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Background Aggressive large B-cell lymphomas (LBCLs) are curable, but previous studies have shown inferior outcomes in minorities. Nurse navigation programs can improve patient outcomes by providing patient support. This study presents the outcomes of White and minority patients with aggressive LBCL at an institution with an active nurse navigation program. Methods The authors prospectively collected baseline characteristics, treatment regimens, and outcome data for patients with aggressive LBCL. Navigation encounters were characterized as low or high intensity. Overall survival (OS) and progression-free survival (PFS) were calculated with Kaplan-Meier methods. Baseline characteristics were compared with Fisher exact tests. Results Two hundred four consecutive patients (47 minority patients and 157 White patients) were included. Results were presented as minorities versus Whites. There were no differences in prognostic scores (Revised International Prognostic Index score of 3-5, 43% vs 47%; P = .50), frontline chemotherapy (98% vs 96%; P = .68), or the incidence of relapsed/refractory disease (40% vs 38%; P = .74). For relapsed/refractory LBCL, similar proportions of patients underwent hematopoietic stem cell transplantation (32% vs 29%; P > .99) or chimeric antigen receptor T-cell therapy (16% vs 19%; P > .99). Enrollment in clinical trials was comparable (17% vs 14%; P = .64). More than 85% received nurse navigation, but minorities had higher intensity navigation encounters (42% vs 21%; P = .01). The 2-year OS rates were 81% and 76% for minorities and Whites, respectively (P = .27); the 2-year PFS rates were 62% and 65%, respectively (P = .78). Conclusions This study shows similar survival between Whites and minorities with aggressive LBCL, which was likely due to equal access to guideline-concordant therapy. Minorities received higher intensity navigation encounters, which may have helped them to overcome socioeconomic disadvantages.

1524 Background: Reports suggested cancer patients were at greater risk for increased morbidity and mortality from COVID-19. A process to mitigate these risks was established at Levine Cancer Institute (LCI) in partnership with Atrium Health’s (AH) Hospital at Home (HAH) initiative. This virtual health navigation process employed expertise from the departments of Hematologic Oncology and Blood Disorders, Oncology, and Supportive Oncology, including a specialized nurse navigation team, to rapidly identify COVID-19 positive LCI patients, monitor them under physician supervision, and escalate care as needed with AH HAH program. Methods: AH Information Services created an automated list of LCI COVID-19 positive patients with a daily database. Each patient was reviewed by a nurse navigator. Review included hematologic or oncologic diagnosis, outpatient or inpatient status, and any COVID-19 symptoms. Once a malignant diagnosis was confirmed, a diagnosis-specific navigator contacted and screened the patient with a COVID assessment tool. Documentation was forwarded to the primary oncologist/hematologist. The tool scored patients for surveillance and treatment needs. A score of 0-2 prompted phone assessment every 48-72 hours, and score of 3-5 required every 24-48 hour calls with physician involvement when appropriate. If score of ≥6, care was escalated to LCI nurse/physician for admission to AH acute care HAH or conventional inpatient admission. Results: From inception on 3/20/2020 to data review date of 12/2/2020, 974 LCI patients were identified as COVID-19 positive and reviewed for nurse navigation (Table). Of the 974, 488 were navigated. Given limited resources, patients with benign conditions were not assigned a navigator, though a similar process was created for sickle cell disease. Of the 974, 75 are now deceased. Only 25 are deceased among the 488 navigated. Conclusions: The COVID-19 pandemic presented unprecedented circumstances to our patients and their clinicians. LCI expeditiously put policies and procedures in place to mitigate the intersection of COVID-19 and cancer. The multidisciplinary response strategy liaising between AH HAH and LCI followed, assessed, and assisted LCI COVID-19 positive patients. With our embedded nurse navigation team’s specialized attention along with enhanced physician oversight and close collaboration with AH HAH, opportunities for care escalation or adjustments in cancer-focused care were promptly identified. Analysis is ongoing to elucidate the lower mortality rate observed among navigated patients.[Table: see text]

e19040 Background: Aggressive BCL is curable but previous studies have shown that minorities have inferior survival, partly due to socioeconomic barriers and poor access to care. NN programs are designed to reduce barriers to care via various methods. We present disease characteristics, treatment, and outcomes of Caucasian (C) & non-Caucasian (NC) pts with aggressive BCL at Levine Cancer Institute which has an active NN program. Methods: We collected demographic, insurance, disease characteristics, treatment, and outcomes for pts with aggressive BCL [diffuse large B cell lymphoma (DLBCL), primary mediastinal B cell lymphoma (PMBCL), or high grade B cell lymphoma (HGL)] between Jan 2016 and Jun 2019. Race (C or NC) was self-reported. NN encounters were characterized as low intensity (basic needs) or high (moderate/high needs). OS and PFS were calculated using Kaplan Meier. Demographics were compared using Fisher's Exact tests. Results: 204 pts (186 = DLBCL, 14 = PMBCL, 4 = HGL) were included (NC = 47; C = 157). NC were younger at diagnosis (median age 56 vs 62 yrs, p = 0.03) and more likely to be uninsured/Medicaid (26% vs 4%, p < 0.0001). There were no significant differences in prognostic scores (44% vs 50% R-IPI score 3-5, p = 0.5), incidence of double hit (11% vs 13%, p = 0.8), frontline rituximab/anthracycline containing chemotherapy (98% vs 96%, p = 0.9), and incidence of relapsed/refractory (R/R) disease (40% vs 37%, p = 0.7) for NC compared to C. For R/R BCL, similar % of pts underwent hematopoietic stem cell transplant (SCT) (32% NC vs 28% C, p = 0.8) or CAR-T cell therapy (16% NC vs 19% C, p = 0.9). Enrollment in clinical trials was comparable (17% NC vs 14% C, p = 0.6). The % of pts receiving NN was similar (81% NC, 87% C, p = 0.4) but NC had higher intensity NN encounters (42% vs 21%, p = 0.01). With median follow up of 35 mo, OS and PFS were comparable between both groups. The 2 yr OS was 81% for NC and 76% for C, p = 0.3; 2 yr PFS was 62% for NC and 64% for C, p = 0.8. Conclusions: We show equivalent survival between Caucasian and non-Caucasian pts with aggressive BCL. Disease biology and treatment patterns--including access to SCT, CAR-T and clinical trials--were similar in both groups. Differences in insurance coverage favored Caucasians. Similar proportion of pts in both groups received nurse navigation, but non-Caucasian pts had higher intensity navigation needs. Providing equal access to care and availability of an active nurse navigation program may overcome racial heath disparities. This study has implications for national health policy.

6510Background: Oncology patient navigation (PN) programs have been developed to improve outcomes and reduce disparities. Few data exist to describe the effect of PN on key clinical outcomes, such ...