Background and Objectives:Febrile neutropenia (FN) is considered a medical emergency. Patients with hematological malignancies (HM) commonly experience FN. Broad spectrum antibiotics have to be started empirically to prevent complications. This study depicts the clinical profile, microbiological profile, antibiotic sensitivity pattern, and outcome in high risk HM.Materials and Methods:In this prospective study, 72 patients with hematologic malignancies, diagnosed and treated for 108 high risk febrile neutropenic episodes from August 2011 to January 2013 at a Regional Cancer Center, in South India were analyzed. Cefoperazone-sulbactum was used as a first-line empiric antibiotic.Results:Majority of the patients with FN episodes had acute myeloid leukemia. Overall culture positivity was 29.62%. The most common organisms isolated were Gram-negative bacilli (63.64%), with Escherichia coli being the most frequent pathogen. All Gram-negative organisms were sensitive to imipenem, whereas sensitivity pattern to other antibiotics were as follows: 85.71%, 78.26%, 69.52%, 63.64%, 41.66% and 47.05% for pipercillin-tazoactum, meropenem, cefoperazone-sulbactum, amikacin, ceftazidime, ciprofloxacin respectively. Overall mortality was 13.5%. Most of the patients responded to empiric antibiotic cefoperazone-sulbactum.Conclusions:In the hematologic malignancies particularly in acute leukemia, there is high risk of developing FN. Empiric therapy with cefoperazone-sulbactum as a first line leads to satisfactory outcome in high risk FN and therapy should be tailored to the most appropriate antibiotics according to the bacterial culture results.

Constitutional mismatch repair deficiency syndrome is a rare autosomal recessive syndrome caused by homozygous mutations in mismatch repair genes. This is characterized by the childhood onset of brain tumors, colorectal cancers, cutaneous manifestations of neurofibromatosis-1 like café au lait spots, hematological malignancies, and occasionally other rare malignancies. Here, we would like to present a family in which the sibling had glioblastoma, and the present case had acute lymphoblastic lymphoma and colorectal cancer. We would like to present this case because of its rarity and would add to literature.

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Background: Acute Myeloid Lymphoma is the clonal proliferation of non-lymphoid blasts comprising at least 20% of total nucleated cells either in bone marrow or peripheral blood. In the recent years, flow cytometry has emerged as a powerful diagnostic tool for AML due to its impact on treatment and prognosis. Aims & Objectives: To analyse the flow cytometry findings in patients diagnosed as acute myeloid leukemias. To evaluate variations in flow cytometry expression in various subtypes of acute myeloid leukemia Materials & Methods: Patients diagnosed as acute myeloid leukaemia on peripheral smears were subjected to flow cytometry analysis. This was a four-year study from July 2015 to June 2017 retrospectively and from July 2017 to June 2019 prospectively. Results: A total of 27 cases diagnosed as Acute Myeloid Leukemia (AML) were included in the study. Acute Promyelocytic Leukemia was observed to be the most common subtype. The most commonly expressed myeloid antigens were CD13 and CD33. There was an aberrant expression of CD7 and CD56 in 1 case each indicating adverse prognosis. Conclusion: Immunophenotyping of the myeloid cells by flow cytometry has revolutionised the diagnosis of acute myeloid leukemias. It aids in confirming the morphological diagnosis, and also helps in assigning specific lineage, accurate sub classification and adequate treatment in challenging cases. Aberrant expressions were observed in 3 cases of AML. Aberrant antigen expression is associated with a poor outcome.  Flow cytometry results interpreted with morphology are not only complementary but also conclusive aiding in therapeutics and predicting prognosis.

Introduction: LABC accounts for 10-20% in the West, while in India, it accounts for 30-60% of all cases. LABC encompasses a wide spectrum of malignant breast tumors with varying presentation and poses a significant therapeutic challenge. Locally advanced breast cancer presents with a difficult management problem. It remains a challenge to achieve local and distant control of locally advanced breast cancer. Locally advanced breast cancer presents with a difficult management problem. It remains a challenge to achieve local and distant control of locally advanced breast cancer neoadjuvant chemotherapy in LABC. Materials and Methods: A prospective, non-interventional study was done on multiple centres in the district of Dakshina Kannada on 100 adult patients admitted in who either presented with histological confirmed locally advanced breast cancer were be included in the study as per the following criteria between June 2014 to May 2019. After this preoperative work up all patients. We used AC regimen in 120 patients. The Response to chemotherapy was studied in all patients who received neo adjuvant chemotherapy according to the Response Evaluation Criteria in Solid Tumors published in February 2000 by European Organization for Research and Treatment of Cancer was used to evaluate the tumor response The patients are followed up for a period of minimum of 3 years and maximum 2 years and at regular intervals during each cycle of chemotherapy. Clinical examination in details about the tumor characteristics and change in size of tumor with status of axillary LN had been entered in the database. After completion of NACT all patients assess for operability and underwent modified radical mastectomy. The surgical specimens removed from all the patients are sent for histopathology examination in the pathology section and are studied for Pathological response and Histological grade. Observations and Results: In the present study, the age of the cases in the study ranged from 22 years to 79 years, 56.72 years SD + 15 years; the most common age group was 40-55 years 48% of the entire study population. Less than 25 years we had 2 cases between 25-35 we had 12 cases all had a family history of cancer. 78% used OPS for contraception. Clinical and pathological complete response was seen more commonly in Her2 subtype cases. NACT could downstage the disease so as to make the inoperable tumor to operable one and possible to resect locally advanced disease.