bluuebunny/crossref_metadata_2025_split huggingface dataset:
PB1756 EFFICACY OF SALVAGE CHEMOTHERAPY REGIMENS IN PATIENTS WITH REFRACTORY OR RELAPSED ACUTE MYELOID LEUKEMIA SINGLE CENTER EXPERIENCE
Authors: Simeonova K. , Nikolova V. , Naseva E. , Stoychov M. , Yankova T. , Donchev M. , Arnaudov G. , Balazenkou G. , Guenova M. , Spasov B. 
Published: June 2019

Background:Although understanding in the pathology of AML has developed and a variety of new therapies to AML have been found recently, no response to induction therapy still happens in 20–40% and relapse after CR occurs in 50–70% of the patients, respectively, which are called refractory or relapsed AML (R/R AML) Thus, it is necessary to find effective therapies in treating R/R AML patients.Aims:To compare the remission rate and survival between CLARA and FLAG‐Ida salvage chemotherapy in treating patients with refractory or relapsed acute myeloidleukemia (R/R AML).Methods:18 R/R AML patients with the following demographic and disease characteristics were treated in our center between 2017‐2018(Table 1.). 7 patients with mean age 46.71 years were treated by CLARA salvage chemotherapy as follows:30 mg/m2/day clofarabine (days 1–5); 1 g/m2/day cytarabine(days 1–5) and 300 mcg/day filgrastim (days 0–till neutrophille recovery). While 11 patients with mean age 50 yeras were treated by FLAG‐Ida: 30 mg/m2/day fludarabine(days 1–5), 2 g/m2/day cytarabine (days 1–5), 8 mg/m2/day idarubicine (days 1–5) and 300 mcg/day filgrastim (days 0–till neutrophille recovery).Results:CLARA salvage therapy achieved 57.1 % complete remission rate (CR) and 85.7% overall remission rate (ORR), which was better than FLAG ‐ Ida chemotherapy which realized 36.4% CR and 54.5% ORR. The 30‐day survival rate was higher in CLARA group 85.7% compared to 63.6 in FLAG‐Ida group and it seemed to realize a prolonged OS compared to FLAG – Ida (Table. 3)imageSummary/Conclusion:In our small group of patients with relapsed/refracoty disease CLARA seemed to be a better tretment option than FLAG ‐ Ida related to both overall response rte and overal survival.
PB1757 MORPHOLOGICAL CHARACTERISTICS, CYTOGENETIC PROFILEAND TREATMENT OUTCOME OF AML1‐ETO POSITIVE ACUTE MYELOID LEUKEMIA; INDIAN PERSPECTIVE.
Authors: S.  , Gupta R. , Gupta A. , Garg A. , Rehman K. , Nityanand S. 
Published: June 2019

Background:Acute myeloid leukemia (AML) is characterized by the proliferation of leukemic myeloid blasts bearing granules and/or Auer rods. Besides acute promyelocytic leukemia, the myeloid blasts in other subtypes of AML have a non‐descript morphology.Aims:The aim of this analysis was to determine the morphological features of t (8;21) positive AML and define a score for predicting positivity for this fusion protein in AML.Methods:A retrospective analysis of all the cases of AML diagnosed over a period of five years (2013‐2017) at our centre was performed. The clinical and laboratory data of the patients was collected from the patient medical records. The bone marrow aspirate smears were reviewed to define the specific features of t (8;21) positive AML; dyspoiesis in maturing granulocytes, long thin Auer rods, eosinophilia, cytoplasmic vacuoles and presence of Auer rods in maturing myeloid cells.Results:A total of 68 cases of t (8;21) positive AML were diagnosed during the study period, with a median age of 19.5 years (range 5‐75 years) with a M:F of 1.7:1. Only twenty percent (14/68) patients belonged to the paediatric age‐group (≤14 years). Granulocytic sarcoma was observed in 10.2% patients at presentation. Morphologically, in accordance to the FAB classification there were 56 AML‐M2, 5 AML‐M1 and 7 AML‐M4 subtypes. Thirteen cases (n = 68) exhibited less than 20% blast in the bone marrow. Characteristic morphological features included presence of dyspoiesis (71%), slender long Auer rods (48%), eosinophilia (19%) cytoplasmic vacuoles in the golgi zone of blasts and maturing myeloid cells (48%). Mast cells, and Auer rods in maturing granulocytic series of cells were seen in a very small fraction of patients, 11% and 3% respectively. 29/68 patients opting for treatment were managed as per the 3+7 protocol. Seventy percent (21/30) achieved CR; there were 5 induction and 8 post induction deaths. With a median follow‐up of 27 months, (range 4‐51 months), the overall survival is 40%. Eleven patients relapsed with a median interval of 7 months, twelve patients‐maintained CR.Summary/Conclusion:Since this sub‐group of AML is believed to be a harbinger of good prognosis, recognition of the distinct morphological features of AML1‐ETO AML is essential; it will facilitate a screening for this genetic abnormality. There was no prognostic correlation with any laboratory parameter, however, presence of granulocytic sarcoma in these patients portends a poor prognosis.
