ALBERT

Description: Introduction. AML standard intensive induction chemotherapy ("3+7" or equivalent) combined with wide spectrum antibiotics can dramatically alter the composition of the gut microbiota, leading to dysbiosis which is characterized by loss of microbial diversity. Such dysbiosis status can promote a pathological condition involving uncontrolled local immune responses, systemic inflammation and increased incidence of adverse events. The development of FMT-based drugs to restore microbial communities could offer novel therapeutic possibilities to reduce such adverse events and potentially improve outcomes in AML. We therefore conducted this single arm prospective phase I/II multicenter trial (NCT02928523) to evaluate the use of a FMT-based drug in association with AML induction treatment to restore the gut microbiota diversity. Patients and methods. A total of 62 consecutive patients aged between 24 and 69 years old with a diagnosis of de novo AML were screened in 7 French sites. At time of admission and AML diagnosis (Step 1=S1), patients' faeces were collected, rigorously screened, prepared following a standardized process, and stored at -80°C until later administration. The drug was administered as an enema after hematopoietic recovery (S2) and before consolidation chemotherapy (Conso). The primary endpoint was the recovery of at least 70% of microbiota diversity (based on the Simpson index) after drug administration and the reduction of multidrug resistant bacteria carriage. Blood and feces samples were collected at S1, S2, and around 10 days post-FMT before Conso (S3). Microbiome diversity restoration was assessed by metagenomics analysis through Illumina HiSeq shotgun sequencing. Antibiotic resistance gene carriage (ARGC, also known as resistome) was evaluated through mapping of readouts on the MEGARES database. Secondary objectives included safety and analysis of host response with assessment of blood and fecal markers by ELISA and Luminex. Results. Overall, 25 patients were actually treated with FMT, and 20 were included in the per-protocol population. Induction Chemotherapy (IC) induced a dramatic shift in microbial communities, with a significant 42.3% decrease of mean α-diversity Simpson index between S1 and S2 at species level (0.85 to 0.50; p

Description: Multiple myeloma remains one of the best indication for intensive chemotherapy followed by autologous hematopoietic stem cell transplantation (autoT). Intensive therapy followed by autologous transplantation is superior to conventional chemotherapy and it was demonstrated that two autoT were superior to one except for patients in very good partial response or in complete response after the first autotransplant. Peripheral blood stem cells (PBSC) can be used as well as bone marrow as HSC source with the same efficacy but very few data have been reported regarding PBSC recruitment. The main goal of our work was to study the impact on overall and event-free survival (OS and EFS) of PBSC recruitment using either growth factors (GF) alone (steady state) or chemotherapy followed by GF. Secondly, we performed a multivariate analysis studying influence on OS and EFS of sex, age, lines of therapy, pretransplant status, TBI, PBSC recruitment and number of autoT. We have analyzed 193 PBSC autoT (1 autoT=160, 2 autoT=33) performed for 160 MM patients [81 males and 71 females, mean age: 55 years (39–71)]. At diagnosis, 88 patients presented a MM Ig G (70k and 18l), 28 Ig A (16k and 12l), 3 Ig D (1k and 2l), 21 light chains k and 13 light chains l, 3 non secreting and 4 with plasmocyte leukemias. According to Durie and Salmon classification 75% of patients were in stage III, 15% in stage II and 10% in progressive I. Before transplantation, patients have received 1 line of poly-chemotherapy (n=141), 2 lines (n=15) or 3 lines (n=4) and 154 were evaluated for the response with 11 complete remission, 113 partial remission and 30 stable or evolutive disease just before transplant. As HSC (n=189), patients received PBSC which were recruited by GF alone (n=105) or cyclophosphamide+GF (n= 84). Conditioning (n=189),consisted in melphalan and TBI (n=51), melphalan alone (n=132), melphalan associated to cyclophosphamide or busulfan (n=6). We divided the population into 4 groups : group 1 who received one autoT of PBSC recruited by GF (n=76), group 2 one autoT of PBSC recruited by chemotherapy+GF (n=50), group 3 two autoT of PBSC recruited by GF (n=16) and group 4 two autoT of PBSC recruited by chemotherapy+GF (n=17). The median follow-up (FU) of the 4 groups were different with shorter FU (group 3: 9.9 months, group 4: 13 months) for patients who received tandem autoT because of the recent character of this strategy as compared to a long term follow-up for patients who received only one transplant (group 1: 35months, group 2: 55.3 months). Probabilities of OS and EFS at 2 years were 76% (95%CI 67–87) and 60% (95%CI 49.5–73) for group 1, 77% (95%CI 65–90.5) and 70% (95%CI 57.5–85) for group 2, 87.5% (95%CI 73–100) and 72.9% (95%CI 49–100) for group 3, 100% and 66.7% (95%CI 36–100) for group 4. The difference was not significant because of follow-up differences between the 4 groups and small number of patients in groups 3 and 4. In addition, multivariate analysis did not show any significant influence of the different studied parameters on OS and EFS. Nevertheless, because of these interesting preliminary results, a longer follow-up is warranted for definitive conclusions.

