, elevation in cholesterol, triglycerides, bile acids and decrease in phospholipids were observed in infected livers. The infected hamsters exhibited hyperlipidemia and hypocholesterolemia. With metronidazole treatment all the values tended to shift towards control levels. The magnitude of the shift was determined by the post-treatment period.Item Anaplastic large cell lymphoma (ALCL) presenting as primary bone and soft tissue sarcoma--a study of 12 cases.(2007-04-22) Pant, Vinita; Jambhekar, N A; Madur, Bhulaxmi; Shet, T M; Agarwal, M; Puri, A; Gujral, S; Banavali, M; Arora, BThis study highlights the rare presentation of anaplastic large cell lymphoma as primary bone and soft tissue tumour. Twelve cases were studied. Clinical impression was non Hodgkin's lymphoma in 4 cases, sarcoma in 6 (osteosarcoma-2, Ewing's/primitive neuroectodermal tumour-1, and sarcoma NOS-3), and tuberculosis of thoracic spine in 1 and the last case involving the rib had a differential diagnosis of tuberculosis and NHL. Histology revealed round cells with eosinophilic cytoplasm and pleomorphic nuclei. Immunohistochemically all tumours were CD30 positive and 8 of 9 cases (88.9%) showed ALK-1 positivity. The pleomorphic cytomorphology ofALCL leads to confusion with the more frequent bone and soft tissue sarcomas affecting the musculoskeletal system. A high index of suspicion is necessary to initiate the correct panel of immunohistochemical markers to first confirm the lymphomatous nature of this tumour and to subsequently subclassify. This alone will lead to an accurate recognition of ALCL and the appropriate chemotherapy.Item Applicability of 2008 World Health Organization classification system of hematolymphoid neoplasms: Learning experiences(Indian Association of Pathologists and Microbiologists, 2018-03) Modkharkar, S; Navale, P; Amare, PK; Chougule, A; Patkar, N; Tembhare, P; Menon, H; Sengar, M; Khattry, N; Banavali, S; Arora, B; Narula, G; Laskar, S; Khanna, N; Muckaden, MA; Rangarajan, V; Agrawal, A; Shet, T; Epari, S; Subramanian, PG; Gujral, SBackground: 2008 World Health Organization (WHO) classification of hematolymphoid neoplasms (HLN) has classified them based on morphology, results of various ancillary techniques, and clinical features.[1] There are no studies looking at the applicability of WHO classification. Aims: The aim of the study was to calculate proportions of all HLN subtypes seen during 1-year period based on 2008 WHO classification of HLN and study applicability and also shortcomings of practices in a tertiary care center in India. Materials and Methods: This was a 1-year retrospective study (January 1st, to December 31st, 2010) where cases were identified using hospital/laboratory electronic records. Old follow-up and referral cases were excluded from the study. Only newly diagnosed cases classified into categories laid down by 2008 WHO classification of HLN included. Results: Out of 2118 newly diagnosed classifiable cases, 1602 (75.6%) cases were of lymphoid neoplasms, 489 (23.1%) cases of myeloid neoplasms, 16 (0.8%) cases of histiocytic and dendritic cell neoplasms, and 11 (0.5%) cases of acute leukemias of ambiguous lineage. Overall, most common HLN subtype was diffuse large B-cell lymphoma (n = 361, 17.0%). Precursor B-lymphoblastic leukaemia/lymphoma (n = 177, 48.2%) was the most common subtype within pediatric age group. Conclusions: All major subtypes of HLN were seen at our center and showed trends almost similar to those seen in other Indian studies. Molecular/cytogenetic studies could not be performed on a significant number of cases owing to logistic reasons (unavailability of complete panels and also cost-related issues) and such cases could not be classified as per the WHO classification system.Item Bone marrow morphological changes in patients of chronic myeloid leukemia treated with imatinib mesylate.