PB1773 OVERAL SURVIVAL OF MEXICAN NATIONAL REGISTRY OF ACUTE PROMYEOLOCYTIC LEUKEMIA, AN ANALYSIS OF 324 CASES
Authors: Zapata N. , Montaño E. , Ramos C. , Espinoza R. , Solis J.C. , Barrera E. , Mijangos J. , Diaz G. , Solís R. , Perez O. , Herrera M. , Gomez D. , Cabrera A. , Flores J.A. , Solano M. , Guillermo V. , Ceballos A. , Ojeda J. , Gomez G. , Lyn L. , Mena V. , De la Peña J.A. , Ortiz M. , Perez J. , Espitia M.E. , Alvarez J.L. , Aguilar M. , Alvarado M. 
Published: June 2019

Background:Acute Promyelocytic Leukemia is a myeloid dissease wich is informed to be more frequent in latinos, but there is few epidemiological data about these.This is a review of 19 Hospitals in different states of Mexico, from Northern to South of Mexico.A retrospective study of all cases of acute promyelocytic leukemia treated from 2007‐2018, a total of 324 cases.Aims:Our Aim objective is to know our overall survival of the population with acute promyelocyic leukemia treated in different institutions in MexicoSecondary objectives: Learn about treatment used in theses different institutions, and mortality related.Methods:We perform a rtrospective analysis from 2007‐2018, a total of 324 cases diagnose with acute promylocytic leukemia, inform consent was perform in all casesResults:The Median age 36 years old (range 15‐73), relation male:female 163:161. Infection at diagnosis 12%(39cases), DIC 31% (102 cases), Hemorrages 21%, CNS:8cases, Gastrointestinal 18cases, urinary tract:15, skin:28 cases. Leucocite at diagnosis median of 22.3 (1.0‐450), Platelets median of 40 (2‐318), Fybrogen median 190 range22‐825, TTPa 32 seconds (28‐255).Risk at diagnosis: low 36%, intermediate:24%, high risk:40%. ATRA used in 94% of the cases and antracyclines used Daunorrubicin 58%, and Idarrubicin 42%. Mortality of 14%. ATRA syndrome 16% in the Daunorrubicin arm and 20% idarrubicinSummary/Conclusion:We show that patient treated with daunorrubicin had a better survival during the induction, with a overall mortality of 14% in the induction related mortality.Median age of diagnosis 36 years old.In Mexico there is no ATO, so we still treating patients with chemotherapy and a maintenance of 2 years afther 3 consolidations, the most used atracycline is daunorrubicin. There was no difference between the ATRA syndrome in both antracyclines.
PB1797 DEATHS IN PEDIATRIC BURKITT LYMPHOMA PATIENTS. WHAT COULD BE IMPROVED?