Description: Introduction: Median age of Chronic Lymphocytic Leukemia (CLL) patients is 72 years with 40% older than 75 and 22.8% over 80 years. Important therapeutic progresses have been made, including chemo-immunotherapy as well as the recent use of targeted therapies, leading to progression-free-survival (PFS) and overall survival (OS) improvements. Although the elderly represents the largest subgroup of CLL patients, they are underrepresented in clinical studies and little is known about their clinical characteristics, treatment and outcome. Consequently, results from trials cannot be directly translated into clinical practice for these patients. Bairey et al (Ann Hematol, 2011) reported a series of 214 patients (80 years or older) diagnosed in Israel between 1979 and 2009 with a mean age of 84. However, in this cohort, 56% of the patients had a Rai stage 0 and only 53 received treatment. Median survival was 56 months. Methods: We performed a retrospective study of CLL patients aged 80 or more at initiation of first line therapy. Patients were treated between 2003 and 2013, in 17 hospitals affiliated to the French Innovative Leukemia Organisation (FILO). We report here a cohort of 201 such CLL patients, and describe their clinical and biological characteristics, treatment options and outcome. Results: Patients' median age was 83.4 years (80-92), 29% were older than 85 years, and the sex ratio was 60% male/40% female. Performance status (97%≤ 2) and nutritional status (median Corporal Mass Index of 25.3 kg/m²) were preserved. The median Cumulative Index Rating Scale (CIRS) comorbidity score was 5. More precisely in term of fitness, 57.8% patients were characterized as "go-go" with a CIRS ≤ 6 and organ comorbidities 3, and CD38 was positive in 43,4% of the 129 cases tested (64%). Cytogenetic data were available for 42% of the patients. Isolated abnormalities were deletion 13q (38.1%), trisomy 12 (21.4%), deletion 17q (10.7%) or deletion 11q (7.1%). Besides, associated chromosomic abnormalities were detected, mainly by fluorescence in situ hybridization (FISH) and complex karyotypes (1.2%). At treatment initiation, Binet stage was either A (27.2%), B (28.7%) or C (41.5%). Therapies consisted mainly in Chlorambucil (65.5%), Bendamustine (10.5%) and Rituximab (44.3%). Indeed, therapy regimens were composed of Chlorambucil alone (45.3%) or chemo-immunotherapy (48.3%) including Rituximab+Chlorambucil (22.7%), Rituximab+Bendamustine (10.4%), Rituximab+Cyclophosphamide+Dexamethasone (5.5%) or Rituximab+Fludarabine+Cyclophosphamide (5.5%). In term of tolerance, 20.2% of the patients required hospitalization and 10% of these cases were febrile neutropenia. Finally, 31.8% required a dose reduction of chemotherapy. The Overall Response Rate was 65.9% with 31.4% of clinical complete remission. The median OS and PFS (from treatment initiation) were 48.6 and 18 months, respectively (cf. Survival curves). Afterwards, an important number of patients (41.3%) remained fit enough to receive a second line treatment. In univariate analysis, only comorbidities evaluated by the CIRS had a significant impact on survival (p=0.03). Indeed patients identified as fit by a CIRS score ≤ 6 and no organ comorbidity 〉 3 had a better outcome. Conclusion: We report a large series of elderly CLL patients, who received first line treatment at a median age of 83. Median OS was about 4 years, which is less than normal population of the same age. Our results suggest that treatment (including immunochemotherapy) is feasible, even in this very old population. Different bias are possible in this retrospective study including the selection of only fit patients, the low percentage of geriatric evaluation, and the possible undertreatment of this population since chlorambucil was the most frequent treatment. In the future, prospective trials should target this population. Oncogeriatric evaluation and