ALBERT

Description: Introduction Autologous stem cell transplantation (ASCT) is the standard care for refractory and relapsed Hodgkin and aggressive non Hodgkin lymphoma, but patients (pts) with high tumor burden before transplantation present a very poor outcome. Furthermore, pts with advanced age or co-morbidities could not be eligible to the procedure. We tested efficacy and feasibility of reinforced mini-BEAM followed by hematopoietic stem cell infusion (mini-ASCT) either as extreme debulking attempt in pts with disappointing response to previous salvage therapy or in pts unsuitable for standard transplantation. Patients and methods Ten Hodgkin’s lymphoma (HL), 10 aggressive B-cell non Hodgkin’s lymphoma (B-NHL) and 3 aggressive T-cell non Hodgkin’s lymphoma (T-NHL) pts received mini-BEAM therapy (BCNU 100 mg/m2 on d-6, VP-16 75 mg/m2/d and Ara-C 200 mg/m2/d from d-5 to d-2, Melphalan 100 mg/m2 on -d1) followed by peripheral blood stem cell infusion (PBSC). Median age was 44 years (range 23–67). Fifteen pts (65%) were primary refractory to first line therapy, while 5 pts and 3 pts had early and late relapse, respectively (22% and 13%); all 23 pts had received at least three previous therapies. Disease status before mini-BEAM was partial remission (PR) in 2 pts, stable disease (SD) in 7 pts and progressive disease (PD) in 14 pts. Results Median number of CD34+ cells infused was 5.77×106/kg (range: 1.4–20.0). Median time to neutrophils and platelets engraftment was 9 days (range 7–11) and 10 days (range 8–15), respectively. Nine pts (39%) had fever with a median duration of three days (range 1–5); only in 2/9 cases an infection was documented. Four pts (17%) experienced mucositis, requiring systemic opioid therapy in a single case. Median hospitalization was 25 days (range 21–37). Overall response rate (ORR) was 34.8% (CR 8.7%, PR 26.1%); 8 pts (34.8%) presented SD and 7 pts (30.4%) PD. Standard ASCT was performed in 12 pts; 11 pts were excluded because of co-morbidities (6 pts) or progressive disease (5 pts). Eleven pts are evaluable for response to ASCT: 5 pts reached CR (41.7%) and 6 PR (50%). Considering all the 23 pts, median overall survival (OS) was 28.5 months with a median follow-up of 9.4 months (range 1.1–39.8), while median event-free survival (EFS) was 13 months with a median follow-up of 5.2 months (range 1.0–39.8). Analysing pts undergone mini plus standard ASCT (cohort 1) apart from pts treated with mini ASCT alone (cohort 2), median OS was not reached in cohort 1 and 8.6 months in cohort 2, with a median follow-up of 11.7 months (range: 2.6–31.4) and 5.3 months (range: 1.1–39.8), respectively (Figure 1); median EFS was not reached in cohort 1 and 3.3 months in cohort 2, with a median follow-up of 13.1 months (range: 3.5–31.4) and 2.8 months (range: 1.0–39.8), respectively (Figure 2). Both differences in OS and EFS are statistically significant (logrank test: p = 0.0098 and p = 0.0187). At univariate analysis, a significant association was detected between standard ASCT and OS (p = 0.009), while both histology (p = 0.831) and response to mini-BEAM (p = 0.364) did not exert any valuable impact on OS. Conclusion ASCT with reduced BEAM as conditioning regimen proved to be a feasible and safe strategy for pts with refractory lymphoma which failed multiple salvage therapies. In this unfavourable setting of pts, ORR was better than expected. Survival data show an advantage for pts subsequently treated with standard ASCT, which must be performed whenever possible. Mini-ASCT can play a role for disease reduction in a tandem-fashion before standard ASCT in younger and to some extent chemosensitive pts. Finally, mini-ASCT can be considered as a valid option for pts uneligible to standard transplantation. Figure Figure Figure Figure

