Abstracts Clinical Lymphoma, Myeloma & Leukemia September 2023 S262 after 30 days of diagnosis. The main reasons for mortality were also analyzed. To prevent ED prior to treatment, the suspected APL patients must be immediately hospitalized and treated as medical emergencies with targeted therapy. Of the 56 patients, 27 (53%) were stratified with low risk and treated with the all-trans retinoic acid + idarubicin (AIDA) protocol. Also stratified with low risk were 2 (4%) patients who were treated with ATRA and arsenic trioxide (ATO); 20 (39%) patients were stratified with high risk and treated with ATRA and hemotherapy; and only 2 (4%) were treated only with ATRA. Conclusion: The clinical and epidemiological features were compared with previously published studies. High-risk patients are in higher percentage in our study population. There was a significant association between the overall survival and risk score and early death. Keywords: AML, acute promyelocytic leukemia, early death, all-trans retinoic acid, case AML-046 Real World Data on Clinical Outcomes of Newly Diagnosed Acute Myeloid Leukemia (AML) Patients Treated With Hypomethylating Agents (HMA) Plus Shorter Duration of Venetoclax (VEN) at a General Hospital Hina Khan MD, Binoy Yohannan MD, Frances CervoniCuret MD, Adan Rios MD McGovern Medical School, University of Texas Health Science Center, Houston, USA Context: Azacitidine-venetoclax is currently approved in older/ unfit AML patients based on the VIALE-A study. The recommended 28-day course of VEN remains a major challenge due to prolonged cytopenia. We reviewed real-world outcomes of patients treated with HMA plus a shorter duration of VEN in the community setting. Objective: To determine the real-world outcomes of older/unfit AML patients treated with HMA and attenuated VEN therapy. Design: Single-center retrospective study of AML patients treated at Memorial Hermann-Texas Medical Center from January 1, 2017, to December 31, 2021. Setting: Academic hospital Patients or Other Participants: Newly diagnosed AML patients ≥18 years old treated with HMA plus VEN. Main Outcome Measures: Composite complete response (CCR; complete response [CR] plus complete response with incomplete hematologic recovery CRi]), toxicity during induction, induction mortality, and median overall survival (OS). Results: We identified 18 AML patients treated with HMA plus VEN. The median age was 72 (range, 59–88) years. Half had an ECOG performance status of 2–4. Based on European LeukemiaNet 2022 data, 11 patients had adverse risk, 2 patients had intermediate risk, and 5 patients had favorable cytogenetics. The HMA regimens included: decitabine 20 mg/m2 for 10 days (n=14), decitabine for 5 days (n=3), and azacitidine 75 mg/m2 for 7 days (n=1). Median duration of VEN administration was 7 (range, 4–14) days, with doses ranging from 100 to 400 mg daily. Among 18 response-evaluable patients, 11 (61%) achieved CCR after one cycle of induction chemotherapy (CR, n=5; CRi, n=6). Key adverse events included sepsis (28%), respiratory failure (11%), and acute kidney injury (6%). There were no deaths within 30 days of induction. No patients received allogenic stem cell transplants for consolidation. The median OS was 12.5 months. Conclusions: The use of HMA in combination with a shorter duration of VEN is well tolerated with no induction mortality. The response rate and survival outcomes were comparable to the 28-day VEN regimen. Our data support a shorter duration of VEN in combination with HMA. Further studies are required to optimize the duration of VEN within the context of this regimen. Keywords: AML, acute myeloid leukemia, hypomethylating, induction, chemotherapy, reduced intensity AML-047 Risk Factors Beyond Chemotherapy Exposure for Therapy‑Related Myelodysplastic Syndrome (tMDS) and Acute Myeloid Leukemia (tAML) Development in Lymphoma Survivors: A 15‑year SEER‑Medicare Analysis Megan Herr PhD1, Abhay Singh MD2, Theresa Hahn PhD1, Swapna Thota MD3 1Roswell Park Comprehensive Cancer Center, Buffalo, USA. 2Cleveland Clinic, Taussig Cancer Institute, Cleveland, USA. 3University of Tennessee Health Science Center, Memphis, USA Context: Therapy-related myeloid neoplasms (tMNs) constitute 10-20% of newly diagnosed myeloid neoplasms and carry poor prognosis. tMNs develop in a small percentage of patients who receive chemoradiotherapy (CRT), thereby suggesting a role of additional factors that may facilitate leukemic transformation. Clonal hematopoiesis (CH) represents a precursor state to overt myeloid neoplasm, and those surviving CRT/genotoxic stress may give rise to tMNs. Objective: To assess if CH-related comorbidities (cardiovascular disease, infections, autoimmunity, etc.) are associated with tMN, beyond CRT. Design/Population: A population-based retrospective cohort study was conducted using cancer registries from the Surveillance, Epidemiology, and End Results (SEER) Program and Medicare claims database. Methods: First primary lymphoma (diffuse large B-cell lymphoma [DLBCL] and follicular lymphoma [FL]) patients aged 66-84 diagnosed 2000-2014 (followed through 2015) and survived at least 1 year, as reported to SEER, were analyzed. Chi-square tests examined associations between comorbidities/potential risk factors and tMNs. Factors significantly associated with tMNs at P<0.05 were included in the multivariable logistic regression model. Results: Among 33,520 lymphoma patients, 293 tMNs cases were identified. tMNs occurred more often after initial chemotherapy vs none (DLBCL-odds ratio [OR]=1.87, 95% CI=1.23-2.83; FL-OR=2.15, 95% CI=1.29-3.61). Prior history of autoimmune conditions significantly increased risk of subsequent tMNs (DLBCL-OR=2.10, 95% CI=1.51-2.91; FLOR=3.46, 95% CI=2.30-5.20). Though infection was not directly associated with increased risk, methods of infection prophylaxis often used in treatment of lymphomas, e.g., use of granulocyte colonystimulating factor (GCSF), significantly increased risk of subsequent tMNs (DLBCL-OR=2.94, 95% CI=2.03-4.26; FL-OR=3.97, 95% CI=2.51-6.28). No other comorbidities of interest (hypertension,
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