new targeted therapies should be part of such future trials. Figure 1. Survival curve 1: Overall Survival Figure 1. Survival curve 1: Overall Survival Figure 2. Survival curve 2: Progression Free Survival Figure 2. Survival curve 2: Progression Free Survival Disclosures Dupuis: ROCHE: Speakers Bureau; ABBVIE: Membership on an entity's Board of Directors or advisory committees. Aurran-Schleinitz:CSLBehring: Honoraria; Janssen: Honoraria. Cymbalista:Karyopharm: Honoraria; Gilead: Honoraria; Roche: Honoraria; Janssen: Honoraria, Research Funding. Dilhuydy:Roche: Honoraria, Other: Travel reimbursement; Janssen: Honoraria, Other: Travel reimbursement; Mundipharma: Honoraria. Cazin:GILEAD,: Honoraria; ROCHE: Consultancy; MUNDIPHARMA: Honoraria, Research Funding; NOVARTIS: Honoraria. Leblond:Roche: Consultancy, Honoraria, Other: Travel, Accommodations, Expenses, Speakers Bureau; GSK: Consultancy, Honoraria, Speakers Bureau; Mundipharma: Honoraria; Gilead: Consultancy, Honoraria, Speakers Bureau; Janssen: Consultancy, Honoraria, Speakers Bureau. Cartron:Sanofi: Honoraria; Gilead: Honoraria; Celgene: Honoraria; GSK: Honoraria; Roche: Consultancy, Honoraria.

Description: Abstract 1594 Background: Follicular Lymphoma (FL) is the most frequent low-grade NHL. Clinical course is heterogeneous, some patients (pts) presenting an indolent clinical course with overall survival (OS) over 15 y and others developing a more aggressive disease with shorter survival. The Follicular Lymphoma International Prognostic Index (FLIPI) or FLIPI-2 are commonly used to predict pts outcome, but fail to identify pts with a really poor prognosis. At diagnosis, few FL pts present with detectable leukemic phase (FL-LP) and this characteristic has been seldom described. Aim: The aim of the study was to describe the clinical features and outcome of FL-LP pts. Results: Among 499 pts diagnosed with FL according to the WHO criteria in the Centre Hospitalier Lyon Sud (transformation and grade 3b excluded) and treated between 01/1992 and 01/2012, 37 (7.4%) had characteristic FL-LP detected by cytological blood smears analysis with confirmation by flow cytometry (kappa/lambda clonality). Median age was 58 y and FLIPI score repartition was 4 pts in low, 16 in intermediate, and 17 in high risk groups. Splenomegaly was present in 23 pts, high tumour burden (GELF criteria) in 11, B symptoms in 8, and ECOG PS〉1 in 3. Seven pts had anaemia, 17 platelets UNL, and 11 LDH 〉UNL. The circulating lymphoma cells expressed the CD10 in 29/37 cases and surface Ig expression was detected in 31/35 cases, mainly IgM or IgG isotype. The median count of circulating lymphoma cells was 1.95.109/L, ranging from 0.6 to 129.109/L, 15 pts having count 〉4.109/L and 6 pts 〉10.109/L. Cytogenetic data were available for 21 pts, 20 carried the t(14;18), or its variant t(18;22), 16 of them having complex karyotype. Two pts were on watchful waiting for 24 and 82 m and 35 received a chemotherapy regimen at diagnosis including rituximab in 27 cases. Overall response rate was 83% (29/35) with 23 CR/CRu. Median progression-free survival (PFS) was 29 m. PFS and OS estimates were 37% and 86% at 5 y and 31% and 68% at 10 y, respectively. Splenomegaly (P=.035), high tumour burden (P=.017), lymphoma cells count greater than 4.109/L (P=.028), β2-m〉UNL (P=.036), and thrombocytopenia (4.109/L (HR 5.92; P=.000916) as independent prognostic factors. After progression, 12 pts received high-dose therapy (HDT) with HSCT as salvage with a long second PFS (68% at 10 y) compared to 8.3 m median PFS in first line. Pts not receiving HDT at salvage had a median second PFS of 27 m. To further evaluate the impact of FL-LP on pts outcome, a 1:3 matched analysis was performed. The FL-LP 37 pts were successfully matched with 111 newly diagnosed FL without FL-LP according to FLIPI score, age, treatment type (abstention vs chemotherapy, with or without rituximab) and