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Chronic lymphocytic leukemia (CLL), the most common leukemia in the western countries, is characterized by immunosuppression due to disease itself and cytotoxic treatments. Since the beginning of COVID‐19 pandemic, patients with CLL appear to be a vulnerable population. In addition, phase III mRNA vaccine trials did not provide information about the efficacy in immunocomprised population. In CLL, the antibody‐mediated response to SARS‐CoV‐2 vaccine is impaired. The goal of this study was to evaluate the effects of SARS‐CoV‐2 vaccination on humoral immune response and on cellular immunity in CLL patients. Humoral immune response to BNT162b2 messenger RNA COVID‐19 vaccine was evaluated in 44 CLL patients comprising 20 treatment‐naïve, 14 under treatment with ibrutinib and 10 in follow‐up after completion of therapy. A positive serological response to SARS‐CoV‐2 vaccination with IgG titers higher than 13 UA/ml was detected in 54.6% of CLL patients with a higher response in patients who obtained remission after treatment. Reduced antibody response was detected in patients under ibrutinib treatment. T‐cell response to overlapping pool of peptides representing the spike region was assessed in paired CLL samples collected before and after 1 month from the second dose of COVID‐19 vaccine in treatment‐naïve and ibrutinib‐treated CLL patients using cytokine secretion assay. Both CD3+ CD4+ and CD3+ CD8+ T cells are able to mount a cellular response to spike peptides with secretion of IFNγ and TNFα before and after vaccination in both treatment naïve and ibrutinib‐treated patients and this cellular immune response is independent by COVID‐19 vaccination. Collectively, T cell response to spike peptides appeared more blunted in CLL patients under treatment with ibrutinib compared to untreated ones. Our study supports the need for optimization of vaccination strategy to achieve an adequate immune response keeping strict preventive measures by CLL patients against COVID‐19. [ABSTRACT FROM AUTHOR]

Keywords: chronic lymphocytic leukemia; IRF4 L116R mutation; proliferation; MYC EN chronic lymphocytic leukemia IRF4 L116R mutation proliferation MYC 707 711 5 12/07/21 20211201 NES 211201 DATA AVAIBILITY STATEMENT The data that support the findings of the study are available on requests from the corresponding author. MYC protein level was inspected in IRF4 transfected CLL cells by immunoblotting after 72 h of co-culture, observing increased MYC protein in IRF4-mutant CLL cells as compared to IRF4-WT cells and control samples (Figure 2E). We first screened a multicenter cohort of 460 CLL patients that comprised 365 untreated CLL cases, 51 treated CLL, including 32 pluri-treated CLL, and 44 Richter transformed cases. [Extracted from the article]

Summary: Aim: During the last decade a continuous increase in non‐albicans species isolation has been observed with Candida parapsilosis being one of the leading species. Aim of this study was to describe the epidemiology of candidemia, particularly of C parapsilosis, its predictors and clinical outcome. Materials and Methods: Incidences of candidemia was evaluated analyzing data from both a prospective collection (2012‐2016) and a retrospective one (2008‐2011). Predictors and outcome were based only on the prospective phase. C parapsilosis potential clusters were analysed by randomly amplified polymorphic DNA (RAPD) technique. Results: 1240 episodes were identified. Incidences of candidemia increased from 1.97 episodes/10 000 patient‐days in 2008 to 4.59/10 000 patient‐days in 2016 (P <.001), mainly due to an increase of C parapsilosis (incidence rate ratio, IRR: 1.04, P <.001). 33.0% of C parapsilosis strains were resistant to fluconazole; no resistance to echinocandins was found. Independent predictors of C parapsilosis candidemia were time of infection (P =.007), previous use of echinocandins (P <.0001) and year in which the episode was registered (P <.0001). 30 days mortality was 32.4% for C parapsilosis, with a significant difference compared to C non‐parapsilosis. Potential clonal C parapsilosis strains were detected by genetic analyses, showing RAPD profile A as the most represented (72.6% of isolates). Discussion: C parapsilosis candidemia is an emerging issue in our center, possibly attributed to some extent to horizontal transmission of the pathogen, as confirmed by the analysis of isolates similarities. Further microbiological and epidemiological investigations are needed in order to identify the most effective measures to reduce the rate of this infection. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Incidence of surgical site infection (SSI) after laryngotracheal (LT) surgery is relatively high, especially in children.Study Design: Retrospective and prospective cohort study.Methods: Clinical records of children who underwent open LT surgery at the Istituto Giannina Gaslini Children's Hospital from January 2008 to August 2017 were reviewed for development of SSI. Standard antibiotic prophylaxis was administered until February 2015. In March 2015, an antibiotic treatment tailored on pathogens isolated from surveillance cultures and prolonged until extubation was introduced. Incidence and risk factors for SSI before and after the new protocol implementation were analyzed by means of univariate and multivariable analyses.Results: A total of 57 procedures were analyzed. SSI incidence was 36% in patients receiving standard prophylaxis and 4% in those treated with the new strategy (P = .004), with an absolute benefit increase of 32% (95% confidence interval: 11%-52%), in absence of any difference in clinical conditions between the two groups.Conclusions: The new management protocol had a highly favorable impact on the development of an SSI.Level Of Evidence: 2b Laryngoscope, 129:2634-2639, 2019. [ABSTRACT FROM AUTHOR]

Once‐a‐week cotrimoxazole is an effective prophylaxis for pneumocystosis during antineoplastic chemotherapy or autologous stem cell transplant. Following allogeneic stem cell transplant, this schedule is at risk of pneumocystosis or neurotoxoplasmosis, as demonstrated by these case reports. Therefore, a 3‐times‐a‐week schedule must be adopted in these patients. [ABSTRACT FROM AUTHOR]

To describe the epidemiology of invasive Candida infection in a tertiary care paediatric hospital. Prospective single-centre survey on all Candida strains isolated from normally sterile fluids and urines in the period 2005-2015 . A total of 299 ICI were documented in 262 patients. Urinary tract infection represented the most frequent diagnosis (62%), followed by fungaemia (34%) and peritonitis (4%). Fungaemia was most frequent in children with cancer (59%) or in low birth weight neonates (61%), while urinary tract infections were more frequent in patients with urinary tract malformation. C.albicans was the most frequently isolated species (60%) compared with C. non- albicans, but differences were present according to the site of isolation and underlying conditions. Overall 90-day mortality was 7%, 13% in fungaemias, 8% in peritonitis and 2% in urinary tract infections. The rates of invasive Candida infection increased during the study period. Invasive Candida infection is diagnosed with increasing frequency in children. Site of isolation and aetiology are frequently related with the presence of underlying, favouring conditions. Mortality was not negligible, especially in the presence of more invasive infections and specific underlying conditions. [ABSTRACT FROM AUTHOR]