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Objective T-cell Brazil Project was designed as an ambispective data collection from January 2015 to December 2022 of previously untreated patients diagnosed with Peripheral T-cell lymphoma (PTCL) or NK/T-cell lymphoma according to the revised WHO 2017 classification in Brazil. The primary and secondary end points were 2-year overall survival (OS) and progression-free survival (PFS). Clinical, treatment and survival data were also correlated. Methodology Twenty centers got approved for the study from the local and national institutional review board and registered their cases only online. OS was calculated from diagnosis date until last seen or death date, whereas PFS until first event, progression / relapse, date of death or last seen. Kaplan-Meier method was applied and a Log-rank test to compare their curves. P-value less than 5% was considered. From a total of 416 patients with PTCL, 46 (11%) were diagnosed as AITL. Results The median age was 65 years (31-82), with 63% males, 94% had advanced-stage disease. All patients received 61% CHOEP, 28% CHOP and 11% CT without anthracycline. 20% of pts were consolidated with autologous transplant (HSCT). There were 19 (41%) deaths, 10 by lymphoma, 8 infections, 1 new neoplasia. With 8-mo median f/u (1-36), OS at 24-mo was 27% and 2-year PFS was 21%. As consolidation, OS was 71% HSCT group vs. 16% no HSCT (P= 0.06) and PFS was 71% vs. 8%, respectively (P= 0.01). Conclusion These analyses are preliminaries but show a poor outcome of AITL in our population. Most patients were treated with anthracycline-containing combination chemotherapy and just 20% received autologous HSCT. A dismal survival was shown for those who did not receive HSCT.

Introduction:Adult T cell Leukemia/Lymphoma (ATLL) is a mature T-Cell-neoplasm related to human T-cell lymphotropic virus type 1 (HTLV-1) infection that shows variable clinical presentation and adverse prognosis with shorter overall survival (OS) when compared to other peripheral T-cell lymphomas (PTCL). Previous epidemiological studies estimated cumulative incidence in endemic regions around the world. In Brazil, mainly due to its vast dimension, data collection has limitations and is subject to bias. In April 2015 theBrazilianT-cell longitudinal project initiative was launched. One of the primary purposes was the collection of epidemiological and clinical data from the most frequent subtypes of newly diagnosed PTCL. Among them, 41 cases of ATLL were recorded. Objectives:The aim of this study is to describe clinical features, frequency and overall survival (OS) of 41 cases of ATLL registered in the ongoingBrazilianT-Cell Project. Methods:This is an ambispective observational study design collecting baseline characteristics, clinical features including date of diagnosis, clinical subtypes, B symptoms, performance status, Ann-Arbor staging, HTLV-1 status, number of sites, nodal and extra nodal presentation and types of skin lesions, peripheral blood counts and biochemical tests, front-line treatment and best response after first-line treatment. REDcap Platform has been used to collect and store data and for descriptive analysis the IBM-SPSS version 24 was applied. Kaplan-Meier method estimated the OS, whereas Log-Rank tests to compare its curves. OS period was calculated from diagnosis date until death or last seen date, and event was death by any cause. Results:Out of 281 cases of PTCL registered so far, 41 were ATLL cases. The median age was 50 years (34-88), 25 (64%) female; a higher incidence of lymphoma subtype was observed (46%), followed by acute (29%), chronic (17%) and smoldering (8%). Most of the patients (85%) had advanced-stage disease (III-IV, Ann-Arbor) and 56% had B symptoms (Table 1); 73% received chemotherapy with anthracycline-based regimens (46.5% CHOEP; 33.5% CHOP; 20% others) whereas 17% were managed with immunotherapy and antiviral therapy. The overall response rate was 30%; no response or progression 46%; stable disease 9% and 15% no data available yet (Table 2). Median follow-up was 13 months and 25 months for 41% of alive patients. Two year OS was 39% (95%CI: 23-55%) (Figure 1). Smoldering and Chronic subtypes showed better OS when compared with acute and lymphoma (100% smoldering, 86% chronic; 30% lymphoma type and 13% acuteP=0.04) (Figure 2). The multivariate Cox Regression analysis found male gender (HR 10.9 95%CI: 3.0-39.7, P Discussion:ATLL prognosis remains poor regardless of the type of treatment regimen and may be associated with the high incidence of lymphoma and acute subtypes, as well as advanced stage disease presentation. Despite the high number of cases seen in southeastern region of Brazil, it is important to emphasize there are still limited data from other regions. Albeit the sample size is small, these findings confirmed literature review data so far, with poor overall survival in a short time and gender and albumin as predictors of OS in the multivariate analysis. Conclusion:This study highlights the poor prognosis associated with ATLL. Moreover, it seems relevant to expand this study to all Brazilian regions. Hence, the need for early diagnosis and new treatment strategies, able to reduce mortality is warranted, that could possibly change the nature and spectrum of disease. Disclosures Federico: Spectrum:Consultancy, Membership on an entity's Board of Directors or advisory committees;Sandoz:Consultancy, Membership on an entity's Board of Directors or advisory committees;Cephalon/Teva:Research Funding;Mundipharma s.r.l.:Research Funding;Celgene:Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding;Millennium/Takeda:Research Funding;Roche:Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding;Takeda:Consultancy, Membership on an entity's Board of Directors or advisory committees.