treatment period (before or after 2000). In these 111 matched pts, 5- and 10-y OS was 97% and 91%, respectively. Considering all 148 pts, high FLIPI score, presence of FL-LP, and β2-m〉UNL were all significantly associated with a worse PFS. In a Cox regression model for PFS (120/148 pts with complete data), high FLIPI score (P=.0034; HR=2) and presence of FL-LP (P=.0085; HR=2.2) remained independently associated with shorter PFS. High FLIPI score and presence of FL-LP were also associated with a shorter OS. Interestingly pts with less than 4.109/L of circulating lymphoma cells had a similar PFS than those without. When circulating lymphoma cells 〉4.109/L as variable (see abstract figure) instead of FL-LP were tested in the Cox regression model for PFS including β2-m〉UNL and FLIPI score as variables, the most significant predictor for a shorter PFS was circulating lymphoma cells 〉4.109/L (P=.0004; HR=3.56) as compared to FLIPI score (P=.051; HR=1.6) and β2-m (P=.09; HR=1.52). Conclusion: The presence of circulating lymphoma cells in FL is a rare event and is associated with shorter PFS independently of FLIPI score and β2-m level. A validation of these findings on pts from the PRIMA study is on progress. However, this population is not homogenous and pts with circulating lymphoma cells 〉4.109/L have a poorer outcome. Although ∼1/3 of the pts experience long term PFS, these pts should be monitored carefully during and after first line treatment to consider HSCT as a therapeutic option to achieve a sustained response. Disclosures: No relevant conflicts of interest to declare.

Description: Abstract 2722 Introduction Follicular lymphoma (FL) is the commonest type of indolent lymphomas and is considered as an incurable malignancy with a relapsing and remitting course. Most patients are diagnosed with FL when they have an advanced stage of disease, only less than 20% presenting with stage I or II. Initial management of early stage (Ann Arbor stage I or II) FL remains undefined. Numerous options exist but radiotherapy appeared to be the standard of care for early stage disease based on single institution or retrospective series. Our aim was to revisit the outcome of patients with localized FL in the era of rituximab. Patients and Methods We analyzed 145 patients treated in our institution with early stage (I or II) FL between January 01/1967 and 01/2011. Patients were retrospectively divided into six groups according to their initial treatment: watch and wait (WW), chemotherapy alone (CT), radiotherapy alone (RT), combination of radiotherapy and chemotherapy (RT-CT), Rituximab alone (Ri) and immuno-chemotherapy (Ri-CT). Results Of the 145 patients (79 females and 66 males), 84 (57.9%) patients had stage I disease and 61 (42.1%) a stage II. Median age was 55 years (20% of patients 〉 65 years). Only 22 (15.2%) of them had a bulky disease (〉 7cm). FLIPI score was 0–1 in 116 pts, 2 in 29 pts and none had a score 〉2. The management of patients significantly varied over the different time (period I: 2000 was better (75%) than for those managed

Description: Abstract 1796 Introduction: FCR chemoimmunotherapy is recommended as first line therapy for fit cll patients. Since the 2007 EBMT guidelines based on the previously published trials using FCR, the definition of high risk CLL has evolved, to include biologic parameters (TP53 disruption by deletion/mutation, high b2-microglobulin level, IgVH unmutated, complex karyotype), refractoriness (progression during fluda-based regimen or within 6mo of completion), and also remission duration (high risk if PFS after FCR 5cm 26%, complex karyotype 44% (n=24/54 with karyotype available). According to FCR remission duration, 11.1% of patients were considered as truly FCR-refractory, 47% had PFS