Description: Background Allogeneic SCT remains the only curative option in myelodysplastic syndromes (MDS). We prospectively evaluated in a multicenter phase 2 GITMO (Italian Bone Marrow Transplantation Group) trial, the feasibility of allogeneic stem cell transplantation (ASCT, primary protocol end-point) after induction treatment with azacitidine (Vidaza, Celgene). According to the protocol, patients had to perform at least 4 and up to 12 cycles of azacitidine as induction treatment before ASCT. Patients not eligible for ASCT could continue treatment until disease progression. Methods Between November 2010 and September 2014, 102 patients were enrolled by 20 Italian hematology centers. Nine patients never started treatment due to progressive disease (PD, n=2), refusal (n=3), or unknown causes (n=4). Of remaining 93 patients, 70 had with IPSS Int-2/High-risk MDS, 15 WHO-defined acute myeloid leukemia (AML) and 8 chronic myelomonocytic leukemia (CMML). There were 32 females and 61 males with median age 59 yrs (range 21-66.5 yrs). At treatment start, ECOG performance status was: 0 in 66 patients, 1 in 17 and 2 in 10 patients, while MDS HCT-index was: low (0) in 43 patients, intermediate (1-2) in 31 and high (〉2) in 18 patients. All 93 patients started azacitidine s.c. at the standard dose of 75 mg/sqm/day, 7 days/month, at a median of 0.8 months (range 0-105 months) from initial MDS diagnosis. Results At response assessment after a median of 4.5 cycles (range 1-11), 25% of patients (n=19) achieved complete remission (CR), 3% marrow-CR (n=2), 14% partial remission (PR, n=11), 9% hematologic improvement (HI, n=7), 35% had stable disease (SD, n=27) and 14% PD (n=11). ASCT was performed in 48 patients (52%), after a median of 4.5 azacitidine cycles (range: 1-11). Data on ASCT are presently available for 45 patients, transplanted with bone marrow (n=10 pts) or peripheral blood stem cells (n=35 pts) from an HLA-identical donor (sibling in 11, and MUD in 34 cases). Forty-five patients did not receive ASCT due to: disease relapse or progression (n=16, 35%), adverse events (n=12, 27%), refusal (n=5, 11%), or other causes (n=12, 27%). At a median follow-up of 18.5 months (range 0.2-31.5), 43 patients are alive (25 received ASCT), and 50 patients died. Causes of death are reported in Table 1. Median overall survival (OS) for the whole patient cohort was 13.4 months (95% CI: 10.9-18.6, Figure 1). Disease status after azacitidine was predictive of significantly improved survival for patients in CR/PR/HI, compared to SD or PD (n=77 patients who completed at least 4 cycles, Figure 2). ASCT considered as time-dependent covariate was associated to a significantly longer survival (p=0.008, HR 0.4, 95% CI: 0.2-0.8). Stratification of MDS according to IPSS and karyotype was not associated to survival. Conclusions Our study shows that allogeneic transplantation following azacitidine is feasible in HR-MDS/CMML and AML, with about 50% of patients being able to undergo HSCT. These data favourably compare with previous studies in MDS on ASCT preceded by conventional chemotherapy. Disease status at the time of HSCT confirms its significant prognostic role for survival, also in the context of hypomethylating treatment, where stabilization of disease also represents a therapeutic target. Disease relapse or progression remain the major causes of death indicating the need for other strategies aimed at improving disease control in MDS. Figure 1. Overall survival (n=93 pts) Figure 1. Overall survival (n=93 pts) Figure 2. Survival according to disease status at response assessment after a median of 4.5 azacitidine cycles (n=77 evaluable pts) Figure 2. Survival according to disease status at response assessment after a median of 4.5 azacitidine cycles (n=77 evaluable pts) Disclosures Voso: Celgene: Honoraria, Research Funding. Off Label Use: Azacitidine used as induction treatment before allogeneic stem cell transplantation in MDS. Finelli:Janssen: Other: Speaker; Novartis: Other: Speaker; Celgene: Other: Speaker, Research Funding.

