bluuebunny/crossref_metadata_2025_split huggingface dataset:
PB2134 THE IMPACT OF COMORBIDITY ON OVERALL SURVIVAL IN MULTIPLE MYELOMA
Authors: Mikhailov E. , Salogub G. , Osipov I. , Melikhova A. , Bessmeltsev S. , Shnalieva N. , Bezrukikh V. 
Published: June 2019

Background:The median age at diagnosis of multiple myeloma (MM) is 66 years. Comorbidity is registered in 40% cases. This can have an impact on overall survival, frequency of complications and duration of hospitalizationAims:The aim of this study was to analyze the impact of comorbidity on overall survival in patients with MM.MethodsThe study included 156 patients with newly diagnosed MM. For each patient a comorbidity score was calculated by using Charlson Comorbidity index (CCI), Cumulative Illness Rating Scale (CIRS), Freiburg Comorbidity index (FCI), Kaplan‐Feinstein index (KFI), Satariano Index (SI). The patients with CCI > 2, CIRS > 5, SI > 0, FCI > 1, KFI > 2 score were defined as high risk group, others were considered as the group of standard risk. Primary endpoint was overall survival. The survival analysis including creation of the Kaplan‐Meier survival curves was performed with use of IBM SPSS Statistics 21 The hypothesis was verificated by log‐rank test.Results:CIRS, KFI and SI did not show statistically significant difference in all groups. OS was significantly lower in high risk group estimated by CCI (96 vs 65 months, log rank p < 0.05). However, age is also included in calculating of this comorbidity index. Due to median age at diagnosis (more than 60 years) the majority of patients is classified as high risk group CCI based only on age. Karnofsky performance status, glomerular filtration rate <30 ml/min and pulmonary diseases were used for estimation by FCI. OS in high risk group was 43 months in comparison to 86 months in group of standard risk (p < 0.05). 2 patients with FCI = 3 had extremely low OS (less than 2 months).Summary/Conclusion:Comorbidity has an impact on OS in patients with MM. According to our analysis, the most valid prognostic instruments turned out to be FCI and CCI. These indices can be used to predict clinical outcomes.image
PB2142 BUSULFAN/CYCLOPHOSPHAMIDE (BU/CY) COMPARED WITH HIGH‐DOSE MELPHALAN (HDMEL) AS CONDITIONING REGIMEN FOR AUTO STEM CELL TRANSPLANTATION OF MULTIPLE MYELOMA
Authors: Fu C. , Zhou S. , Jin S. , Yan L. , Shang J. , Shi X. , Wang J. , Yao Y. , Wu D. 
Published: June 2019

Background:High dose melphalan (HDMEL) represents the standard conditioning regimen before auto stem cell transplantation (ASCT) for multiple myeloma (MM). But melphalan was inconvenient to obtain in mainland China.Aims:We compared two groups of MM patients who received HDMEL and busulfan/cyclophosphamide (BU/CY) regiment followed by ASCT.Methods105 patients newly diagnosed with MM in our center undergoing ASCT between May 2012 and August 2017 were enrolled. They were divided into two groups according to conditioning regimen (BU/CY vs. HDMEL). In BU/CY group, busulfan [0.6 mg/kg for those with creatinine clearance rate (CCR)≥60 ml/min and 0.5 mg/kg for CCR≥40 ml/min and <60 ml/min] was administered q6 h on days ‐7∼‐5 (7.2 mg/kg and 6.0 mg/kg in total, respectively) and cyclophosphamide (1.8 g/m2 for those CCR≥60 ml/min and 1.5 g/m2 for CCR≥40 ml/min and <60 ml/min) was given once on days ‐4∼‐3. In HDMEL group, melphalan (200 mg/m2) was given one dose on day ‐2.Results:At a median follow‐up of 30 months (range 0∼74 months), the average overall survival (OS) and median progression‐free survival (PFS) in BU/CY group were 53.7 months [95% confidence interval (CI) 49.3∼58.1] and 59.0 months (95% CI 48.3∼69.7) respectively, showing no significant difference with that of HDMEL group [average OS: 52.6 month (95% CI 44.5∼60.8) and median PFS: 8.0 months (95% CI 46.9∼69.1) respectively]. No significant difference was found in incidence of pneumonia, fever, mucositis, abnormal liver function, abnormal renal function between BU/CY group and melphalan group. No VOD was observed during the research.Summary/Conclusion:BU/CY conditioning regimen for MM before ASCT is not inferior to the HDMEL regimen in the Chinese mainland population. The regimen is effective and the toxicity can be tolerated.
PB2159 CHOLESTEROL LEVELS PROVIDE PROGNOSTIC INFORMATION IN PATIENTS WITH MULTIPLE MYELOMA
Authors: Peipei X. 
Published: June 2019

