Abstracts Clinical Lymphoma, Myeloma & Leukemia September 2023 S252 disease, and treatment-related factors that affect nutritional status during chemotherapy. Methodology: Design: A retrospective study was conducted in which patient records were retrospectively obtained at admission and subsequently at 1 month and 3 months post initiation of chemotherapy and intervention with the PPSN model to elucidate the efficacy of PPSN on the nutritional status of these children. Additionally, potential factors that may contribute to malnutrition incidence among pediatric cancer patients were examined as potential correlates of malnutrition incidence. Population: All eligible pediatric hemato-oncology patients (n=90) admitted for chemotherapy aged 1–12 years. Patients with lowperformance scores on Karnofsky scale were excluded. Setting: Tertiary Care Hospital in New Delhi, India. Main Outcome Measure: Nutritional status in pediatric hemato-oncology patients Results: A statistically significant improvement in weight-for-age (P=0.013), hemoglobin (P=0.001), and triceps skinfold thickness (P=0.001) was observed in the study population at 1 month and 3 months, respectively. The mean value of weight-for-age (kgs) at initiation, at 1 month, and 3 months of study participants was 17.8, 18.15, and 18.25. The mean value of triceps skinfold thickness (mm) at initiation, at 1 month, and 3 months of study participants was 5.97, 6.04, and 6.22, respectively. The mean value of hemoglobin (gm/dL) at initiation, at 1 month and 3 months of study participants was 7.38, 9.06, and 9.09, respectively. Conclusion: The PPSN model improved nutritional status in pediatric hemato-oncology patients during chemotherapy. This was associated with significant improvements in weight-for-age, hemoglobin, and triceps skinfold thickness. Keywords: pediatric hematology-oncology, nutritional status, PPSN model, malnutrition, chemotherapy ALL-471 Veno‑Occlusive Disease Risk and Other Outcomes in Patients With B‑Cell Precursor Acute Lymphoblastic Leukemia Receiving Inotuzumab Ozogamicin and Proceeding to Hematopoietic Stem Cell Transplantation Marcos de Lima MD1, Partow Kebriaei MD2, Francesco Lanza MD3, Christina Cho MD4, Gizelle Popradi MD5, Manmeet Kaur MPH6, Mei-Jie Zhang PhD6, Fan Zhang PhD7, Richa Shah PharmD8, Erik Vandendries MD9, Kofi Asomaning PhD9, Stephanie Dorman PhD10, Matthias Stelljes MD11, David I. Marks MBBS, PhD12, Wael Saber MD6 1Ohio State University, Blood and Marrow and Cellular Therapy Program, Columbus, USA. 2MD Anderson Cancer Center, Houston, USA. 3Ospedale di Ravenna, Ravenna, Italy. 4John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, USA. 5McGill University Health Centre, Montreal, Canada. 6Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, USA. 7Pfizer Inc, Shanghai, China. 8Pfizer Inc, Collegeville, USA. 9Pfizer Inc, Cambridge, USA. 10Pfizer Inc, Ontario, Canada. 11Universitätsklinikum Münster, Münster, Germany. 12University Hospitals Bristol NHS Trust, Bristol, United Kingdom Context: Inotuzumab ozogamicin (InO; CD22-directed antibody–drug conjugate indicated for relapsed/refractory (R/R) B-cell precursor acute lymphoblastic leukemia [ALL]) has been associated with hepatotoxicity/hepatic veno-occlusive disease (VOD), particularly after HSCT. Objective: Post-HSCT outcomes in patients who received InO before first HSCT. Design: Observational, post-authorization safety study; final analysis, 5-year (y) data (Aug 2017–Aug 2022). Patients: United States, with B-cell precursor ALL. Main Outcome Measures: Overall survival (OS), non-relapse mortality (NRM), relapse, adverse events (AEs). Multivariate analyses examined prognostic factors for NRM/VOD and outcomes in patients (≥18 y) with ALL and the subset with R/R ALL. Results: 261 patients with ALL (median age 39 y): 36% in first complete remission (CR1), 46% in CR2, 11% in CR≥3, 4% in first relapse, 1% in ≥third relapse, 2% with primary induction failure. CR/CRi and minimal residual disease negativity achieved in 80% and 64% of patients, respectively, after InO. Median (range) time from last InO dose to HSCT, 2.4 months (0.6–26.2). Post-HSCT OS at 18 months: patients with ALL, 54%, patients with R/R ALL, 50%. NRM within 18 months in 22% and 25%, respectively; most common causes were VOD (26%, 24%) and graft-versus-host disease (GVHD; 22%, 19%). Relapse within 18 months in 40% of both sets of patients. AEs occurring in ≥30% of patients with ALL and R/R ALL, respectively, within 100 days post-HSCT: bacterial infection (51%, 56%), viral infection (44%, 44%), and acute GVHD (grades II–IV, 43%, 41%). Of 35 patients who developed VOD, 15 cases were mild, 20 severe. Multivariate analyses (204 patients with ALL): Karnofsky score <90 or unknown vs 90–100 (HR, 3.00, 7.55; P=0.0010, <0.0001) and dual alkylators (compared by myeloablative conditioning (MAC)/no dual alkylators and reduced-intensity conditioning (RIC)/non-MAC: HR, 0.15, 0.26; P=<0.0001, 0.0027) were negative prognostic factors for NRM at 18 months. Dual alkylators were a negative prognostic factor for VOD at 100 days (compared by MAC/no dual alkylators and RIC/non-MAC: odds ratio, 0.26, 0.15; P=0.0275, 0.0032). Conclusions: VOD incidence was consistent with previous reports. Dual alkylators should be avoided, when possible, in this patient subset. These patients should be considered for clinical trials testing novel prophylactic treatments for VOD. Keywords: ALL, acute lymphoblastic leukemia, B-cell acute lymphoblastic leukemia ALL-476 Correlation of CT Chest Findings With Bronchoalveolar Fluid (BAL) Analysis in Adolescent and Adult Leukemia and Lymphoma Patients With Febrile Neutropenia Sweta Bothra MD, Meenakshi Thakur MD, Akshay Baheti MD, Amit Janu DNB, Ujjwal Agarwal MD, Hasmukh Jain MD, Jayashree Thorat MD, Manju Sengar MD, Sandeep Tandon MD, Suyash Kulkarni DNB Tata Memorial Hospital, Mumbai, India
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