Context: Diffuse large B cell lymphoma (DLBCL) is non-Hodgkin lymphoma's most common histological subtype. It has a slight predominance in men, around 65 years old median age, but an age-increasing prevalence. Although R-CHOP (rituximab associated to cyclophosphamide, doxorubicin, vincristine and prednisone) is considered its standard treatment, studies generally exclude patients over 80 years old due to their clinical conditions. This results in a lack of scientific data for best therapeutic management to this group of patients. Objective: To evaluate clinical, laboratory and therapeutic profile of DLBCL patients aged equal to or over 80 years old treated at Santa Casa hospital in Sao Paulo, Brazil between January 1, 2013, and December 31, 2017. Design: Retrospective, cross-sectional cohort study of DLBCL patients diagnosed with 80 years old or older treated at Santa Casa hospital in Sao Paulo, Brazil from January 1, 2013 to December 31, 2017. We analyzed their clinical, laboratory and therapeutic data. Patients or other participants: We analyzed 13 patients with DLBCL diagnosed between January,2013 and December 2017. HIV, HBC, and HCV positive serology patients were excluded. Results: We analyzed 13 patients with 83 years old median age, predominantly female (M / F ratio 1.0 / 2.25). More than 90% had some previous comorbidity; cardiovascular and endocrine-metabolic diseases were the most prevalent. At diagnosis, 61.5% had constitutional symptoms and 46.2% had Ann Arbor advanced staging. Concerning laboratory data at diagnosis, 46.2% were anemic, 15.4% were plaquetopenic, 23.1% were lymphopenic and 69.3% were hypoalbuminemic. According to Hans' criteria, 53,8% were non-GCB DLBCL. In prognostic evaluation according to the R-IPI and NCCN-IPI respectively 46.1% were intermediate-risk and 61.5% high-risk, respectively. R-mini-CHOP was more frequently used for treatment (38.5%) followed by R-CHOP. About 60% of patients who underwent chemotherapy completed treatment initially proposed. The median overall survival (SG) was 118 days and 84.6% died, almost 40% by sepsis. Patients with high serum albumin values and higher hemoglobin values had a statistically significant better OS (p = 0.020). Conclusions: DLBCL in very elderly patients is an orphan clinical situation. It has some relevant characteristics that must be taken into account to offer more adequate and safer therapy.

Context: WM is a rare indolent non-Hodgkin lymphoma that mainly affects people over 60 years old. It is characterized by lymphoplasmacytic cells bone marrow infiltration and IgM gammopathy. Patients have asthenia, weight loss, mucosal bleeding, lymph node enlargement, splenomegaly and neurological changes resulting from hyperviscosity and/or cytopenias. Treatment goal is to relieve symptoms. Recently, targeted drugs have been used, which may increase its median overall survival in the next years. Notwithstanding these drugs are not equally available around the world. Objective: To recognize clinical, epidemiological profile and treatment evaluation of WM patients at Santa Casa de Sao Paulo, Brazil. Design: WM retrospective analysis cohort diagnosed between January 1, 2000 and December 31, 2016. Patients or other participants: We analyzed patients with WM diagnosis. HIV, HBV, and HCV positive serology patients were excluded. Results: There were 18 patients, 10 men/8 women, with 61 years old median age. Fifteen patients presented with splenomegaly; 14 had B symptoms at diagnosis. Median serum IgM was 3019 mg/dL; 8 patients were submitted to plasmapheresis because of symptomatic hyperviscosity syndrome. 70% were classified as High/Very-high risk and all patients were treated upfront. As 1st line treatment we used alkylant + prednisone in 12 patients; alkylant + prednisone + anthracycline in 3 patients; fludarabine in 2 patients and to 1 patient only prednisone. Less than 25% got CR/VGPR; 5.5% got PR and 72% were refractory. There were 2 deaths before 2nd line treatment for which we used fludarabine-based therapy in 9, alkylant + prednisone + anthracycline in 2 and alkylant + prednisone in 1 patient. Ten patients were dead before 3rd line therapy. Mean OS was 55 months. Hb under 9.5 g/dl and platelets under 120×103mm3 had statistically significant worse median OS. Conclusions: Our Waldenstrom macroglobulinemia cohort showed poor response to 1st line chemotherapy regimens. IPSS-WM showed that they arrive in severe clinical conditions making it a challenging treatment. The absence of new available target drugs might have resulted in bad 1st line response and a high relapse rate.