Authors: Abdelrahman H. , Hamoda A. , El Kenaai N. , Salem S. , Zaki I. , Taha G. , Ahmed O. 
Published: June 2019

Background:Many patients with Burkitt lymphoma has rapid tumor regression following administration of chemotherapeutic drugs. However, while the patients are making “good progress” clinically, some of them suddenly collapse and die.Aims:The aim of this work is to analyze causes of death among pediatric mature B cell NHL, to identify adverse prognostic factors that might put those patients at high risk of mortality at different phases of treatment. And finally, to set a series of recommendation to ameliorate the OS and avoid unexpected treatment related mortalityMethods:We conducted a retrospective analysis that included all Burkitt Lymphoma (BL) patients who were diagnosed and treated at CCHE during the period from 06/2012 till end of 12/2018 and died. All patients were treated according to LMB96 protocol, and were stratified as low, intermediate or high risk group. Analysis included epidemiologic data, initial presentation, laboratory and radiologic investigations, tumor stage, risk stratification, direct cause of death, associated co‐morbidity and phase of treatment where death occurred.Results:Out of 570 patients recorded during the study period, 84 (14.7%) died. Majority (69%) were males with mean age 7.6 years. Most of them (94%) had advanced stage (III and IV) disease. Forty eight patients from intermediate (12.2%), and 36 from high risk group (28.3%) died. Majority of patients (78.6%) died in active disease, while 21.4% died in CR/PR. Main causes of death were septic shock (34.5%), disease progression in (31%), tumor lysis syndrome (TLS) (11.9%). Other reported causes of death were sever chest infection (6%), multi‐organ failure associated with sepsis (6%), pulmonary hemorrhage (2.4%), neutropenic enterocolitis, GVHD, and gut perforation (1.2%) each. Three patients (3.6%) died upon arrival to the hospital without receiving any kind of chemotherapy, 17 (20.4%) during prephase, 24 (28.5%) during induction, 8 (9.5%) during consolidation, 2 (6.1%) during maintenance phase. For relapsing patients, 18 (21.4%) died from chemotherapy toxicity of second line, while 6 (7.1%) were on palliative care when they died.Summary/Conclusion:Despite being a well‐equipped tertiary care hospital dedicated to the management of pediatric malignancies, we report a very high mortality rate in our hospital. Late presentation, TLS and sever sepsis are main causes of death throughout different phases of treatment. For relapsed patient, toxicity of 2nd line chemotherapy and tumor progression are the main causes of death. We need intensify supportive care measures, and to better identify patients at high risk for mortality to avoid unnecessary patients’ death.
PB1804 OUTCOME OF AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION IN FIRST COMPLETE REMISSION IN PATIENTS WITH LOW‐RISK PERIPHERAL T‐CELL LYMPHOMAS (PTCLS)
Authors: Huang H. , Liu S. , Chen X. , Jin Z. , Wu D. 