Background:Hypocholesterolaemia has been reported to be associated with cancer risk and progression.Aims:he aim of this retrospective study was to investigate the prognostic value of cholesterol levels in patients with multiple myeloma (MM).MethodsA total of 153 patients newly diagnosed with MM were retrospectively enrolled. The relationship between cholesterol levels and clinical characteristics was evaluated. The prognostic value of cholesterol levels was explored.Results:The levels of low‐density lipoprotein cholesterol (LDL‐c), high‐density lipoprotein cholesterol (HDL‐c) and triglycerides (TC) were significantly lower in MM patients (P < 0.001). What is more, multivariate analyses showed that low TC and LDL‐c levels were independent predictors of a better OS (overall survival; HR = 6.893 and 0.204; CI = 1.135‐41.868 and 0.045‐0.930, P = 0.036 and 0.040) and PFS (progression‐free survival; HR = 7.416 and 0.216; CI = 1.365‐40.290 and 0.047‐0.999, P = 0.020 and 0.049).Summary/Conclusion:Serum cholesterol levels in MM patients were low, and TC and LDL‐c levels could be used as prognostic markers for MM patients.
PB2171 THE COMPARISON OF THE RELATIONSHIP BETWEEN POLYNEUROPATHY FREQUENCY AND CLINICAL AND LABORATORY FINDINGS IN MULTIPLE MYELOMA CASES
Authors: Yikilmaz A. Senturk , Akinci S. , Bakanay S. , Dilek I. 
Published: June 2019

Background:Multiple myeloma (MM) patients compose approximately 10% of patients with hematological malignancies. Polyneuropathy (PN) is one of the most important complications related to the disease and treatment.Aims:Multiple myeloma (MM) patients compose approximately 10% of patients with hematological malignancies. Polyneuropathy (PN) is one of the most important complications related to the disease and treatment.MethodsA total of 121 MM cases followed in the Hematology Clinic of Atatürk Training and Research Hospital between 2010‐2018 were included in the study. Electromyography results were evaluated retrospectively and clinical and laboratory findings were compared. Five cases with diabetes mellitus were excluded from the study. Chi‐square method was accepted as statistically significant p <0.05.Results:The median age of the patients was 64.5 (min 39 max: 88), and Female/Male ratio was 51/65 (44%/65%). Demographic data of 28 (24.3%) patients with PN and 87 (75.7%) patients without PN were presented in Table 1. Renal function tests were normal in 64 (55.7%) of 87 patients without polyneuropathy (p = 0.005). There were 28 (23%) cases with extramedullary plasmacytoma larger than 1.5 cm which were detected by MR imaging at the time of diagnosis. In cases with extramedullary plasmacytoma, the prevalence of polyneuropathy was higher at the initial diagnosis (p = 0.012).Summary/Conclusion:There are publications in the literature showing that PN is associated with perineural and perivascular monoclonal immunoglobulin accumulation in MM. In our cases, there was no correlation between the presence of PN during diagnosis and the immunoglobulin subtype, but it was found to be related to the presence of renal dysfunction and the presence of extramedullary plasmacytoma. And we think that this result is the considerable.image
PB2183 SUPERIORITY OF CYBORD OVER VAD IS MORE EVIDENT IN FIRST THAN IN SECOND LINE TREATMENT OF MULTIPLE MYELOMA
Authors: El Gammal M. , Hassan N. , Fatah M. Abdel 
Published: June 2019