Description: Abstract 4959 Few epidemiological data about IFI in chronic lymphoid malignancies are available in literature. Our aim is to describe epidemiology, clinical manifestations and outcome of IFI in these patients (pts). We reviewed the records of pts with lymphoproliferative disorders, treated between 2004 and 2010 for probable/proven IFI, according to the revised criteria of EORTC/MSG. We registered 40 probable/proven IFI. Twenty-five pts were affected by lymphoma, 9 by CLL, 3 by Waldenström macroglobulinemia, 2 by multiple myeloma and 1 by hairy cell leukemia. The median age was 57 years (r: 17–71). Twenty-nine pts (75%) had progressive/relapsed hematological disease, and 75% were treated with multiple lines of chemotherapy. Risk factors for IFI were: neutropenia (11 pts), previous solid organ transplant (3) or allogeneic HSCT (3), treatment with high dose steroids (3), monoclonal antibodies (MABs) such as rituximab (9) and alemtuzumab (3), nucleosidic analogues (3) or multiple of these factors (8). Regarding mortality the following factors were evaluated: deep and prolonged neutropenia, multiple lines chemotherapy, MABs and purine analogues administration, diagnosis and status of the underlying disease. Incidence of IFI was 2,7%; (moulds 2%, yeasts 0,4%, mixed infections 0,3%). We recorded 7 yeast infections: 6 were documented by cultures (3 C. albicans, 2 C. glabrata and 1 Blastoschyzomices capitatus), and 1 by the microscopic observation of Candida spp in the vitreum. Thirty pts developed an invasive mould infection (IMI); 3 of them had a proven pulmonary IMI diagnosed by histology (2 Aspergillus spp, 1 Mucor). Twenty-seven pts had a probable IMI: 24 had lung involvement, 2 a sinusal localization, and 1 a pulmonary infection disseminated to brain. Mycological criteria were more often provided by the positivity of the galactomannan antigen (GM, 14 pts) in serum and/or BAL fluid. Cultures resulted positive in 12 cases (5 A. fumigatus, 2 Aspergillus spp, 2 A. flavus, 1 A. niger, 1 Fusarium and 1 for both Scedosporium and Aspergillus); in 4 of them, both GM and culture positivity from the BAL fluid were present. Finally, we observed 3 mixed infections by both moulds and yeasts: in 2 pts a proven yeast infection with isolation in the blood culture (1 C. albicans, 1 C. glabrata) was associated to a probable IMI with the positivity of CT scan and GM; in 1 pt autopsy revealed a pneumonia by Candida spp and a disseminated infection by Aspergillus spp. Eight of 40 pts died due to infection, but only in one pt IFI was the unique cause of death. IFI attributable mortality rate was 20%. At the univariate analysis, the only risk factor related to mortality was the administration of multiple lines of chemotherapies (p 0.04). Disclosures: No relevant conflicts of interest to declare.

Description: A proper assessment of elderly patients is a relevant clinical problem in the onco-hematological setting. In this context, age and extra-hematological morbidity are of primary importance, but performance status and overall functionality related to geriatric age, as physical abilities, cognitive aspects and ability to self-management are not negligible. Thus, a defined multi-dimensional assessment is needed to differentiate between fit, unfit and frail older adults (Klepin ASH Education Program 2014). We propose a tool to evaluate the tolerance to more or less intensive treatments in over 60 years aged patients, and to estimate the impact on the outcome. Our algorithm is based on 4 main variables universally recognized: age, performance status, comorbidities and geriatric aspects (functional, physical and cognitive). 1- As regards age, two cut-off values were considered: 70-years limit because it represents the threshold below which the allogeneic bone marrow transplantation may still run; and the 85-year limit because it denotes the edge beyond which chemotherapy (also non-intensive) should not be administered. 2- About performance status, it was chosen the ECOG (Eastern Cooperative Oncology Group) scale more or equal to 3 as the limit beyond which chemotherapy should be avoided. 3- Considering co-morbidities, the SIE, SIES GITMO group consensus-based definition of inability to intensive and non-intensive chemotherapy in acute myeloid leukemia (Ferrara et al. Leukemia 2013) was chosen to identify both patients candidate to intensive or candidate to only non-intensive chemotherapy. 4- Approaching the geriatric assessment, two levels of impairment were considered: the most important level of seriousness occurs when the Activities of Daily Living (ADL) functional scale is not overtaken; the lowest level of seriousness is verified if at least one among the functional Instrumental Activities of Daily Living (IADL) scale or the physical Short Physical Performace Battery (SPPB) scale or the cognitive Mini Mental State Examination (MMSE) scale are not overcome. The stratification of patients works with some steps that must be excluded in order to get over the various levels of fitness (Figure 1). We call this approach the NO-chain algorithm. It foresees that: - Patient with at least one of the following features are considered frail: 85 or more years of age; at least 3 of ECOG; assessed functional impairment with the ADL scale

