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e24030 Background: Physical activity (PA) in cancer survivors improves quality of life (QOL), functioning, fatigue, and reduces the risk of treatment complications, cancer recurrence and death. However, the optimal intervention for increasing PA is not established. Most prospective studies have shown a 6-12-week program to be an effective intervention but this is often not feasible. Therefore, we piloted a one-time individualized exercise prescription in our cardiac rehabilitation center to improve PA in cancer survivors. Methods: We prospectively enrolled cancer survivors who had completed curative intent treatment, with no evidence of active disease in this pilot study. Survivors who consented underwent a consultation with an exercise physiologist for needs assessment followed by a supervised exercise session with a tailored exercise prescription. Survivors also filled out surveys assessing their PA and QOL at baseline (bl), 3, 6 and 12 months after intervention. Clinical information was collected via chart review. We estimated longitudinal PA score and change in PA using mixed models incorporating scores from all available time points using SAS (v 9.4). Results: Between May 2018 and January 2020, 50 participants (26 lymphoma and 24 solid tumor survivors) completed the intervention. 20% participants were on maintenance therapy during the study. Clinical characteristics of 42 evaluable participants are summarized in Table. The survey response rate was 82%, 58%, 58%, 46% at bl, 3, 6 and 12 months respectively. The level of PA improved with time [mean (SE) PA score: 58.5 (4.3) bl, 63.9 (4.8) at 3, 57.6 (4.8) at 6, 62.6 (5.3) at 12 months]. The change in PA from baseline to follow-up time-points [bl vs 3m p=0.41; bl vs 6m p=0.88; bl vs 12m p=0.55] or between the lymphoma and solid tumor survivors was not statistically significant and limited by sample size. No significant trend in QOL was seen. Conclusions: Individualized exercise prescription using the cardiac rehabilitation program may be a feasible, widely applicable tool to implement a PA intervention among cancer survivors. The trend towards improvement in PA in this novel one-time intervention provides intriguing evidence and deserves future study in larger sample sizes to understand if it can improve and create sustainable PA change comparable to longer term exercise interventions.[Table: see text]

Introduction The COVID-19 pandemic has significantly affected many aspects of healthcare, including medical education and training. Its impact on hematology/oncology (HO) fellowship programs has not yet been characterized. Methods The American Society of Hematology (ASH) and American Society of Clinical Oncology (ASCO) sent an anonymous survey in June 2020 to all HO program directors (PDs) addressing program changes during the COVID-19 pandemic and their perception of impact on trainees' experience, education, and mental health. The survey included 32 multiple-choice and open-ended questions. Participants who completed the survey received a $10 gift card. Quantitative descriptive analyses of multiple-choice questions were conducted. Open-ended responses were analyzed qualitatively using NVivo software. Results Of 233 invited PDs, 103 (44%) respondents completed the survey; 22 additional surveys were incomplete and not included in the analysis. Table 1 summarizes PDs and program characteristics. In response to the pandemic, 42% (N=43) of programs removed fellows from outpatient clinics and 63% (N=65) changed research location to home (Figure 1). Most PDs reported their fellows were participating in telehealth for HO care (79%, N=81) and 21% (N=22) had their fellows re-deployed to cover medicine and other non-HO services. To support fellows' mental health most programs held additional virtual meetings (76%, N=78) and social events (52%, N=54). Twenty one percent of PDs (N=22) reported their program's professional development funds were completely cut or frozen and 17% (N=17) had funds cut slightly. Most PDs reported the pandemic negatively impacted fellowship overall (67% slight to significant negative impact, N=69), 72% identified clinical education as negatively impacted (72% slight to significant negative impact, N=74), and 35% (N=36) reported significant negative impact on research training/productivity. Twenty three percent (N=24) of PDs thought their fellows were not able to make good use of their time during the pandemic, professionally speaking. One third (33%, N=34) of PDs anticipated the pandemic would lead to lack of fellow clinical preparedness, 24% (N=25) with need to make up clinical rotations, and 15% (N=15) anticipated a negative impact on HO board pass rates. Post-pandemic, most PDs plan to maintain some virtual educational sessions (73%, N=75) and telehealth in fellows' continuity clinic (55%, N=57). Among PDs, the prevalence of burnout increased from 16% (N=16) pre-pandemic to 45% (N=46) during the pandemic (p<0.0001). Seventeen percent (N=18) of PDs witnessed moderate signs of fellow burnout and 52% (N=54) witnessed minor signs of fellow burnout during the pandemic. Several educational and research constraints were identified via qualitative analysis: limited in-person clinical rotations, supervision of telehealth encounters, training year promotion and making up clinical time, limited professional development activities, board exam cancellations, and inability to perform research. Additional PD-identified trainee concerns included: ability to obtain childcare, separation from family, and Visa concerns among international fellows. PDs anticipated that financial constraints leading to cuts or removal of discretionary funds may have negative consequences for fellows' professional development activities and could force PDs to decrease program size in the future. PD recommendations for ASH and ASCO included: reducing or eliminating fellow membership fees, providing free access to educational materials and meetings, eliminating in-training examination fees, providing virtual sessions on career development, telehealth and wellness, virtual journal clubs, PD webinars focused on navigating fellowship issues and virtual interviews, and extending ASCO YIA funding for a second year. Conclusions PDs reported that their fellowship programs' clinical, educational, and research experiences have been impacted by the COVID-19 pandemic. PDs are concerned about the impact of budget cuts on fellows' professional and career development. PD burnout increased during the pandemic and most PDs observed at least mild burnout among their fellows. Professional societies can support fellowship programs by limiting fees and costs associated with membership, exams, and meetings, and increasing virtual opportunities for both fellows and PDs. Disclosures Velazquez Manana: Portola Pharmaceuticals: Other: Immediate family member stock ownership; Midatech: Other: Immediate family member stock ownership; Corbus Pharmaceuticals: Other: Immediate family member stock ownership.