Published: June 2019

Background:Patients with peripheral T cell lymphomas (PTCLs) generally have a poor prognosis with conventional chemotherapy. Consolidation with autologous stem cell transplantation is an option for patients with PTCL. However, whether prospective or retrospective studies on the timing of autologous stem cell transplantation remains controversial. We cannot determine whether autologous stem cell transplantation is necessary in patients with PTCL achieving first complete remission (CR1) following induction chemotherapy, especially in patients with low‐risk group. Therefore, we compare prognosis of low‐risk patients who underwent ASCT in CR1 following induction regimens and patients who underwent observation and waiting during CR1.Aims:We compare progression‐free survival of low‐risk patients who underwent ASCT in CR1 following induction regimens and patients who underwent observation and waiting during CR1.Methods:We completed a retrospective analysis for low‐risk PTCL patients who underwent either observation or up‐front ASCT during CR1 in our center between 1/1/2007 and 12/31/2018. In our study, patients with PTCL age ≤65 years(median age, 52 years) and IPI score 0‐1 were included. Histologic subtypes include PTCL not otherwise specified (PTCL‐NOS), angioimmunoblastic T‐cell lymphoma a(AITL) and anaplastic lymphoma kinase‐negative large cell lymphoma (ALK‐negative ALCL). In addition, patients with cutaneous T cell lymphoma and anaplastic lymphoma kinase‐positive large cell lymphoma (ALK‐positive ALCL) were excluded. The probabilities of PFS was calculated by the Kaplan‐Meier method and compared by a log‐rank test. The estimated lymphoma of relapse was calculated using cumulative incidence.Results:In our center, 42 patients met all inclusion and exclusion criteria. And 29 patients underwent observation and waiting in CR1, 13 patients underwent consolidative ASCT. In low‐risk patients of PTCL, with a median follow‐up of 22 months, estimated 2‐year PFS and 5‐year PFS in the observation group were 57.4% and 46.0%, respectively. Among ASCT recipients, the 2‐year and 5‐year PFS were 67.7% and 54.2%, respectively. When considering incidence of disease relapse, the 1‐year cumulative incidence of relapse in the observation and ASCT groups was 20.3% and 32.3%, respectively. However, there were no difference between observation and ASCT groups.Summary/Conclusion:In conclusion, for low‐risk PTCL patients achieving CR1 following induction therapy, consolidative ASCT does not extend progression‐free survival compared to observation. We favor proceeding to observe and wait because of high toxic of hematopoietic stem cell transplantation.image
PB1811 A SINGLE ARM MULTICENTENNIAL CLINICAL STUDY IN THE TREATMENT OF PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA(PCNSL) WITH ALTERNATIVE CHEMOTHERAPY SEQUENT WITH AUTOLOGOUS TRANSPLANTATION
Authors: zhou S. , Li J. , Wen Q. , Wang S. , Lou S. , Yang T. , Li B. , Liu X. , Han X. , Gao L. , Zhang C. , Kong P. , Gao L. , Liu Y. , Zhang X. 
Published: June 2019

Background:Primary central nervous system lymphoma(PCNSL)is a highly aggressive form of lymphoma with poor clinical outcomes and lack of a standard treatment regimen.Aims:To explore the methods of treatment in PCNSL.Methods:Patients aged 18‐60 years with newly diagnosised PCNSL are treated with MTX+CDOD (Cyclophosphamide 750 mg/m2 d1, Doxorubicin HCl 40 mg/m2 d1, Vindesine 4 mg d1, dexamethasone 10 mg d1‐5, MTX 3 g/m2 d2) /MTX+HD‐Ara‐C (cytarabine 1.5 g/m2 q12 h d1‐2, methotrexate 3 g/m2 d3) Alternative chemotherapy for 6 total cycles, whose response evaluation is more than partial remission(PR) then sequentially with ASCT.Results:From June 2017 to June 2018, 17 patients in five hospitals in southwest China accepted CDOD+MTX/HD‐Ara‐C+MTX Alternative chemotherapy sequent with ASCT. The median age was 46(32‐57), 9 males and 8 females, among the pathological types, 1 patient was high‐grade B‐cell lymphoma, and the rest were DLBCL. Two patients dropped out of the study at course 4 and 5 of chemotherapy for disease progression, the remaining 15 patients received ASCT sequentially. Before transplantation, 12 patients reached complete remission(CR), 3 patients reached PR. The overall remission rate of chemotherapy is 88%. After transplantation, 13 patients CR, 2 patients still PR. By January 2019, the median follow‐up time was 9 months(7‐12), two patients relapsed and one patient died after recurrence, the median overall survival(OS) is 9months9(7‐12), and the median progression free survival(PFS) is also 9 months9(6‐12). No grade III/IV hematological or non‐hematological adverse events were observed.Summary/Conclusion:Our preliminary results show that RCDOD+MTX/HD‐Ara‐C+MTX alternative chemotherapy sequent with ASCT is a effective and safe trentment for PCNSL, and long‐term follow‐up is needed to further evaluate its efficacy.