Description: Introduction: Erythropoietin stimulating agents (ESAs) are first-line therapy for International Prognostic Scoring System (IPSS)-low risk myelodysplastic syndrome (MDS) when symptomatic anaemia (Hb

Description: Patients who failed fludarabine (FLU) or showing a relapse after several lines of chemo or immuno therapy have poor chance to obtain further response to treatment. Oxaliplatin (OX) is a third generation platinum compound with a 1,2 diaminocyclohexamine carrier ligand, it has a different activity and side effect profile from cisplatin. In order to test the activity of OX in CLL we administered first this agent as monotherapy in relapsed patients. OX covalently binds DNA, inducing DNA intra and inter-strand cross-links. FLU has been shown to have a biochemical modulating effect on others antineoplastic agents. Moreover, FLU and Ara-C act synergistically to inhibit excision repair of DNA cross-links. This evidence provides a rationale to test the combination of OX, FLU and Ara-C in patients with advanced CLL. The first cohort of patients received OX 140 mg/m2, as single agent. The second cohort of patients received OX, at increasing dose 17.5 (1st course), 25 (2nd course), 35 mg/m2 (from 3rd course up to the 6th course), days 1–4; Fludarabine 25 mg/m2, days 2 and 3; Ara-C 1 g/m2, days 2 and 3. Courses were given every 4 weeks for a total of 6 courses; all patients received G-CSF 5μcg/m2. Prophylaxis against tumor lysis syndrome, PCP and DNA virus were provided. Seven patients (M=4;F=3; Median age = 62 years; Binet stage B =3, Binet stage C= 4) who received a median of 3 previous (range 2–5) lines of treatment, two of them resistant to FLU, have been treated with OX as single agent. Patients receiving at least 1 course were evaluable for toxicity. Four patients completed the entire program of treatment, 2 patients received 4 courses of OX and they didn’t continued treatment because of persistant neutropenia from the previous course. The last patient stopped OX after the second course because of disease progression. The major toxicity was hematologic. Grade 3–4 neutropenia and thrombocytopenia were experienced in 5 and 6 patients respectively. There were no treatment related deaths. One patient showed a disease progression, 2 patients showed PR while 4 remained with stable disease. No response was observed in patients who had failed FLU. In the second cohort 4 patients (M=3: F=1; Median age=61 years) have been treated with the combination of FLU, OX and Ara-C. Three patients presented abdominal bulky disease resistant to the last treatment. Three patients were FLU resistant. Three patients received the entire program while the fourth patient stopped treatment after three courses because of a hepatic toxicity while on partial response. The major toxicity was hematologic and appeared OX-dose dependent. Grade 3/4 neutropenia was experienced by 1/4, 2/4 and 4/4 patients treated at 17.5, 25 and 35 mg/m2 OX levels respectively. Grade 3–4 thrombocytopenia was experienced by 2/4, 3/4 and 4/4 patients treated at 17.5, 25 and 35 mg/m2 OX levels respectively. No treatment related deaths were observed. One patient reached CR, and 3 patients a PR. Considering the three patients with bulky disease, disappearance of the abdominal involvement in one patient and reduction 〉 50% in the other two patients were recorded. The usefulness of OX given as single agent is limited in patients with advanced CLL, at the contrary these preliminary results of the combination OX, FLU and Ara-C appeared very promising. Further accrual of patients to be treated with the combination using OX at 35 mg/m2, days 1–4, is warranted.

