ALBERT

Description: Abstract 1860 Poster Board I-885 Introduction: Initially developed for the treatment of benign conditions such as osteoporotic crush fractures and vertebral haemangiomas, percutaneous vertebroplasty (PV) has since been shown to provide symptomatic and functional relief in patients with lesions related to neoplastic conditions including multiple myeloma (MM).1,2 The aim of this study is to present the experience of PV for a cohort of patients with MM treated at our tertiary referral centre over a 5 year period between 2004 and 2009. Patients and Methods: The electronic radiology reports for all patients treated with PV in the Imperial Healthcare NHS Trust were studied and those treated for lesions related to MM identified. Their medical records were then reviewed to extract baseline patient and disease characteristics as well as pain score and analgesic regimens pre and post the procedure. Any procedural related complications were also recorded. Following this, where possible, patients were contacted directly by telephone and asked to assess their benefit from the intervention. They were asked to describe their pain score, analgesia use and mobility post procedure and assessed for performance status based on the European Cooperative Oncology Group (ECOG) scale. Where patients reported a benefit they were asked whether that benefit had been sustained. Results: Of 132 procedures performed between 2004 and 2009, 26 patients were treated for painful lesions secondary to MM. Between 1 and 3 vertebral levels were treated, according to assessment of the patient and spinal MRI images by the consultant interventional radiologist at the pre-procedure workup appointment. Sixty-five percent of patients rated their pain as severe and 35% as moderate prior to the procedure. Seventy-seven percent reported a significant improvement with a reduction in their pain score. Seven patients (26%) reported some benefit on waking from the anesthetic, which then improved further over the following days to weeks. The median time of onset of relief post procedure was 3 days with a mean of 8.8 days. Fifty-eight percent of patients were able to reduce their systemic analgesia post procedure: 9 patients stopped all forms of opiate analgesia and the others were able to reduce their doses requirement by 30-75%. Fifty-eight percent of patients reported a significant improvement in their mobility and 5 had an improvement in their formal ECOG score - primarily due to being able to recommence work. Follow up times varied between 20 days and 42 months (mean 19 months) and those that experienced benefit reported that it was sustained for a mean of 13.5 months (range 1.5 – 35 months). The majority of patients whose pain returned had a concurrent progression of their myeloma, however 9 patients who were under ongoing follow up an average of 16 months from their procedure had not experienced any disease progression and reported sustained back pain relief up to the time of the study. Discussion and Conclusions: The results of this study serve to confirm and extend those reported in recent literature. Most studies have involved limited patient numbers (

Description: Abstract 1697 There is increasing evidence for the role of KIR genetics in predicting outcome of haematological malignancies. We recently showed that donor (but not recipient) KIR genes 2DS1, 3DS1 and 2DL5a are associated with significantly less relapse in AML patients following matched sibling allogeneic stem cell transplantation. Interestingly, this effect was not seen in patients with AML secondary to MDS but only in de novo AML.1 To explore whether outcome of non-transplant treatment for AML might be affected by KIR genetics we performed KIR genotyping on the DNA sample archive from the Medical Research Council UK AML 10 and 15 trials. All patients underwent four courses of chemotherapy according to MRC protocols. KIR genotyping was performed using Qiagen SSP PCR KIR genotyping kits as previously described.1 We measured KIR gene frequencies in AML samples obtained at diagnosis from 469 de novo AML, and 38 secondary AML and compared the gene distribution with that of a normal control population of 246 individuals. To allow for multiple comparisons, significance was set at p

Description: Abstract 677 In 2009 the spread of influenza A (H1N1) satisfied the World Health Organization (WHO) criteria for a global pandemic and led to the initiation of a vaccination campaign to ensure protection for the most vulnerable patients. However, the immunogenicity of the 2009 H1N1 vaccine in immunocompromised patients has not been specifically evaluated. Furthermore, the number of doses of vaccine required for effective immunization against H1N1 has not been established. Whereas the European Medicines Agency (EMEA) and the UK Department of Health (DoH) recommended the injection of two doses of inactivated H1N1 vaccine 3 weeks apart in immunocompromised individuals, the Centers for Disease Control and Prevention recommended immunization with one dose of inactivated H1N1 vaccine for patients with cancer receiving chemotherapy, followed by a booster vaccine after completion of treatment if the pandemic continued. The aim of this study was to determine the safety and efficacy of the 2009 H1N1 vaccine in patients with hematologic malignancies. We prospectively evaluated the humoral and cellular immune responses to monovalent influenza A/California/2009(H1N1)v-like strain surface antigen vaccine in 97 adults with hematologic malignancies and 25 adult controls. Patients received two intramuscular injections of the vaccine 21 days apart and controls received one dose. Antibody titers, expressed as geometric mean, were measured using a hemagglutination-inhibition assay on days 0, 21 and 49 after injection of the first dose. The induction of virus-specific T-cell responses by H1N1 vaccination was assessed directly ex-vivo by flow cytometric enumeration of antigen-specific CD8+ and CD4+ T-lymphocytes using an intracellular cytokine assay for IFN-γ and TNF-α production on days 0 and 49. Of the 97 patients, 32 had chronic myeloid leukemia (CML) in chronic phase in complete cytogenetic response on the tyrosine kinase inhibitors imatinib or dasatinib, 39 had a B-cell malignancy in complete remission (CR) or untreated, and 26 were recipients of allogeneic hematopoietic stem cell transplantation (allo-SCT) in CR at least 6 months beyond transplant and without evidence of graft versus host disease. The vaccine was well tolerated, with no obvious difference in side effects for patients and controls. By day 21 post-vaccination, protective antibody titers of 1:32 or more were seen in 100% of controls compared to 39% of patients with B-cell malignancies (p