(2008-04-16) Joshi, S; Sunita, P; Deshmukh, C; Gujral, S; Amre, P; Nair, C NBackground: Imatinib mesylate has shown promising results in chronic myeloid leukemia (CML) in all phases. This drug is an effective treatment for patients with CML in chronic phase as it induces hematological remission in nearly all patients and cytogenetic responses in many. The bone marrow changes produced by this drug are different from the treatment modalities used earlier in CML. Materials & Methods: We studied 80 patients of CML on treatment with Imatinib at doses of 400-800 mg per day. Morphological and cytogenetic evaluation (Ph analysis) of bone marrow aspirates was done at six months of treatment. Result: In our study, 95% (76 out of 80) patients showed complete hematological response and 63.3% showed major cytogenetic response at the end of six months of treatment. The most commonly observed changes in the bone marrow aspirates at the end of six months of therapy were in the form of reduction in the cellularity, reduction in the M: E ratio to a mean of 2:1, presence of relative erythroid hyperplasia, normalization of megakaryocytic morphology and variable increase in the bone marrow lymphocytes. None of these changes had significant correlation with the patient's Ph status. Conclusion: We advise study of trephine biopsies to overcome the often-faced problem of hemodiluted aspirates in these cases and evaluation of sequential bone marrows to check the durability of these morphological changes and their correlation with the cytogenetic response with emphasis on cytogenetic changes other than Ph positivity.Item BRAFV600E mutation in hairy cell leukemia: A single-center experience(Indian Association of Pathologists and Microbiologists, 2018-12) Bibi, A; Java, S; Chaudhary, S; Joshi, S; Mascerhenas, R; Rabade, N; Tembhare, P; Subramanian, PG; Gujral, S; Menon, H; Khattry, N; Sengar, M; Bagal, B; Jain, H; Patkar, NBackground: BRAFV600E mutation has been reported as a unique genetic lesion of hairy cell leukemia (HCL), a subset of which lacks this lesion and shows adverse outcomes. Aims: To determine the prevalence of BRAFV600E in HCL from our center and derive clinicopathological correlation, if any. Materials and Methods: A 9-year retrospective analysis of 46 consecutive cases of HCL diagnosed on morphology and immunophenotyping was done. Stained smears were used as samples for amplification refractory mutation system polymerase-chain reaction using fluorescent primers for mutation detection. Results: BRAFV600E mutation was detected in 41/46 patients (89.1%) while absent in control samples of chronic lymphocytic leukemia. Cases mimicking HCL-variant clinically or immunophenotypically too showed the presence of this mutation. HCL with mutated BRAF presented at a younger age. No statistical difference in blood counts, tumor load, and immunophenotype patterns existed among BRAF mutated and unmutated group. Nine patients (45%) with mutated BRAF had residual disease following treatment with cladribine. Conclusion: BRAFV600E mutation analysis has a definitive role in the diagnosis of HCL.Item Childhood proptosis: the invaluable but overlooked peripheral blood smear.(2001-06-12) Sethi, A; Ghose, S; Gujral, S; Jain, P; Kumar, RTwo cases of granulocytic sarcoma presenting as childhood proptosis are described. This highlights the significance of peripheral blood smear examination in establishing the diagnosis of Acute Myeloid Leukaemia (AML).Item Clinico-hematological profile in biphenotypic acute leukemia.(2009-04-07) Gujral, S; Polampalli, S; Badrinath, Y; Kumar, A; Subramanian, P G; Raje, G; Amare, P; Arora, B; Banavali, S D; Nair, C NBACKGROUND: We present a clinico-hematological profile and treatment outcome of Biphenotypic Acute Leukemia (BAL). AIM: Study incidence and subtypes of BAL, correlate with age, morphology, and cytogenetic findings and correlate the clinico-hematological data with the treatment response. St Jude's and the EGIL's criteria have been compared for their diagnostic and clinical relevance. MATERIAL AND METHODS: Diagnosis was based on WHO classification, including clinical details, morphology, cytochemistry, immunophenotyping, and molecular genetics. We included those cases, which fulfilled the European Group for the Immunological Characterization of Acute Leukemia's (EGIL's) scoring system criteria for the diagnosis of BAL, as per recommendation of the WHO classification. RESULTS: There were 32 patients diagnosed with BAL, based on EGIL's criteria. Incidence of BAL was 1.2%. B-Myeloid (14 cases) followed by T-Myeloid BAL (13 cases) were the commonest subtypes. Polymorphous population of blasts (16 cases) was commonly associated with T-Myeloid BAL (10 cases). BCR ABL fusion positivity was a common cytogenetic abnormality (seven cases). Fifteen patients received chemotherapy; eight achieved complete remission (CR) at the end of the induction period. CONCLUSIONS: Pediatric BAL and T-B lymphoid BAL have a better prognosis. A comprehensive panel of reagents is required, including cytoplasmic markers; to diagnose BAL. St Jude's criteria is a simple, easy, and cost-effective method to diagnose BAL. The outcome-related prognostic factors include age, HLA-DR, CD34 negativity, and subtype of BAL. BCR-ABL expression is an important prognostic factor, as these cases will be labeled as Chronic myeloid leukemia (CML) in blast crisis with biphenotypic expression and treated accordingly.Item Clinico-pathological impact of cytogenetic subgroups in B-cell chronic lymphocytic leukemia: Experience from India.