PB1822 HIV‐ASSOCIATED LYMPHOMA: A REPORT OF 40 CASES AT YOPOUGON TEACHING HOSPITAL IN CÔTE D’IVOIRE
Authors: Kouakou B. , Diakité M. , Silué A.D. , Packo D.L.V.S.C. , Atiméré Y.N. , N’dhatz‐Comoé E. , Kamara I. , Chefou E.H.M. , Botti R.‐P. , Danho N.C. , Tolo‐Dièbkilé A. , Koffi G.K. , Sanogo I. 
Published: June 2019

Background:Lymphomas are a heterogeneous group of malignant haemopathies characterized by ganglionic and extra ganglionic infiltration of lymphoid cells. Their occurrence during the HIV infection had a specific clinical, therapeutic and evolutionary particularities.Aims:The aims of our study was to evaluate and compare the clinical, therapeutic and evolutionary aspects of HIV and none HIV patients.Methods:It was a descriptive and analytical case‐control study of patients with lymphoma followed at the department of clinical hematology at Yopougon Teaching Hospital from January 2014 to October 2016. The histology and immunohistochemistry was the diagnosis’ means to retain the diagnostic of lymphoma. The HIV test was performed by Western Blood. The variables of our study were the epidemiological, clinical, therapeutic and evolutionary aspects. Statistical analyzes were performed with épi info 351 and SPSS. The statistical test used was the ki2 test.Results:We collected 40 cases of lymphoma including 15 cases of HIV positive and 25 cases negative. The average age was 47 years with extremes of 27 and 65 years old. There was more male than female with a sex ratio of 2 for HIV positive and 3.16 for HIV negative. The reasons of consultation were dominated by polyadenopathies. The WHO performans status was stage 2 for 53.33% of HIV‐positive patient and stage 1 for 68% of HIV‐negative patients. Among HIV‐positive patients, 60% knew their status before the discovery of lymphoma and 53% already had opportunistic infections dominated by digestive and genital candida infection in 50% of cases. We noted 80% of aggressive lymphoma in the HIV‐positive patients with 26.6% Burkitt's lymphoma versus 68% aggressive lymphoma in the HIV‐negative patient. The lymph node localization was the most common with 66.6% for HIV‐positive patients and 84% for HIV‐negative patients. The breast localization was particularity observed with HIV positive patient. 86.6% of HIV‐positive patients have a bad prognosis against 16% for the HIV‐negative patients. For the treatment, the CHOP 21 protocol was the most used in both groups with 66.8% for HIV‐positive patients and 60% for HIV‐negative patients. The compliance was poor at 77% with HIV‐positive patients. The Median survival was 33 and 11 months, respectively, in the HIV‐negative and HIV‐positive patients.Summary/Conclusion:The prognosis of lymphoma with HIV remains pejorative in our country because often unknown before the diagnosis of lymphoma.
PB1823 PROGNOSTIC FACTORS AND TREATMENT OUTCOME OF RELAPSING AND REFRACTORY MATURE B CELL NON HODGKIN LYMPHOMA CCHE EXPERIENCE
Authors: Hamoda A. , Abdelrahman H. , Fathy el semary S. , El Kinaai N. , Zaki I. , Salem S. , Naggy N. , Ahmed O. 