Introduction: While the COVID-19 pandemic has affected many aspects of clinical care, research, and medical training, its impact on hematology-oncology trainees and professional development has not been described. The American Society of Hematology (ASH) and the American Society of Clinical Oncology (ASCO) sought to assess the impact of COVID-19 on fellows enrolled in hematology-oncology programs. Methods: In spring 2020, ASH and ASCO developed and administered a survey by e-mail to active hematology-oncology fellow members. Response formats used both a semi-Likert scale and open-ended text. Questions focused on fellow experiences and how changes in their programs have impacted their personal and professional lives across several domains. Multiple-choice responses were analyzed using descriptive statistics, and NVivo software was used for qualitative analysis of open-ended questions. Results: Respondent demographics are described in Table 1. Of 2,306 trainees, 620 (27%) responded to the survey. Most respondents continued patient care responsibilities during the pandemic (80%). Almost half of all trainees (47%) reported that they felt less productive than usual. Stress and/or anxiety about the current situation was the most cited factor affecting productivity in the overall cohort (Figure 1). One-third (33%) of respondents had volunteered or were assigned to clinical/non-clinical COVID-19-related efforts. Of the 90 visa holders in our cohort, 30% (N=27) reported experiencing issues with their visa/immigration status. Eight percent of respondents stated their career plans had changed due to COVID-19. Of those who said their plans had changed, 30 respondents were considering careers in academia pre-pandemic and 11 were considering private practice. However, only 14 respondents were considering academia post-pandemic while 19 were interested in private practice. Overall, most respondents had concerns about at least one of the following: salary reductions, availability of networking events, family well-being, mental health and obtaining a job (Figure 2). The prevalence of burnout increased from 22% (N=105) before the pandemic to 33% (N=161) during (p<.001). Of the respondents who did not report burnout before COVID-19, 22% noted new-onset burnout during the pandemic. New-onset burnout prevalence varied based on the type of work respondents performed: no COVID-related work (17%), COVID-related non-clinical work (26%), and COVID-related clinical work (34%) (p<0.01). The open-ended responses yielded several consistent themes. Clinical and educational constraints were enumerated: lost learning opportunities due to low patient volumes, unavailability of colleagues to discuss cases, and overall low perceived quality of virtual learning. Trainees also reported reduced motivation to complete work within a stipulated time frame due to lack of robust discussions in the virtual environment and technological challenges in navigating educational resources. Trainee research was also severely impacted as laboratories closed, experimental animal colonies were lost, and many research activities ceased. Respondents also expressed concern that cuts in research training initiatives and budgets would jeopardize faculty positions for graduating fellows and that funding for travel and conferences was suspended. Fellows' recommendations for ASH and ASCO included improved online education, virtual research training and networking opportunities, practical guidance on caring for immune-compromised patients during the pandemic, increased funding resources for trainees, mental health resources, and advocating on behalf of trainee visa holders. Conclusions: Hematology-oncology trainees reported their training experiences have been deeply impacted by the COVID-19 pandemic. A majority of trainees are concerned about the negative impact on career opportunities, research funding, financial well-being, and mental health. Burnout increased during COVID-19, especially in trainees who were assigned to specific COVID-related efforts. Training programs and professional societies can support trainees by increasing trainee research funding, online networking and learning opportunities, mental health resources and, support for international trainees. Disclosures Velazquez Manana: Corbus Pharmaceuticals: Other: Immediate family member stock ownership; Portola Pharmaceuticals: Other: Immediate family member stock ownership; Midatech: Other: Immediate family member stock ownership. Wun:Glycomimetics, Inc.: Consultancy.