(2013-07) Kadam, Amare P S; Gadage, V; Jain, H; Nikalje, S; Manju, S; Mittal, N; Gujral, S; Nair, RBACKGROUND: The present study of 238 B‑cell Chronic Lymphocytic Leukemia (B‑CLL) patients were undertaken to seek the prevalence and to evaluate clinico‑pathological significance of recurrent genetic abnormalities such as del(13q14.3), trisomy 12, del(11q22.3) (ATM), TP53 deletion, del(6q21) and IgH translocation/deletion. MATERIALS AND METHODS: We applied interphase – fluorescence in situ hybridization (FISH) on total 238 cases of B‑CLL. RESULTS: Our study disclosed 69% of patients with genetic aberrations such as 13q deletion (63%), trisomy 12 (28%), 11q deletion (18%), 6q21 deletion (11%) with comparatively higher frequency of TP53 deletion (22%). Deletion 13q displayed as a most frequent sole abnormality. In group with coexistence of ≥2 aberrations, 13q deletion was a major clone indicating del(13q) as a primary event followed by 11q deletion, TP53 deletion, trisomy 12, 6q deletion as secondary progressive events. In comparison with del(13q), trisomy 12, group with coexistence of ≥2 aberrations associated with poor risk factors such as hyperleukocytosis, advanced stage, and multiple nodes involvement. In a separate study of 116 patients, analysis of IgH abnormalities revealed either partial deletion (24%) or translocation (5%) and were associated with del(13q), trisomy 12, TP53 and ATM deletion. Two of 7 cases had t(14;18), one case had t(8;14), and four cases had other variant IgH translocation t(?;14). CONCLUSION: Detail characterization and clinical impact are necessary to ensure that IgH translocation positive CLL is a distinct pathological entity. Our data suggests that CLL with various cytogenetic subsets, group with coexistence of ≥2 aberrations seems to be a complex cytogenetic subset, needs more attention to understand biological significance and to seek clinical impact for better management of disease.Item A clinicopathologic study of mantle cell lymphoma in a single center study in India.(2008-07-30) Gujral, S; Agarwal, A; Gota, V; Nair, R; Gupta, S; Pai, S K; Sanger, M; Shet, T; Subramanian, P G; Muckaden, M; Laskar, SWe present clinical features, histopathology and results of treatment in cases of mantle cell lymphoma (MCL) at our hospital. We had 93 cases (2.1%) of MCL out of total 4301 cases of non-Hodgkin's lymphoma (NHL) in a 4-year period. It included 68 cases (1.7%) of MCL from 3987 cases of NHL diagnosed on histopathology. Remaining 25 cases (7.9%) diagnosed solely on peripheral blood examination were excluded. Thirty-six (85%) patients had advanced-stage disease. Sixty-three were nodal and five were extranodal (all gastrointestinal tract). Common patterns were diffuse (64%), nodular (25%) and mantle zone type (11%). Sixty-two cases had lymphocytic while six had blastic morphology (all nodal). Tumor cells expressed CD20 (100%), CD43 (94%), CD5 (89%) and cyclin D1 (85%). Bone marrow was involved in 25 (59%) cases. Thirty-two patients could be treated. Median recurrence-free survival was 22.23 months. Diffuse pattern of nodal involvement had a lower overall survival.Item Desmoplastic small round cell tumor: extra abdominal and abdominal presentations and the results of treatment.