Background:In the era of novel anti‐myeloma agents and monoclonal antibodies (daratumumab) and due to their high cost, earlier low cost regimens (VAD or CyBorD) may be used.Aims:to compare outcome of treatment of CyBorD versus VAD regimens in multiple myelomaMethodsThis cohort study included 89 MM patients treated at National Cancer Institute (NCI), Cairo, Egypt from January 2011 to December 2015. All patients were evaluated clinically and laboratory for different responses with either lines of treatment (VAD versus CyBorD), and correlated with different survival parameters; progression free (PFS), disease free (DFS), and overall survival (OS), and clinico‐pathologic factors.Results:The median age of patients was 54 years (32‐76), with male predominance (male to female ratio 1.87:1). The most common presenting symptoms were bony pains (44.9%) followed by bony masses (22.5%), fractures (16.9%), pallor (7.9%), neurological symptoms (5.6%) and finally oliguria (2.2%). CyBorD have better overall response rate (≥PR) (p = 0.031), PFS (p = 0.004) and DFS (p= 0.013) as 1st line treatment compared to VAD regimen. Also in previously treated patients CyBorD showed better PFS (p = 0.039) compared to VAD regimen. There was a significant relation between age (p = 0.001& < 0.001) and ASCT (p= 0.001&0.034) with PFS and OS respectively.Summary/Conclusion:CyBorD have significant better overall response treatment (≥PR), PFS and DFS in 1st line treatment compared to VAD regimen. While in previously treated patients only PFS benefit for CyBorD over VAD regimen was obtained. Age and ASCT had significant effect on PFS and OSimage
PB2188 ANALYSIS OF MINIMAL RESIDUAL DISEASE IN PATIENTS WITH MULTIPLE MYELOMA RECEIVING DARATUMUMAB
Authors: Glazanova T. , Chubukina Z. , Bubnova L. , Karyagina E. , Garifullin A. , Voloshin S. , Bessmeltsev S. 
Published: June 2019

Background:Over the past two decades, with the advent of new drugs, the tactics of treatment of patients with multiple myeloma (MM) has changed significantly; however, the general problem of the effectiveness of MM therapy remains unresolved to date. This disease is characterized by a progressive course and development of resistance to both proteasome inhibitors (bortezomib) and immunomodulatory drugs (lenalidomide), i.e. double refractoriness. Anti‐CD38 monoclonal antibodies are suggested for the treatment of heavily‐pretreated patients, including patients with double refractoriness.Aims:To study the dynamics of minimal residual disease (MRD) in patients with MM with double refractoriness receiving daratumumab.MethodsSeven patients with MM refractory to prior bortezomib and lenalidomide treatment were included in the study from 2017 to 2019. The number of lines of previous therapy was 5 (median = 3). The average age of patients–61 years (48–76 years). Daratumumab was administered to all patients as an intravenous infusion at a dose of 16 mg/kg: weekly at Weeks 1‐8, biweekly at Weeks 9‐24 and from Week 25 till progression. MRD assessment in bone marrow aspirate using multicolor flow cytometry (with a sensitivity of 10−5) was performed every 3 months from the start of treatment. To assess the effectiveness of treatment, generally accepted criteria were used.Results:Overall response was 86%. Fifty‐seven % of patients achieved a very good partial response, 29% had a partial response and 14% developed disease progression during therapy. After 3 months of therapy, 6 (86%) patients were MRD‐positive (median 0.072%, range 0.017–0.15%), of these, in 5 patients the monitoring showed a decrease in the number of myeloma cells, while in one patient MRD‐negativity was achieved. One patient (14%) with a very good partial response, after 3 months from the start of therapy, achieved an indicator of MRD‐negativity <0.01% (median ‐ 0.005%), however, after 6 months the MRD status changed to positive.Summary/Conclusion:Daratumumab treatment regimen demonstrated a high level of general response. The MRD score reflects the clearance of residual tumor cells and is an important independent prognostic criterion for determining the depth of remission, for stratification by risk groups and disease prognosis.
PB2202 VALIDATION OF THE PRIMERDESIGN® QUANTITATIVE ALLELE SPECIFIC AMPLIFICATION KIT FOR THE DETECTION OF THE JAK2V617F MUTATION
Authors: Vaz D. 
Published: June 2019

