Catheter Related Bloodstream Infection by Brevibacterium casei in a Patient with B Cell Acute Lymphoid leukemia - A Case Report

Patients with long term indwelling catheters with underlying immunosuppression or comorbid conditions are predisposed to develop catheter related blood stream infections with unusual organisms. Brevibacterium spp. are catalase-positive, non spore-forming, non-motile, aerobic, Gram-positive bacteria. Brevibacterium spp werenot considered a human pathogen, until recently few infections were noted. We report a case of catheter related blood stream infection by Brevibacterium casei in 17 year old young adult with B cell acute lymphoid leukemia. Patient was treated successfully with intravenous Vancomycin and Piperacillin-tazobactam along with peripherally inserted central catheter removal. Keywords: Brevibacterium casei, Catheter related blood stream infections, Sepsis, Immunocompromised

Subsequent primary cancers among survivors of adolescent and young adult onset cancers in the United States.

10604 Background: Adolescent and young adult (AYA) cancer survivors are at increased risk of subsequent primary cancer (SPC); however, a comprehensive examination of risk patterns across cancer types is lacking in the U.S. Methods: SPC incidence and mortality was calculated among >1-year cancer survivors aged 15 to 39 years at first primary cancer (FPC) diagnosis during 1992-2016 in 12 Surveillance, Epidemiology, and End Results registries. Rates were expressed as number of cases/deaths per 10,000 person-years and compared with those expected in the general population using standardized incidence (SIR) and standardized mortality ratios (SMR). Results: Among 202,440 survivors of AYA-onset cancers (mean age at FPC diagnosis, 31.8 years; 60.7% women), 6,675 SPC cases (34.3 per 10,000) and 3,786 SPC deaths (19.4 per 10,000) occurred during 1,955,119 person-years of follow-up (mean, 9.7 years), corresponding to an SIR of 1.58 (95%CI = 1.54-1.62) and SMR of 4.19 (95%CI = 4.06-4.33. In men, overall incidence and mortality SPC rates were statistically significantly higher for each of 21 FPC types compared with risks in the general population, except for thyroid cancer mortality. In women, risk was statistically significantly higher for 14/23 FPC types for incidence and 19/23 FPC types for mortality. SIRs were highest in survivors of pancreatic cancer (SIR = 5.68, 95% CI = 2.94-9.93; 84 per 10,000), Kaposi sarcoma (SIR = 5.15, 95%CI = 4.62-5.73; 116 per 10,000) and liver cancer (SIR = 4.97, 95%CI = 2.57-8.68; 68.4 per 10,000) in men, and acute lymphoid leukemia (SIR, 3.27, 95% CI = 2.22-4.64; 49.5 per 10,000), Hodgkin lymphoma (SIR = 2.47, 95% CI = 2.22-2.73; 51.6 per 10,000), and bone sarcoma (SIR = 2.41, 95%CI = 1.80-3.16; 47.6 per 10,000) in women. SMRs were highest in survivors of pancreatic cancer, acute lymphoid leukemia, and stomach cancer in men, and liver cancer, acute lymphoid leukemia, and soft tissue sarcoma in women. Conclusions: Overall and type-specific risk patterns of SPCs among AYA cancer survivors differ considerably across FPC type, highlighting the need for targeted approaches for cancer prevention and surveillance in survivorship care planning.

Aberrant immunophenotypic expressions in acute lymphoid leukemia: an observational analytical study

Background: This study aims to find out the expression of aberrant immunophenotypic markers in acute lymphoid leukemia (ALL) and to co-relate its expression with cytogenetic and molecular data.Methods: Retrospective cum prospective study was carried out in 75 patients of ALL who presented to Apollo Gleneagles hospitals, Kolkata from January 2014 and March 2019. Flow cytometry analysis was done using FC500 (Beckman coulter) All cases were classified according to latest WHO classification.Results: Out of 75 cases of ALL, 23 cases (30.67%) showed aberrant cross-lineage expression. Amongst the B-ALL cases, the most common aberrant antigen expressed were myeloid antigens 17 cases (77.27%). Aberrant T- antigens were noted in 4 cases (18.10%). Aberrant co-positivity of myeloid as well as T-antigens was seen in 1 case (4.54%). The most common aberrant myeloid antigen expressed was CD33 (77.7%) followed by CD13 (22.2%) and then CD15 (11.1%). Co-positivity of CD13 and CD33 was noted in 2 cases. CD2 and CD33 co-positivity was noted in 1 case. The most frequently expressed aberrant T-antigen was CD2 seen in 3 out of 5 cases (60%).Conclusions: In B-ALL, the most common aberration was myeloid antigen positivity followed by cross-lineage T-antigen expression. Aberrant CD33 expression was most frequently associated with t(9;22) followed by t(12;21). Aberrant CD15 was most frequently associated with t(4;11). No association with adverse hematological parameters or any significant increase in cytogenetic and molecular abnormality was noted in cases expressing aberrant antigen in comparison to cases not expressing aberrant antigens.