In 2013, the American Society of Hematology (ASH) published recommendations with Choosing Wisely to limit surveillance imaging in aggressive lymphoma. We studied surveillance imaging practice patterns for diffuse large B-cell lymphoma (DLBCL) before and after the ASH Choosing Wisely campaign. We used OptumLabs Data Warehouse, a national insurance claims database, to retrospectively study imaging frequency in survivors of DLBCL from 2008 to 2016. Three time periods were defined: Period 1 (2008 to 2010), Period 2 (2011 to 2013), and Period 3 (2014 to 2016). One thousand four hundred seventy-two patients were included. Median follow up was approximately 2 years. During the first and second years of surveillance, imaging remained stable between Period 1 (years 1 and 2: 199 [91%] and 137 [83%], respectively) and Period 2 (years 1 and 2: 257 [88%] and 172 [77%], respectively; P = .38), but decreased in Period 3 (years 1 and 2: 315 [78%] and 83 [61%], respectively; P < .01). In a multivariable logistic regression, year after 2012 was a significant predictor of decreased overuse (more than two scans per year in the first year of surveillance; [odds ratio, 0.49 for 2013 v 2008; P = .02]). Our study demonstrated the rate of surveillance scans—both computed tomography and positron emission tomography imaging—in DLBCL decreased after the ASH Choosing Wisely campaign. Multiple factors, such as changes in recommendations, reimbursement, and provider knowledge base, may have all contributed and should be studied further.

11012 Background: The proportion of women in the field of hematology and oncology (H&O) has increased over recent decades, but representation by women in leadership positions remains a challenge. Our aim was to examine representation of winners of recognition awards by gender and race from the major international hematology and oncology societies. Methods: Published award recipients from the seven major H&O societies were reviewed, with 26 years of data included (1994-2019). Awardee demographics and academic rank were collected and included in the analysis. Gender was determined based on awardee full name and verified by public data. Chi-square and Cochran-Armitage tests were used to analyze the data. Results: Over the past 26 years, 942 awards were presented at the 7 major H&O societies. We excluded 27 gender specific awards from the analysis. Of the 915 awardees included in analysis, award recipients were overwhelmingly men (77.9%) and non-Hispanic white (84.7%). Gender breakdown by society is described in table. ESMO and ASTRO represented the lowest distribution of women at 9.1% and 11.1%, respectively. Women awardees received 30.3% of the awards categorized as humanistic and education-related, while only receiving 16.0% of awards in the basic sciences category (p<0.01). The Cochran-Armitage test demonstrated an upward trend in the number of women awardees, from 10% between 1994-1998 to 25.6% between 2014-2019 (p=0.0004). Over the past five years, the average proportion of women medical oncologists was 35.6% per the AAMC. In this time period, women oncologists have received only 24.0% of all awards, suggesting the awardees included in the study period do not represent the proportion women in the field (p=0.00424). Black, Hispanic, and Asian awardees represented 3.7%, 3.3%, and 6.8% of the total awardees, respectively. Of the 64 Black and Hispanic awardees, 60.9% of the awards were for investigating healthcare disparities and only 4.6% were given for basic science research. Conclusions: During our study period, women physicians and investigators were less likely to receive recognition awards from the seven major H&O societies compared to men. We also observed a considerable low proportion of minority awardees in all oncology subspecialties. While the proportion of women awardees has increased over time, significant underrepresentation remains. [Table: see text]