Description: The aim of this study is to define the HCV infection in nongastric marginal zone B-cell lymphoma of MALT. We studied 208 patients (pts) diagnosed and treated in Hematology Units joined in a cooperative Italian survey on marginal zone neoplasms. Median age was 64.4 years (126 F, 82 M). In 90% of pts a single mucosal site was involved (skin or subcutaneous tissue 27%, salivary glands 18%, orbit 14%, Waldeyer’s ring 13%, lung 9%, bowel 4%, other sites 6%). The ratio between stage I - II and stage III – IV was 1.2. 48% of pts showed nodal involvement. Among the 84 pts with stage IV disease, 60% were stage IV because of BM involvement, 10% had 〉1 MALT site or a diffuse involvement and 30% had both features. 17% had a small MC (24 IgM, 9 IgG and 3 IgA). An autoimmune background was present in 15 pts. HCV infection was documented in 60 of 172 pts (35%). Most HCV+ pts (97%) showed a single MALT site. The distribution of sites between HCV+ and HCV− cases was statistically significant (p=0.03) with HCV+ pts showing a more frequent involvement of skin or subcutaneous tissue (35%), salivary glands (25%), orbit (15%). BM+ was present in 37%. 42% of pts had nodal disease and 43% showed signs of chronic active hepatitis. HCV-RNA was detected in 22/24 pts (92%). Characteristics associated with to HCV+ were female sex (p=0.004), age 〉60 yrs (p=0.007), no leukemic disease (0.01). NHL localizations leading to Ann Arbor stage IV in HCV+ and HCV− pts were statistically different (p=0.03): 71% of HCV+ pts had a single MALT site with BM+. After first line therapy 73% achieved CR and 17% PR for an ORR of 90%. The ORR was 65% in pts receiving CHT, 76% in pts treated with RT, 90% in those treated with surgery. 30% experienced relapse (46) or progression (16) after a median of 18 mo from response. In 30 cases the relapse/progression occurred at the original disease sites. The median duration of F-U was 2.7 years. The estimated 5-years OS and EFS for all pts were 83 % (95% CI, 76%–90%) and 37% (95% CI, 28%–46%) respectively. At the time of last F-U, 29 pts were dead (9 from NHL). In univariate analysis, poorer OS with: multiple MALT sites (p=0.0003), B symptoms (p=0.003), ECOG ≥2 (p=0.00005), leukemic disease (p=0.006), bulky disease (p=0.0003), abnormal LDH (p=0.0007), stage III–IV (p=0.001), nodal involvement (p=0.0004), no CR/PR (p=0.0009). Orbit and skin localizations were significantly associated with a better OS (p=0.0005). Among pts with stage IV disease, those with no BM involvement had a longer OS (p=0.04). In multivariate analysis, features significantly associated with poorer OS were: BM+ (p=0.004), ECOG≥2 (p=0.007), Hb ≤11 g/dl (p=0.04), presence of a MC (p=0.04). In conclusion, this study demonstrates that nongastric marginal zone lymphoma are characterized by a high prevalence of HCV infection. Pts with involvement of a single MALT site, especially orbit, skin, and salivary glands, are those with the highest prevalence of HCV. Among HCV+ pts, almost half show signs of active chronic hepatitis. HCV-related nongastric lymphomas of MALT seem an ideal target for exploiting the antilymphoma activity of antiviral treatments.

Description: Abstract 923 Introduction: The increased risk of bleeding in myelodysplastic syndromes (MDS) is due to low platelet (PLT) counts and abnormalities of PLT morphology and function. Severe thrombocytopenia occurs in about 10% of low and Int-1 International Prognostic Scoring System (IPSS) risk MDS patients in whom PLT transfusions are indicated mainly in the presence of bleeding. Short therapeutic effect and the development of refractoriness to PLT transfusions motivate research in novel treatments. Eltrombopag is an oral, non peptide, non-competitive agonist of the thrombopoetin-receptor (TPOR) which interacts selectively with the TPOR transmembrane domain to initiate TPO signaling. Eltrombopag is indicated for the treatment of thrombocytopenia in patients with chronic immune (idiopathic) thrombocytopenic purpura. Its potential in increasing PLT count in lower risk MDS has not been evaluated. Study Design and Methods: We present preliminary results of a Phase II, multicentre, prospective, placebo-controlled, single blind study to evaluate the safety and efficacy of eltrombopag in low and intermediate-1 risk adult MDS patients with PLT count 200 Gi/L or adverse events. PLT response is defined as Response (R) if: 1) baseline 〉 20 Gi/L: absence of bleeding and absolute increase in PLT ≥ 30 Gi/L/mm3; 2) baseline 〈 20 Gi/L: PLT

Description: Introduction : The International Prognostic Scoring System (IPSS) better defines the outcome and transformation risk of myelodysplastic syndromes (MDS) than FAB classification. The latter was previously found to identify different patterns of peripheral blood (PB) CD34+ cells in MDS. Whether a correlation exists between PB CD34+ cells and IPSS classification of MDS is undetermined. Patients and Methods : PB CD34+ cells detected at the diagnosis of 29 MDS [according to WHO, 8 refractory anemias (RA), 7 refractory cytopenias with bi-/tri-lineage dysplasia, 5 RA with excess of blasts (RAEB)-I, 5 RAEB-II, 4 mixed MDS/myeloproliferative disorders] were compared with IPSS and its determinants [karyotype class, bone marrow (BM) blasts