(2005-04-06) Biswas, G; Laskar, S; Banavali, S D; Gujral, S; Kurkure, P A; Muckaden, M; Parikh, P M; Nair, Chandrika NBACKGROUND: Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm of adolescent males. Current multimodality treatment prolongs life and rarely achieves cure. AIM: To review the presenting features, histopathology and outcome of 18 patients with DSRCT treated at a single institution. SETTING AND DESIGN: This is a retrospective observational study of patients with DSRCT who presented at the Tata Memorial Hospital between January 1994 to January 2005. MATERIALS AND METHODS: Eighteen patients of DSRCT seen during this period were evaluated for their clinical presentation, response to chemotherapy and other multimodality treatment and overall survival. The cohort of 18 patients included 11 males (61%) and 7 females (39%) with a mean age of 16 years (Range 1(1/2)--30 years). Majority (83%) presented with abdomino-pelvic disease. The others, involving chest wall and extremities. There were 6 patients (33%) with metastatic disease at presentation. RESULTS: The treatment primarily included a multimodality approach using a combination of multiagent chemotherapy with adjuvant surgery and radiotherapy as applicable. A response rate of 39% (CR-1, PR-6), with chemotherapy was observed. The overall response rate after multimodality treatment was 39% (CR-5, PR-2). The overall survival was poor except in patients who had complete excision of the tumor. Conclusion:0 Abdomino-pelvic site was the commonest presentation, the disease can occur at other non-serosal surfaces also. Despite aggressive treatment the outcome was poor. However, complete surgical excision seems to provide a better survival.Item Effect of short term vitamin A deficiency on organ weights, blood glucose and lactate levels and, tissue protein and glycogen contents of albino rats: a preliminary study.(1987-10-01) Ramachandran, A V; Mehan, S P; Gujral, SThe effect of short term dietary vitamin A deficiency in post-pubertal female rats in terms of weight gain, food consumption, organ weights, haemoglobin content, blood glucose and lactate levels and, tissue protein and glycogen contents has been evaluated to gain insight into the possible interrelationship between vitamin A and general metabolism. Significant elevation in blood glucose level and reduction in blood lactate and haemoglobin along with a tendency of reduction in weights of spleen, adrenals and ovaries have been noted. Lowered tissue protein and glycogen contents and reduced body weight gain have also been revealed. Obviously, reduced functional competence of some of the organs and certain alterations in general metabolism especially of carbohydrates are suspected and hence is discussed in relation to supportive evidences available.Item Effectiveness of N-N-bis-P-chlorophenyl-3p-tolyl glutaric acid diamide (SRC-3605) as a hypocholesterolaemic compound in hypercholesterolaemic female weanling and adult rats.(1978-07-01) Gujral, S; Puar, M; Ranka, NSRC-3605, N-N-bis-P-chlorophenyl 3-p-tolyl glutaric acid diamide, was studied for its hypocholesterolaemic effect on serum and liver cholesterol in hypercholesterolaemic weanling and adult female rats. Weanlings were administered doses of SRC-3605 ranging from 100 to 300 mg/kg body weight for 4 or 8 consecutive days. The greatest hypocholesterolaemic effect was observed with doses of 150, 200 and 250 mg, although a progressive decreases in serum cholesterol was noted with increasing doses. Hepatic cholesterol decreases supported the serum data, but were inconsistent. Hypercholesterolaemic adult animals received 50, 100, 150 or 200 mg/kg body weight of either SRC-3605 or clofibrinic acid for 4 days. A decrease in serum cholesterol levels was observed only with the 200 mg SRC-3605. No clear-cut influence of the either compounds was found on hepatic cholesterol. The results indicated that SRC-3605 possesses the property to reduce both serum and liver cholesterol in hypocholesterolaemic weanling female rats.Item Fludarabine in lymphoproliferative malignancies: a single-centre experience.(2008-07-10) Prabhash, K; Vikram, G S; Nair, R; Sengar, M; Gujral, S; Bakshi, A; Gupta, S; Parikh, P MBACKGROUND: Fludarabine has been reported to be an effective drug for the treatment of chronic lymphocytic leukaemia (CLL) and indolent lymphomas. However, its safety and efficacy in Indian patients has not been studied. We retrospectively analysed our experience with fludarabine in low grade lymphomas and CLL. METHODS: The records of all patients with low grade lymphoma or CLL who received fludarabine between April 1999 and November 2006 were analysed. Response evaluation was done as per the National Cancer Institute-Working Group guidelines for CLL and International Workshop criteria for non-Hodgkin lymphomas, respectively, in those patients who received at least 3 cycles of