53-year-old male with iMCD developed hematoma at biopsy site. He was diagnosed with acquired hemophilia A and Hashimoto’s both were associated with iMCD. He has been in remission without recurrence of hemophilia after Rituximab 375 mg/M² weekly for 1 month, and 375 mg/M² every 2 months for maintenance.

10503 Background: Gender bias can be reinforced through the use of gender-subordinating language and differences in the forms of address. We examined how professional titles were used during speakers’ introductions at the American Society of Clinical Oncology (ASCO) Annual Meeting. Methods: A retrospective observational study of video-archived speaker introductions at the 2017 and 2018 ASCO annual meetings was conducted. Data were extracted by mixed-gender coders. Professional address was defined as professional title followed by full name or last name. Multivariable logistic regressions were used to identify factors associated with the form of address. Results: 2511 videos were reviewed and 812 met inclusion criteria. Regarding speakers’ characteristics, 530 (65%) were non-Hispanic white (NHW), 743 (92%) held a MD or MD-PhD degree, and 484 (60%) were an associate or full professor. Female speakers were less likely to receive a professional address compared to male speakers (61% vs. 81%, p < 0.001). Female speakers were more likely to be introduced by first name only (17% vs. 3%, p < 0.001). Males were less likely to use a professional address when introducing female speakers compared to male speakers (53% vs. 80%, p < 0.01). No gender differences in professional address were observed for female introducers (p = 0.13). Male introducers were more likely to address female speakers by first name only compared to female introducers (24% vs. 7%, p < 0.01). In a multivariable regression including gender, race, degree, and academic rank, male speakers were more likely to receive a professional address compared to female speakers (OR: 2.67, 95%CI: 1.81-3.94, p < 0.01). Black speakers of both genders were less likely to receive a professional address compared to NHW (OR: 0.10, 95%CI: 0.01-0.53, p < 0.01). Female gender was a predictor for a non-professional form of address (first name only) (OR: 9.50, 95%CI: 4.38-20.62, p < 0.01). Conclusions: When introduced by men, female speakers were less likely to receive a professional address and more likely to be introduced by first name only compared to male speakers. Selective use of forms of address may strengthen gender bias; more research is needed to explore the causes of this disparity and its influence.

e20077 Background: Small cell lung cancer (SCLC) accounts for about 10% to 15% of lung cancers among women and men. Though heavily associated with smoking, its incidence in women is rapidly increasing despite a decline in cigarette exposure. Given the changing demographics of SCLC and hormonal factors associated with other forms of lung cancer, we studied differences between sexes in SCLC. Methods: Utilizing the National Cancer Database, we identified all incident SCLC cases from 2004 to 2014. Patients were classified as limited stage (LS) or extensive stage (ES). Women were stratified by menopausal status (≥55 years = postmenopausal). Kaplan-Meier method and Cox regression were used for overall survival (OS) and multivariable analysis. Results: 161,978 patients were identified. No significant sociodemographic differences were observed between sexes. The majority of patients were non-Hispanic whites (89.1%), followed by non-Hispanic blacks (7.5%). Men were more likely to be diagnosed with ES disease than women (63% vs. 56%). Both sexes initiated treatment within a similar time frame from diagnosis (chemotherapy, median: 18 days, IQR 8-32). Women had better median OS compared to men in both LS (15.2 vs. 12.7 months, HR: 0.85, 95% CI 0.83-0.86, p < 0.0001) and ES (6.4 vs. 5.7 months, HR: 0.88, 95% CI 0.87-0.90, p < 0.0001). No racial or ethnic disparities in OS were observed, overall and when examined within sex and disease stage groups. Differences between sexes in OS were also observed when comparing patients within the same racial/ethnic group (women having better OS). When divided by menopausal status, postmenopausal women with LS and ES had worse OS than premenopausal women (14.7 vs. 22 months, HR: 1.50, 95% CI 1.44-1.56; 6.1 vs. 9.8 months, HR: 1.41, 95% CI: 1.37-1.46, respectively). We also observed worse OS in older men when divided by age ( < 55 years and ≥55 years). In multivariable analysis, older age, postmenopausal status, and Medicaid as primary insurance were associated with worse OS for both LS and ES. Conclusions: In this large cohort, women with SCLC had better OS compared to men. Post-menopausal women had worse OS compared to pre-menopausal women. Since older men had a similar trend of worse survival compared to younger men, age might exert a more significant influence on survival than hormonal status in SCLC. Further studies with data on sexual hormone levels are necessary to better understand their role in women with SCLC.

