ALBERT

Description: Background: Survivors of hematopoietic stem cell transplantation (HSCT) are 2 to 4 times more likely to develop cardiovascular diseases, accounting for 2-11% of mortality among long-term survivors. Early diagnosis and treatment of modifiable risk factors, such as arterial hypertension, are imperative in this group of patients. The aim of this study is to evaluate the prevalence and associated factors for arterial hypertension following HSCT in a Colombian population. Methods: A retrospective study was conducted in 220 consecutive adult HSCT recipients who underwent transplantation between 2009 and 2017 at a third level referral center in Colombia. Blood pressure data, from two different measures, were collected at 7 time points: day of mobilization for autologous HSCT (auto-HSCT) and day 0 before infusion for allogeneic HSCT (allo-HSCT), day 7, and months 1, 3, 6 and 12 post-HSCT. Arterial hypertension was defined as a systolic blood pressure 140mmHg and/or a diastolic blood pressure 90 mmHg. Patients with history of arterial hypertension were excluded. Descriptive statistics were used to analyze patient's demographic data. Bivariate and multivariate analyses were performed to assess the association between clinical characteristics and arterial hypertension. Results: One hundred and seventy-one patients were included, with a median age of 45 years (range 18-71). Eighty-nine patients (52.1%) were male. One hundred and fifteen patients (67.3%) underwent auto-HSCT and 56 (32.7%) allo-HSCT. The most common indication for HSCT were lymphomas (39.8%), followed by leukemia (28.6%) and multiple myeloma (23.4%). Thirty-six patients (21.1%) developed arterial hypertension by the end of the first year of follow-up. Prevalence of hypertension at each time point was 2.3% on day 7 post-HSCT, 4.7%, 5.3%, 5.5% and 8.1% at 1, 3, 6 and 12 months respectively. Allo-HSCT (P

Description: Introduction: Autologous hematopoietic stem cell transplantation (auto-HSCT) is a complex medical process that has evolved throughout the years, becoming a potentially curative therapy for many hematologic neoplasms and non-malignant marrow disorders, as well as a clinical option for some autoimmune diseases. During the past decades, HSCT has had important advances in technology and technique, patient supportive care, and conditioning protocols, making it a safer procedure. As a result, patient survival rates continue improving. Nonetheless, it is unclear if these improvements are also seen in developing countries. The aim of the present study is to assess survival rate for patients who underwent auto-HSCT in a Colombian population. Methods: A retrospective cohort study was conducted at a tertiary referral center in Colombia, South America, on patients who underwent auto-HSCT between November 2009 and December 2017. Descriptive statistics were used to analyze patient's demographic characteristics. The Kaplan-Meier method was used to assess overall survival (OS) and relapse-free survival (RFS) rates at 100 days, one year, and five years following auto-HSCT. Results: One hundred and fifty-seven patients were included, with a mean age of 49.54 years (range 14-71). Seventy-nine (50.31%) were men. Classifying patients by age group, 68.7% of the patients (n=108) were in the 20-60 years old group and 28% (n=44) were older than 60 years. The most common indication for auto-HSCT was multiple myeloma (42.7%), followed by non-Hodgkin lymphoma (35%) and Hodgkin lymphoma (13%). Peripheral blood stem cells were the graft source in all patients (100%). High-dose melphalan (MEL 200) was the conditioning regimen administered to patients with diagnosis of multiple myeloma, and BEAM (carmustine, etoposide, cytarabine, and melphalan) to patients with lymphoma. OS was 91.7% (CI95% 86.2-95.1) at 100 days, 81% (CI95% 73.9-86.4) at one year, and 60.9% (CI95% 51.3-69.1) at five years. RFS was 94.9% (CI95% 90-97.4) at 100 days, 86.3% (CI95% 79.7-90.8) at one year, and 70.5% (CI95% 66.6-80.7) at five years. Classifying patients by pre-transplantation disease stage as defined by the EBMT study group, OS for early disease was 85.5% (CI95% 75.6-91.8) at one year and 58.2% (CI95% 43.7-70.2) at 5 years, 88.1% (CI95% 76.5-94.1) at one year and 51.8% (CI95% 33.9-66.9) at 5 years for intermediate stage, and 100% at one year and 42.3% (CI95% 7.3-75.4) at 5 years for advanced disease. The most common cause of death was disease progression. There were 51 deaths (32.48%) post-transplantation, 5.73% (n=9) in the first 100 days, 7.6% (n=12) between 100 days and 1-year, and 18% (n=29) after the first-year post-transplantation. Non-relapse mortality was 3.2% at both 100 days and 5 years. Conclusion: OS and RFS of auto-HSCT were very similar to the outcomes reported in the existing literature mainly assessed in developed countries. The most common cause of death in patients who underwent auto-HSCT was progression of the primary disease, and transplant-related mortality was low. Figure. Figure. Disclosures No relevant conflicts of interest to declare.

