of cancer treatment. Clinicians must recognize AIHA as a possible complication of solid tumors
to facilitate prompt diagnosis and treatment.
BURDEN OF CHEMOTHERAPY-RELATED MYELODYSPLASTIC SYNDROME/ACUTE MYELOID LEUKEMIA IN THE CHEMOTHERAPEUTIC ARMAMENTARIUM Sindhu Thevuthasan MD1, Shiva Jashwanth Gaddam MD2, Udhayvir Grewal MD, Poornima Ramadas MD2; Department of Medicine1, Section of Hematology and Oncology2, LSU Shreveport, Shreveport LA.
Introduction: One of the well-established adverse events (AE) associated with conventional chemotherapy drugs is Therapy-related Myelodysplastic Syndrome and Acute Myeloid Leukemia (t-MDS/AML). It has historically carried a poorer prognosis when compared to de novo disease. Newer chemotherapy medicines like PARP inhibitors have also been implicated in developing this complication. However, comprehensive real-world data is lacking pertaining to the AE burden relative to individual drug classes. Study: We utilized the FDA Adverse Events Report System (FAERS) public dashboard to obtain the data. Data was available for the years 1970 – 2023. We retrieved the number of events that were reported as “Myelodysplastic Syndrome” or “Acute Myeloid Leukemia” for individual chemotherapy classes that have historically been known to cause t-MDS/ AML. Disproportionality analysis was performed by calculating the reporting odds ratio (ROR) with its
95% confidence interval (CI). The drug class with the highest ROR of MDS/AML was the topoisomerase inhibitors - ROR 2.38 (95% CI 2.27-2.49). Intercalating agents like anthracyclines and mitoxantrone had the next highest ROR of 2.12 (95% CI 2.04 - 2.21). The novel drug class PARP inhibitors had the third most burden of t-MDS/AML with an ROR of 1.57 (95% CI 1.46 - 1.69). Discussion: In performing this retrospective analysis, we identified that among all the chemotherapy drug classes, the topoisomerase II inhibitors were associated with the highest burden of t-MDS/ AML, followed by intercalating agents and PARP inhibitors. Further data is essential to identify the patient characteristics associated with a higher risk of developing this dreaded complication. This could improve patient-counseling prior to treatment initiation, assist with alternate drug choices when applicable, and perhaps aid in developing strategies for closer monitoring in high-risk patients.
THE CURIOUS CASE OF RHIZOBIUM RADIOBACTER Ali Yousuf DO, Suzanne Cooper MD, James Kuo MD, Robert Mipro BS, Shaun Walker DO; Department of Medicine, LSU Health, Lafayette, LA.
Introduction: Rhizobium radiobacter is an opportunistic, gram-negative organism found primarily in plants and soil. It has a rare association with infections in humans, primarily those in immunocompromised states and patients with foreign bodies. Recently, there has been evidence to suggest an association between rare microorganisms such as Aspergillus and Rhizobium radiobacter, and co-infection with Sars-Cov-2. Case: A 47-year-old female with HER2-positive breast cancer and recent infection with COVID-19 was admitted for an acute community-acquired pneumonia. She was initiated on broad-spectrum antibiotics at the time of presentation. A Computed Tomography of the thorax depicted right lung masses and hilar lymphadenopathy. Given her
medical history and immunocompromised state from chemotherapy, a comprehensive infectious workup was conducted. She underwent a diagnostic bronchoscopy with lavage for evaluation. The resulting cultures returned positive for Aspergillus and Rhizobium radiobacter. The patient was transitioned to a more specific antibiotic regimen and started on long-term antifungal therapy, along with close outpatient monitoring of her infection and symptoms. Discussion: Post-COVID pneumonia is a recently recognized entity. Rhizobium radiobacter is a rare cause of pneumonia, and its isolation from bronchoalveolar lavage is uncommon. The management of post-COVID pneumonia requires a multidisciplinary approach involving 32
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