Description: Blastic plasmacytoid dendritic cell neoplasm is a rare and aggressive neoplasm for which there is still no current consensus on the best therapeutic approach. Most patients respond to intensive chemotherapy, but relapses are almost inevitable with median overall survival (OS) in the largest patient series ranging from 8 to 12 months except for patients who could benefit from allogenic hematopoietic stem cell transplantation (allo-HSCT). We present results of the first line treatments used in France between 2000 and 2013 for 86 patients recruited in the French network of BPDCN (abstract ASH 2015 N°78460). Seventeen patients were treated with acute lymphoid leukemia (ALL)-like therapy (median age : 63 yo) , 19 with acute myeloid leukemia (AML)-like therapy (median age : 40 yo), 16 patients with CHOP-like therapy (median age : 72 yo), 16 patients with NK/T-like therapy (based on high-dose methotrexate and L-asparaginase, ± dexamethasone, median age: 59 yo), and 12 patients received "other treatments" (OT, means variable drugs, median age : 82 yo). Thirty four patients obtained a complete remission (CR) and received HSCT (autologous n=4, or allogeneic n=30). The response rates for CHOP-like and OT groups were 31.3% and 25.0% respectively. For ALL-like, AML-like, and NK/T-like groups, response rates reached 70.6%, 78.9%, and 62.5% respectively (no statistic difference). Relapse rates among responders for CHOP-like and OT groups were 60% and 33.3% whereas there were only 25%, 26.7%, and 20% in ALL-like, AML-like, and NK/T-like groups respectively. For patients who obtained remission, the median of remission duration was 8.0 and 14.0 months for patients who received CHOP-like treatments (n=5) and OT (n=3) respectively and 10.0, 10.0, and 9.0 months for ALL-like (n=11), AML-like (n=14), and NK/T-like groups (n=9) respectively (p = 0.6339). In preclinical studies, we have shown that BPDCN cells are sensitive in vitro to idarubicine (Angelot Delettre F et al, 2015) so we studied patients receiving idarubicine in first line therapy in our series (n=9). From these 9 patients, 7 obtained CR and only one relapsed after 10 months. The 6 patients in continuous CR without any relapse have received HSCT (allo, n=5 or auto, n=1). Two out of those 6 patients are alive at the time of data collection with a follow-up of 40 and 87 months; the other 4 patients died after the graft, one relapsed after auto-HSCT, and 3 died of infectious complications after allo-HSCT. The median OS for patients who received HSCT, auto or allo (n=34) and other patients (n = 52) is respectively 49 and 8 months (p 〈 0.0001, Figure 1). The beneficial effect of HSCT persists independently of age in multivariate analysis. These results suggest that NK/T-like, AML-like, and ALL-like groups give better results than CHOP-like and OT groups. However, there is no significant statistical difference between AML-like, ALL-like, and NK/T-like groups. Thus it seems to be wise to combine "lymphoid" drugs like methotrexate, L-asparaginase and dexamethasone with "myeloid" drug such as idarubicine. The importance of allogenic stem cell transplantation to sustain remission is clear in this study and other one (Roos-Weil et al, 2013). We also observed a prolonged CR in one patient after auto-HSCT. Based on our results, we will propose the first prospective, multicentric, phase II trial in BPDCN, testing a combination of 3 cycles of methotrexate, L-asparaginase, idarubicine and dexamethasone followed by an allo-HSCT in first clinical remission for all eligible patients or repeated cycle of these drugs for unfit patients with auto-HSCT if possible. Kaplan-Meier overall survival curves compared by the Log-Rank test in the cohort of 34 HSCT patients (auto and allo, blue line) and 52 non HSCT patients (red line) (p

