HTCT 3120 1-8 hematol transfus cell ther. 2 0 2 0;x x x(x x):xxx-xxx w w w . h t c t . c o m . b r Hematology, Transfusion and Cell Therapy

The purpose of this study was to describe the clinical aspects of the epidemiology of candidemia and compare the prognostic impact of potential risk factors and the microbiology data of adults and children with cancer. A prospective cohort study enrolling 99 adults and 130 children with candidemia at a tertiary oncology care center in Brazil was undertaken. A total of 229 episodes were analyzed. The overall mortality was higher among adults than in children (37.4% vs. 7.7%, respectively). Univariate analysis revealed significant differences in the risk factors associated with death between both groups. Mortality was similar following fungemia with Candida albicans and all C. non-albicans species. However, significant differences in the interspecies distribution and death rates were observed, mainly among C. glabrata, krusei, and tropicalis species. Multivariate analysis showed comorbidities and neutropenia to be independently associated with mortality in adults, while in children, only comorbidities negatively affected the outcome. Comorbidities were the most important independent prognostic factor in both groups. The inclusion of detailed information about pre-existent illnesses might have a real benefit in studies of candidemia outcome.

During the COVID-19 pandemic, special attention has been addressed in cancer care to mitigate the impact on the patient’s prognosis. We addressed our preparation to face COVID-19 pandemic in a Hematological and Stem Cell Transplant Unit in Brazil during the first two months of COVID-19 pandemic and described COVID-19 cases in patients and health care workers (HCW). Modifications in daily routines included a separation of area and professionals, SARS-CoV-2 screening protocols, and others. A total of 47 patients and 54 HCW were tested for COVID-19, by PCR-SARS-CoV-2. We report 11 cases of COVID-19 in hematological patients (including 2 post stem cell transplant) and 28 cases in HCW. Hematological cases were most severe or moderate and presented with several poor risk factors. Among HCW, COVID-19 were mostly mild, and all recovered without hospitalization. A cluster was observed among HCW. Despite a decrease in the number of procedures, the Transplant Program performed 8 autologous and 4 allogeneic SCT during the period, and 49 onco-hematological patients were admitted to continuing their treatments. Although we observed a high frequency of COVID-19 among patients and HCW, showing that SARS-CoV-2 is disseminated in Brazil, hematological patients were safely treated during pandemic times.

CD26/DPPIV (dipeptidil peptidase IV) displays an array of diverse functional properties, with a role in the development of several human cancers. This enzyme is found mainly anchored in the membrane of cells although it also has an enzymatically active plasma isoform. The regulation of biological activities of cytokines by DPP IV activity has a potential role in the homeostatic regulation of hematopoiesis. In this study, we analyzed the CD26 antigen cell membrane expression by flow cytometry and the DPPIV activity in plasma of patients of acute leukemia. The results showed that the plasma DPPIV activity is significantly higher in leukemia patients and could be 100% inhibited by Januviae (Merck Sharp & Dohme) a selective DPPIV inhibitor. Although CD26 expression on immune cells were not leukemia-dependent the analysis of the correlation between CD26 expression and the DPPIV plasma activity were statistically significant (p , 0.01) in acute lymphoid leukemia (B-ALL and T-ALL).

Our data suggest that concurrent or sequential administration of BPs with conventional chemotherapeutic drugs may have significant therapeutic potential for CLL patients.