ALBERT

Description: Introduction: Acute Myeloblastic Leukemia (AML) is the most frequent acute leukemia in the adults and its incidence increases with age. There are few studies about the demography and outcomes of AML patients in Chile and the only report belongs to a public hospital from 2000. We discuss the results of patients treated in our institution with AML non promyelocytic. Patients and Methods: Retrospective analysis of the epidemiologic, clinical and laboratory characteristics of diagnosis (cytology and flow cytometry) and treatment of AML non promyelocytic patients between 2010-2014. Statistical analysis of the data was performed using SPSS Statistics v21 software. Results: 63 patients were diagnosed with AML non M3, 52 males (66%), with a median age of 55.4 years (range: 16 - 89). Diagnosis laboratory tests (mean values and ranges) were: WBC 45.989/mm3 (range: 700 - 405.000); hemoglobin 9,1 g/dl (range: 5,2 - 14,1); platelets 75.548/mm3 (range: 10.000 - 454.000); peripheral blood blasts 38% (range 0 - 100); bone marrow blasts 74% (range 25 - 100%). The cytogenetic risk groups were: favorable (n=5, 8%), intermediate (n=33, 52%), adverse (n=8, 13%) and unknown (n=17, 27%). Of all the patients, 75% (n=47) received induction chemotherapy (CT) and 25% (n=16) palliative care. The mean age of the group with cytogenetic analysis was 51.2 years and only 8.6% did not receive consolidation CT. On the other hand, the group of patients with unknown cytogenetics had a mean age of 68 years and 57% did not receive consolidation CT. The mean survival of the CT group was 27.3 month (range: 0 - 53). By contrast, the mean survival in the palliative care group was 1 month (range: 0 - 6). The mean follow up in all patients was 13 months, (range: 1 - 55) and 17 months (range: 1 - 54) in the group that received CT. 87% (n=41) of patients with CT had febrile neutropenia with respiratory and intestinal focus most commonly identified. The induction mortality was 4,2% (n=2). Complete cytologic remission was achieved in 70% (n=33). The 3-year relapse free survival (RFS) and overall survival (OS) in the CT group were 25% and 31%, respectively. The multivariate survival analysis using Cox’s regression demonstrated that the variables that had significant impact in RFS and OS were: age at diagnosis (

Description: Introduction: Patients undergoing hematopoietic cell transplantation (HCT) have an increased risk of Clostridium difficile infection (CD) and multiple risk factors have been found. Literature reports CD infection in nearly 20% of transplanted patients. No information about this infection in HCT patients has been reported in Chile. Patients and Methods: We performed a retrospective analysis of 250 patients undergoing HCT at the Catholic University Hospital in Santiago, Chile, between 2000 and the first semester of 2013, including allogeneic (allo) HCT and autologous (auto) HCT patients. Statistical analysis of the data was conducted using SPSS Statistics v21. Results: Of the 250 transplanted patients studied, 59% (n=147) were allo-HCT and 41% (n=103) were auto-HCT. The mean age was 39 years old (range: 15-69), with a male predominance (151 patients; 60%). The main indication for HCT was acute leukemia (n=104; 42%) followed by multiple myeloma (n=36; 14%) and lymphoma (n=49; 20%). 93% of patients received myeloablative (MA) conditioning regimen, and all of them received proton pump inhibitors and prophylactic antibiotics during the previous months of the HCT. Of the 250 patients studied, 192 (77%) had at least one episode of diarrhea that required study, among them 13% (n=25) were documented as positive for CD (toxin assay or PCR test), the mean age of this group was 36 years old (range: 18-62), also with a male predominance (15 patients; 60%). All of the infected patients had mild to moderate diseases and there were no deaths attributed to it. 80% (n=20) of the infected patients underwent allo-HCT and 20% (n=5) auto-HCT. In the allo-HCT group, 53% had acute lymphoblastic leukemia (ALL), 6% acute myeloid leukemia (AML), 24% chronic myeloid leukemia (CML) and 12% other causes. In the auto-HCT group, 40% were transplanted due to multiple myeloma, 20% amyloidosis, 20% germinal cancer and 20% acute myeloid leukemia. No patient required total central parenteral nutrition previous to the infection. During the 3 months before HCT, 84% (n=21) of the infected patients used antibiotics including cephalosporins, carbapenem, aminoglicosides and vamcomycin. The overall incidence of CD infection in the first week, month and year after transplant, was 4.0%, 6.4% and 10%, respectively, with a median time frame from transplantation to infection diagnosis of 20 days. In auto-HCT, 7 days, 30 days and 1 year CD incidence was 1.9, 2.9 and 4.9%, respectively. In allo-HCT, 7 days, 30 days and 1 year CD incidence was 5.4, 8.8 and 13.6%, respectively. There was no significant statistical difference in overall survival (OS) between the infected and non-infected patients one year after the transplant (OS 67.6% for CD negative vs. 72.0% for CD positive, p=0.61). Conclusions: In our institution CD infection in patients undergoing HCT had a similar incidence to other reports. Most of cases occur before the first week after HCT (40% of the cases), and the incidence of the infection remained stable during the first year after the procedure. We identified the type of transplant (allo-HCT 3 times higher risk than auto-HCT) and disease (ALL 3 times higher risk than AML) as risk factors for CD infection. Disclosures No relevant conflicts of interest to declare.

Description: INTRODUCTION: Nutritional support is pivotal in patients with hematologic malignancies and hematopoietic cell transplantation (HCT). Optimal nutritional status is associated with a shorter time of engraftment and less infection rates during the initial phase. We present our experience in nutritional assessment pre and post transplantation. OBJECTIVE: To evaluate the possible association between nutritional parameters and outcomes such as overall survival and specific complications, in patients who underwent HCT. PATIENTS AND METHODS: Retrospective study in patients with HCT between June 2011 and May 2014 in our center. We assessed nutritional status before transplantation and then 10 days after it. Nutritional assessment included anthropometry, body mass index (BMI), albumin, prealbumin and total urinary nitrogen (TUN). Statistical analysis was made using IBP SSPS v.20. RESULTS: We studied a total of 50 patients between June 2011 and May 2014. Media following time: 35 months. Median age was 41 years (18-67), 33 (66%) were male and 17 (33%) female. Thirty two underwent (64%) allogeneic HCT and 18 (36%) autologous HSCT, with 42 undergoing (84%) myeloablative conditioning and 8 (16%) reduced intensity conditioning. Diagnoses included acute leukemia (26), lymphoma (7), multiple myeloma (13), and aplastic anemia (3). Thirty seven patients developed mucositis and 31 required parenteral nutrition (PN). Twenty three patients developed mucositis and required PN (mild: 2, moderate: 20, severe: 1) Incidence of mucositis between allogeneic and autologous HCT that required PN was similar (75% vs 72%). Albumin levels were 4,1mg/dL before and 3,3 mg/dL 10 days after HSCT (p〈 0,05). No difference was found between BMI, dynamometry and TUN before and after HCT. TUN before HCT was associated with more days of PN (p