Idrobo, Henry

Abstract Introduction: Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) is the most common PTCL subtype, accounting for approximately 25% of all PTCL cases. The median age at diagnosis is 60 years and is more prevalent among males. Currently, most epidemiological data on T- and NK-cell lymphomas come from developed countries. Thus, very few data are available regarding this condition in Latin American countries, especially in those aged 60 years and older. The Latin American Group of Lymphoproliferative Disorders (GELL) has previously reported on the impact of serum albumin level in survival outcomes in PTCL-NOS. Therefore, we aim to evaluate the clinical, demographic, and outcome patterns of elderly patients with PTCL-NOS. Methods: We conducted an observational, retrospective study of newly diagnosed PTCL-NOS between January 2000 and December 2020. Patient must be aged 60 years and older. All clinical data were retrieved from clinical records at the different participating institutions. The study outcomes were overall survival (OS) and progression-free survival (PFS). The International Prognostic Index (IPI), the Prognostic Index for T-cell lymphoma (PIT), and the NCCN IPI scores were used for risk stratification. Kaplan-Meier and log-rank test were used for survival analysis. Univariate and multivariate Cox regression analysis were used to estimate hazard ratios (HR) with a 95% confidence interval (CI). Outcomes with a p-value <0.05 were considered statistically significant. Results: A total of 107 patients were included; median age at diagnosis was 72 years (range 60-92), 61% were male, 46% had an ECOG ≥2, 70% had stage III-IV, and 15% had more than one extranodal site. The IPI, PIT and NCCN-IPI scores stratified 51%, 69%, and 74% of patients as high- / high-intermediate risk, respectively. Seventy-four (69%) patients received first-line systemic therapy. Most patients (53%) were managed with CHOP/CHOP-like regimen, followed by CHOEP (19%). The overall response (OR) rate to first-line therapy was 61% (complete response, CR 41%). Salvage therapy was given to only 9 patients; the OR rate was 44% (CR 11%). With a median follow-up of 29 months (95% CI 13-45 months), the 2-year OS was 46% (95% CI 36-59), with median survival time of 16 months (95% CI 10-NR). In the multivariate analysis, patients with serum albumin levels <3.5 g/dL had median survival of 7 months (95% CI 3-20) and 2-year OS rate of 24% (95% CI 13-46%), while patients with albumin ≥3.5 g/dL did not reach the median survival time and had a 2-yOS rate of 67% (95% CI 36-65%) (p<0.0001) (Table 1, Figure 1). Patients with a lymphocyte-to-monocyte ratio (LMR) >7.6 had a median OS of 8 months (95% CI 6-NR) and a 2-year OS of 10% (95% CI 2-65), while patients with a LMR ≤7.6 did not reach the median OS and had a 2-year OS of 57% (95% CI 45-72) (p = 0.0108) (Table 1, Figure 1). Conclusions: This large cohort of Latin American PTCL-NOS patients aged ≥60 years showed overall response rates comparable to previously published data. However, survival rates were shorter compared to those reported in developed countries. In this study, we again confirmed low serum albumin level (<3.5 g/dL) as an adverse prognostic factor for OS in PTCL-NOS, and independent from the IPI, PIT and NCCN-IP scores. Additionally, we describe for first time in a Latin American cohort the impact of the LMR on survival, demonstrating poor outcomes in those with LMR >7.6. We are currently validating our findings in a prospective cohort of Latin American PTCL patients and to improve clinical decision-making in those deemed at high-risk for early mortality. Figure 1 Figure 1. Disclosures Otero: Astra Zeneca: Current Employment. Castillo: Abbvie: Consultancy, Research Funding; BeiGene: Consultancy, Research Funding; Pharmacyclics: Consultancy, Research Funding; Janssen: Consultancy; Roche: Consultancy; TG Therapeutics: Research Funding.