Background:Janus Kinase 2 (JAK2) is part of a group of tyrosine kinases which are involved in cellular signalling. A point mutation in codon 617 of the JAK2 gene (JAK2 V617F) causes a ‘gain of function’ effect of this process, stimulating proliferation of the myeloid cell lines, including erythrocytes and platelets, as well as causing myelofibrosis in the bone marrow. Testing for this specific mutation using an allele‐specific PCR kit at our facility (NHLS‐TAD), Pretoria] should provide quick and reliable results to investigate suspected myeloproliferative neoplasms. As part of method comparison, 15 specimens known to be positive for the JAK2V617F mutation and 19 specimens known to be JAK2 negative, as previously assessed using PCR with melting curve analysis at Charlotte Maxeke Johannesburg Academic Hospital, will be analysed using the Primerdesign Quasa test kit on the BioRad CFX 96 platform. Results of the two PCR tests will be compared to evaluate accuracy of the kit.Aims:To validate the Primerdesign® quantitative allele specific amplification (Quasa) kit for detection of the JAK2V617F mutation in DNA extracted from whole blood samples.Methods:Patients’ samples, previously tested at the National Health Laboratory Service laboratory, Charlotte Maxeke Johannesburg Academic Hospital, will be used. These comprise both whole blood collected in EDTA as well as genomic DNA. 15 specimens known to be positive for the JAK2V617F mutation as well as 19 JAK2 negative specimens will be analysed as part of method comparison. We have chosen a sample size of 34 due to the substantial cost of each kit and we are limited due to financial constraints. The WHO international reference panel for genomic JAK2V617F with proposed percentages of 0, 0.03, 1, 10.8, 29.6, 89.5 and 100% will be used for quantitative analysis of the kit. In addition, we will be analysing a diluted JAK2V617F WHO sample to confirm the manufacturer's claim of an analytical sensitivity of 0.1%. Specimens already analysed will be re‐tested using the Primerdesign® quasa kit on the CFX96 real‐time PCR platform (Bio Rad).Results:There is a 95% concordance between the results obtained from the index test (Primerdesign kit) when compared to the test of reference (LightCycler). Precision includes repeatability and reproducibility, both of which were shown in this study. We were able to detect 0.1% mutant DNA in background wild type DNA as claimed by the manufacturer. Therefore the analytical sensitivity was at 0.1%. The ability of the test to not detect the mutation in a known negative sample was at 100% concordance. Therefore analytical specificity was 100%Summary/Conclusion:The Primerdesign allele specific kit has the capability of being able to produce qualitative as well as quantitative results based on the manufacturer's instructions. Being able to provide this diagnostic test in our department will decrease turn‐around time and improve patient care.
PB2203 IMPROVEMENT OF THE HEMATOLOGIC TOXICITIES OF RUXOLITINIB IN PATIENTS WITH MPN‐ASSOCIATED MYELOFIBROSIS USING A COMBINATION OF THALIDOMIDE, STANOZOLOL AND PREDNISONE
Authors: Duan M. , zhou D. 
Published: June 2019