Description: Acute myeloid leukemia (AML) is a heterogenous group of diseases characterized by a clonal proliferation of myeloid progenitors. Its poor prognosis with conventional chemotherapy justifies seeking for adjuvant immunotherapeutic approaches to eliminate minimal residual disease. We evaluated an immunotherapeutic strategy that bypass the need for epitope identification and the limitation due to HLA restriction. Naturally processed peptides were extracted by acid elution from AML cells at diagnosis, and loaded on mature dendritic cells (mDCs) derived from autologous monocytes obtained when the patients were in complete remission (CR). We evaluated i) the feasibility to elute naturally processed peptides from AML cells at diagnosis, ii) the capacity of mDCs loaded with eluted peptides (mDC/EP) to stimulate specific T cell lines in vitro. We showed that stimulation by mDC/EP was able to generate anti-leukemic T cells lines from PBMC of 6 AML patients in CR. CD4+ and CD8+ T cells were isolated from T cell lines of 5 patients and analyzed for their proliferation, INF-γ production and cytotoxicity in response to autologous or allogeneic AML targets, or to normal autologous PBMC. We showed that both CD4+ and CD8+ leukemia-specific T cells were generated in vitro by mDC/EP stimulations since proliferation of CD4+ T cells, IFN-γ secretion by CD4+ and CD8+ T cells and cytotoxicity mediated by CD8+ T cells were induced in response to stimulation with autologous AML cells. Furthermore, we could not detect auto-immune recognition of autologous normal PBMC, consistent with the specificity of the T cell response induced by mDC/EP. These results provide the proof of concept for using mDC/EP to vaccinate patients with poor-risk AML, and will soon be evaluated in a phse I/II clinical trial.

Description: Background: Rituximab has demonstrated significant clinical efficacy in the treatment of NHL, particularly in combination with chemotherapy, and its use has dramatically changed the treatment and outcome of both indolent and aggressive B-cell NHL over the past decade. Furthermore, consistent toxicity data have been obtained with a safe and tolerable profile in a large majority of patients. Aim: The objective of this retrospective study is to evaluate the long-term efficacy of rituximab monotherapy (4 weekly infusion at induction followed by 4 infusion every 2 months as consolidation) used for patients with relapsed indolent NHL. Results: From May 1998 through January 2011, Among 919 patients with indolent NHL treated in our department, 488 (53%) relapsed and were treated with rituximab alone (first and later relapse). 126 (26%) responded and were still in response 2 years later. These 126 patients (68 (54%) males and 58 (46%) females with a median age of 61 y; range: 17-94) are the subject of our analysis. 24% were over 70 years old, 45% were in first relapsed and 25% in later relapsed. Only 16% of the population have more than one co-morbidities (cardiac and or renal respectively); 79% a normal PS (0-1) with only 4 patients having a PS 〉2; 80% no bulky disease but 72% a disseminated disease (73% stage III and IV). In this study, 60 (48%) patients had a follicular lymphoma with 50% at an intermediate risk group according to the FLIPI score ; 20 (16%) a marginal zone lymphoma, and 43 (34%) a small lymphocytic or lymphoplasmacytic lymphoma and 3 patients other characteristics of lymphoproliferative disorders. After rituximab monotherapy, 55% of the entire cohort was in complete response (CR) and 31% in CRu or partial response and 5% in stable disease. Among these 126 patients, 74% progressed later than 3 years (38% later than 5 years). With a median follow-up of 6.5 years, 4-year and 8-year PFS were 70% and 30%, respectively. 18% had transformation into Richter syndrome and 12 patients have died. Conclusion: Rituximab monotherapy is an effective therapy in selected relapsed indolent NHL and allows long-term response. This strategy could be used as “spare of chemotherapy” which is an important question today, especially in indolent not curable disease. Disclosures No relevant conflicts of interest to declare.

