Large granular lymphocytic leukemia (LGLL) is a rare hematological malignancy that arises from cytotoxic T lymphocytes (T‐LGLL) in 85% of cases and natural killer (NK) cells in the rest. A significant knowledge gap exists regarding the pathogenesis, treatment choices, and prognostic factors of LGLL. We report a cohort of 319 consecutive LGLL patients who presented to our cancer center between 2001 and 2020. A total of 295 patients with T‐LGLL and 24 with chronic NK‐cell lymphoproliferative disorder (CLPD‐NK) were identified. The median age was 65 years (range, 17–90 years). Eighty‐three patients (26.0%) had autoimmune diseases. A total of 119 patients (37.3%) had coexisting malignancies, 66 (20.7%) had solid tumors, and 59 (18.5%) had hematological malignancies. Most coexisting malignancies were diagnosed before the diagnosis of LGLL. Treatment was needed for 57% of patients. Methotrexate (MTX), cyclophosphamide (Cy), and cyclosporine A (CSA) were most used and had similar response rates between 61.5%–74.4%. Cy produced more complete responses (32.3%) compared to MTX and CSA (15.7% and 23.1%, respectively). Thrombocytopenia, splenomegaly, and female gender (after controlling for autoimmune diseases) were associated with decreased response rates to MTX, CSA, or Cy. Autoimmune diseases were associated with increased response rates. Thrombocytopenia was an independent risk factor for worse survival.

ESBL E. coli accounted for more than 40% of CA-UTIs during 2015. A history of previous hospitalization, surgery, and antibiotic use should be considered when treating this type of infection. Action should be taken to confirm these worrisome results and avoid the major consequences for public health.

The objective of this study was to determine the serotype distribution and antibiotic resistance of invasive pneumococcal disease (IPD) strains in children from Lima, Peru, before and after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7), which was introduced in the national immunisation program on 2009. We conducted a prospective, multicentre, passive surveillance IPD study during 2006–2008 and 2009–2011, before and right after the introduction of PCV7 in Peru. The study was performed in 11 hospitals and five private laboratories in Lima, Peru, in patients <18 years old, with sterile site cultures yielding Streptococcus pneumoniae. In total 159 S. pneumoniae isolates were recovered. There was a decrease in the incidence of IPD in children <2 years old after the introduction of PCV7 (18.4/100 000 vs. 5.1/100 000, P = 0.004). Meningitis cases decreased significantly in the second period (P = 0.036) as well as the overall case fatality rate (P = 0.025), including a decreased case fatality rate of pneumonia (16.3% to 0%, P = 0.04). PCV7 serotypes showed a downward trend. Vaccine-preventable serotypes caused 78.9% of IPD cases, mainly 14, 6B, 5, 19F and 23F. A non-significant increase in erythromycin resistance was reported. Our findings suggest that the introduction of PCV7 led to a significant decrease of IPD in children under 2 years old and in the overall case fatality rate.

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Introduction MCL is an incurable B-cell lymphoma, accounting for 3-8% of Non-Hodgkin Lymphoma (NHL). Efforts to increase frontline treatment intensity with cytarabine (AraC), autologous transplant, and prolonged Rituximab maintenance have improved outcomes for many. However, those with TP53 mutations do not show similar benefit, highlighting a need for novel approaches in this setting. Lenalidomide plus Rituximab (R2) has been shown to have activity in MCL, but little data exist in the context of TP53 alterations. Methods We retrospectively reviewed 145 patients diagnosed with MCL between 2005 and 2019. Cases were selected by diagnosis of MCL and clinical evaluation from July 2018 to June 2019. A total of 145 unique cases were identified, of which 63 had insufficient testing for TP53, 50 were negative, and 32 were mutation positive by cytogenetics, NGS, or FISH. Patients with mutated TP53 were further assessed for the primary outcome of event-free survival (EFS) and a secondary outcome of overall survival (OS). All statistical analyses were performed using SPSS software. Results Of 32 analyzed patients, 72% were male, with median age 67 years (46-87) and median WBC 15 (3-283). All but one patient presented with ECOG PS 0-1. LDH was elevated in 44%, with high MIPI in 56% of patients. Ki67 was available in 8 cases (median 30%), with 2 additional cases noted only as "blastoid." Frontline therapy consisted of Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone (RCHOP) or Bendamustine plus Rituximab (BR) with maintenance Rituximab (6 patients), AraC, and/or transplant (8), R2 (8), BTK+Rituximab (2), or palliation (XRT 1, Rituximab 2, watchful waiting 5). Seven patients received R2 in the relapsed setting. With median followup of 44 months, the median OS was not reached (83%), and median EFS among all treated patients was 36 months. Among those who received frontline R2, 63% were male, with median age 68 (55-75), median WBC 74 (11-283), with elevated LDH in 50% and high MIPI in 88%. Ki67 was available for 2 patients, and measured 10% and 80%. The Median OS and EFS were 100% with median followup on therapy of 15 months. Conclusions Survival was surprisingly robust across this cohort of high risk MCL. Treatment with Lenalidomide plus Rituximab may provide an alternative regimen for TP53-mutated MCL in the first-line setting. Further analysis of long-term data will be beneficial to monitor durability of remission. Figure Disclosures Chavez: Kite: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Membership on an entity's Board of Directors or advisory committees; Genentech: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Bayer: Membership on an entity's Board of Directors or advisory committees; Karyopharm: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees. Bello:Celgene: Speakers Bureau. Sokol:EUSA: Consultancy. Pinilla Ibarz:Novartis: Consultancy; Teva: Consultancy; Janssen: Consultancy, Speakers Bureau; Abbvie: Consultancy, Speakers Bureau; TG Therapeutics: Consultancy; Bayer: Speakers Bureau; Sanofi: Speakers Bureau; Bristol-Myers Squibb: Consultancy; Takeda: Consultancy, Speakers Bureau. Shah:Celgene/Juno: Honoraria; Kite/Gilead: Honoraria; Incyte: Research Funding; Jazz Pharmaceuticals: Research Funding; Pharmacyclics: Honoraria; Adaptive Biotechnologies: Honoraria; Spectrum/Astrotech: Honoraria; Novartis: Honoraria; AstraZeneca: Honoraria.