Background:Anemia and thrombocytopenia are the most frequently reported adverse events of ruxolitinib in patients with MPN‐associated myelofibrosis (MPN‐MF). Although thalidomide, androgens and prednisone have previously demonstrated improvements in myelofibrosis‐associated anemia, it is unclear whether these drugs are effective in patients taking ruxolitinib.Aims:To evaluate the efficacy and tolerability of combination therapy with low dose thalidomide, stanozolol and prednisone (TSP) in patients with IPSS intermediate‐2 or high‐risk myelofibrosis (MF) who received ruxolitinib treatment.Methods:Sixty‐five patients with MPN‐MF who took ruxolitinib were enrolled in this retrospective study, of which 46 patients also took TSP while 19 did not take TSP (TSP and non‐TSP groups).Results:Within the first 24 weeks, the proportion of patients with anemia and platelet count ≥50 × 109/L were 45.7% and 67.4% in the TSP group as compared to 0% and 10.5% in the non‐TSP group (p < 0.001). The mean hemoglobin level in the non‐TSP group reached the nadir after approximately 12–16 weeks of therapy, but gradually increased in the TSP group.Summary/Conclusion:In summary, TSP regime can improve anemia and thrombocytopenia during ruxolitinib treatment in patients with MPN‐MF, and the associated adverse events were manageable.image
PB2232 THE NATURAL ANTICOAGULANTS IN PATIENTS WITH PHILADELPHIA‐NEGATIVE MYELOPROLIFERATIVE NEOPLASMS
Authors: Efremova E. , Korsakova N. , Matvienko O. , Fominykh M. , Silina N. , Golovina O. , Papayan L. , Martynkevich I. , Samorodova A. , Polushkina L. , Voloshin S. , Shuvaev V. 
Published: June 2019

Background:Myeloproliferative neoplasms (MPNs) are characterized by an increased frequency of thrombotic complications. Patients with MPNs show little or no abnormalities in traditional coagulation tests. Chronic inflammation associated with pathological secretion of several inflammatory cytokines leads to activation of endothelial cells and imbalance between coagulation and anticoagulation systems.Aims:To estimate the natural anticoagulants activity and activated protein C resistance in MPNs patients.Methods:The study included 99 MPNs patients (aged 25 – 86 years, median = 55) and 43 healthy controls (aged 30‐73 years, median = 46). There were 65 female and 34 male in the study group. 75 (76%) patients were JAK2V617F positive, 24 (24%) were JAK2V617F negative. Antithrombin (AT), protein C (PC) activities and free protein S level (PS) estimation was performed by standard techniques. Thrombin generation was assessed by calibrated automated thrombinography (CAT) according to Hemker et al. Measurement was conducted in platelet poor plasma with or without thrombomodulin (TM). Such parameters as endogenous thrombin potential (ETP, nM∗min) and peak thrombin (Peak, nM) were evaluated. ETP and Peak sensitivity for TM were calculated as percent of these parameters decrease after TM adding to assay (S ETP, % and S Peak, % respectively). STATISTICA 6.0 package was used for data analysis. Parameter results were presented as median (Me) with 95% confidence intervals (CI), p<0.05 was considered statistically significant.Results:Protein C and protein S activity, Peak and ETP decrease were lower in patients with MPN than controls. Patients with Jak2V617F‐ had a tendency to lower sensitivity for TM in comparison with Jak2V617F+ patients. This fact could have a significant role in thrombotic complication development.Summary/Conclusion: Our results showed presence of activated protein C resistance probably caused by anticoagulant protein C system dysfunction. Jak2V617F influence on hemostatic parameters demands further investigations.image
PB2240 EPIDEMIOLOGICAL DATA ON MYELOFIBROSIS IN ALBANIAN POPULATION (1999‐2018)
Authors: Çalliku E. , Perolla A. , Pulluqi P. , Caja T. , Cili A. , Ivanaj A. 
Published: June 2019

Background:Worldwide published epidemiological data on primary and secondary myelofibrosis (MF) are scarce, and multiple sources are needed to assess the disease burden in each country, in our country we have a lack of epidemiological data on MPD and MF.Aims:The aim of our study is to evaluate the annual incidence of Myelofibrosis in the Albanian population during the period of time from 1999‐2018.Methods:In our study the data were collected from the registries in our Service of Hematology and from the registries in the Department of Statistics, UHC “Mother Teresa” and were analyzed with SPSS 22.0. We have analyzed the data of all patients, age > 18 years, diagnosed with Myelofibrosis and hospitalized in the UHC “Mother Teresa” and in our Service of Hematology from 1999 to 2018.Results:During the interval 1999‐2018 in our hospital are diagnosed 108[100%] patients with MF, 54 pts (50%) males, and 54 pts (50%) female. The annual incidence of MF in Albania results around 0,22 new cases / 100,000 habitants per year. The median incidence of MF is about 5,7 new cases per year with a peak in 2013 (13 new cases) and an increase with respectively 10 new cases in 2017 and 15 new cases in 2018.The median age at the moment of the diagnosis resulted in 62,5 years old (interval range 25‐83 years old)Almost all the patients were on advanced stages of MF at the moment of the diagnosis (95%).Actually, 49 patients are on treatment with Ruxolitinib since 2015.Summary/Conclusion:A careful study, using standardized definitions of MF and complete assessment of patients including both primary and secondary MFs, should be performed to estimate the population aimed to receive novel era treatments for these neoplasms
PB2278 PRETREATMENT SERUM 25(OH) VITAMIN D AS PREDICTOR OF EVENT‐ FREE SURVIVAL IN LYMPHOID MALIGNANCIES
Authors: Djurasinovic V. , Mihaljevic B. , Vukovic V. , Antic D. , Tomic K. , Otasevic V. 
Published: June 2019

