Clinical Lymphoma, Myeloma & Leukemia September 2023 S237 Abstracts both localized and generalized lymphadenopathy. Most requested investigations were CBC, EB, CMV IgM, and ESR; bone marrow was done in 57 (14%) cases. Imaging (local neck, ultrasound) was done in 56%. Computed tomography (CT) chest or abdomen was done in 25%; among them, 19% had ultrasound-guided biopsy. Unnecessary LN biopsy was reported in <10% of biopsied LNs. 56% had received antibiotics and 25% had received a short course of steroids. Conclusion: Viral etiology was the most common cause of LN. Generalized lymphadenopathy was more prevalent. Alarming signs for more serious illness were generalized LN, bone aches, splenomegaly, purpura, and fever for more than 2 weeks. Keywords: ALL, LN, splenomegaly, purpura, CBC, bone marrow, case ALL-022 Assessment of Molecular Response to Tyrosine Kinase Inhibitors in Tunisian Patients With Ph+ Acute Lymphoblastic Leukemia Rim Frikha MD, PhD, Amina El Aoud BS, Hassen Kamoun MD University Hospital, Sfax, Tunisia Context: Acute lymphoblastic leukaemia (ALL) is a heterogeneous disease that is often associated with several chromosomal and molecular abnormalities. Patients who have the Philadelphia (Ph) chromosome and associated BCR-ABL1 oncogene have a particularly poor prognosis. Philadelphia-chromosome positive acute lymphoblastic leukemia (Ph+ ALL) has dramatically improved following the introduction of targeted therapy with tyrosine kinase inhibitors (TKI). Objective: This study was carried out to assess the minimal residual disease in Tunisian patients with Philadelphiachromosome positive acute lymphoblastic leukemia (Ph+ ALL) treated by tyrosine kinase inhibitors (TKI) with chemotherapy. Design: A seven-year retrospective study was carried out in the Hospital University of Sfax, south of Tunisia. Patients: A Ph+ALL patients treated with TKI (tyrosine kinase inhibitors) for a minimum duration of 3 months were enrolled in this study. Intervention: Quantitative assessment of the BCR-ABL transcript was performed using the Cepheid Xpert BCR-ABL ultra-assay. Main Outcome Measure: According to the European Leukemia Net guidelines, molecular response and outcome were evaluated. Results: Eight patients with Ph+ALL were enrolled. The median age was 45 years, the sex ratio M/F was 3. According to the ELN criteria, Optimal and suboptimal response were noted in 7 (87.5%), and one (12.5%) patients, respectively. Conclusion: Current results are promising and show high molecular response rates in Tunisian Ph+ALL, though follow-up is still too short to determine their impact on remission duration and long-term survival. A larger study is mandatory to elucidate prognosis impact of TKI in the management of Ph+ALL. Keywords: ALL, BCR-ABL rearrangement, MRD monitoring, Philadelphia chromosome, acute lymphoblastic leukemia, prognosis ALL-023 Outcome of Adult Acute Lymphoblastic Leukemia: A Single‑Center Experience Hawar Ghareb Khudhur MD1, Kawa Muhamadamin Hasan PhD2, Ranan Kardagh Polus IFCAP3, Ahmed Khudair Yassin FICMS2, Nawsherwan Sadiq Mohammad PhD4, Saya Salahaldeen Najmaldeen MD1 1Clinical Hematology, Nanakali Hospital, Erbil, Kurdistan Region, Iraq. 2Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq. 3Department of Pathology and Medicine, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq. 4Laboratory Hematopathologist, Nanakali Hospital, Erbil, Kurdistan Region, Iraq Background: Adult acute lymphoblastic leukemia (ALL) has a dismal outcome even within optimal situations as the 5-year overall survival (OS) does not reach 40%. Objective: The objective of this study was to evaluate the outcome of adults diagnosed with ALL in Erbil, Iraq, and to determine the factors predicting better survival among them. Patients and Methods: We analyzed data from 71 adult ALL patients aged 14–81 years (mean age: 28.6 years). Diagnosis was based on peripheral blood film, bone marrow examination, and flow cytometry. Results: The median OS was 21 months, and the median relapse-free survival (RFS) was 13 months. The 3-year OS and the 3-year RFS were 49.3% and 40.8%, respectively, while the 5-year OS and the 5-year RFS were 37.5% and 32.5%, respectively. Conclusion: In the study, factors predicting better survival included younger age at diagnosis, remission achievement at first induction, completion of risk assessment, and allogeneic stem cell transplantation optimal response. Keywords: ALL, adult, overall survival, Philadelphia chromosome, case ALL-026 The Prognostic Values of the IL‑10 (G1082A) and TNF‑α (G308A) Polymorphisms in Egyptian Patients With Acute Lymphoblastic Leukemia: A Single‑Centre Study Mohamed Ali Fellow1, Yehea Wahba MD2, Mohamed Ghonem MD3 1Medical Oncology Unit, Damieta Cancer Center, DK, Egypt. 2Pediatrics and Genetics Unit, Department of Pediatrics, Faculty of Medicine, Mansoura Pediatric Hospital, DK, Egypt. 3Hematology Unit, Clinical Pathology Department, Mansoura Faculty of Medicine, DK, Egypt Background: Interleukin-10 (IL-10) and tumor necrosis factoralpha (TNF-a) genes contribute to oncogenesis. We evaluated the influence of the IL-10 (G1082A) and TNF-a (G308A) polymorphisms on the prognosis and outcome of Egyptian patients with acute lymphoblastic leukemia (ALL). Methods: We investigated 64 children and 76 adults with ALL, between 2016 and 2019, for the IL-10 (G1082A) and TNF-a (G308A) polymorphisms using allele-specific PCR and PCR-RFLP (restriction fragment length
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