fludarabine. Toxicity was graded as per the common terminology criteria for adverse events, version 3.0. Median event-free survival was obtained using Kaplan-Meier survival analysis. RESULTS: Forty-seven patients were included in the study and 189 cycles were administered (median: 4 cycles per patient). Sixteen patients had a treatment delay, 14 due to myelosuppression. Twenty-five patients had low grade lymphoma and 22 had CLL. The response was evaluable in 22 patients with low grade lymphoma and 20 with CLL. The overall response rate for CLL was 100% in those treated upfront (n=9) and 55% in those with relapsed disease (n=11). The overall response rate for low grade lymphoma was 88% (63% complete remission) in untreated patients and 79% (43% complete remission) in those with relapsed disease. Common adverse events were myelosuppression and infection. Two patients died of sepsis and 4 due to disease progression on treatment. Median event-free survival for patients treated upfront with fludarabine was 31.4 months. CONCLUSION: In our patient population, response to fludarabine is similar to that in the published literature. Our patients had a higher frequency of haematological toxicity.Item Follicular dendritic cell tumour of tonsil - is it an under-diagnosed entity?(2005-10-05) Bothra, R; Pai, P S; Chaturvedi, P; Majeed, T A; Singh, C; Gujral, S; Kane, S VNeoplasms of follicular dendritic cells are uncommon and while majority of them occur in lymph nodes, they are increasingly recognized at varied sites such as abdominal viscera. Tonsil is the most common extra nodal site for occurrence of FDCT in the head and neck region. We describe three cases of follicular dendritic cell tumour occurring in the tonsil.Item Immunophenotyping of mature T/NK cell neoplasm presenting as leukemia.(2010-04) Gujral, S; Polampalli, S; Badrinath, Y; Kumar, A; Subramanian, P G; Nair, R; Sengar, M; Nair, CIntroduction : Mature T/NK cell lymphomas (MTNKL) presenting as leukemia are rare and show considerable overlapping of clinical, morphological and immunophenotypic features. AIM: Critical analysis of the morphology and immunophenotypic profile of MTNKL. Materials and Methods : We reviewed 380 consecutive cases of mature lymphoid neoplasm that presented as leukemia and were diagnosed on morphology and immunophenotyping of bone marrow and/or peripheral blood samples. Results : Peripheral blood and bone marrow involvement was seen in all cases. MTNKL constituted 4% (nine cases) of all mature lymphoid neoplasms presenting as leukemia. It included four cases of T-large granular leukemia (T-LGL), two of T-cell prolymphocytic leukemia small cell variant (T-PLL), two of adult T-cell leukemia/lymphoma (ATLL) and one of primary cutaneous gamma delta T-cell lymphoma (PCGDTCL). T-LGL revealed CD4-/CD8+ phenotype in three, and CD4+/CD8+ phenotype in one case. CD56 was absent in all the cases of T-LGL. One case of T- PLL small cell variant showed CD4+/CD8- phenotype, while the other revealed CD4-/CD8+ phenotype. Both cases of ATLL showed CD4+/CD8+/CD25+ phenotype. The single case of PCGDTCL showed CD4-/CD8- phenotype pattern. CD3 and CD5 were expressed in all MTNKL. CD7 was absent in three cases of T-LGL. TCRα/β was performed in three cases of T-LGL and was positive in all. TCRα/β was also seen in both the cases of T-PLL small variant. However, TCRα/β was seen in the single case of PCGDTCL. Conclusion : Mature nodal T/NK cell neoplasms are rare and MTNKL presenting as leukemia are even rarer. There is an overlap between the immunophenotypic profiles of different MTNKL subtypes and elaborate T/NK cell panels are required for their evaluation.Item Is there a role for metronomic induction (and maintenance) therapy in elderly patients with acute myeloid leukemia: A literature review.