Description: Introduction: Idelalisib (IDELA), the first PI3K delta inhibitor, is indicated in Europe in combination with rituximab (R) or ofatumumab for the treatment of adult patients (pts) with CLL and as monotherapy for the treatment of adult pts with refractory FL. IDELA provides an important therapeutic option for the management of CLL and FL, but there are few real word data on its effectiveness and safety. The objective of this study was to describe the management of IDELA therapy in a real word setting in France for patients with CLL or FL. Methods: This multi-center retrospective clinical practice survey started in February, 2017 and ended in July, 2017. During this period, 52 physicians agreed to complete a questionnaire collecting data for each pt they have treated with IDELA according to the marketing authorization label: demographic, clinical and biological pt characteristics at the time of IDELA initiation; pt follow-up modalities including nurse and pharmacist consultations; conditions of IDELA use; duration of treatment; reasons for discontinuation; and treatment administered before and after IDELA discontinuation. Analyses were conducted separately in CLL and FL groups and data are presented descriptively. Results: The 52 participating physicians were geographically well distributed and were mostly located at regional hospitals (44%) or university hospitals (38%). Data on 529 pts were collected, including 384 CLL pts (20.1% 1L, 33.9% 2L, 46% 3L+) and 145 FL pts (60.7% 3L, 26.9% 4L, 12.4% 5L+), of whom 61% and 63% respectively were still on treatment at the time of the survey. For CLL/FL respectively, median age was 69 y/68 y, 27.6%/24.8% were aged 〉 75 y, 76.7%/72.0% were ECOG 0-1, median number of comorbidities was 1.0 for both CLL and FL with hypertension as the most common and median prior therapies was 2 in both groups. For CLL pts, 65.1% had disease stage Binet C and most had poor prognostic markers (14.6% del(11q), 44.0% del(17p) and 19.7% TP53 mutation). IDELA was initiated, at 150 mg BID in 90.6%/93.8% of CLL/FL pts respectively. Median duration of treatment was 24.0 months for overall CLL and not reached in del(17p)/TP53m sub-group and in FL group. Independent predictors of longer treatment duration were ECOG ≤ 1, prophylaxis against Pneumocystis jirovecii Pneumonia (PJP) or cytomegalovirus (CMV) infections and consultation with a nurse at initiation of treatment in the CLL group and ECOG score ≤ 1 in the FL group (Table 1, 2). Most of CLL/FL pts respectively had a nurse consultation at the start of IDELA (68.0%/56.6%) and prophylaxis for PJP or CMV (93.0%/77.0%). Sixty nine percent of pts in each group were tested for CMV before starting IDELA. In CLL/FL groups respectively, 61 pts (15.9%)/22 pts (15.2%) had at least one IDELA dose interruption. Diarrhea was the main reason for interruption (G1-2: 28%/11%, G3-4: 21%/21%) followed by neutropenia (30%/18%), pneumonia (11%/25%, non-infectious: 1%/7%) and ALT/AST elevation (6%/14%). IDELA was permanently discontinued in 152 CLL pts/54 FL pts respectively, mainly for disease progression (34%/41%), diarrhea G3-4 (16%/6%), diarrhea G1-2 (4%/2%), remission or good response (9%/19%), pneumonia (9%/13%, non-infectious: 3%/7%), neutropenia and ALT/AST elevation (5%/2% each). Of 151 CLL pts/54 FL pts who permanently discontinued IDELA, 83 (55%)/34 (63%) received subsequent treatment, mainly ibrutinib monotherapy (70%) in the CLL group and chemotherapy combined with anti-CD20 (63%) in the FL group. Conclusion: This large clinical practice survey provides useful information about the management of IDELA treatment across France and permits factors predictive of treatment duration to be identified. Most FL pts had advanced disease and most CLL pts had genetic markers of poor prognosis. Safety was in accordance with the known safety profile of IDELA. PJP prophylaxis contributed to longer duration of treatment in CLL and should be prescribed to all pts receiving IDELA. Consultation with a nurse before and during treatment helps manage CLL and FL pts treated with IDELA and can prolong duration of treatment. Disclosures Feugier: Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Gilead: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. Nunes:Gilead Sciences: Employment. Abdelhadi:Gilead Sciences: Employment. Ysebaert:Roche: Consultancy, Research Funding; Gilead Sciences, Inc.: Consultancy, Research Funding; Janssen: Consultancy, Research Funding.