Description: Introduction: Myelodysplastic syndromes (MDS) comprise a varied group of clonal myeloid neoplasms characterized by cytopenias and an increased risk of progression to acute myeloid leukemia. Prognosis is variable, but little is known about the clinical features of MDS in the Colombian population. The diverseness of the disease and changes in standardized diagnostic criteria throughout the years have hinder accurate case detection and epidemiologic evaluation of MDS in our population. Objective: The aim of the present study was to determine the clinical characteristics and evaluate the overall survival (OS) of patients with MDS treated at two large referral centers in Colombia. Methods: An observational, retrospective study was conducted at two tertiary care centers in Colombia. Patients diagnosed with MDS at Clinica FOSCAL and Hospital San Jose between June 2013 and June 2019 were selected. Descriptive statistics were used to analyze baseline demographic characteristics and clinical data such as disease classification, risk stratification, and treatment. The Kaplan-Meier method was used to assess overall (OS) at 1, 3 and 5 years. Results: A total of 96 patients were included. Median age at diagnosis was 75 years (range 31-104). Fifty-two (54.2%) patients were male. According to the 2016 World Health Organization classification of MDS, the most commonly diagnosed subtype was MDS with multilineage dysplasia (31.2%), followed by MDS with excess blasts (13.5%); however, 35.4% of patients had an unclassifiable MDS sub-type. Twenty-nine (31.2%) patients were screened for cytogenetic abnormalities, the most common chromosomal abnormalities were deletion in the long arm of chromosome 5 (4.2%) and deletion of 7q (2.1%). Therapy related MDS was diagnosed in 13 (13.5%) patients and secondary MDS associated to pesticides exposure in 2 (2.1%) patients. After stratifying patients by the International Prognostic Scoring System (IPSS), the majority of patients were in the intermediate risk group, with 21 (34.4%) and 16 (26.2%) patients in the intermediate-1 and intermediate-2 categories respectively. Almost 80% of the patients presented one or more comorbidities, the most common was cardiac disease (30.5%). Supportive care with erythropoiesis-stimulating agents was the most common first-line treatment (61.4%), followed by iron chelation therapy (6.2%). Forty-eight (50%) patients were treated with hypomethylating agents (HMA), 43.7% receiving azacytidine and 6.3% decitabine. Among HMA-treated patients, 49.6% were in the intermediate-2 and high-risk IPSS groups. Two patients underwent allogeneic hematopoietic stem cell transplantation. Only patients treated with HMA and cytarabine/idarubicin chemotherapy achieved a complete response (11.5%). OS at one- and five-years post-diagnosis was 73.4% and 40.7% (95%CI 62.4-81.6 and 27.1-53.9) respectively. Patients in the intermediate-2 and high-risk IPSS groups had lower survival rates compared to those in the low and intermediate-1 risk groups. The OS for patients treated with azacytidine was 77.2% (95%CI 60.7-87.5%) at one-year, 43.2% (95%CI 23.9-61.1%) at three-years, and 37.8% (95%CI 19.0-56.5) at five-years after diagnosis. The most common cause of death was infection (51.3%), followed by disease progression (24.3%). Conclusions: The OS of patients with MDS in our study is similar to the reported in the existing literature. Knowing the epidemiology, clinical characteristics, risk stratification, and disease outcomes of MDS patients in our population is crucial to decide the best treatment strategies and improve the clinical outcomes of our patients. Disclosures Sossa: Roche: Honoraria; Astellas: Honoraria; Takeda: Honoraria; Novo: Honoraria. Abello:Dr. Reddy's: Consultancy, Research Funding; Takeda: Honoraria, Research Funding; Amgen: Consultancy, Research Funding; Novartis: Consultancy, Honoraria; Abbvie: Consultancy, Research Funding. Peña:Roche: Honoraria. Salazar:Novartis: Honoraria; Janssen: Honoraria. Sandoval-Sus:Celgene: Speakers Bureau; Massive Bio: Consultancy; Janssen: Consultancy; MorphoSys US: Consultancy.