e19523 Background: Previous studies have shown a disparity in outcomes of MM between clinical trials and real-world practice. This could be partly due to clinical trial exclusion of patients who need urgent treatment due to high burden of disease or significant illness. In this study, we aim to analyze the impact of time to initiation of systemic therapy for MM on overall survival (OS). Methods: We included MM patients reported to National Cancer Data Base (2004-2014). We excluded 2,860 patients with suspected smoldering MM due to initial treatment beyond 120 days. Relative risk of delayed time to systemic therapy was assessed by logistic regression model. Kaplan-Meier method and Cox multivariate analysis were used to evaluate the association between time to therapy and OS. Results: A total of 53, 519 MM patients were included. Median time to systemic therapy in our cohort was 18 days (range 0-120). Of the entire cohort, 24% patients received systemic therapy for MM < 7 days from diagnosis, and 32% received it after 30 days. Factors associated with time to systemic therapy > 30 days were Black race (OR 1.12, CI 1.07-1.16), female sex (OR 1.10, CI 1.06-1.14), lower Charlson comorbidity score (OR 1.36, CI 1.28-1.45), and academic facility (OR 1.18, CI 1.13-1.24). The median OS for patients who initiated therapy > 30 days after diagnosis was longer than those who received it within 7 days (37 vs. 29 month, p < 0.001). Similarly, on multivariate analysis, patients who received treatment > 30 days after diagnosis were found to have a lower mortality as compared to those who initiated treatment < 7 days (HR 0.81, CI 0.79-0.83; Table). Conclusions: In our study, time to initiation of systemic therapy was an independent prognostic factor in MM. This could be related to the high-risk nature of disease of patients treated within a short duration of diagnosis. These findings have implications for future clinical trial design, which should allow for a pragmatic approach toward enrollment of these high-risk patients to improve external validity. [Table: see text]

Background Women are currently under-represented in ‘C-suite’ leadership positions at academic medical centres, including medical school deans, department chairs and hospital chief executive officers (CEOs). There are many potential reasons for the low percentage of women in academic medical leadership, including lack of mentorship and sponsorship, increased non-work responsibilities compared with men, implicit bias, and others. Methods We collected data from 136 fully accredited US allopathic medical schools regarding sex of the medical school dean and sex of the CEO of the largest academic medical centre/teaching hospital affiliate. Schools where students rotate at non-academic centres were excluded from the final analysis, leaving 124 schools where we investigated the relationship between sex of US medical school dean and affiliated academic medical centre CEO. Results 16.9% of current medical school deans and 17.7% of affiliated academic medical centre CEOs were female. Systems with one female leader were significantly (6.25-fold, 95% CI 2.22 to 17.56, p=0.001) more likely to have a second female leader, regardless of geographical region or institution type (public vs private). Conclusions There is a significant positive association between medical school dean and affiliated academic hospital centre CEO sex. There are many potential factors that could contribute to this positive association, including mentorship, sponsorship and medical system consciousness about gender equity, among others. This relationship is important to recognise as we strive for more gender parity for women in positions of leadership in academic medicine.