Abstracts Clinical Lymphoma, Myeloma & Leukemia September 2023 S318 Context: Venetoclax (VEN), a potent Bcl-2 inhibitor, is currently approved in combination with azacitidine (AZA) in acute myeloid leukemia (AML) patients unfit for intensive chemotherapy. Research is still ongoing about the broader indication of its application. Design and Objective: In this retrospective cohort study, we aimed to analyze data on AML and high-risk myelodysplastic syndrome (MDS-EB1 and -EB2) treated with VEN in our tertiary center at University of Pécs, Pécs, Hungary. Outcomes included overall survival, histological response (measurable residual disease [MRD] status), and clinical response (complete remission/complete remission with incomplete count recovery [CR/Cri]). Results: Between May 2020 and September 2022, a total of 31 patients received VEN therapy in our institution (5 with MDS and 26 with AML). Among MDS cases, 1 received 8 cycles of VEN-AZA followed by haploidentical allogeneic stem cell transplantation (alloSCT); 1 received 5 cycles of VEN-AZA and achieved CR/CRi; 2 received VEN-AZA for less than 2 cycles and died (1 refractory case, the other had stable, MRD negative disease but died in acute myocardial infarction); and 1 was refractory and switched to best supportive care after 1 month of treatment. Among the 26 AML patients, 4 received VEN as part of conditioning and/or bridging before allo-SCT (none achieved CR/CRi before transplantation). 1 patient died from intracranial bleeding before ASCT, the other 3 underwent successful ASCT (2 died in early relapse, 1 had an unknown outcome). The other 22 AML patients received first- or later line VEN-AZA treatment: 9 achieved MRD negativity at some point of treatment (there was no follow-up biopsy in 4 cases), 14 died during follow-up (3 achieved MRD negativity, median survival 8.1 months, range: 3.0-21.7 months), 8 are still alive (6 achieved MRD negativity, all were at least for a period in CR/CRi, median followup 17.1 months, range: 8.0-32.1 months). The main causes of death were sepsis and intracranial bleeding. Conclusion: Our results are comparable to those reported in the literature: VEN in combination with AZA is a good therapeutic option in unfit AML patients. Its use in other indications, eg, as part of bridging, requires further studies. Keywords: AML, acute myeloid leukemia, venetoclax, azacitidine, myelodysplastic syndrome AML-665 Predictors of Outcomes in Patients With MECOM EVI1 Rearranged AML or MDS Yael Kusne MD PhD1, Alyssa McGary MS2, Katalin Kelemen MD, PhD3, Mark Litzow MD4, Aref Al-Kali MD4, James Foran MD5, Talha Badar MBBS MD5, Mrinal Patnaik MBBS4, Abhishek Mangaonkar MBBS4, Lisa Sproat MD1, Jeanne Palmer MD1, Patricia Greipp DO4, Cecilia Arana Yi MD1 1Department of Hematology Oncology, Mayo Clinic, Phoenix, USA. 2Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, USA. 3Department of Hematopathology, Mayo Clinic Arizona, Scottsdale, USA. 4Division of Hematology, Mayo Clinic, Rochester, USA. 5Department of Hematology Oncology, Mayo Clinic, Jacksonville, USA Background: MECOM (EVI1) rearrangements in MDS/AML are rare and carry an unfavorable prognosis. Although allo-HSCT may prolong survival, factors impacting outcomes are not known. We conducted a retrospective analysis of patients with MECOM (EVI1) to associate clinicopathologic variables with prognosis. Methods: This study was IRB approved. Patients >18 years of age with MDS or AML and MECOM EVI1 at Mayo Clinic between 01/2012 - 12/2022 were included. Overall survival (OS) and leukemia free-survival (LFS) were estimated using the Kaplan-Meier method. Outcome differences between sub-groups and univariate analyses were assessed with Cox regression. Results: 60 patients met criteria. 63% (n=38) were male. The median age at diagnosis was 67.8 yrs (range, 56 – 75). 80% had AML (n=48) and 18% had MDS (n=11). 67% had secondary AML/MDS (n=40). 33% (n=16) had AML with myelodysplasia related changes (AML-MRC). Inv(3)/t(3;3) was present in 65% (n=39) and t(3;21) was present in 12% (n=7). 38% percent (n=23) had cooccurring monosomy 7 or 7q deletion and 5% had complex karyotype (n=3). SF3B1 was the most common cooccurring mutation in 31% (n=10), followed by KRAS 19% (n=6). 38% (n=23) received intensive chemotherapy. Complete response (CR) rates were 36% with intensive treatment (n=8) and 4% with non-intensive treatment (n=1; P=0.007). 30% (n=18) underwent SCT (78% in CR1 and 22% in CR2) and of those, MAC was used in 38% while 61% received RIC. The mOS in the entire cohort was 11 months (95% CI 6.2, 17). Patients who received a SCT had longer mOS compared to patients who did not (19 vs 6.2 months, HR=0.31, 95% CI 0.16,0.64; P=0.001). AMLMRC was a poor prognostic factor in the HCST group for OS (HR=4.23, 95% CI 1.02, 17.5, P=0.047). Intensive vs non-intensive chemotherapy, response prior to transplant (CR vs no CR) or having 2 or more mutations on NGS did not significantly impact OS or LFS. Conclusions: In line with previous reports, allo-HSCT was associated with improved survival outcomes. Our results showed a high frequency of secondary AML/MDS, but only AML-MRC was associated with decreased survival outcomes. Regardless of therapy type, outcomes were poor. Novel therapies are urgently needed for these patients. Keywords: AML, MDS AML-682 Incidence of Oral Mucositis in Patients Undergoing Systemic Chemotherapy for Hematologic Malignancies Artem Oganesyan MD1,2, Lusine Harutyunyan MD1, Araksya Vanoyan MD1, Nare Martirosyan MD1, Maria Badikyan MD1, Nerses Ghahramanyan MD1, Karapet Hakobyan MD1, Karen Meliksetyan MD1, Samvel Danielyan MD1, Yervand Hakobyan MD1,2 1Department of Adult Hematology, Hematology Center after R. Yeolyan, Yerevan, Armenia. 2Department of Hematology and Transfusion Medicine, National Institute of Health, Yerevan, Armenia Background: Chemotherapy-induced oral mucositis (OM) represents a major complication related to systemic anti-cancer treatment leading to disruptions in the treatment plan, decreased quality of life due to pain, distress and discomfort, as well as
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