percentage, number of cytopenias]. Karyotype classes were as follows: good (GK): normal, isolated 5q-, 20q-, -Y; poor (PK): more than 2 anomalies, chromosome 7 abnormalities; intermediate (IK): other. Multiple group comparisons were made using Kruskal-Wallis one way analysis of variance. Continuous and categorical variables were compared by means of the Mann-Witney U test and the Fisher exact test, respectively. Results: According to IPSS, 10 (34.5%) low risk (LR), 10 (34.5%) intermediate risk (IR)-1, 8 (28%) IR-2 and 1 (3%) high risk (HR) patients (pts) were identified, respectively. Nineteen (66%), 6 (21%), and 4 (19%) patients presented GK, IK and PK, respectively. Chromosome 7 and chromosome 17 anomalies were reported in 14% and 10% of patients, respectively. Each 5q- and -Y occurred in 7% of patients. Neutrophil counts less than 1.8 x 10(9)/L, hemoglobin less than 10 g/dL, and platelet counts less than 100 x 10(9)/L were detected in 9 (31%), 19 (66%), and 14 (48%) pts, respectively. Less than 5%, 5 to 10%, and 11 to 20% BM blasts were observed in 18 (62%), 6 (21%) and 5 (17%) patients, respectively. Median PB CD34+ cells were 10.4/mcL (range, 2.7–66.4). Proportion of LR/IR-1 patients with 10 or more CD34+ cells/mcL was significantly lower than that of IR-2/HR pts (35% vs 100%, p=0.001). In the latter, median PB CD34+ cells (25/mcL, range 10–66.4) were significantly higher than those detected in LR (5.6/mcL, range 2.7–10.4) and IR-1 (14/mcL, range 3.1–37.3) patients, respectively (p=0.0003 and =0.045, respectively). Median PB CD34+ cells in the GK group (4.7/mcL, range 2.7–15) were significantly lower than those in the IK (30/mcL, range 4.6–56) and PK (36/mcL, range 13–66.4) groups, respectively (p=0.03 and =0.01, respectively). Similarly, median PB CD34+ cells were significantly lower in patients with less than 5% BM blasts than in patients with 11–20% BM blasts (4.9/mcL vs 25.2/mcL, p=0.036), and in patients with 0–1 cytopenias than in patients with 2–3 cytopenias (6.2/mcL vs 16.8/mcL, P=0.023). Conclusions: By dividing MDS according to IPSS, definite patterns of PB CD34+ cells can be identified. Intermediate and unfavourable karyotype, previously correlated with reduced BM CD34+ cell apoptosis, are also associated with high PB CD34+ cell counts. A prognostic impact of PB CD34+ cell assessment in newly diagnosed MDS is suggested.

Description: Abstract 4945 Background: bone marrow blast count is a crucial parameter to determinate the prognostic score according to IPSS in myelodysplastic syndromes. However even among the major experts the agreement about detection of a blast cells by optical microscopy is less than 90% (Mufti et al: Haematologica 2008). The aim of this study is to evaluate prognostic significance of immunocytometric count of medullar blasts compared to cytological count. Method: in a retrospective analysis of 104 patients with a minimum follow-up of three years, IPSS was calculated replacing cytological count of blasts with the flow cytometry one. Blasts were expressed as percentages of total cellularity, and identified by the combination of CD45/SSC with/without CD33, CD34 and CD117 antigens. The monoclonal antibodies used were CD34 FITC, CD117 PE, CD45 PerCp, CD33 APC. Acquisition of information on 1×105 stained cells corresponding to the whole bone marrow cellularity was assessed on a dual-laser FACSCalibur flow cytometer using the CellQUEST software (Becton Dickinson, San José CA USA). Survival of “low + intermediate-1 risk” (“IPSS1+2”) patients was compared to “intermediate-2 + high risk” ones (“IPSS3+4”) using Kaplan Meier method followed by logrank test. The comparison of ability among all blast count models to distinguish the probability of survival of the two groups (“IPSS 1+2” vs “IPSS3+4”) was based on χ2 value obtained by the logrank test. Results: considering IPSS obtained from any of the immunocytometric markers considered (CD33, CD34, CD117 and CD45dim/SSC), “IPSS1+2” group had always an extremely better survival than “IPSS 3+4” group with a level of statistical significance similar to survival study of “standard IPSS”. Of all markers, CD45dim/SSC was the most capable to distinguish survival of “IPSS1+2” group versus “IPSS3+4” group (χ2 = 42. 5). Among others, CD117 and CD33 had a better discriminating power than cytological count (respectively χ2 = 38, 1 and χ2 = 22, 3 versus χ2 18, 2); only CD34 was worse than cytological count (χ2 =14, 2). Conclusion: the immunocytometric markers considered are demonstrated to be even better than cytological count as parameter in IPSS score. Their use has to be encouraged, especially where there is little experience in optical microscopy. Disclosures: No relevant conflicts of interest to declare.