OBJECTIVE: To evaluate the efficacy of intravenous iron III-hydroxide saccharate for treating adult patients with iron deficiency anemia lacking satisfactory response to oral iron therapy. METHODS: Between January 2003 and January 2004, 25 patients with iron deficiency anemia who presented intolerance or inadequate response to iron oral therapy, or hemoglobin level < 7 g/dl were studied. The main laboratory tests performed were: complete blood cell count, reticulocyte count, serum iron, total iron-binding capacity, serum ferritin. Patients received a weekly dose of 200 mg of iron diluted in 250 mL of 0.9% sodium chloride solution administered intravenously for 30 minutes. Treatment continued until a hemoglobin level = 12 g/dL for women and = 13 g/dL for men were obtained or until full administration of the total dose of parenteral iron recommended for each patient. RESULTS: Edian age of the patients studied was 45 years (ages ranging from 31 to 70). Nineteen out of 25 patients (76%) were women. The most common cause of iron deficiency anemia was abnormal uterine bleeding observed in 68% of the female patients (13 out of 19) and partial gastrectomy observed in 67% of the male patients (4 out of 6). Seventeen (68%) patients were included in this study because they did not respond to oral iron therapy, 24% (6 out of 25) showed intolerance to oral iron and 8% (2 out of 25) presented hemoglobin level < 7 g/dl. Correction of anemia was obtained in 12 out of 19 female patients (63%) and in 5 out of 6 male patients (83%). The mean hemoglobin and ferritin values were 8.09 g/dl and 4.20 ng/ml (pre-treatment) and 12.42 g/dl and 87.78 ng/ml (post-treatment) (p

O objetivo desse estudo foi avaliar a eficácia do uso intravenoso de sacarato de hidróxido de ferro III no tratamento de pacientes adultos com anemia ferropriva. No período de janeiro de 2003 a dezembro de 2005, estudamos cinqüenta pacientes com anemia ferropriva que apresentaram intolerância e/ou resposta inadequada ao tratamento com ferro por via oral e/ou valor de hemoglobina inferior a 7,0 g/dL. Os principais exames laboratoriais realizados foram: hemograma completo, contagem de reticulócitos, ferro sérico, capacidade total de ligação de ferro e ferritina sérica. Os pacientes receberam uma dose semanal de 200 mg de sacarato de hidróxido de ferro III diluído em 250 mL de soro fisiológico a 0,9%, administrado por via intravenosa em trinta minutos. O tratamento foi realizado até a obtenção do valor de hemoglobina igual ou maior que 12,0 g/dL para mulheres e 13,0 g/dL para homens, ou até a administração da dose total de ferro parenteral recomendada para cada paciente. A idade mediana dos cinqüenta pacientes estudados foi de 45 anos, variando entre 28 e 76 anos; quarenta (80,0%) eram do sexo feminino. A causa mais comum de anemia ferropriva no sexo feminino foi sangramento uterino anormal observado em 25/40 pacientes (62,5%) e, no sexo masculino, gastrectomia parcial em 7/10 (70,0%). Vinte e quatro (48,0%) pacientes foram incluídos nesse estudo por falta de resposta à terapia com ferro oral, 22 (44,0%) por intolerância ao ferro oral e quatro (8,0%) por hemoglobina < 7,0 g/dL. Os valores médios da hemoglobina e da ferritina sérica foram de 8,48 g/dL e 4,65 ng/mL (pré-tratamento) e 12,34 g/dL e 93,20 ng/mL (pós-tratamento)(p