1537 Background: The severe acute respiratory syndrome 2 (SARS-cov-2) virus causing COVID-19 has brought great challenges to global health services affecting cancer care delivery, outcomes, and increasing the burden in oncology providers (OP). Our study aimed to describe the challenges that OP faced while delivering cancer care in Latin America. Methods: We conducted an international cross-sectional study using an anonymous online survey in Spanish, Portuguese, and English. The questionnaire included 43 multiple choice questions. The sample was stratified by OP who have treated patients with COVID-19 versus those who have not treated patients with COVID-19. Data was analyzed with descriptive statistics and Chi-square tests. Results: A total of 704 OP from 20 Latin American countries completed the survey (77% of 913 who started the survey). Oncologists represented 46% of respondents, followed by 25% surgical-oncologists. Of the respondents, 56% treated patients with COVID-19. A significant proportion of OP reported newly adopting telemedicine during COVID-19 (14% vs 72%, p=0.001). More than half (58%) of OP reported making changes to the treatments they offered to patients with cancer. As shown in the table, caring for patients with COVID-19 significantly influenced practice patterns of OP. Access to specialty services and procedures was significantly reduced: 40% noted significantly decreased or no access to imaging, 20% significantly decreased or no access to biopsies, 65% reported delays in surgical oncology referrals, and 49% in radiation oncology referrals. A vast majority (82%) reported oncologic surgeries were delayed or cancelled, which was heightened among those treating patients with COVID-19 (87% vs 77%, p=0.001). Conclusions: The COVID-19 pandemic has significantly affected the way cancer care is delivered in globally. Although changes to healthcare delivery are necessary as a response to this global crisis, our study highlights the significant disruption and possible undertreatment of patients with cancer in Latin America that results from COVID-19.[Table: see text]

Abstract Introduction Multiple myeloma (MM) has characteristics that influence the prognosis and are useful to make decisions regarding treatment. Diagnosis and treatment patterns of hematological malignancies have not been described in Colombia and having access to this regional information could guide public health policies and help design clinical trials. The Colombian Association of Hematology and Oncology (ACHO) designed a registry for Hemato-Oncological diseases to fill this information gap. This is the first report of RENEHOC focusing on MM. Methods We conducted an ambispective multi-centric cohort study of clinical records available from patients with MM that were diagnosed in the most populated regions of Colombia. We collected demographic, diagnostic, clinical and treatment data at different time points from diagnosis to the most current follow up. The computerized de-identified data was consolidated and analyzed using basic statistical measures of central tendency and dispersion. The most current follow up included data available from last clinic visit, loss of follow up, death or withdrawal of consent. This study was approved by local and centralized institutional review board. Results We analyzed data from 206 MM patients (pts). Average age at diagnosis was 62.9 (SD 10.2) years and 51.4% of pts were male. Most common symptoms at diagnosis were bone pain (74.2%), anemia related (58.2%) and pathological fractures (45.1%). Mean time from symptoms to diagnosis was 7.3 (Range 1-44) months. Baseline mean hemoglobin, creatinine and calcium serum levels were 10.5 g/dL, 1.58 mg/dL and 9.2 mg/dL respectively. At diagnosis, 22% of patients presented with renal failure and 30% required dialysis. Immunoglobulin (Ig) subtype distribution was: IgG 50.6%, IgA 20.6%, only light chain secretion (61% Kappa) and IgM 1.1%. In 11.6% all Igs were low. Most pts were diagnosed at advanced stages (64.5% Durie-Salmon III, and 37% and 47% International Staging System II and III respectively). Molecular prognostic characterization was performed only in 39 patients (18.4%). Four patients were considered too fragile for active treatment. The most common initial treatment was triple combinations that included Bortezomib (84% of patients). Among those, CyBorD was the most frequently used first line therapy (58.3%), followed by VTD (14.6%). Mean number of cycles was 4.8 (SD 2.5). Overall Response Rate (ORR) 74.7% was observed. Only 40% of patients treated with intense induction therapy received autologous transplant. Response to treatment including transplant are shown in table 1. Second and further lines of treatment were highly variable. 18 patients were treated with a second autologous transplantation consolidating 2nd line therapy. 12 patients received Carfilzomib combinations, all of them in 2nd line. 5 patients were treated with Daratumumab, all >2nd line. Mean follow-up time was 33.53 (SD 3.6) months. After a median follow up of 27 months we observed in our cohort an overall survival of 82% and 68% of patients progression-free. . Conclusions This first report focusing on MM highlights important differences on patient's characteristics and treatment in Colombian patients. This includes and treatment initiation due to insurance barriers; high risk clinical characteristics and complications upon diagnosis and low rate of transplantation in patients otherwise eligible for this procedure. Rates of response to induction seem slightly lower than reported (CB Reeder 2009). However, overall survival and progression-free survival met the expectations for this type of patients. The development of country specific databases may influence the design of policies, allocation and use of resources and improve patient outcomes. Only cooperative efforts like the one spearheaded by RENEHOC can achieve those goals. Disclosures No relevant conflicts of interest to declare.