Published: June 2019

Background:Treatment of non‐Hodgkin lymphoma (NHL) is an example of successful therapy of cancer in children with a cure rate approximating 80%. Unfortunately, relapsed NHL has a dismal outcome, and customary treatment is by highly toxic chemotherapy followed by hematopoietic stem cell transplantation (HSCT).Aims:To analyze prognostic factors, and to report treatment outcome of relapsing/refractory mature B cell NHL.Methods:A retrospective analysis including all patients less than 18 years initially diagnosed as mature B cell NHL who were primary refractory to chemotherapy or relapsed during the period between July 2012 till end of 2017 at the Children Cancer Hospital Egypt (CCHE).Results:Out of 494 patients diagnosed during the study period, 34 (7%) were included in our study. Twenty‐three (67.6%) had Burrkitt lymphoma, while 5 (14.7%) had diffuse large B cell lymphoma. The majority were males (79.4%), with a median age 6.2 years. According to Modified Murphy Staging, 6 patients (17.6%) were stage II, 24 (70.6%) stage III, and 4 (11.8%) stage IV. Bone marrow (BM) involvement at presentation was detected in 2 patient, and 3 (8.8%) had CNS infiltration. Thirty patients (88.2%) received LMB protocol, and 4 (11.8%) R‐CHOP as primary chemotherapy. One patient (2.9%) was treated as low risk, 28 (82.4%) as intermediate, and 5 (14.7%) high risk. Median delay in 1st line treatment was 22 days (range 0 to 162).Twenty two patients (64.7%) relapsed, and 12 (35.3%) had tumor progression. Relapse was early in 15 (68.2%), and late in 7 patients (31.8%). It was documented by tissue biopsy in 30 patients (88.2%), and bone marrow aspirate in 3 (8.8%). Patients relapsed other than primary site were 6/34 (17.6%). CNS relapse was detected in 8 (23.5%), BM in 8 (20.5%), while combined BM and CNS in 2 (5.9%). R‐ICE was the 2nd line of treatment in 29 patients (85.3%), and complete 2nd remission (CR) was achieved in 7 patients (20.6%). Allogeneic HSCT was done for 2 patients (5.9%), and autologous HSCT for 3 patients (8.8%). Finally, 7/34 (20.5%) patients were alive in CR, and 24/37 (70.5%) died. The 3 years Overall survival (OS) 35.3%, with no statistical difference between relapsing and progression. The 3 years OS for patient who underwent HSCT was 80% compared 20% for no HSCT (p = 0.034).Summary/Conclusion:Our relapse rate is higher than the literature probably due to delay of chemotherapy with loss of dose intensity. For patients in second remission, HSCT markedly improves the outcome.
PB1824 MARITAL STATUS AS A PROGNOSTIC FACTOR IN DIFFUSE LARGE B‐CELL LYMPHOMA, SEER DATA BASED STUDY
Authors: Ahmed M. , Pandu A. , Darwish T. , Mostafa N. 
Published: June 2019

Background:Studies showed that marital status has an impact on the survival of patients with different types of cancers. There's no study, up to our knowldge, that discussed the prognostic impact of marital status on the outcome of Diffuse Large B‐cell Lymphoma (DLBCL) Patients.Aims:To assess the impact of marital status on the outcome of patients with DLBCL before and after the addition of Rituximab to the treatment.Methods:We reviewed the Surveillance, Epidemiology, and End Results (SEER) registry and compared survival trends among DLBCL patients from 1973 to 2015. Patients were classified according to their marital status into 3 gropus; Group I (married), group II (Single) and group III (Widowed/Divored/separated)Results:We identified 118293 patients above the age 19 years, (54% males, 85% white, 62% are 60+ years), staging information was available for 90% of cases, were distributed between early stage (I/II) and advanced stage (III/IV) (45% each).Fifty Eight percent of patients were in group I, 16% in gruop II and 26% in group 3. After excluding patients with missed data it was found that group III are significantly associated with older age (>60 years) and female sex compared to group I and group II with p‐value 0.00 each.Median overall survival time (OS) in pre‐Rituximab era (Diagnosed 1997 or before) was 29 Months compared to 213 Months in post‐Rituximab era (after 1997). Before introduction of Rituximab There was statically significant difference in the OS of Married group (50 Months) compared to Single (15 months)and widowed/divorced/separated group (17 months), P Value 0.00. After 1997, Married & single patients were associated with better outcome with Median OS of (227 Months) compared to (63 months) in the widowed/divorced/separated group, p‐value 0.00.Summary/Conclusion:Marital status has a prognostic significance on the outcome of DLBCL. Widowed/divorced/separated group had worse prognosis than married group, this group may need more social support to improve their outcome.