(2013-04) Tandon, N; Banavali, S; Menon, H; Gujral, S; Kadam, P A; Bakshi, AAcute myeloid leukemia (AML) in older adults differs biologically and clinically from that in younger patients and is characterized by adverse chromosomal abnormalities, stronger intrinsic resistance, and lower tolerance to chemotherapy. In patients over age 60 with AML, cure rates are under 10% despite intensive chemotherapy, and most of them die within a year of diagnosis. Over the last decade, metronomic chemotherapy has emerged as a potential strategy to control advanced/ refractory cancer. Here, we report a case of a 68‑year‑old gentleman having AML with high‑risk cytogenetic features, who achieved complete remission on our oral metronomic PrET (PrET: Prednisolone, etoposide, thioguanine) protocol on an outpatient basis. He was later treated with standard high‑dose (HD) cytosine arabinoside (Ara‑C) consolidation followed by maintenance with etoposide, thioguanine, and sodium valproate. Presently, the patient is nearly 35 months since diagnosis and 21 months off treatment. This case report and review highlights that the combination of oral low‑intensity metronomic therapy, followed by standard HD consolidation therapy and metronomic maintenance therapy may be well tolerated by elderly patients especially with less proliferative, high (cytogenetic)‑risk AML who are otherwise deemed to be unfit for intensive intravenous induction chemotherapy regimens. References for this review were identified through searches of Pubmed for recent publications on the subject as well as searches of the files of the authors themselves. The final list was generated on the basis of originality and relevance to this review.Item Leiomyosarcoma of the maxilla as second malignancy in retinoblastoma.(2008-07-20) Qureshi, Ss; Mistry, Rc; Natrajan, G; Gujral, S; Laskar, S; Banavali, SPatients with hereditary retinoblastoma are at increased risk of second primary tumor, the commonest tumor being osteosarcoma. Leiomyosarcoma developing as second primary neoplasm in retinoblastoma patients is unusual and most have occurred in the field of previous radiotherapy. Although with aggressive therapy better survival can be achieved, the overall prognosis of patients developing these second neoplasms is poor. In this report we present a case of leiomyosarcoma of the maxilla as a second neoplasm in a patient with bilateral retinoblastoma which has developed outside the radiation field.Item Megakaryocytic emperipolesis: A histological finding in myelodysplastic syndrome.(2009-10) Sable, M N; Sehgal, K; Gadage, V S; Subramanian, P G; Gujral, SItem Molecular genetics of BCR-ABL1 negative myeloproliferative neoplasms in India(Indian Association of Pathologists and Microbiologists, 2018-06) Rabade, N; Subramanian, PG; Kodgule, R; Raval, G; Joshi, S; Chaudhary, S; Mascarenhas, R; Tembhare, P; Gujral, S; Patkar, NIntroduction: Over the past decade, we have moved on from a predominantly morphological and clinical classification of myeloproliferative neoplasms (MPN) to a more evolved classification that accounts for the molecular heterogeneity that is unique to this subgroup of hematological malignancies. This usually incorporates mutations in Janus kinase 2 (JAK2), MPL, and calreticulin (CALR) genes. In this manuscript, we report the frequency of these mutations in a cohort of Indian patients at a tertiary cancer center. Materials and Methods: One hundred and thirty cases of MPN were included in this study. These cases were diagnosed and classified based on the World Health Organization 2008 criteria. JAK2 and MPL mutations were detected using high sensitivity allele-specific polymerase chain reaction using fluorescent labeled primers followed by capillary electrophoresis. A subset of JAK2 and CALR mutations were assessed using a fragment length assay. Results: Among the MPN, we had 20 cases of polycythemia vera (PV), 34 cases of essential thrombocythemia (ET), and 59 of myelofibrosis (MF). JAK2, MPL, and CALR mutations were mutually exclusive of each other. Seventeen cases were categorized as MPN unclassifiable (MPN-U). JAK2p.V617F and MPL mutations were present in 60% (78 of 130) and 5.3% (7 of 130) of all MPN. All the PV cases harbored the JAK2 p.V617F mutation. A total of 23.8% (31 of 130) of patients harbored CALR mutations. CALR exon 9 mutations were detected in 60.8% (14 of 23) and 50% (5 of 10) of JAK2 and MPL negative MF and ET cases, respectively. MPN-U cases included three JAK2 p.V617F positive, two MPL p.W515 L, and 12 CALR positive cases. Ten different types of CALR indels (8 deletions and 2 insertions) were detected of which Type I and Type II mutations were the most common, occurring at a frequency of 45.1% (14 of 31) and 22.5% (7 of 31), respectively. Discussion and Conclusion: We report frequencies of JAK2 p. V617F, MPL exon 10 and CALR mutations in 130 patients similar to those reported in western literature. These mutations carry not only diagnostic but also prognostic relevance.