Background:Vitamin D was investigated as a prective factor in lymphoid malignancies recently.Aims:Assessment of 25(OH) vitamin D status in lymphoid malignacies before active treatment and its influence on event‐free survival (EFS).Methods:Study included 153 patients, median age 58(18‐84) years with diagnose: diffuse large B cell lymphoma‐70, Hodgkin lymphoma‐22, chronic lymphocitic leukemia‐21, follicular lymphoma‐20 and multiple myeloma‐20, who had pretreatment 25(OH) vitamin D level. Comorbidities were assessed by Cumulative comorbidity index (CIRS). Patients were treated with immunochemotherapy and followed for event‐free survival for median 38(2‐53) months.Event was defined as progression or death.Results:Pretreatment serum 25(OH) vitamin D was 34,4 ± 13,6 nmol/l, without significant difference between lymphoma subgroups (ANOVA p = 0,069). Multivariate Cox regression for EFS showed 25(OH)D<25nmol/l (HR 2,732, 95%CI 1,37‐5,44), elevated LDH (HR 3,79, 95%CI 1,87‐7,66) and CIRS > 3 (HR 2,88, 95%CI 1,43‐5,78) as significant parameters for EFS.Summary/Conclusion:Average pretreatment 25(OH)D level in lymphoid malignancies is low. Severe deficiency, 25(OH)D <25nmol/l, is strong predictor of EFS in analysed group of patients.
PB2287 REFERENCE INTERVALS OF BLOOD COUNT IN HEALTHY FULL‐TERM PREGNANT GREEK WOMEN
Authors: Karantani K. , Petassis G. , Tsioni K. , Issa M. , Tsamis E. , Vagdatli E. 
Published: June 2019

Background:Since blood count reference intervals are generally based on samples collected from non pregnant women, these should not be used for the evaluation of pregnant women.Aims:The aim of this study was to determine White Blood Cells (WBC), Neutrophils (NEU) and Lymphocytes (LY) reference ranges in healthy Greek full‐term pregnant women and to evaluate them before and after delivery.Methods:Blood samples from 278 healthy pregnant women, before and after labour were collected using EDTA anticoagulated tubes. WBC, NEU and LY were determined in COULTER LH780 analyzer pre and one or two days post partum. 5% of the upper and lower results concerning WBC, NEU and LY were excluded. A normality test was performed using SPSS 21 statistical software and median, minimum and maximum ranges were calculated.Results:The WBC, NEU and LY mean, median, maximum and minimum values in healthy prepartum women are showed in Table I. Out of 278 pregnant women, only in 112 (40,3%), there was a statistically significant (p = 0.001) decrease in WBC post partum with a simultaneous fall of NEU in 84,8% of them. Furthermore, there was a post partum NEU decrease, only in 129 (46,4%) out of them, albeit not statistically significant (p = 0.283), whereas there was a LY significant fall (p = 0.004) in 114 (41,64%) of them.Summary/Conclusion:WBC and NEU in healthy full term pregnant women prepartum are elevated, while LY are within normal range.40,3% reduce WBC post partum. Nevertheless, in an excessive number women post partum develop elevated WBC due to possible infection.image