627. Aggressive Lymphoma (Diffuse Large B-Cell & Other Aggressive B-Cell NHL)- Retrospective/Observational Outcomes in HTLV-1 ATLL, Gray Zone & Primary CNS Lymphoma & Intravascular DLBCL


Epidemiology, Clinical Features, and Outcome of HTLV-1 Related Adult T-Cell Leukemia-Lymphoma in a Prevalent Area in the United States

Luis E Malpica Castillo, et al.

The authors of the study conclude:

ATLL continues to have a poor outcome despite conventional therapies thus urging the development of novel approaches. Our study found higher rates of hypercalcemia and elevated LDH in A type as compared to those previously reported in Japanese pts, which suggests the Afro-Caribbean ATLL variant may present more aggressively. AZT-IFN was highly associated with a superior outcome in pts with aggressive ATLL who achieved CR with this regimen over chemotherapy alone. Altogether, our clinical experience suggests AZT-IFN is a reasonable first line option for aggressive leukemic ATLL types, and may be the best treatment option for UC type. Chemotherapy remains the preferred choice for L type ATLL, and A type when AZT-IFN is not be feasible, with consideration of allo-HSCT upfront.



Targeting CD30 Expression in Adult T-Cell Leukemia-Lymphoma (ATLL)

Luis E Malpica Castillo, et al.

The authors of the study conclude:

CD30 expression in ATLL is heterogeneous and occurs at variable frequencies, and tends to be higher in L-type, and lower in A/UC-types that respond to AZT-interferon therapy. Our data suggest CD30 may represent an elusive target in A-type ATLL, thus warranting further optimization of BV in leukemic subtypes. The analysis of additional cases is still ongoing and the final results will be presented at the meeting.

This project has been accomplished with the support of "ASH HONORS award" achieved in 2016.



Gray Zone Lymphoma (GZL) with Features Intermediate between Diffuse Large B-Cell Lymphoma (DLBCL) and Classical Hodgkin Lymphoma (cHL): A Pathologic Consensus Study with Patient Outcomes and Prognostication across 15 North American Centers

Andrew M. Evens, et al.

The authors of the study conclude:

Altogether, accurate diagnosis of GZL remains challenging and improved therapeutic strategies are needed. High tumor cell content is very helpful when differentiating between GZL and cHL, the most common alternative diagnosis. Additionally, CD30 expression was common, while EBV positivity was rare. The small number of pts and relative heterogeneity of therapy limit definitive delineation of optimal therapy for GZL; however, our results suggest that DLBCL based therapy was most effective, including R-CHOP. Finally, we identified prognostic factors that identified GZL pts with divergent clinical outcomes.



Induction Chemo-Immunotherapy with the Matrix Regimen in Patients with Newly Diagnosed PCNSL – a Multicenter Retrospective Analysis on Feasibility and Effectiveness in Routine Clinical Practice

Elisabeth Schorb, et al.

The authors of the study conclude:

The MATRix protocol is feasible and effective in the treatment of newly diagnosed PCNSL in routine practice, and can be delivered to patients aged >70, with reduced PS and/or co-morbidity to produce similar clinical outcomes to the IELSG32 trial. Importantly, close monitoring and consideration of dose reductions is strongly recommended, especially during cycle 1, to avoid treatment associated complications. Further details will be presented at the meeting.



Multicenter Retrospective Study of Features and Outcomes of Patients with Intravascular DLBCL Treated at Academic Institutions within the United States

Marcus Geer, et al.

The authors of the study conclude:

This represents the largest retrospective case series of IV DLBCL conducted at academic institutions in the US to date. In this 53 patient cohort, the most common presenting sites of IV DLBCL were brain, skin, and bone marrow. Overall survival was favorable in treated pts who survived longer than two months from diagnosis, suggesting that poor outcome in this disease may partly be attributable to difficulty diagnosing IV DLBCL early enough to administer therapy. Lower IPI score, in particular lower ECOG PS and LDH were associated with improved survival. While CR was achieved in the majority of treated patients, more data is needed to determine whether durability of responses and OS are more attributable to time to diagnosis, specific treatment regimens, or as yet unknown difference in disease biology.



Liquid Biopsy for the Identification of Intravascular Large B-Cell Lymphoma

Yasuhito Suehara, et al.

The authors of the study conclude:

Mutations in MYD88 and CD79B are frequent in IVLBCL. Targeted sequencing suggested that tumor cell-derived DNA is abundant in serum/plasma. Liquid biopsy to detect L265P MYD88 and Y196 CD79B may provide a powerful tool for approaching diagnosis of IVLBCL.