No abstract

Education regarding CDI must be extended to transplant recipients and their general practitioners. Other targets for future CDI rate reduction must include stringent antimicrobial stewardship (both in hospital and in the community) and judicious PPI prescribing.

The standard of care for fit patients with Mantle Cell Lymphoma (MCL) includes cytarabine containing induction treatment and consolidation with BEAM (Carmustine, Etoposide, Cytarabine and Melphalan). Chemo-refractory cases have a poorer prognosis and are candidates for allogenic stem cell transplantation (allo-SCT). Targeted therapy, such as BTK-inhibitors or BCL-mimetics can be used to bridge patients to SCT. COVID-19, a novel coronavirus has the potential to cause life threatening immune dysregulation and cytokine release syndrome (CRS) resulting in respiratory failure. Haematology patients, particularly post allogenic stem cell transplant, are high risk for developing CRS due to T-lymphopenia. PD, a 55-year-old male, with chemo-refractory MCL tested positive for COVID-19 day + 45 post allo-SCT after presenting with mild gastrointestinal symptoms and remained positive for 70 days. At day + 92 relapse was confirmed by CT and axillary node biopsy. Ibrutinib, a BTK inhibitor, was commenced with resolution of symptoms and a negative test within 20 days. With minimal reduction in adenopathy, Ibrutinib was stopped at day +110, while Cytarabine and Venetoclax (BCL-mimetic) were commenced with Donor lymphocyte infusion at day +145 resulting in complete remission. Ibrutinib's therapeutic role against COVID-19 is now being investigated in clinical trials.