Abstracts Clinical Lymphoma, Myeloma & Leukemia September 2023 S254 (34.9%); and in the Ph-negative group: CDKN2A/B–44 (30.1%), PAX5–40 (27.4%), and IKZF1–33 (22.6%). The patients were grouped into three categories, with CNA in 1 gene–51 cases (27%), 2 genes–36 cases (19%), and >=3 genes–46 cases (24%). The Phpositive cohort had 12 cases (27.9%), 10 cases (23.25%), and 16 cases (37.2%) with CNAs in 1 gene, 2 genes, and >=3 genes, respectively; the Ph-negative cohort had 39 cases (26.7%), 26 cases (17.8%), and 30 cases (20.5%) with CNAs in 1, 2, and >=3 genes, respectively. Conclusions: Our study indicates that the CNAs in Phpositive B-ALL differ from that of Ph-negative B-ALL. The most affected gene in the Ph-positive B-ALL cohort was IKZF1 compared to CDKN2A/B in the Ph-negative cases. The Ph-positive cohort overall had CNAs in a higher number of genes (>=3 genes–37.2% of cases) than the Ph-negative cohort (20.5%), possibly indicating a higher genomic susceptibility in Ph-positive B-ALL. Keywords: B-ALL, MLPA, CNAs, Ph-positive, Ph-negative ALL-553 Unexplained Increase in Incidence of T‑Acute Lymphoblastic Leukemia/ Lymphoma in Armenia Nare Martirosyan MD1, Arusyak Ivanyan MD1, Maria Badikyan MD1,2, Liana Hambardzumyan MD1,3, Lusine Harutyunyan MD1, Alisa Movsisyan MD1,3, Anna Sevoyan MD1,4, Yervand Hakobyan MD, PhD1,4, Gevorg Tamamyan MD, PhD1,2,5,6, Samvel Danielyan MD, PhD1, Astghik Voskanyan MD1,2 1Hematology Center after Prof. R. Yeolyan, Yerevan, Armenia. 2Immune Oncology Research Institute, Yerevan, Armenia. 3Hemophilia and Thrombosis Center, Yerevan, Armenia. 4National Institute of Health, Yerevan, Armenia. 5Pediatric Cancer and Blood Disorders Center of Armenia, Yerevan, Armenia. 6Department of Pediatric Oncology and Hematology, Yerevan, Armenia Background: T-acute lymphoblastic leukemia/lymphoma (T-ALL/LBL) is a hematologic malignancy arising from immature T-cell precursors with an average annual incidence of 0.13 cases per 100,000 population for T-ALL (SEER database report). Aims: The aim of our study was to analyze the incidence of T-ALL/LBL in Armenia during the period of 2017-2021. Methods: We analyzed the medical records of all adult patients diagnosed with T-ALL/LBL from 01/01/2017 – 12/31/2021 at Hematology Center after Prof. R. Yeolyan, which is the only specialized institution in Armenia involved in the treatment of blood disorders, meaning the data are countrywide. Results: A total of 37 patients were diagnosed over the 5-year period. At diagnosis the median age was 40 years (18–67 years) and 56.7% (21) of the patients were male. In 2017 and 2018, 7 cases of T-ALL/LBL were reported annually (the annual incidence 0.31 and 0.3 per 100,000, respectively). This number decreased to 3 cases in 2019 (the annual incidence 0.1 per 100,000), but subsequently increased to 5 cases in 2020 (the annual incidence 0.22 per 100,000). Notably, the incidence of T-ALL/LBL significantly rose to 15 cases in 2021 (the annual incidence 0.7 per 100,000). It is important to highlight that there were no significant changes in the population of Armenia during the study period (2,852,000 in 2017 and 2,791,000 in 2021). Conclusion: This analysis showed a significant increase in T-ALL/LBL incidence in 2021 compared with the preceding 4-year period. Potential factors, including the impact of COVID-19 infection, various stressors, and genetics should be thoroughly investigated to gain a deeper understanding of their potential role in the notable increase in T-ALL/LBL incidence. Keywords: T-ALL/LBL, annual incidence, potential factors, increase of incidence, investigation ALL-555 Acute Lymphocytic Leukemia in Pregnancy, Case Report and Review of the Literature Mariam Aldarweesh MBChB1, Eman Alazmi MD1, Fatima Khadadah MD2, Hadeel Al-Enezi MD1, Ahmed El-Sheashaey BScPhm, CPPS3, Evangelia Vlachodimitropoulou PhD4, Ahmed Alhuraiji MD3, Ramesh Pandita MD3 1Department of Obstetrics & Gynecology, Maternity Hospital, Kuwait City, Kuwait. 2Department of Hematology, Kuwait Cancer Center, Kuwait City, Kuwait. 3Kuwait Cancer Control Center, Kuwait City, Kuwait. 4Kings College London, London, United Kingdom Introduction/Case Report: Leukemia occurs in about 1 in 1,000 pregnancies and of these only 28% have acute lymphocytic leukemia (ALL). We report a case of a 28F G2P1 diagnosed with Philadelphia negative B-ALL at 24 weeks’ gestation. She was induced with UKALL14 and achieved a flow negative complete remission post-induction. During induction chemotherapy, the fetus remained at the 50th percentile. The patient was kept on weekly vincristine and prednisone and had an elective repeat c-section at 31+3 weeks for her to safely resume chemotherapy. Baby girl had an uneventful course and was discharged from hospital on Day 29. Given the sparse data on this challenging topic, we decided to review the literature for all reported cases of ALL in pregnancy. Methods: We reviewed the literature for all reported cases of ALL from 2010 to 2023. We collected available data on the patient, pregnancy, and fetal outcome as well as leukemia characteristics and chemotherapy received. Results: We found 11 patients across 9 papers. The median age was 33 (16-41). The most-affected pregnancies were third-trimester pregnancies (range 9-36 weeks). Philadelphia status was reported in 8 patients, and of these, 4/8 were positive. Patients received all standard ALL chemotherapy agents, including asparaginase and except for methotrexate. Dasatinib and imatinib were given to two patients at 33 and 24 weeks, respectively; the first resulted in a live birth, the second fetus experienced nonspecified complications and was delivered at 30 weeks. There were no reports of patients who were treated with immune therapy while pregnant. Of those reported, 7/7 patients went into a remission postinduction. N=5/10 were dead at last follow-up, one from leukemia, and 3 from infectious complications. Ten pregnancies resulted in successful live births, except for one patient who had a first trimester pregnancy and miscarried at 16 weeks. Conclusion: Treatment of women presenting with ALL at or beyond the second trimester of pregnancy is possible with high remission rates for the mothers
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