Abstracts Clinical Lymphoma, Myeloma & Leukemia September 2023 S240 ALL-114 A Comparison of Serum Immunoglobulin Levels Among Pediatric Acute Leukemias Ayşe Ceyda Ören MD, Esra Pekpak Şahinoğlu MD, Sinan Akbayram MD Gaziantep University Faculty of Medicine, Division of Pediatric Hematology and Oncology, Gaziantep, Turkey Objective: This study aimed to compare the initial serum immunoglobulin levels between pediatric acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) patients, as previous studies have yielded conflicting results. It is the first study in the country to investigate serum immunoglobulin levels in pediatric ALL and AML patients. Methods: A total of 260 pediatric patients diagnosed with AML and ALL between June 2017 and March 2023 were included. Written informed consent was obtained from parents, and statistical analysis employed the Shapiro-Wilk test, Spearman rank correlation analysis, Chi-square test, and Bonferroni test. Serum immunoglobulin (Ig) G, A, and M levels were measured retrospectively using the turbidimetric immunoassay method. Results: The study evaluated the serum Ig levels of 215 ALL and 45 AML patients, with a median age of 64 months at the time of diagnosis. The median concentrations of IgG, IgA, and IgM were determined. High expression of IgG, IgM, and IgA was observed in a portion of the patients, while low expression was found in others. No significant differences were found between IgM levels and types of leukemia. However, AML patients exhibited significantly higher levels of IgG and IgA. There were no significant differences between IgG, IgA, and IgM levels and T- or B-cell types of ALL. Correlation analysis indicated that AML patients had higher levels of IgG and IgA compared with T- and/or B-cell ALL patients. Conclusion: Previous studies on serum Ig concentrations in childhood leukemia have presented conflicting findings. However, this study demonstrated that AML patients have higher levels of IgG and IgA compared with ALL patients. Further research is necessary to explore the significance and implications of these findings in the context of leukemia pathogenesis and prognosis. Keywords: ALL, acute leukemias, AML, pediatric hematology, serum immunoglobulin levels ALL-142 Efficacy and Safety of Single‑Agent Blinatumomab as Salvage Therapy in Relapsed/Refractory B Cell Acute Lymphoblastic Leukemia (B‑ALL): Real‑Life Experience İbrahim Halil Açar MD, Birol Güvenç MD Çukurova University Faculty of Medicine, Department of Haematology, Adana, Turkey Background and Objectives: Despite improved survival rates in adult B-ALL, many challenges remain in the management of patients with relapsed/refractory (r/r) B-ALL. Targeted therapies have been developed to overcome this challenge in r/r B-ALL. Blinatumomab, a bispecific anti-CD19/CD3 antibody, has demonstrated promising efficacy in the treatment of r/r B-ALL patients. This study aimed to evaluate the outcomes of blinatumomab treatment in adult patients with r/r B-ALL at a single center. Materials and Methods: In this retrospective, single-center, observational study, we included 34 adult patients with r/r B-ALL between 2019 and 2021 treated with blinatumomab. Treatment response, overall survival (OS), minimal residual disease (MRD), and feasibility of allogeneic hematopoietic stem cell transplantation (allo-HSCT) were assessed. Prognostic factors associated with treatment response and survival were also identified. Results: Patients received an average of 1 (1–3) cycles of blinatumomab treatment. No adverse events occurred in 79.4% of patients (n=27), while 20.6% (n=7) experienced various adverse events. Among these, 11.8% (n=4) were cytokine release syndrome, 5.9% (n=2) neurotoxicity, and 2.9% (n=1) neutropenia. The overall response rate was 64.7% (n=22), with a complete response rate of 44.1% (n=15). MRD negativity was achieved in 44.1% (n=15) of patients. Allo-HSCT was performed in 50% (n=17) of patients. Median follow-up time after blinatumomab treatment was 5.5 months (range: 1–40 months), median OS was 10 months (95% CI: range 3–17 months) and 3-year survival rate was 36%. Factors associated with increased mortality included hepatosplenomegaly, lymphadenopathy, high lactate dehydrogenase levels, high peripheral blood blast rate, and previous central nervous system involvement. Allo-HSCT after blinatumomab treatment was a factor associated with reduced mortality risk. Conclusion: Single-agent blinatumomab is a safe and effective treatment as salvage therapy in r/r B-ALL patients with poor prognostic features. Our findings support the effectiveness and safety of blinatumomab in adult patients with r/r B-ALL in a single-center real-world setting. The identification of prognostic factors can help guide treatment decisions and optimize patient outcomes. Keywords: blinatumomab, acute lymphoblastic leukemia, ALL, relapsed, refractory, single-center experience ALL-201 Pediatric Acute Lymphoblastic Leukemia: Incidence of Complex Karyotype by Subgroup Carlos Alonso-Muñoz BS1, Carlos Cortés-Penagos PhD1,2, Mayra Monares-Juárez BS2 1Laboratorios Mendel, Morelia, Michoacán, Mexico. 2Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, Mexico Context: Acute lymphoblastic leukemia (ALL) is characterized by the presence of chromosomal abnormalities in lymphoid cell lineage. Traditionally, this disease is classified according to immunophenotype into B or T cells, and subdivided into pre-B, pro-B, and common. Cytogenetic alterations detected by karyotyping provides a better perspective on prognosis of patients. Current treatments provide favorable recovery expectation in more than 90% of cases; however, the presence of complex karyotype is associated with poor outcomes. In this work we present the incidence of complex karyotype in cases of pediatric ALL. Objective: To establish the incidence of complex karyotypes with ALL subtypes
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